Schizophrenia May Be an Autoimmune Condition

[ ♪INTRO ] The World Health Organization estimates that
schizophrenia affects 20 million people worldwide. Other sources suggest that the actual number
is three or more times that. And people with schizophrenia are two to three
times more likely to die prematurely, largely because of preventable illnesses and suicide. So it’s considered a serious global health
issue. Medications and treatment programs can help
people, but they don’t always. And while they can relieve symptoms, they
cannot cure them. The thing is, it’s proven hard to develop
better treatments because, well, we don’t actually know what schizophrenia is. We don’t know how it develops, or what exactly
causes it. But a hypothesis that the immune system is
a major player has been gaining traction. And if it’s right, it could give doctors
new ways to treat schizophrenia, or even prevent it from developing in the first place. People with schizophrenia have a different
interpretation of reality than most of us – they experience hallucinations, delusions,
and disruptions in typical thought processes. And though there’s no medical test that
can confirm a person has schizophrenia, there tend to be some structural differences in
the brains of people who receive the diagnosis. In particular, several regions vary in size
from what’s expected. And initially, scientists thought that such
abnormalities were neurodevelopmental — meaning, they grew that way in utero and during childhood. Though, some scientists thought they might
be neurodegenerative instead — the result of deterioration of brain tissue later on. And over the past fifteen years or so, the
scales have been slowly shifting that way. Some research suggests that both processes
are involved. But the increased emphasis on the role of
degenerative processes has brought a decades-old hypothesis back to the forefront. See, if schizophrenia arises or progresses
because of a loss of brain tissue, then the question becomes why that tissue is disappearing. And growing evidence suggests that may be
the result of a person’s immune system attacking their brain. In other words, schizophrenia may be an autoimmune
condition. There’s lots of evidence that the immune
system is somehow involved in at least some schizophrenia cases. Like, the symptoms of schizophrenia are often
tied to inflammation, one of the ways the immune system can try to thwart what it sees
as unwelcome guests in the body. Inflammation isn’t bad, per se. It can be part of a healthy immune response
to pathogens. It’s just that you don’t want too much
of a good thing. And that seems to be what’s happening. People with schizophrenia have higher levels
of inflammatory markers in their blood, for example. Whether that’s because inflammation causes
schizophrenia or the other way around isn’t clear. But some experts believe that inflammation
in the body could signal changes to the brain which, in turn, trigger or exacerbate schizophrenia
symptoms. That may also explain why infections in general
increase the likelihood of someone developing schizophrenia. Infections can result in the blood-brain barrier
becoming permeable, allowing inflammation into the brain. Like, a 2011 study that looked at over three
million people in Denmark found that being hospitalized for an infection increased a
person’s risk of developing schizophrenia by 60%. And infections have been known to trigger
autoimmune conditions, too. In fact, in that same 2011 study, people who
were hospitalized for an infection and had had an autoimmune condition at some point
were more than twice as likely to develop schizophrenia. And by itself, having an autoimmune condition
increased the risk of schizophrenia by 29%. That’s a common theme. Decades of research has found a lot of overlap
between schizophrenia and autoimmune diseases. Though there are some notable exceptions,
overall, the likelihood of developing schizophrenia is higher in people with autoimmune disorders,
and vice versa. Even having a parent or sibling with an autoimmune
condition can raise a person’s risk of schizophrenia by 20%. And as far back as the 1970s, doctors noticed
that people with schizophrenia have a lot of central nervous system autoantibodies,
or antibodies that bind to their own cells in their brain and spinal cord. These are a hallmark of certain kinds of autoimmune
disease. So it may be that the symptoms of schizophrenia
also stem from the immune system attacking the body — or, in this case, immune cells
in the brain overstepping. Multiple studies have noted that the central
nervous system’s immune cells, called microglia, tend to be more active in people with schizophrenia. And among other things, these cells play a
huge role in synaptic pruning — the process by which the brain eliminates unneeded connections. Pruning happens to all of us, but it seems
like the brains of people with schizophrenia prune more than they should, which may explain
why some parts end up smaller. And researchers might finally be zeroing in
on exactly what triggers microglia to get so snippy. A January 2020 study in mice found that coaxing
cells to overproduce one protein in the complement system — a part of the immune system that
boosts the response to pathogens — was enough to send microglia into overdrive. That led to overeager synaptic pruning and
schizophrenic symptoms. There may be more than one thing that sets
microglia off, of course. Which is why a person’s immune system, genes,
developmental conditions in utero, and reaction to psychological stress can all converge to
trigger the condition. But, the connection between autoimmunity and
schizophrenia is pretty convincing. And if an overactive immune system is a big
part of schizophrenia, then effective treatments could lie in getting it to calm down. For instance, scientists are already trying
to figure out whether therapies that target autoantibodies in the brain can help people
with schizophrenia. And it turns out that NSAIDs — pain relievers
and fever reducers that also reduce inflammation — can help treat the symptoms of schizophrenia
in tandem with traditional antipsychotic medications. Eventually, we may even be able to predict
who will develop schizophrenia based on immunological markers — or prevent symptoms from developing
altogether. In the meantime, just knowing about the overlap
between autoimmunity and schizophrenia could make a big difference. The authors of one study urged clinicians
not to automatically dismiss complaints that might be symptoms of autoimmune disease as
hallucinations or delusions. And hopefully, the more we unravel the role
of autoimmunity in schizophrenia, the better equipped we’ll be to help tens of millions
of people worldwide. Thanks for watching this episode of SciShow
Psych! If you’re hungry to learn more about autoimmune
conditions, you can pop over to our main SciShow channel to watch our episode explaining why
they’re more common in women. But don’t forget to click that subscribe
button and ring the notification bell first! Here on SciShow Psych, we’re all about brains
— so if you want to understand yours a bit better, you won’t want to miss an episode. [ ♪OUTRO ]

47 thoughts on “Schizophrenia May Be an Autoimmune Condition

  1. This is an extremely important topic. I have some minor inflammatory issues currently affecting my skin, but my mother has schizophrenia. I always wondered in inflammation and immune issues played a part.

  2. If true, this would change the current treatment paradigm of 1st and 2nd generation antipsychotics; that's awesome.

    Edit: oof I just want to make a small suggestion for a correction: microglia is said like "My-Crow-Glee-Yuh

  3. This is so interesting. The idea that this may not even be a mental disorder is revolutionary for helping people with schizophrenia, but helping destigmatize the disorder as a whole. I really hope there’s new developments in this and that we’re closer to helping people who have, in my opinion, one of- if not the most crippling disorders.

  4. There is one simple but dangerous experiment to test the hypothesis, and if it is correct to also cure schizophrenia, knock out the person's immune system and replace it with a new once via a bone marrow transplant.

  5. Depression also is tied to inflammation in the brain. Maybe the neurodegeneration of various parts also link to brain inflammation

  6. Oh God oh God oh God I have IBD but 10 years ago I was diagnosed with schizo it's bad enough my immune system has been eating my gut but now my immune system is eating my brain WTF WTF

  7. Interesting and worthwhile video. Be sure to download the supporting scientific papers linked with the video.

  8. Hopefully, by unearthing the mechanisms behind delusions, we can find a cure for the liberals that think their brain knows their gender more than their groin.

  9. This is really fascinating!! As someone with multiple autoimmune conditions, I'm glad modern medicine is continuing to look into these factors. The immune system is complicated, and we barely understand how the human brain even works, so I wouldn't be surprised.

    I have narcolepsy and a few recent studies have hypothesized that it may actually be an autoimmune condition. I caught H1N1 when I was 16yrs old and got extremely sick. Almost immediately afterwards, I suddenly developed GI symptoms. A few weeks and a few tests later, I was diagnosed with severe ulcerative colitis (a type of IBD similar to chrons disease). Nobody else in my family has any autoimmune conditions.

    I've spent the last decade battling chronic illness and ended up having multiple major surgeries since the meds didn't work. My narcolepsy symptoms started in childhood but I wasn't diagnosed until a few years ago. My GI doctor is the one who first told me the theory that infections can trigger autoimmune conditions. Many systems in the body are connected in ways we don't fully understand!

  10. Wow. My daughter is Schizoaffective, and she was recently diagnosed with an autoimmune disorder (we think it may be RA, we're going to the rheumatologist soon). This is eye opening.

  11. I don't know I have schizophreniaand like I get really bad headaches right before hardcore hallucination set in or when the voices start to go out of control so I guess yeah me and I have to take Tylenol to get my headache to go away I'm not medicated my state will not approve me for disability so I can't get the medication.

  12. So do they think the same of depression and GAD? Because I had an MRI for unrelated reasons and it showed my frontal lobe was very aged up. I've had depression and GAD my entire life, and I've read papers on how those conditions affect brain structure.

  13. Pregnant women with low vitamin D levels tend to drive it. That or mutations that interfere with normal processing of vitamin D.

  14. there's some influenza strain that does seem to trigger an auto immune response against the brain even after the influenza symptoms are long gone

  15. My great-uncle had paranoid schizophrenia, and there are autoimmune diseases all over that side of my family—ulcerative colitis, lupus, etc.

  16. There are quite a few antioxidants that cross the blood brain barrier including:
    DHA a s EPA Omega 3
    Procyanadin (OPC)
    Quercetin and related compounds
    EGCG and l-theanine
    Magnesium l-threonate
    Gingko Biloba
    And most nootropics

  17. Schizophrenia tends to manifest at ages of 18 and 40. This would indicate that the disorder was not purely auto-immune.

  18. I take a ton of meds and have remicade infusions every 6 weeks due to my UC (autoimmune disease) I wonder if similar treatment could help with schizophrenia then? I know in addition to my main illness it helps with my psoriasis and arthritis

  19. Wow. I work in law enforcement, so I deal with folks dealing with this. This is huge. I really hope we can make some headway through this.
    Is there any word on the worm studies about auto-immune disorders they had been doing? I have a coworker who has Crone's and when she's feeling bad, I always offer her some tasty tasty worms.

  20. I’ve never heard microglia pronounced with the accent on the o before. I’ve always heard it pronounced with each of the i’s accented. I guess it’s like “metrocity” in Megamind.

  21. It’s micro-glia (my-crow-glee-ah). I could forgive it the first time but as someone studying neuroscience it got really grating :/

  22. Anthony is quickly blossoming into one of the best hosts on this channel – very exciting! (Please give him the support in preproduction with pronouncing unfamiliar words).

  23. 3:00 i have a bit of constructive criticism for Anthony, if that's okay… 60% is a really startling amount of correlation, so it probably should have been emphasized, as opposed to being the quietest part of that statistic. if anything, Hank probably would've gone off-script and briefly quipped something like "holey headmeat, batman! i think i get why we're making this video now" though i'm not saying that you should pause and do a quip; thats his thing, not necessarily yours lol

  24. This can also explain why chronic marijuana use can trigger schizophrenia as the body is responding to changes in synapses and the high levels of toxins introduced into the body.

  25. Working nights in a mental health facility, I'll say the most common thing I see between patients with the traits associated with schizophrenia is sleep disruption, or lack of sleep. Once people have come in, it's not uncommon for them to have been up for over a week without ever even trying to sleep. We'll get people who insist that they need no more than 2 hours of sleep a day, and will do everything to fight going to sleep. This isn't 100%, but usually when people do not benefit from sleep while showing signs of schizophrenia they wind up having bipolar disorder. I believe we will not get a proper grasp of what's going on with patients who present symptoms of schizophrenia until we explore the correlation between it and sleep disruption. It could be autoimmune, it could be a development in utero, but all of it has something to do with sleep. We have patients who fit the schizoaffective guidelines who will be at our facility for days, weeks, even months, without ever sleeping more than 3 hours a day. We've had patients who have never slept more than a half hour a day. The brain is not designed to function like that. Every single one of them insist that they don't need to sleep.

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