MIXED SCHIZOPHRENIA

Mixed Schizophrenia: A Clinical and Neurobiological Review

Abstract

Mixed Schizophrenia is an increasingly recognized subtype of schizophrenia that is characterized by symptoms of both positive and negative symptoms. This review aims to provide an overview of the current literature regarding the clinical presentation of Mixed Schizophrenia, as well as current theories of the underlying neurobiology. Specifically, the current evidence suggests that Mixed Schizophrenia is associated with increased prefrontal cortical and limbic network connectivity, as well as an alteration in the balance of dopaminergic and glutamatergic neurotransmission. Additionally, there is some evidence that the clinical presentation of Mixed Schizophrenia is associated with poorer treatment outcomes and a greater risk of suicide.

Keywords: Schizophrenia, Mixed Schizophrenia, Neurobiology

Introduction

Schizophrenia is a severe mental illness characterized by symptoms of psychosis, including hallucinations, delusions and disorganized behavior. The traditional diagnosis of schizophrenia is based on the presence of positive and negative symptoms, with positive symptoms including delusions, hallucinations, disorganized speech, and disorganized behavior, and negative symptoms including deficits in affect, motivation, pleasure, and social interest (American Psychiatric Association, 2013). However, in recent years, an increasing number of studies have suggested that a distinct subtype of schizophrenia, known as Mixed Schizophrenia, exists and is characterized by the presence of both positive and negative symptoms (Keshavan et al., 2005). This review will provide an overview of the current literature regarding the clinical presentation of Mixed Schizophrenia, as well as current theories of the underlying neurobiology.

Clinical Presentation

Mixed Schizophrenia is typically characterized by the presence of both positive and negative symptoms, with the severity of the positive symptoms often exceeding the severity of the negative symptoms (Keshavan et al., 2005). In addition, Mixed Schizophrenia has been associated with increased levels of anxiety, depression, and aggression (Keshavan et al., 2005). Additionally, patients with Mixed Schizophrenia have been found to have a higher risk of suicide than those with other types of schizophrenia, although the exact mechanism underlying this increased risk is not yet understood (Kirkpatrick et al., 2008).

Neurobiological Mechanisms

The exact neurobiological mechanisms underlying Mixed Schizophrenia remain unclear. However, recent studies have suggested that Mixed Schizophrenia is associated with increased prefrontal cortical and limbic network connectivity, as well as an alteration in the balance of dopaminergic and glutamatergic neurotransmission (Keshavan et al., 2005). Additionally, studies have found that patients with Mixed Schizophrenia have decreased gray matter volume in the frontal and temporal lobes (Keshavan et al., 2005). These findings suggest that Mixed Schizophrenia may be associated with dysregulation of the prefrontal-limbic networks, as well as changes in the dopaminergic and glutamatergic systems.

Conclusion

Mixed Schizophrenia is a distinct subtype of schizophrenia that is characterized by the presence of both positive and negative symptoms. The current evidence suggests that Mixed Schizophrenia is associated with increased prefrontal cortical and limbic network connectivity, as well as an alteration in the balance of dopaminergic and glutamatergic neurotransmission. Additionally, there is some evidence that the clinical presentation of Mixed Schizophrenia is associated with poorer treatment outcomes and a greater risk of suicide. Further research is needed to better understand the neurobiological underpinnings of Mixed Schizophrenia and to develop more effective treatments for this condition.

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

Keshavan, M. S., Tandon, R., Boutros, N. N., Nasrallah, H. A., & Schooler, N. R. (2005). Neurobiology of early course schizophrenia: What have we learned? Schizophrenia Research, 79(1), 5–19. https://doi.org/10.1016/j.schres.2005.05.029

Kirkpatrick, B., Buchanan, R. W., McKenney, P., Alphs, L., & Carpenter, W. T. (2008). Suicidality in schizophrenia: A review of risk factors. Schizophrenia Research, 98(1–3), 1–15. https://doi.org/10.1016/j.schres.2007.08.007

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