Schizophrenia Phenomena after Brain Injury - Research Paper Example

Schizophrenia Phenomena after Brain Injury Name Institution Date Schizophrenia Phenomena after Brain Injury Introduction Brain injury refers to the physical damage that occurs to living brain tissue due to external and mechanical force (Michael & Solomon, 2012). Brain injury generally results from blunt force or from a penetrating wound (Young et al, 2015). Brain injury has been shown to cause significant adverse mental health outcomes. Evidence shows that brain injury augments the risk of many neuropsychiatric disturbances for example mood disorders, cognitive impairment as well as anxiety disorders (Fann et al, 2009). However, there is controversy if brain injury is a risk factor for schizophrenia. For instance, while some studies show that there is unlikely link between brain injury and schizophrenia, there is also evidence that shows that brain injury can cause schizophrenia or schizophreniform psychosis (Rierger, 2016). Therefore, it is evident that schizophrenia phenomenon after brain injury is not well understood. Consequently, the focus of this essay is to find out if brain injury can result to schizophrenia and help in understanding the schizophrenia phenomena after brain injury. Study Background Brain injury is the most common traumatic event that affects CNS and also results to considerable mortality and morbidity. Brain injury can cause cognitive impairment and emotional instability in patients and this can result to mental health disorders such as schizophrenia (Rierger, 2016). After brain injury, neurological damage occurs and this causes cognitive impairment after temporal cortex damage after the injury. The brain injury can also result to frontal lobe damage and this may result to attention deficits and loss of executive function. These cognitive impairments can result to symptoms such as confusion, delusions, agitation, hallucinations, among other mental problem symptoms (Rierger, 2016). Additionally, damage on frontal lobe as well as the limbic system can result to changes in emotional function. Because these brain regions are responsible for controlling fear and impulse; their damage can cause some schizophrenic symptoms because of the inability to control emotions (Tohid, 2015). Problem Statement Mental and psychological problems are common after brain injury and some of these problems can be associated with schizophrenia. Schizophrenic symptoms after brain injury pose a challenge to healthcare providers as well as to the patients. Evidence shows that a big percentage of patients who suffer brain injury exhibit mental problems that can be associated with schizophrenia (Schwarzbold et al, 2008). Schizophrenia is a major stressor for the patient and caregivers as well. In addition, schizophrenia decreases functional independence, result to hospitalization, adversely affects social life, reduces productivity, and also disturbs family dynamics (Millier et al, 2015). As a result, it is important to establish the schizophrenia phenomena after brain injury, in order to develop the most effective intervention for schizophrenia resulting from brain injury. Aims To investigate the relationship between brain injury and schizophrenia To find out if the psychosis symptoms and neurological and mental health symptoms after brain injury can be associated with schizophrenia To understand the schizophrenia phenomena after brain injury Research Question 1. How does the schizophrenia phenomenon occur and what are the mechanisms that can result to schizophrenia after brain injury? Literature Review Brain injury causes harm to the brain injury and this can result to cognitive impairment and emotional instability (Millier et al, 2015). Some of the cognitive impairment symptoms can be associated with schizophrenia. Once brain injury occurs, neurological damage occurs, for example breakdown of the blood-brain barrier as well acute inflammation within the brain. The neurological damage can result to cognitive impairment, for example memory deficits following temporal cortex damage and attention deficits, as well as the loss of executive function following the frontal lobe damage. The cognitive impairments can result to the problems in information processing, confusion, psychosis, agitation, and other symptoms associated with schizophrenia (Chan, 2011). Furthermore, in event brain injury causes damage to the limbic system or the frontal lobe; this can significantly alter the emotional function which is a major symptom in schizophrenia (Hoffman, 2013). This is because limbic system and frontal lobe are the brain parts that control fear and impulse and hence if these brain parts that influence emotional control are damaged, schizophrenia symptoms such as agitation and psychosis may occur (Hoffman, 2013). Schizophrenia is associated with cognitive impairment. After a brain injury, a person experiences cognitive impairments and exhibits symptoms such as memory problems, attention deficit, and executive function deficits (Schwarzbold et al, 2008). These cognitive impairments can result to confusion. As a result, the confusion can result to symptoms such as delirium, delusion and hallucinations and these symptoms are manifest in schizophrenia (Mrozek et al, 2012). Neurological damage within the brain causes cognitive impairment. Neurological damage following brain injury consist of breakdown of the blood-brain barrier penetration of peripheral blood cells, activation of resident immune-competent cells, as well as the intrathecal discharge of massive immune mediators, like interleukins and chemotactic factors (Adam et al, 2011). Accordingly, after neurological damage, a brain injury patient suffers from cognitive impairment. In serious brain injury, there may be reduced blood flow to the cortical cerebral as well as injury of the interconnection located between the frontal cortex and the sub-cotical nuclei within the hypothalamus, striatum, globus pallidus, and substantia nigra (Sours et al, 2015). The interconnection plays a role of arousal and cognitive function and hence injury to the interconnection after brain injury results to reduced arousal and reduced cognitive function. In addition, when an individual experiences decreased arousal and reduced cognitive function, a person is not able to appropriately interact with environment stimulation and this may result to schizophrenic symptoms such as agitation, confusion which can further graduate to serious symptoms like delirium, delusions or hallucination (Phillips et al, 2015). DSM-IV-TR for schizophrenia can be associated with a temporal relationship between brain injury and the symptoms’ onset (Phillips et al, 2015). A study performed on the relationship between schizophrenia and brain injury established that brain injury results to deficits that can cause schizophrenia (Shalev et al, 2009). Some of the deficits after brain injury that were correlated with schizophrenia include ectroencephalographic abnormalities, in particular within temporal lobes and focal lesions within the fontal and temporal lobes. Another study also found out that there were a high percentage of frontal or frontal injuries, in patients with psychosis symptoms in schizophrenia after brain injury (Tohid et al, 2015). The study also found out that individuals with previous brain injury were at higher risk of developing psychotic symptoms associated with schizophrenia after new brain injury (Rierger, 2016). Schizophrenia is normally associated with psychotic episodes. A study conducted on psychosis after brain injury and revealed clues regarding pathophysiology of psychotic symptoms also common in schizophrenia (Batty et al, 2010). A neurobiological model for psychosis was developed and the model suggested that schizophrenia symptoms such as delusions and hallucinations are comparable to neurological symptoms like aphasia and apraxia (Kahn & Sommer, 2015). Brain injury impairs neural structures within a defined local and this causes psychotic symptoms (Sours et al, 2015). As studies further show, psychosis is allied to dysfunction of the frontal systems, the temporal lobes as well as the neurotransmission pathways projected within these regions (Hannawi et al, 2016). If an event regulation among the systems rapture, there is a likelihood of temporal limbic activity increasing (Michael & Solomon, 2012). As a result, a person becomes susceptible to psychotic symptoms. However, there is also a different view that suggests even though brain injury is an external factor that can result to development of schizophrenia, the response of brain to the brain injury event can differ and this is dependent on the intrinsic biological traits of the person (Fong et al, 2000). Accordingly, just like most pathologies, schizophrenia allied to brain injury, can have multi-factorial etiology, whose genetic causes have a non-mendelian aspect (Fong et al, 2009). Locating Literature This study will adopt a systematic review as the methodology. Different databases will be used to locate literature and articles for the study. Specifically, OVID MEDLINE, Cochrane, Google Scholar, PUBMED, and PsychINFO, will be searched to locate literature and journal relevant articles. Key terms that will be used in the search include: “schizophrenia and brain injury”; psychosis and brain injury”; “head injury and mental problems”; “brain injury”; ‘mental health problems”; “hallucinations and brain injury”. All these terms are the MeSH terms that will be used when searching for literature and evidence to be used. Only relevant articles to the study topic will be used. Conclusion In conclusion, the reviewed literature in the essay reveals that there is an increased risk of schizophrenia after brain injury. The essay indicates that the increase in risk to schizophrenia from brain injury is due to injury on brain parts such as temporal cortex damage and frontal lobe damage. As a result, injury to the parts causes neuropsychiatric disturbances and cognitive impairment. The cognitive impairment and the neuropsychiatric disturbances manifest through symptoms such as such as delusions, hallucinations, psychosis and confusion, among other symptoms. These are some of the symptoms that are predominant in schizophrenia. Therefore, this essay provides an overview of how brain injury can end up causing schizophrenia. Investigation of the molecular consequences of brain injury in regard to schizophrenia risk may provide a fruitful line of enquiry in relations to link between brain injury and schizophrenia. References Adam C, Zink B & Joanna S. (2011). Blood-brain barrier pathophysiology in traumatic brain injury. Transl Stroke Res. 2(4), pp: 492–516. Batty R, Rossell S, Francis A, Hopwood M. (2010). Traumatic Brain Injury and Secondary Psychosis. Schizophrenia Research. 117(2-3), pp: 206-207. Chan C. (2011). Clarifying the confusion about confusion: Current practices in managing geriatric delirium. BCMJ. 53(8), pp: 409-415. Fann J, Hart T & Schomer K. (2009). Treatment for Depression after Traumatic Brain Injury: A Systematic Review. J Neurotrauma. 26(12), pp: 2383–2402. Fong T, Samir T & Inouye S. (2009). Delirium in elderly adults: diagnosis, prevention and treatment. Nat Rev Neurol. 2 5(4), pp: 210–220. Hannawi Y, Abers M, Geocadin R & Mirski M. (2016). Abnormal movements in critical care patients with brain injury: a diagnostic approach. Critical Care.20(60). Hoffman M. (2013). The Human Frontal Lobes and Frontal Network Systems: An Evolutionary, Clinical, and Treatment Perspective. ISRN Neurology. 1(1), pp: 1-34. Kahn R & Sommer E. (2015). The neurobiology and treatment of first-episode schizophrenia. Molecular Psychiatry. (2015) 20, 84–97. Millier A, Schmidt U, Murthy V, Toumi M et al. (2015). Humanistic burden in schizophrenia: A literature review. Journal of Psychatiric Research. 1(54), pp: 85-93. Michael B & Solomon T. (2012). Seizures and encephalitis: clinical features, management, and potential pathophysiologic mechanisms. Epilepsia. 53(4), pp:63–71. Mrozek S, Vardon F & Geeraerts T. (2012). Brain Temperature: Physiology and Pathophysiology after Brain Injury. Anesthesiology Research and Practice. 2012 (2012), pp: 1-13. Phillips J, Hawedi D, Eissa A & Moustafa A. (2015). The Cerebellum and Psychiatric Disorders. Front Public Health. 3(66). Rierger S. (2016). Personality and Behavior Changes Subsequent to Traumatic Brain Injury: A Review of the Literature. International Journal of Emergency Mental Health and Human Resilience. 1(1). Schwarzbold M, Diaz A, Martins E, Rufino A, Amante L, Thais M, Joano Q, Hohl A, Linhares M & Walz R. (2008). Psychiatric disorders and traumatic brain injury. Neuropsychiatr Dis Treat. 4(4), pp: 797–816. Shalev H, Serlin Y & Alon F. (2009). Breaching the Blood-Brain Barrier as a Gate to Psychiatric Disorder. Cardiovascular Psychiatry and Neurology. 2009 (2009), pp: 1-7. Sours C, Zhuo J, Roys S, Shanmuganathan K, Gullapalli R. (2015). Disruptions in Resting State Functional Connectivity and Cerebral Blood Flow in Mild Traumatic Brain Injury Patients. PLoS ONE. 10(8): e0134019.  Tohid H, Faizan M & Faizan U. (2015). Alterations of the occipital lobe in schizophrenia. Neurosciences (Riyadh). 20(3): 213–224. Young L, Rule G, Bocchiei R, Waliko T, Buns J & Ling G. (2015). When Physics Meets Biology: Low and High-Velocity Penetration, Blunt Impact, and Blast Injuries to the Brain. Front Neurol. 6(89). Read More

Aims To investigate the relationship between brain injury and schizophrenia To find out if the psychosis symptoms and neurological and mental health symptoms after brain injury can be associated with schizophrenia To understand the schizophrenia phenomena after brain injury Research Question 1. How does the schizophrenia phenomenon occur and what are the mechanisms that can result to schizophrenia after brain injury? Literature Review Brain injury causes harm to the brain injury and this can result to cognitive impairment and emotional instability (Millier et al, 2015).

Some of the cognitive impairment symptoms can be associated with schizophrenia. Once brain injury occurs, neurological damage occurs, for example breakdown of the blood-brain barrier as well acute inflammation within the brain. The neurological damage can result to cognitive impairment, for example memory deficits following temporal cortex damage and attention deficits, as well as the loss of executive function following the frontal lobe damage. The cognitive impairments can result to the problems in information processing, confusion, psychosis, agitation, and other symptoms associated with schizophrenia (Chan, 2011).

Furthermore, in event brain injury causes damage to the limbic system or the frontal lobe; this can significantly alter the emotional function which is a major symptom in schizophrenia (Hoffman, 2013). This is because limbic system and frontal lobe are the brain parts that control fear and impulse and hence if these brain parts that influence emotional control are damaged, schizophrenia symptoms such as agitation and psychosis may occur (Hoffman, 2013). Schizophrenia is associated with cognitive impairment.

After a brain injury, a person experiences cognitive impairments and exhibits symptoms such as memory problems, attention deficit, and executive function deficits (Schwarzbold et al, 2008). These cognitive impairments can result to confusion. As a result, the confusion can result to symptoms such as delirium, delusion and hallucinations and these symptoms are manifest in schizophrenia (Mrozek et al, 2012). Neurological damage within the brain causes cognitive impairment. Neurological damage following brain injury consist of breakdown of the blood-brain barrier penetration of peripheral blood cells, activation of resident immune-competent cells, as well as the intrathecal discharge of massive immune mediators, like interleukins and chemotactic factors (Adam et al, 2011).

Accordingly, after neurological damage, a brain injury patient suffers from cognitive impairment. In serious brain injury, there may be reduced blood flow to the cortical cerebral as well as injury of the interconnection located between the frontal cortex and the sub-cotical nuclei within the hypothalamus, striatum, globus pallidus, and substantia nigra (Sours et al, 2015). The interconnection plays a role of arousal and cognitive function and hence injury to the interconnection after brain injury results to reduced arousal and reduced cognitive function.

In addition, when an individual experiences decreased arousal and reduced cognitive function, a person is not able to appropriately interact with environment stimulation and this may result to schizophrenic symptoms such as agitation, confusion which can further graduate to serious symptoms like delirium, delusions or hallucination (Phillips et al, 2015). DSM-IV-TR for schizophrenia can be associated with a temporal relationship between brain injury and the symptoms’ onset (Phillips et al, 2015).

A study performed on the relationship between schizophrenia and brain injury established that brain injury results to deficits that can cause schizophrenia (Shalev et al, 2009). Some of the deficits after brain injury that were correlated with schizophrenia include ectroencephalographic abnormalities, in particular within temporal lobes and focal lesions within the fontal and temporal lobes. Another study also found out that there were a high percentage of frontal or frontal injuries, in patients with psychosis symptoms in schizophrenia after brain injury (Tohid et al, 2015).

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