A string of violent tragedies have plagued the U.S. over the past few years. In many cases, the perpetrator has been a young man who, prior to the event, had demonstrated unusual behavior or disordered thought processes, such as social isolation, paranoia, or hallucinations.
Indeed, the backgrounds of many assailants suggest the diagnosis of schizophrenia, a mental disorder that affects almost 1% of the adult population and which most often presents during the late teens or twenties; the incidence of schizophrenia is about 3 per 10,000 individuals but its chronicity leads to a relatively high prevalence in human society. Though the specific etiology of schizophrenia has not been determined, it is thought that a group of defective genes result in both biochemical and structural changes in the brain, leading to the symptoms mentioned above; men and women are equally affected though the disease tends to develop earlier and is often more severe in males. While these genetic defects are usually inherited (the identical twin of a patient with schizophrenia has a 50% chance of developing the disorder), they may also result from spontaneous gene mutations and might act in concert with environmental factors (e.g. malnutrition, viruses, toxin exposure) to produce the mental illness. Current therapy involves the use of drugs that ameliorate the biochemical defects in the brain but the potential for gene-based therapy is on the horizon.
A crucial factor in the early diagnosis and management of schizophrenia is the willingness of family and friends to seek medical help for the individual when behavioral or psychological changes are first noticed. Of course, since the disease presents in the late teens or early adulthood, subtle signs may be difficult to distinguish from the emotional lability so common in this age group; any evidence of paranoia, hallucinations or delusional thoughts, however, should prompt immediate referral to a mental health professional. If individuals with schizophrenia are diagnosed at an early stage and receive proper psychiatric treatment, they rarely indulge in violent behavior; unfortunately, for a variety of financial, political and cultural reasons, a significant percentage of patients never receive adequate therapy.
