Schizophrenia, as a mental illness, has been portrayed in art, popular culture, and the media for years, but even everyday man is not deprived of encounters with schizophrenia. So, the question is, what exactly is schizophrenia? The origin of the name is hidden in the two Greek words schizo = split and fren = mind. Schizophrenia is a mental illness in which a distorted vision of reality occurs, and the most common manifestations include sound hallucinations, paranoia, and bizarre delusions. But if we go a few steps back and consider the disease at the molecular level, it is important to point out that genetics play an important role in the development of schizophrenia and the predisposition to schizophrenia is hereditary. However, there is evidence that certain behaviors of the mother and her life habits during pregnancy can greatly increase the risk of developing the disease later in the life of the child. In order to understand the reason for the development of schizophrenia, it is necessary to return to the beginning of the story, to the very conception of a child.
Stress in pregnancy
Let’s start from the beginning, was the pregnancy a planned event or not? Research has shown that there is a correlation between unwanted pregnancy (interacting with genetic risk) and an increased risk of developing schizophrenia in offspring in young adulthood. Unwanted pregnancy is not the only cause of the increased frequency of schizophrenia in the offspring, but also stress. During stress, levels of glucocorticoids (such as cortisol, also known as stress hormone) are increased in the mother’s body. They can negatively affect the development of the fetal brain and thus create a syndrome that has certain signs of schizophrenia. Stress, but also cigarette smoking, during pregnancy is associated with a higher risk of developing fetal hypoxia (or oxygen starvation) – a condition that occurs in the fetus due to lack of oxygen. Fetal exposure to hypoxia results in a higher likelihood of developing schizophrenia later in life.
Diseases and nutrition in pregnancy
What should an “ideal” pregnant woman look like? As we have already established, stress should be minimized. Depression (especially during the second trimester) also increases the risk of developing schizophrenia (by the same mechanism as stress) 3. As for other health problems, hypertension, and the use of diuretics in pregnancy also contribute to the development of schizophrenia in offspring in young adulthood, and in addition to these, analgesics are on the blacklist of schizophrenia. Viruses and bacteria are not good guys in this story either. Namely, research has shown that infections such as influenza, herpes, rubella, toxoplasmosis, and respiratory infections during pregnancy were positively correlated with the development of schizophrenia in children. The mechanism behind these events has not been fully elucidated but is thought to be related to the maternal immune system. During the infection, the mother’s body increases the production of IgG and some cytokines (mostly IL-8) that are thought to be harmful to the fetus. When we talk about health, nutrition is an indispensable component. There is evidence that underweight women and deficiencies of folate, vitamin D, iron and protein during the prenatal period increase the risk of schizophrenia in a child. Direct association can be observed because these micronutrients are important components of molecules in neurodevelopment, and indirect effects are possible because nutritional deficiencies could result in de novo mutations in genes critical for brain development. If we combine poor nutrition and a higher probability of infections, we could explain why births during winter and spring are positively correlated with the development of schizophrenia in children. Various theories have been put forward to explain this association, but the most widely accepted are those involving the presence of teratogenic agents or a lack of nutrients in the diet, which impairs fetal brain development.
Although genetics continues to battle the development of schizophrenia in offspring, all the above factors may contribute to the development of schizophrenia in children. If they can contribute, it is understandable to conclude that avoiding them can, at least to some extent, reduce the risk. Therefore, pregnant women are definitely advised to avoid emotional stress, bad life habits such as smoking and generally maintaining a “good” immunity for the better health of the child.
Translated by Filip Sakoman
Literature
2. McNeil et al. “Unwanted pregnancy as a risk factor for offspring schizophrenia-spectrum and affective disorders in adulthood: a prospective high-risk study.” Psychological medicine 39, no. 6 (2009): 957-965.
3. Clarke et al. “Predicting risk and the emergence of schizophrenia.” Psychiatric Clinics 35, no. 3 (2012): 585-612.
4. Stilo, Simona A., i Robin M. Murray. “The epidemology of schizophrenia: replacing dogma with knowledge.” Dialogues in clinical neuroscience 12, no. 3 (2010): 305.
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