Stating that schizophrenia, which is one of the diseases that are difficult to treat in psychiatry, is a disease with a similar frequency all over the world, Psychiatrist Prof. Dr. Nevzat Tarhan said that new information about the disease has emerged thanks to the innovations in the field of medicine. Drawing attention to the importance of early treatment in schizophrenia, Tarhan said, “Timely and strong treatment is important. If it is poorly treated, it is suppressed, but because it is not fully controlled, the disease becomes chronic.” warned. prof. Dr. Nevzat Tarhan pointed out the importance of environmental support and rehabilitation process in the treatment process. Stating that addictive substances, some drugs used in the treatment of attention deficit, can trigger schizophrenia if the person has a genetic predisposition, Tarhan said, "In particular, drugs that increase dopamine should be used under the supervision of a doctor." Üsküdar University Founding Rector, Psychiatrist Prof. Dr. Nevzat Tarhan made evaluations about schizophrenia.
Its incidence is similar in the whole world and culture.
Noting that schizophrenia is the most difficult disease in the main treatment in psychiatry, and is encountered with similar frequency in the society and all over the world, Prof. Dr. Nevzat Tarhan said, “In a city of 100 thousand people, there are 80 cases of schizophrenia every year. On average, this figure corresponds to about 1 percent. The fact that it is similar in all cultures all over the world gives an important idea about the genetics of the disease.” said.
A lot of genetic research is being done.
Stating that very serious genetic research has been carried out on this disease in recent centuries, Prof. Dr. Nevzat Tarhan said, “Currently, there are target genes identified in schizophrenia. We are currently investigating those target genes in patients for scientific purposes. To determine the prevalence, if the person has a target gene, that gene is being investigated. There may also be target genes in diseases such as autism and bipolar. If there are those target genes, there is a different outcome related to the disease and the treatment. It's different if the target gene isn't there." said.
Genetic treatments being researched
Stating that genetic treatments have emerged in the fight against many diseases, Prof. Dr. Nevzat Tarhan said, “You determine the target gene, a virus is loaded with harmless viruses called adenoviruses. A gene carrier is created to change that gene. We inject this protein or the virus that corrects that gene into the body. The virus goes away and binds to that gene. It inhibits the gene from working. That technology (MRNA). There is a separate laboratory for these treatments, a stem cell laboratory. As Üsküdar University, we have established transgenetic cell laboratories within our body.” Stating that MRNA technology, which came to the fore in the fight against the pandemic, is now on the agenda for the treatment of psychiatric diseases, Prof. Dr. Nevzat Tarhan said, “We will first perform a gene scan on the person using that technology. A system that screens for disease-specific genes in humans. It is aimed to screen only genes that are outside of the common genes in all humans, namely genes that produce faulty proteins. In such cases, it gives us genetic clues to schizophrenia.” said.
Schizophrenia means split mind
Pointing to the meaning of the word schizophrenia, Prof. Dr. Nevzat Tarhan said, “Schizo is a word that means splitting, splitting, fragmentation. Fren also means mind. It's a beautiful term, like splitting the mind. It expresses well. Greek origin. At the beginning of the 20th century, this definition was accepted and it has not been changed and continues today.” said.
There are three realities: dream, fantasy, and the real world.
Stating that human beings normally have three realities, Prof. Dr. Nevzat Tarhan said, “It is a dream reality. In the dream, we are in a different world. One is flying there, traveling the worlds, fighting, doing things, turning. When we wake up, we say it was a dream. We have a dream reality. They call it daydreaming. A person who dreams during the day. It happens a lot in children and adolescents. He dreams, he thinks about something. He always has a purpose, he tries to do something accordingly. When anything happens after that, he says, it's a dream, it goes back to the real world.” said.
People with schizophrenia have difficulty distinguishing
Noting that the real world is the world we live in, Prof. Dr. Nevzat Tarhan said, “There are things that people will and will not do. There is a familiar world created by reasoning. This is real reality. The other is imaginary reality. It is physical, imaginary and dream reality. People with schizophrenia have a disorder of distinguishing between these three. A healthy brain has a reality testing network called reality testing. It's real, it's not real. The dream makes the distinction, not the dream.” said.
John Nash is a prime example
Stating that there are schizophrenic individuals known worldwide, Prof. Dr. Nevzat Tarhan said: “It is not easy to diagnose schizophrenia. A very famous case known as schizophrenia is described in the movie Beautiful Mind. American mathematician John Nash, Nobel Prize laureate and Abel Prize winner, is a brilliant professor of mathematics but somehow produces faulty proteins due to faulty genetic structure in the brain. When the wrong protein is produced, the brain produces images, dreams and sounds. That person produces something, first believes in it. He's trying to banish the voices. He talks to himself while doing this. This man is dreaming and is hospitalized, saying he has schizophrenia, but because he is a smart person, after a while, after a few treatments, he is interested in mathematics when he is fine. He then looks that these are hallucinations. Those hallucinations come while studying math. There are three people. A man, a woman and a child are saying something to him. She doesn't care at all. He continues his work. Then schizophrenia ends. This person is called schizophrenic. In fact, this is our current new treatment approach. After realizing that schizophrenia is a recording and perception disease in the brain, we started to focus on this in treatment. Whether the person does a reality test or not. Hallucinations occur when the brain produces faulty protein. It produces false delusions. The person has to decide that it is not real about him. Once you teach this, schizophrenia ends. In intelligent people, the disease is easily defeated.” Stating that better psycho-social psychoeducation can be done with people with high IQ in coping with the disease, Prof. Dr. Nevzat Tarhan said, “These people learn to do reality testing more easily. When he learns, he enters the healing period of the disease.” said.
Producing faulty protein is prevented by drug treatment
Stating that the need for serotonin and dopamine increases when there is a certain stress and a certain environment in the determined genes in the brain, Prof. Dr. Nevzat Tarhan said, “These two important chemicals activate that gene that is normally dormant in that person and start to produce faulty protein. The faulty protein also disrupts brain chemistry. When brain chemistry deteriorates, one's judgment deteriorates. We are currently aiming to correct this situation with medication. Defective expression of the gene is suppressed by drugs. It is prevented from producing faulty protein.” said.
Early and vigorous treatment is important
Drawing attention to the importance of early treatment in schizophrenia, Prof. Dr. Nevzat Tarhan said, “Timely and strong treatment is important. If it is poorly treated, it is suppressed, but because it is not fully controlled, the disease becomes chronic. For him, strong, comprehensive and early treatment is very important in schizophrenia. After that acute period passes and that chemical storm in the brain is resolved, social adaptation and rehabilitation studies are now carried out on the person.” said.Prof. Dr. Nevzat Tarhan stated that there are very important rehabilitation centers in this area in Europe and said that unfortunately, rehabilitation centers in this area could not be established in our country.
Drug rejection is common in patients with schizophrenia.
Noting that rehabilitation centers make very important contributions to the recovery of the patient, Prof. Dr. Nevzat Tarhan said, “The mental health centers established and serving in our country have been very useful, but they are not enough. It has become very difficult to control many diseases. Especially in schizophrenia patients, drug rejection is very common. Since there is no awareness of the disease, the person does not accept his own disease. For him, he sees every treatment method as an enemy. Schizophrenia may be behind the violence against many physicians. Thinking, 'They will put me in the hospital, they will hurt me, they will kill me, they will rape me', they attack anyone in a white coat. Therefore, the approach to these patients is very different and important.” said.
Dopamine-enhancing drugs should be used with caution.
Noting that addictive substances and some drugs used in the treatment of attention deficit can trigger schizophrenia if the person has a genetic predisposition, Prof. Dr. Nevzat Tarhan said, “It is very important to use drugs especially under the supervision of a doctor. Drugs that increase dopamine should be used with extreme caution. Too much dopamine in the brain means that if the person has a susceptibility gene, it causes schizophrenia. Dopamine is the reward chemical of the reward/punishment system in the brain. The brain secretes too much dopamine in schizophrenia.” warned.
People with schizophrenia make their love investment only in themselves
Referring to the main symptoms of schizophrenia, Prof. Dr. Nevzat Tarhan said, “Dereistic thinking style is autistic lifestyle. Dereistik is used to mean a way of thinking that does not fit the truth. Freud says that children with autism first love and admire themselves first when they are born. The child just says 'me and my mother' without learning about life. He is investing love in his ego. Later, as he grows up, he invests in love to his father, family, friends, country, country, and as he grows and matures, he makes mental and emotional investments in the universe, existence and creator. People with schizophrenia do not invest their love in others either. It just turns it on itself.” Stating that schizophrenia patients experience changes in emotions, thoughts, behaviors and lifestyles from time to time, Prof. Dr. Nevzat Tarhan said, “There may be emotional changes. Some have enthusiasm, some types of schizophrenia have introversion, some types of schizophrenia have obsession, some have skepticism. Others are disconnected from everything. In the cases we call disorganized schizophrenia, nonsense speech can be seen. Various examples are seen in the world from time to time, mass suicides may occur.” he said.
Treatment methods for schizophrenia have advanced a lot.
Stating that the treatment of schizophrenia has progressed a lot today, Üsküdar University Founding Rector, psychiatrist Prof. Dr. Nevzat Tarhan said, “Medicine has made significant progress in this sense. 3/1 of cases get better, 3/1 of cases don't get better no matter what you do. The other 3 in 1 come to what we call social healing, they have been using drugs for years. Therefore, it takes time to diagnose schizophrenia. The case cannot be called schizophrenic at a glance. Just having a thought disorder is not enough for the diagnosis of schizophrenia. Emotional, thought and behavioral disorders should also be accompanied. The person's social harmony is impaired. Environmental support is also important in individual psychotherapy in treatment. For example, in many cases of schizophrenia, the environment becomes constructive. Because it is constructive, it can watch schizophrenia without relapse. Medicine in the treatment of schizophrenia is more advanced than before. Now that many of the brain's secrets are understood, no one should label schizophrenia as incurable." said.