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GAZETTE
SEPTEMBER 1990
"Most psychiatrists believe that
there is a biological disorder
underlying schizophrenia."
phrenia are probably unduly
susceptible to stress in general, be
it of biological, psychological or
social origin.
Most psychiatrists believe that
there is a biological disorder under-
lying schizophrenia. In recent years
weight has been given to this view
by the emergence of the Dopamine
theory of aetiology. Dopamine is a
neurotransmitter, that is one of the
chemicals which convey messages
through the nervous system. It is
related to Noradrenaline. The
Dopamine hypothesis is based
partly on the evidence that
amphetamine abuse produces a
syndrome very similar to schizo-
phrenia and can aggravate schizo-
phrenia. Amphetamines are known
to enhance the effects of
Noradrenaline and Dopamine.
Secondly, the antipsychotic drugs
which relieve the symptoms of
schizophrenia produce Parkinson-
ism as a side effect. Dopamine is
known to be deficient in Park-
inson's disease, which can be
relieved by giving L.Dops. It is
believed that the drugs exert their
actions on schizophrenia by block-
ing the Dopamine receptors. The
suggestion is that the underlying
disorder in schizophrenia is some
disturbance of dopamine trans-
mission. This is clearly not the
whole answer as these drugs are
much more effective in treating the
acute symptoms of schizophrenia
than in relieving the basic chronic
symptoms.
Recently CT brain scans have
revealed dilated ventricles in the
brains of some schizophrenics and
even more recently Positron
Emission Tomography has shown
differences in the metabolism of
the brains of patients suffering
from schizophrenia when contrast-
edwith the brains of normal control
subjects.
Treatment
I will only briefly touch on the
subject of treatment. For the acute
phase drugs of the phenothiazine
group, such as Largactil, are used
to produce relief from hallucina-
tions, delusions and disturbed
behaviour. Sometimes ECT can be
beneficial, but since the intro-
duction of the drugs its use is less
often required.
When the patient has become
accessible the main focus of treat-
ment is on resocialising andhelping
him to resume employment. This
can be a long term problem re-
" . . . since the introduction of
. . . drugs [the use of ECT] is
less often required."
quiring careful gradation of
activities from simple occupational
therapy in hospital through day
hospital and on to sheltered work-
shops. Open employment is of
course the goal but is not always
reached. Impairment of volition or
drive and difficulty with concen-
tration may be permanent features
and impossible to overcome in
some cases. It is for chronic cases
of schizophrenia that the whole
gamut of community psychiatric
care is required. Longterm main-
tenance drug treatment is neces-
sary in the majority of cases.
•
Part 2 of this article will be
published in the November Gazette,
and will examine the medico-legal
aspects of schizophrenia.
I r i sh S t e nog r a ph e rs
L imi t ed
(Director:
Sheila Kavanagh)
Qualified Experienced Stenographers.
Fast, efficient service.
Overnight Transcripts by arrangement
Contact: Secretary,
"Hillcrest", Dargle Valley,
Bray, Co. Wicklow.
Telephone: 0 1 - 8 6 2 1 84
A 10 WE EK C O U R SE I N
P L A N N I NG LAW
A 10week lecture course in planning law will
commence on October 10th, 1990 and
continue until 12th December in Earlsfort
Terrace, Dublin 2.
The course will focus on the introduction of
environmental impact assessment and on
recent case law on planning enforcement.
A comprehensive set of lecture materialswill
be distributed at the end of the course.
Further information may be obtained from
T he
D i r e c t o r , Ex t ra M u r a l S t ud i e s, U . C . D . ,
Be l f i e l d, Dub l in 4 . Te l : 6 9 3 2 4 4 .
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