Discussion: Discuss the neurobiology of psychosis. What neurotransmitters are involved? What does imaging tell us? How do the biological markers correlate to the diagnosis of schizophrenia?

Discussion: Discuss the neurobiology of psychosis. What neurotransmitters are involved? What does imaging tell us? How do the biological markers correlate to the diagnosis of schizophrenia?

Discussion: Discuss the neurobiology of psychosis. What neurotransmitters are involved? What does imaging tell us? How do the biological markers correlate to the diagnosis of schizophrenia?

 

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Schizophrenia Discussion

Psychosis is characterized by a loss of contact with reality. A person’s ability to perceive and respond to the environment becomes so disturbed that it impairs their functioning at home, work, and school. The neurobiology of psychosis can be attributed to changes in neurochemistry, particularly altered activity in markers of dopamine and glutamate transmission (Mehta, 2020). Psychosis is associated with increased dopamine receptors and abnormalities in the neurotransmitters serotonin, norepinephrine, acetylcholine, and GABA.

Positive psychotic symptoms are thought to be caused by increased limbic dopamine activity, while negative symptoms are due to reduced frontal dopamine activity. The dopaminergic pathology may be due to abnormal receptor number, sensitivity, or dopamine release (Kesby et al., 2018). Reduced GABA activity causes increased dopamine activity, which results in psychotic symptoms. Furthermore, increased norepinephrine levels in psychosis cause increased sensitization to sensory input. Also, the reduced function of the glutamate N-methyl-D-aspartate (NMDA)-type receptor is hypothesized to cause positive and negative psychotic symptoms.

Neuroimaging studies reveal differences between the brains of people with psychosis and those without the disorder. Brain imaging in psychosis often reveals several anatomical abnormalities, including ventricular enlargement, sulci enlargement, and cerebellar atrophy (Mehta, 2020). There is also a decrease in the cerebral and intracranial size and a decrease in the frontal lobe. Imaging can also reveal anatomical abnormalities of the amygdala, hippocampus, temporal lobes, and basal ganglia.

Biological markers correlate to the diagnosis of psychosis, particularly with positive and negative symptoms. For instance, reduced dopamine activity in the mesocortical system is associated with negative symptoms (Kesby et al., 2018). On the other hand, increased dopamine activity in the mesolimbic system causes positive symptoms. The two impaired biological processes may coexist, resulting in a person exhibiting negative and positive symptoms.

References

Kesby, J. P., Eyles, D. W., McGrath, J. J., & Scott, J. G. (2018). Dopamine, psychosis and schizophrenia: the widening gap between basic and clinical neuroscience. Translational Psychiatry, 8(1), 1-12. https://doi.org/10.1038/s41398-017-0071-9

Mehta, U. M. (2020). The social neuroscience of psychosis: From neurobiology to neurotherapeutics. Indian Journal of Psychiatry, 62(5), 470–480. https://doi.org/10.4103/psychiatry.IndianJPsychiatry_550_20