A collaborative study between the University of Nevada Reno School of Medicine, and the University of Maryland School of Dentistry reports its findings: people with a certain type of schizophrenia do have physical differences from the rest of us. The study, published in Schizophrenia Bulletin on August 19, 2019, points out some differences in mouth structure in people with one form of schizophrenia called deficit schizophrenia, compared with other schizophrenics and non-schizophrenics.
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What is schizophrenia?
Schizophrenia is a major psychosis, a mental health disorder characterized by severe and chronic delusions, hallucinations and paranoia. This changes the pattern of thinking of the affected individual, as well as the emotional state and behavior. Such symptoms can profoundly disrupt the normal functioning and life quality of the affected person.
A delusion is a fixed or immovable belief that is based upon a false premise. On the other hand, a hallucination occurs when a mentally ill person has a sensory experience that is not based on reality or tangible phenomena. These can make it very difficult for the person to experience life normally, or to distinguish real life from his ‘own world’.
The palate in schizophrenia
Nobody quite understands the mechanisms of schizophrenia. However, the current study highlights the wider dimensions of the palate in people with deficit schizophrenia compared with other people. Deficit schizophrenia refers to a form of this psychosis in which the person habitually experiences two or more negative symptoms, such as asociality or amotivation. This is considered a distinct form of schizophrenia with different risk factors, a distinct course, a different response to treatment, and now, different biology.
The researchers looked at the measurements of the oral palate in people with schizophrenia, deficit schizophrenia, and other people. The mean measurements were found to be 33.7, 37, and 34 cm respectively. The trend towards a wider oral palate was found only in the second group, and may be a sign of abnormal neurodevelopment during the period of palate development in the womb. This is usually an event timed between 6-17 weeks of pregnancy. However, this is also the time when neurons travel from their original place of origin to their final brain position.
Thus schizophrenia should be considered an illness of the whole organism and not only of the mind. Researcher Gary Hack says, “Our finding of physical orofacial differences in schizophrenia suggests that the whole-body model of this illness is not only more accurate but is a more appropriate model to present to patients, their family members, and students.”
Deficit schizophrenia: not just all in the mind?
The researchers plan to go forward with the palate studies, both in terms of dimensional differences and underlying reasons for the abnormal palate development. The palate is thus only a marker of a divergence from the normal pathway of neural development in deficit schizophrenia, compared to the lack of such a departure in other forms. The findings are important in that they could be indicative of a very early determination of abnormal brain development in fetal life, at the junction of the first and second trimesters.
This “would support the concept that deficit schizophrenia is a separate disease within the syndrome of schizophrenia," according to another researcher, Brian Kirkpatrick. In addition, the researchers are wondering whether they implicate viral exposure in pregnancy as a cause of this aberrant neurodevelopment that results in deficit schizophrenia. For instance, some antibodies are present at higher concentrations in deficit patients compared to other schizophrenics. This offers great scope for future studies.
The researchers applaud the successful teamwork between multiple and diverse disciplines to tease out the physical differences between the groups of patients. Kirkpatrick sums up: “It’s been exciting to find a difference in events from the earliest stage of patients’ lives, which may lead to an understanding of one cause of schizophrenia in this group of patients. International research collaborations make positive impacts on global health possible.”
An early developmental marker of deficit versus nondeficit schizophrenia. Brian Kirkpatrick, Özlem Gürbüz Oflezer, Mehtap Delice Arslan, Gary Hack, & Emilio Fernandez-Egea. Schizophrenia Bulletin, 19 August 2019, sbz024, https://doi.org/10.1093/schbul/sbz024. https://academic.oup.com/schizophreniabulletin/article-abstract/doi/10.1093/schbul/sbz024/5551220/?redirectedFrom=fulltext