ETIOLOGY

In the first half of the 20th century, studies focused on trying to find a particular
pathologic structure associated with the disease, largely through autopsy, but such a site was not
discovered. In the 1950s and 1960s, the emphasis shifted to examination of psychological and
social causes. Interpersonal theorists suggested that schizophrenia resulted from dysfunctional
relationships in early life and adolescence. None of the interpersonal theories has been proved,
and newer scientific studies are finding more evidence to support neurologic/neurochemical
causes. However, some therapists still believe that schizophrenia results from dysfunctional
parenting or family dynamics. In the 1970s, studies began to focus on possible neurochemical
causes, which remain the primary focus of research and theory today.

BIOLOGIC THEORIES

A. Genetic Factors
Most genetic studies have focused on immediate families (i.e., parents, siblings,
and offspring) to examine whether schizophrenia is genetically transmitted or
inherited.
The most important studies have centered on twins; these findings have
demonstrated that identical twins have a 50% risk of schizophrenia; that is, if one
twin has schizophrenia, the other has a 50% chance of developing it as well. Fraternal
twins have only a 15% risk. This finding indicates a genetic vulnerability or risk of
schizophrenia. Other important studies have shown that children with one biologic
parent with schizophrenia have a 15% risk; the risk rises to 35% if both biologic
parents have schizophrenia.
B. Neuroanatomic and Neurochemical Factors
People with schizophrenia have relatively less brain tissue and cerebrospinal fluid
than those who do not have schizophrenia; this could represent a failure in the
development or a subsequent loss of tissue. The research consistently shows
decreased brain volume and abnormal brain function in the frontal and temporal areas
of persons with schizophrenia.
One prominent theory suggests excess dopamine as a cause. This theory was
developed on the basis of two observations: First, drugs that increase activity in the
 dopaminergic system, such as amphetamine and levodopa, sometimes induce a
paranoid psychotic reaction similar to schizophrenia. Second, drugs blocking
postsynaptic dopamine receptors reduce psychotic symptoms.
C. Immunovirologic Factors
Exposure to a virus or the body’s immune response to a virus could alter the brain
physiology of people with schizophrenia. Recently, researchers have been focusing
on infections in pregnant women as a possible origin for schizophrenia. Waves of
schizophrenia in England, Wales, Denmark, Finland, and other countries have
occurred a generation after influenza epidemics. Also, there are higher rates of
schizophrenia among children born in crowded areas in cold weather, conditions that
are hospitable to respiratory ailments.