Schizophrenia is a mental illness whose etiology is not fully understood. Genetic factors are considered to play a certain role in the development of the disease. The risk of mental deviations also increases if there are relatives with schizophrenia in the family. The stress diathesis model is considered an influential factor in the origin of schizophrenia. In this case, diathesis is a biological predisposition to a certain disease state, and stress is a psychosocial factor provoking this predisposition, such as trauma and alcoholism.
A significant role in the pathology’s mechanism of origin and development is given to such a factor as a lack of dopamine, also called the happiness hormone. Its deficiency in the cerebral cortex contributes to developing negative manifestations and cognitive disorders. Drugs that block dopamine receptors are most effective in eliminating the symptoms of schizophrenia.
Schizophrenia debuts between the ages of 18 and 30. It can proceed in the form of seizures or permanently over a long period. Cases are known when the disease is limited to one or two seizures. The disease is extremely varied in its manifestations.
Schizophrenia comes in many forms and is often difficult to diagnose. For example, sluggish schizophrenia has features similar to neurosis and requires in-depth research to clarify the diagnosis. People who are ill begin to show oddities. They become isolated, withdraw from their surroundings, may talk to themselves, and believe they are being irradiated or affected by hypnosis, waves, or gas. Behavior becomes strange and sometimes dangerous. The person suffering from anxiety and hallucinations cannot take care of themself, is afraid to go out, and cannot seek medical attention.
The signs of schizophrenia are sometimes so pronounced that they endanger the patient’s health and life. Without treatment, the disease progresses, and in severe cases, it can lead to emaciation and death of the patient in a short period.
How is schizophrenia treated?
Schizophrenia is treated only under the supervision of an experienced specialist. Therapy includes medication and psychological sessions. Supportive therapy lasts at least a year after the first attack, after the second – for three years, after the third – at least five years. After the fourth exacerbation, medication is usually taken for life.
During periods of exacerbation, patients are hospitalized in a psychiatric hospital. But many patients are treated as outpatients, not needing a hospital stay. Treatment can also be carried out in a day hospital. The doctor determines the form of therapy. Special attention is given to different types of occupational therapy, appropriate psychotherapy, and psychoeducation. But there is no complete cure for the disease, only remission periods of varying duration are possible.
Schizophrenia is often associated with various diseases: overweight, cardiovascular abnormalities, and type II diabetes. The development of pathologies is influenced by taking medications, which many patients have to use for the rest of their lives. The side effects of antipsychotic drugs are very diverse, depending on the type, dose, and time of taking the remedy. They should warn the psychiatrist before the start of therapy and during further treatment, as well as suggest ways to combat these symptoms.
Relatives of the patient should observe the patient’s well-being after starting medication and inform the specialist of signs of improvement and the appearance of negative symptoms. With information, the doctor can change the dosage of the medication or prescribe another drug and take measures to control or reduce the intensity of side effects of drug therapy.
Diabetes mellitus: briefly about the disease
Type 2 diabetes mellitus is a comorbid condition along with schizophrenia. It is characterized by high blood sugar (glucose) levels. It comes in two types. Type 1 develops due to insulin deficiency when the β-cells of the pancreas stop producing it. But this variant is rare. Type 2 diabetes is common in 95% of patients when insulin is produced in insufficient quantities, and the mechanisms of its interaction with tissue cells are disturbed.
The disease usually develops around the age of 40, and, alas, it is completely incurable. It is caused by genetic predisposition, and the provoking factors are low physical activity and an unbalanced diet. The first symptom of the pathology is an increase in blood sugar: on an empty stomach above 6.1 mmol / L and after meals above 11.1 mmol / L.
Constantly high blood sugar greatly affects the body and leads to the development of chronic complications of diabetes. The disease can lead to vision loss, kidney failure, and damage to the foot’s blood vessels, nerves, muscles, and bones (the so-called “diabetic foot”). Over time, diabetes progresses, and the effect of the medication taken wears off. In this case, the doctor changes the medication prescription. It is very important to keep the sugar level always under control. You can not independently cancel the prescribed medications. Diet and exercise are no less important factors in controlling diabetes than pills.
Schizophrenia and diabetes mellitus: the relationship
One factor in the development of diabetes mellitus in schizophrenia is obesity, which is half the cases caused by taking atypical neuroleptic drugs such as clozapine, olanzapine, risperidone, or amisulpride. They affect the beta cells of the pancreas, impairing insulin secretion, and leading to increased blood glucose levels. In experiments with animals, it was found that taking antipsychotic drugs makes it difficult to transport glucose from the bloodstream to the tissues and reduces insulin sensitivity. And the clinical manifestation of this condition is hyperglycemia and diabetes mellitus.
Being overweight is one of the causes of the development of diabetes in people without mental disorders. The body’s cells become insensitive (unresponsive) to insulin. The pancreas begins to produce insulin intensively, but over time it becomes unable to produce the necessary amount, leading to the development of diabetes.
Among patients with schizophrenia and bipolar disorder, overweight is most common in women – 72%. In men, the figure reaches 37%. Patients who do not eat a healthy diet and lead a sedentary lifestyle are particularly susceptible to obesity. Type 2 diabetes mellitus in people with schizophrenia develops three times more often than in normal people. Studies show abnormal fasting glucose levels and impaired glucose tolerance. Many scientific papers cite evidence that people with psychotic disorders have insulin resistance.
While taking neuroleptics, it is important to monitor weight constantly. Its reduction directly affects blood glucose levels. To do this, relatives need to monitor the patient’s diet carefully and provide him with daily physical activity: walks and cleaning around the house. In addition to weight loss, it helps to improve overall health, reduce the risk of cardiovascular disease and improve the action of insulin produced by the pancreas.
Weight loss methods for schizophrenia
When treating a patient, it is very important to monitor their general health, diet, and physical activity to avoid gaining excessive weight. It is important to give up alcohol and other biologically active substances: they aggravate the course of the disease or contribute to its relapse while in remission. Patients are shown a special diet: a lot of vegetables and fruit, wholemeal products, and a small number of animal fats.
Activity during the day is important: it is necessary to establish a regime of sleep and wakefulness, avoiding sleepless nights and prolonged lying in bed. You should also maintain moderate physical activity every day.
Recent studies have shown that several antipsychotics are weight-neutral and can be used for alternative therapy. For example, the atypical neuroleptics olanzapine and risperidone are being replaced by ziprasidone and aripiprazole. There is evidence that such changes in the therapeutic regimen have a positive effect on lipid metabolism.