Studies On The Possibility Of Preventing Schizophrenia

In general, the possibility of preventing schizophrenia is of great interest to researchers, who often seek to identify the early signs and risk factors of the disorder. Researchers note that for many people with schizophrenia, pre-existing impairments in mental health and social function may be present for months or years before the first psychotic episode. Many experts believe that schizophrenia develops due to the interaction of genetic and environmental risk factors. Early intervention is often associated with better outcomes, but regardless of when schizophrenia is identified, the condition can often be treated by working with medical and mental health professionals.

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Studies on neurobiological mechanisms

Some recent studies have examined potential neurobiological risk factors in the development course of schizophrenia.

Researchers noted that pre-existing impairments in mental health and social function may be present for many years before a person’s first psychotic episode. These early symptoms preceding psychosis are often referred to as the prodrome or prodromal phase. When the first-episode psychotic break occurs, abnormalities in brain structure have usually already manifested. 

While updated evidence may be needed, the duration of untreated psychosis can be associated with "incomplete symptom remission, a higher likelihood of relapse, and a reduced quality of life."

Ultra-high-risk individuals

The ultra-high risk (UHR) is an assessment tool that may identify people who are at a high risk of transitioning to psychosis, in which at least one positive symptom, such as hallucinations, delusions, or disorganized thinking and speech, persists for at least a week. 

UHR's criteria can evaluate attenuated psychotic symptoms (APS), brief limited intermittent psychotic symptoms (BLIPS), and genetic vulnerability. 

Recently, researchers have been revisiting these criteria to reflect the idea that genetic vulnerability, APS, and BLIPS groups may not only transition to psychosis at different rates, but they could also present a clinical risk that doesn't just reflect the transition to psychosis. 

In general, most ultra-high-risk individuals do not go on to develop psychosis. However, UHR individuals may experience non-psychotic disorders, attenuated psychotic symptoms, and poorer long-term function. To reflect these findings on the outcomes of long-term function, some studies are now less focused on the transition to psychosis. Instead, they tend to be concerned with establishing a "broader clinical risk profile by examining baseline clinical characteristics and long-term outcomes."

Early diagnosis complications

Some studies note that the lack of biomarkers indicating early-stage neuropsychiatric conditions, such as schizophrenia, often limits timely intervention to address diseased neurons. They argue that knowledge of these biomarkers might enable clinicians to address these neurons before they become too severe to be remedied. Researchers looking into these aspects generally seek new models to identify and study early signals that could suggest the presence or eventual development of neuropsychiatric disorders. 

Early-stage models typically reflect genetic and environmental risk factors, reproduce neural abnormalities, and incorporate practical and ethical factors. 

Dopamine dysfunction may be closely linked to the development of schizophrenia. However, dopamine blockage doesn't always alleviate schizophrenia symptoms, suggesting that other neurotransmitters may also be involved. Researchers note that abnormalities in neural development may stem from neurotransmitter dysfunction in different areas of the brain. Impaired glutamate signaling and serotonin pathways may be two of these affected areas. 

Researchers are looking into induced pluripotent stem cell (iPSC) and organoid technology to study the possible biomarkers for schizophrenia, as they believe the disorder may be caused by the interaction of genetic risk factors and environmental factors.

Family history 

Researchers note that the heritability rate of schizophrenia tends to be high. Twin and adoption studies are often used to portray heritability rates of various disorders, with some studies suggesting that schizophrenia’s heritability rate could be as high as 79%. 

However, findings also indicate that many heritability factors haven’t yet been identified, and "the reported environmental risk factors do not explain all the variances not attributable to genetic risk factors." These researchers suggest the need for new methods that reflect complex multi-level mechanisms that could contribute to the development of schizophrenia.

Birth complications and early-onset schizophrenia

Many studies have examined the link between birth complications and the risk of developing schizophrenia. Risk factors can include the premature rupture of membranes, premature birth, the use of resuscitation or an incubator, and forceps delivery.

One study focused on the association between perinatal obstetric complications and executive dysfunction in early-onset schizophrenia. The study's findings suggested that early-onset schizophrenia could be characterized by higher incidences of birth complications and more severe executive dysfunction.

Prevention in early life

The London Child Health and Development Study (CHADS) generally focused on children aged nine to 11 years who were at risk for developing schizophrenia. The study primarily aimed to chart the course of psychological, cognitive, and biological functions in children while identifying potential targets for early prevention strategies. The study's findings suggested that high-risk children usually experienced increased stress and cognitive function impairments, as well as brain abnormalities. 

The London Child Health and Development Study also looked into intervention strategies. They determined that cognitive behavioral therapy can be helpful in addressing many mental health conditions, and this study identified CBT as a viable intervention strategy to alleviate schizophrenia symptoms and improve function. 

Prevention strategies

According to researchers, the main goal of using early detection strategies is to "prevent the transition to full-blown psychosis." In so doing, researchers have examined the effectiveness of antipsychotic medication and particular therapies.

As mentioned previously, cognitive behavioral therapy (CBT) is one therapeutic approach that is being extensively studied for its usefulness in preventing schizophrenia symptoms. While more recent evidence may be needed, one study suggests that CBT and low-dose antipsychotic medications during the prodromal phase may prevent or delay the onset of acute schizophrenia.

Fostering mental health

Many people with schizophrenia learn to manage symptoms with the support of a therapist, medication, and holistic approaches. If you or someone you know is at risk for developing schizophrenia, having sessions with a therapist in-person or online can be invaluable. 

If speaking to someone online is more comfortable for you, you may reach out to a licensed therapist through a platform like BetterHelp, which can conveniently connect you with a licensed mental health professional by phone, video, or online chat. Many therapists using the platform employ cognitive behavioral therapy, an approach that has been found to be helpful in alleviating schizophrenia symptoms in many studies. 

An updated systematic review and meta-analysis examining therapist-assisted CBT delivered online suggested that online therapy could yield "similar effects as face-to-face therapy." The review included 30 studies involving 3053 participants, including people with schizophrenia. The results "indicate that whether online or in-person, CBT can "yield similar symptomatic improvement across all study populations."