Novel Cases of Schizophrenia

Running head: NURSING
Assignment Number Two
Name of the Student
Name of the University
Author Note

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Introduction
Schizophrenia is a complex mental disorder that is primarily characterized by recurrent
episodes of psychosis. In the year 2017, according to findings from the Global burden of Disease
Study, there were approximately 1.1 million novel cases of schizophrenia, in addition to a total
of 19.8 million diagnosed cases, all across the world (James et al., 2018). This chronic mental
health disorder is manifested by a plethora of symptoms that include hallucination, and delusion,
disorganised behaviour or speech, and impairment in cognitive ability. The early onset of the
mental disorder, together with its chronic progress often makes it a disabling illness for several
patients, in addition to their family members (Searles, 2018). Disability is a consequence of both
negative symptoms that are characterized by deficit or loss, in addition to cognitive symptoms
like and impairment in working memory, attention, and executive functioning.
Other signs and symptoms that are usually manifested by schizophrenia patients are
reduced emotional expression, social withdrawal, and absence of motivation (Bilderbeck et al.,
2019). The symptoms generally begin during young adulthood and often fail to resolve if left
untreated. Many individuals diagnosed with the condition suffer from other mental disorders as
well as panic disorder, substance abuse disorder, obsessive compulsive disorder, and depressive
disorder. This assignment will describe theories of aetiology that provide an explanation for
schizophrenia, in relation to a 26 year old female client Jess, who had been diagnosed with the
condition, approximately 6 years ago, and is currently under the assistance of the NDIS.
Theories of aetiology
The aetiology of schizophrenia is generally believed to be multifactorial, with a range of
small-effect and large-effect propensity genes demonstrating an interaction with countless

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environmental factors. These factors often result in modifications in neuroplasticity that are
developmentally mediated, thus leading to a cascade of dysfunctions in neuronal circuit and
neurotransmitters, eventually leading to impairment in connectivity (Wynn et al., 2019). Several
researchers support the theory of schizophrenia onset due to neurodevelopmental abnormalities
in temporal lobe that has been associated to delusions, hallucinations, and thought disorder
(Café-Mendes et al., 2017). Obstetric complications like preeclampsia, low birth weight,
premature birth, and hypoxia, in addition to winter-spring births are also encompassed in the
aetiology theories (Clarke & Kelleher, 2017). The theories also elaborate on exposure of a foetus
to microbial infections like genitourinary disease and toxoplasmosis, during gestational period
that leads to a compromise in normal neurodevelopment (Severance & Yolken, 2019). There is
strong evidence that prenatal exposure of foetus to infection and genetic risk might
synergistically interact, to expand the likelihood of developing schizophrenia.
Family history
Jess was reported to have a family history of schizophrenia. According to Käkelä et al.
(2017) schizophrenia is an extremely heritable mental disorder, and the early onset of the
disorder is correlated with high genetic loading. Schizophrenia outcomes have also been
associated with the age of disorder onset, in addition to the presence of a family history of the
psychotic disorder. Hence, families having schizophrenia patients are considered subpopulations
for genetic studies. As claimed by Nuhu et al. (2016) uncorrelated dizygotic and monozygotic
concordances of 29% and 88.7% have also been associated with schizophrenia. In addition, the
researchers elucidated that adolescent and child onset of schizophrenia carries a significantly
great familial risk, when compared to adult onset. Approximately 20% of adolescents and child
onset schizophrenia reports the presence of at least one primary family member affected with the

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condition, in addition to 50% that reports presence of first degree relative affected with
schizophrenia.
The same has been affirmed by Lu et al. (2018) who stated that family history is a long
standing risk factor for being affected with schizophrenia. Large genetic studies that focus on
schizophrenia have been made possible due to genotypic technologies that are of a low cost. The
researchers analysed 5959 schizophrenia cases, in comparison to 8717 controls that had been
recruited from four Nordic nations. Findings suggested that family history of schizophrenia and
genetic risk score for the condition were the major risk factors that increase the susceptibility of
an individual to suffer from the psychotic disorder. In a joint model, all the impacts of genetic
risk score remained unchanged, thus highlighting the possibility of amalgamating family history
and genetic score for predicting schizophrenia at early stages. The fact that the family history of
Jess is significant for schizophrenia can be directly associated with her diagnosis of the psychotic
disorder. This can be further supported by findings from genome-wide association studies
(GWAS) that have produced not less than hundred susceptibility variants, which strongly
confirm a substantial contribution, in relation to allelic effects.
Schizophrenia has been identified to be a direct consequence of inherited factors. On
analysing single nucleotide polymorphism in patients who reported a family history of the
aforementioned psychotic illnesses, a significant increase was observed for the effect SNP
amongst those who had a positive family history, in comparison to those without any family
history (Nagelkerke's R2 = 0.0021; P = 0.00331; P‐value threshold <0.4). Apart from the fact that
aggregate effect of the SNPs was substantially higher for positive family history, detectable
allelic effects were identified in particular family subgroups (Bigdeli et al., 2016). Family history
can be further established as the cause for schizophrenia diagnosis in Jess through the