The Neuroproteomics Laboratory at the Institute of Biology (IB) is one of the bodies at Unicamp that routinely studies schizophrenia. But it's not the only one. This Thursday (24), a group of researchers from different areas met in the institute's congregation room to deliberate on the matter, at the invitation of this laboratory.
The activity was part of World Schizophrenia Day, which seeks to raise awareness in society about the challenge of treating the disease and offering care to those suffering from it. "This year the campaign's motto is 'What can I do?'. This question provokes reflection, given that schizophrenia affects 1% of the world's population", highlighted researcher Valéria de Almeida, from the Neuroproteomics Laboratory.
According to her, the date also aims to reduce stigmas, create opportunities for overcoming challenges for these patients, highlight issues that deal with their insertion in the job market and increase the level of hope. These strategies can help improve the quality of life of people with schizophrenia, she believes, despite this being one of the most serious mental disorders in psychiatry.
At the Neuroproteomics Laboratory, led by Professor Daniel Martins de Souza, the research group has focused particularly on the issue of disease mechanisms and treatment advances. “We intend to take this awareness beyond our benches", he highlighted.
According to the World Health Organization (WHO), schizophrenia is the third leading cause of loss of quality of life in people aged between 15 and 44 years. “Its pathophysiology is extremely complex and it is in this scenario that the IB Laboratory has been working”, said the researcher.
Several lines of research in the group carry out studies on schizophrenia using proteomics as a tool. “We use pre-clinical models with different types of cells, including stem cells from patients, to try to better understand schizophrenia. We also employ some lineages, such as oligodendrocytes, responsible for producing myelin in the central nervous system. These cells are manipulated in different ways, through treatments and through molecular and cell biology manipulations”, he revealed.
Valéria informed that there is currently research related to the attempt to search for biomarkers, that is, protein profiles that can be modified depending on the response to treatment. “We have samples obtained from patients treated with antipsychotics and we are trying to discover how these proteins can be modulated, which are capable of predicting a good or bad response to antipsychotic treatment. We are at the beginning, but we hope to one day contribute to psychiatrists regarding these tests.”
The researcher described that there are several other approaches, such as studies postmortem, from brain regions of patients with schizophrenia, and this has contributed greatly to revealing some pathways, processes that may be implicated in the pathophysiology of schizophrenia. “We have studied the most peripheral part. Some of our research will try to understand how clozapine, an antipsychotic, can cause agranulocytosis (absence of certain white blood cells, neutrophils, which are part of the body's defense system against diseases) and try to improve the profile of this drug in the future. ”
Psychiatry
Unicamp HC psychiatrist Paulo Dalgalarrondo, present at the IB event, spoke about “Phenomenology of schizophrenia and psychopathological changes”. He has worked on the issue of schizophrenia for over 35 years at the University.
The professor, who belongs to the Faculty of Medical Sciences (FCM), praised the performance of the IB Neuroproteomics Laboratory. “Your work is cutting-edge and we would like to get closer to you to do collaborative research. We don't have contact with the benches, but we really value it and know how important this work is to better elucidate schizophrenia. Scientific knowledge on the subject will certainly allow better care and more effective treatment for these patients”, he stressed.
He commented that the HC Psychiatry Ward currently serves mainly acute cases of schizophrenia and that the Outpatient Clinic, which takes place on Tuesday afternoons, generally treats patients with very serious conditions. “As we are a tertiary level hospital, the patients who go to Unicamp are those who cannot be treated in primary, basic care.”
According to the psychiatrist, patients with schizophrenia continue to face strong social stigma. “He is popularly known by pejorative expressions such as crazy, person who says and does nonsense things, crazy, crazy. These are terms that are inappropriate, as they are disrespectful to this patient, who suffers a lot.”
Schizophrenia is a serious mental disorder, he said, like autism spectrum disorders, which are the most serious in psychiatry and behavioral medicine. The individual presents behavioral changes and changes in contact with reality. The most characteristic symptoms are mainly auditory hallucinations. These patients hear voices that comment on what they do, that belittle them, that threaten them, that order them to do things.
They also suffer from delusions, which are false ideas, false judgments. They think their neighbors want to kill them, some think their parents are putting poison in their food, they think their co-workers are talking bad about them. They have changes in thinking and behavior. They become disorganized, confused, and their speech cannot always be understood. Affection can also change. As a result, the individual may experience emotional withdrawal and become isolated.
The doctor clarified that schizophrenia is a heterogeneous disorder and that this term was coined by the Swiss psychiatrist Eugen Bleuler (1857-1939), with a predominance of loss of associations and internal mental organization of behavior. "It is a split in the various aspects of behavior, a loss of the internal harmony of the psyche", he pointed out.
Bleuler even used the term schizophrenia because, in his opinion, it was not a single disease. It was a group of diseases whose manifestation is schizophrenia. They involve various types of early or fetal brain involvement, with genetic involvement as well.
According to Paulo Dalgalarrondo, the disease usually evolves into a chronic condition. Individuals experience a flare-up of schizophrenia in their early 20s. Most do not have the possibility of a cure, and outbreaks recur. “This pathology can be disabling. Many patients do not have a return to social life and work, becoming dependent on their family or state organizations”, he said.
Work, study, personal relationships and self-care can also be seriously impaired. Around 2/3 of patients develop significant psychosocial difficulties: 1/3 develop very severely, 1/3 develop a little better and 1/3 intermediately.
The doctor highlighted that schizophrenia is a clinical syndrome that affects perception, thinking, will, mood and personality, deeply affecting the psyche. It usually appears in adolescence or youth (63% before the age of 30) and more rarely in childhood.
When having outbreaks, the individual becomes quite disturbed, hallucinating and delirious. It improves within one to two months, but remains with residual symptoms such as emotional detachment and social isolation. “Evolution is often deteriorating. The distribution between sexes is balanced, but it has a slower evolution for women and later,” she highlighted.
Read more about advances in schizophrenia at Journal of Unicamp.
