Schizophrenia In The Postnatal Period
Schizophrenia is a severe mental illness that is associated with much stigma and misinformation. While some people with schizophrenia experience only one or a few episodes, for others it may remain a ongoing health condition. People with schizophrenia often also experience depression and/or anxiety.
Risks Related To Stopping Medication
In one study, for instance, researchers found that pregnant women who discontinued using antidepressants were 5 times as likely to see their depression worsen than women who kept taking their meds during pregnancy. Many antidepressants are considered safe for use in pregnancy.
The jury is still out on the safety of antipsychotic medicines in pregnancy. Some studies have suggested that taking antipsychotic medication during pregnancy can lead to birth defects, especially when taken during the first trimester. However, a large study published in September 2016 in JAMA Psychiatry showed that use of antipsychotic medicines during the first trimester did not meaningfully increase the risk of birth defects in kids. Several studies also have shown that the drug Haldol does not cause birth defects.
According to the National Institute of Mental Health, no medication is considered perfectly safe for all women at all stages of pregnancy. And there are a few psychoactive drugs that most pregnant women should avoid due to their risk of birth defects.
These drugs include mood stabilizers, and perhaps benzodiazepines. Mood stabilizers are medicines to help even out the highs and lows of bipolar disorder. They also may be used by some people with schizophrenia or schizoaffective disorder. Benzodiazepines are commonly prescribed to treat anxiety. Some people with schizophrenia also experience anxiety, so may be prescribed benzodiazepines.
The Ghost Of The Schizophrenogenic Mother
A few years back, my colleague Erik Parens and I ran a project whose basic aim was to understand the debate over using psychotropic medications to treat children with emotional and behavioral problems . Of course this debate is really a number of debates nested together. Some say that diagnostic thresholds in psychiatry are too low, causing too many children to be diagnosed, while others counter that mental disorders are underrecognized in children. Some argue that troubled children need behavioral treatments not drugs, while others point out that many medications show impressive efficacy in clinical trials. Some say that problematic moods and behaviors are caused by brain malfunctions that are no more prevalent today than they were 30 or 50 years ago, while others argue that we have the etiological picture all wrong: its our society that is troubled, not our kids . We found important insights on all sides of these debatesand, in fact, if you scratch the surface you find significant agreement where you initially saw polarization .
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Physical Abnormality In The Brain
Neuroimaging technology has made it far easier for scientists and researchers to study the brain and its functions. It has been especially enlightening when it comes to the structure of the brain and how it can affect many different components. Neuroimaging technology has demonstrated that a healthy person’s brain looks different than that of a person’s brain who has schizophrenia. The brains of patients with schizophrenia often show more gray matter, cavities filled with fluids near the center of the brain, and areas showing dramatically less or more activity than that of the normal brain.
Schizophrenia Symptoms And Pregnancy
You may be wondering, does schizophrenia get worse during pregnancy?
Some people find that their schizophrenia symptoms are minimal during pregnancy while others may struggle with symptoms throughout pregnancy. Common schizophrenia symptoms include: hearing, feeling or smelling things that arent there, thinking illogical or untrue beliefs, or having disorganized thoughts or speech.
Some of these symptoms could put you and your babys health at risk, so its important to tell your ob-gyn about any schizophrenia symptoms you may be experiencing.
Your ob-gyn may recommend that you see a maternal-fetal medicine specialist. These are doctors that help take care of women with complicated and high-risk pregnancies.
It is possible to experience schizophrenia for the first time during pregnancy. The symptoms of schizophrenia typically appear in a persons late teens through early thirties.
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Immune Stimulation To Brain Pathology
The effects of these risk factors suggest that a variety of inflammatory mechanisms disrupt the expected normal development of the brain the consequence being a cascade of events producing behavioral abnormalities in the patient that lay dormant until long after the insult. As such there is no direct evidence of a foetal or perinatal brain tissue injury, but indirect pathology at both an anatomical and neurochemical level.
Obstetric Complications In Hr And Control Groups
The control offspring had diagnosed asphyxia more often than the HR offspring, which seems to be at odds with previous studies. However, diagnosed asphyxia was rare both in HR and control offspring, and the prevalence observed in the control group, 4.8%, is quite similar to that observed in a large Finnish general population sample from the 1980s. In contrast, the previous study by Dalman et al. defined asphyxia based on an Apgar score below 7. Overall, the median Apgar score was slightly lower in the HR than the control offspring, which fits with previous findings., The higher prevalence of previous miscarriages among HR mothers is also in line with previous studies.
In most of the cases, the mothers psychotic disorder had commenced after the birth of the offspring, and mothers with preexisting psychotic disorder had more obstetric complications than mothers who developed psychotic disorder after the birth of the offspring. This is consistent with the findings by Jablensky et al. who also observed that the risk of obstetric complications was increased only when the mother had developed schizophrenia before the birth of the offspring, which may explain why we observed fewer differences between HR and control mothers than most previous studies.
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New Evidence Of Influenza
In the study, which appears in the August issue of the Archives of General Psychiatry, researchers followed a large group of children born to mothers in Alameda County, Calif., who were part of the Child Health and Development Study from 1959-1966. The children were followed up for psychiatric disorders 30-38 years later.
Researchers identified 64 of the adult children as having schizophrenia and compared them to 125 similar, healthy study participants.
The study showed that the risk of developing schizophrenia was seven times higher among those children whose mothers were exposed to influenza during the first trimester of pregnancy based on blood tests.
There was no increased risk of schizophrenia associated with influenza exposure during the second or third trimester.
When researchers looked at a broader time period of influenza exposure during pregnancy, they found the risk of schizophrenia was about three times higher for those exposed during early to mid-pregnancy.
“Our data suggest the possibility that up to 14% of schizophrenia cases would not have occurred if influenza exposure during early to midpregnancy had been prevented,” write the researchers.
Routine vaccination of nonpregnant women for the flu virus may be worth considering, the researchers write.
SOURCES: Brown, A. Archives ofGeneral Psychiatry, August 2004 vol 61: pp 774-780. News release, ColumbiaUniversity College of Physicians and Surgeons. WebMD Medical Reference fromHealthwise: “Schizophrenia.”
Stressed Moms Schizophrenic Kids
Severe emotional stress during the first delicate months of a woman’s pregnancy may permanently impair the neurodevelopment of her unborn child, leading to an increased risk of schizophrenia later in life, new research suggests.
The link between maternal stress and fetal development is not new: A study in the Lancet in 2000 suggested, for example, that a mother’s stress during pregnancy may increase the risk of congenital brain malformations in her baby. And it has been well established that severe maternal stress is associated with low birth weight and premature birth. Now, a new study by British and Danish researchers in this week’s Archives of General Psychiatry examines the impact of stress the acute, agonizing kind, such as that experienced with death or sickness in the mother’s immediate family, and not the run-of-the-mill anxiety of daily life on the future psychiatric health of her offspring.
If the severity of maternal stress matters, then one would expect the death of child to cause more injury than the death of a parent. Indeed, says Abel, her data hinted at such a response compared with women who lost a parent, those who lost a child appeared to have a higher likelihood of giving birth to a child at risk for schizophrenia but her sample size was too small to confirm the theory.
Potential New Drug Target
The researchers also investigated a possible way to reverse the damage. When they gave some of the affected mice a drug that targets the nuclear receptors, they found that the downregulated genes associated with oligodendrocytes and GABA were upregulated. This coincided with reductions in some behaviors.
First author Motoko Maekawa says, This was evidence that drugs acting on nuclear receptors can be a new therapy for schizophrenia.
The researchers also found evidence that the same nuclear receptor genes are downregulated in people with schizophrenia. They discovered this by examining hair follicles from two groups of schizophrenia patients.
The next step is to test the effectiveness of drugs that target these nuclear receptors in patients with schizophrenia, and to investigate how nuclear receptors regulate the function of oligodendrocytes and GABAergic neurons to prevent the development of schizophrenic pathophysiology.
Obstetric Complications Predicting Later Development Of Mental Disorders Among Hr Offspring
The following variables were included in the Cox regression models predicting the development of schizophrenia spectrum psychoses: sex, birth weight, maternal infections during pregnancy, maternal hypertension during pregnancy, and placental abnormalities. In the model, females had lower risk than males . Infections during pregnancy , placental abnormalities , and maternal hypertension during pregnancy were all associated with an elevated risk of schizophrenia spectrum psychoses. The findings remained similar when we restricted the analysis to the offspring of mothers with DSM-IV schizophrenia spectrum psychoses: placental abnormalities , maternal infections , and hypertension predicted the development of schizophrenia spectrum disorders in the offspring, and females had lower risk than males .
The following variables were included in the regression models predicting the development of other mental disorders: sex, birth weight, diastolic BP at arrival to the hospital, and duration of second stage of labor, which was categorized into the 3 groups of < 10, 1019, and 20min. In the model, maternal diastolic BP predicted the development of other mental disorders in the offspring. The finding remained similar when the analysis was restricted to offspring of mothers with schizophrenia spectrum psychosis .
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What Are The Symptoms Of Schizophrenia
The main symptoms of schizophrenia are:
- Delusions False beliefs of persecution, guilt or grandeur, or being under outside control
- Hallucinations These most commonly involve hearing voices
- Thought disorder Speech may be difficult to follow with no logical connection
Other symptoms of schizophrenia include:
- Lack of motivation
Women With Schizophrenia At Higher Risk Of Pregnancy Delivery Complications: Study
- Women’s College Hospital
- Women with schizophrenia are nearly twice as likely to experience pre-eclampsia, pre-term birth and other serious pregnancy and delivery complications as women without the condition, a landmark study has found.
Women with schizophrenia are nearly twice as likely to experience pre-eclampsia, pre-term birth and other serious pregnancy and delivery complications as women without the condition, a landmark study by researchers at the Institute for Clinical Evaluative Sciences and Women’s College Hospital has found.
The first-of-its-kind study, published today in the British Journal of Obstetrics and Gynecology, is the first to report high birth weights, and increased rates of hypertension and thromboembolic disease in pregnant women with schizophrenia.
“Traditionally, women with schizophrenia have had low fertility rates, and little attention was paid to their reproductive health,” said Dr. Simon Vigod, lead author of the study, a psychiatrist at Women’s College Hospital and a scientists at ICES. “But recently, with fertility rates on the rise among these women, we must now turn our attention to ensuring their reproductive health and that of their babies.”
The population-based study of women aged 15 to 49 who gave birth to a live or stillborn infant in Ontario from 2002 to 2011 also found that:
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What Is It Like To Be Schizophrenic And Pregnant
When youre pregnant, there are so many things to you have to think about. As a woman suffering from schizophrenia, those worries can be even more complicated. Fertility rates among women with the disorder tend to be low, but what can a woman who has schizophrenia do if she finds out shes pregnant?
First, good prenatal care is an absolute must. A mom with schizophrenia might be referred to a Maternal-Fetal medicine specialist to help her through issues her regular OBGYN may not be able to address. Some schizophrenics find their symptoms ease during pregnancy, while others might experience symptoms for the first time.
Second, its important to avoid drugs, smoking, and alcohol. Mothers who experience schizophrenia are more likely to engage in substance abuse during pregnancy than mothers without a mental illness. It seems like common sense these days, but it bears repeating: drug and alcohol use during pregnancy can lead to severe complications for both mom and baby.
Third, keep taking your medication. Schizophrenia is often controlled with medication, but some women who struggle with mental illness will stop taking their medication out of fear that it will harm their fetus. This can cause symptoms to worsen or lead to erratic mood changes. While the National Institute of Mental Health admits there is no drug that is completely safe during pregnancy, it is essential to work with your health care provider to choose the best course of action.
Time And Place Of Birth
Two major epidemiological notions for a neurodevelopmental theory of schizophrenia are season of birth, and place of birth. Seasonal birth rates of schizophrenics differ from those of the general population with people born during winter or early spring, where there is a greater predominance of infections such as colds and influenza, having an increased risk of developing schizophrenia .
Urbanicity, compared to being raised in a rural area, also gives rise to a greater risk of schizophrenia with the increase in susceptibility found before, rather than around, the time of illness onset . Indeed individuals moving to a higher degree of urbanization during upbringing show an increased risk of schizophrenia , while moving rurally decreases the risk, suggesting that repeated exposures to candidate risk factors such as infection and exposure to toxins while either in the womb, or during development confer a greater risk toward psychosis . An alternative hypothesis is the influence of cognitive social capital that is aspects of mutual trust, bonding and safety exert a developmental stress-related impact on the mental health of the children growing up in these urban environments . Indeed the role of nutrition could also influence here. Both of these factors are discussed below.
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Prenatal Exposure To Infection
Research on prenatal infection and the aetiology of schizophrenia has been extensively reviewed by Brown , and Brown and Derkits . Epidemiological and birth cohort studies show that infection is a credible environmental risk factor for schizophrenia with foetal exposure to viral or parasitic agents increasing one’s susceptibility to the disorder.
Much of the evidence pertaining to within-womb infection and schizophrenia is from influenza studies. An initial study reporting an increased risk of schizophrenia in individuals that had been in the second trimester of development during the 1957 influenza pandemic was confirmed by others , although a recent publication studies did not demonstrate an increased risk of schizophrenia among children exposed during any trimester or month of prenatal life of this epidemic . Alternatively, other influenza epidemics do support the maternal influenza hypothesis with a further study, this time with birth cohort data, demonstrating that maternal influenza during the first half of pregnancy is found to be associated with an increase in susceptibility of the foetus to develop schizophrenia, in this case, a three-fold influence .
Summary And Future Directions
In summary, evidence from 2 independent natural experiments supports the hypothesis that prenatal nutritional deficiency is related to the development of schizophrenia. Given that micronutrient deficiencies are common during pregnancy, even in well-fed populations, this work could stimulate public health efforts to ensure adequate nutritional intake during pregnancy, which may not only facilitate the prevention of schizophrenia but also result in additional improvements in health outcomes for offspring throughout the life course.
A second strategy is to assess the individuals who developed schizophrenia after prenatal exposure to famine. The study in China now provides a large enough sample for this purpose. The homogeneous environmental exposure makes this a particularly good strategy for identifying genes that play a role in schizophrenia., For example, this homogeneity increases the statistical power for detecting genetic variants hypothesized to interact with prenatal nutritional deficiency to cause schizophrenia. With the advance of genomic technology, this design may also permit exploration of whether prenatal starvation induced genetic mutations or epigenetic effects that predispose to schizophrenia. For example, hcy appears to act as a methyl donor following activation to S-adenosylmethionine, influencing DNA methylation, which could alter regulation of genes.
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How Do You Detect Toxoplasmosis
To find out if you have toxoplasmosis, your doctor can do a blood test to see if you have those antibodies. If youve been infected recently, your body may not have had time to make them. So even if your test doesnt show any signs of them, your doctor may want to do another test a few weeks later to be sure.