Schizophrenia is associated with an increased frequency of tu-berculosis
(not accounted for by institutionalization), celiac disease, myxedema and
arteriosclerotic heart disease. Patients who present with atypical psychoses
have been noted to have an increased risk of ankylosing spondylitis and
uroarthritis, which may indicate a relationship between the histocompatibility
com-plex and schizophrenia. Along these lines, there is a strikingly decreased
risk for rheumatoid arthritis among patients with schizophrenia.
The cause of schizophrenia is currently not known. A leading view is
that schizophrenia may be heterogeneous with respect to etiology. Thus,
multiple causative mechanisms may give rise to distinct disease subtypes. If
this is true, it is important for psy-chiatric researchers to differentiate the
homogeneous subtypes of this illness. Moreover, it has been proposed that more
than one causative mechanism might interact (the so-called double-hit
hy-pothesis) to cause the illness in some individuals. In this section, the
main etiological theories of schizophrenia are examined.
Schizophrenia represents a daunting challenge for genetic researchers
for several reasons: the paucity of extendedmultigenerational family histories containing
large numbers of affected individuals; the possibility of genetic
heterogeneity, such as more than one phenotype or more than one genetic
vari-ant; and a lack of agreement on the mode of transmission. The fo-cus of
research has shifted to multiple genes of small to moderate effects which may
compound their effects through interactions with each other and with other
nongenetic risk factors.
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