My husband was recently diagnosed with schizophrenia. In addition to being concerned about him, I’m concerned that someday our two young children might have this disease. What are the chances they will inherit the illness and what kind of advances are being made toward treatment and early detection?

Only one out of every ten children of a schizophrenic parent will develop schizophrenia. The risk of 10% is greater than the frequency of schizophrenia in the general population, which is about 1%. Therefore, schizophrenia is more frequent in some families than others, but fortunately, most children of schizophrenic parents are completely normal. One of the enduring mysteries of this disease is that genes alone do not explain who gets ill. For example, identical twins have all their genes in common. However, if one is a schizophrenic, only half of the co-twins gets the same disease. About 40% of the co-twins of a schizophrenic live completely normal lives without disease. Much research is going on to discover more about how genes and life events influence who gets sick with schizophrenia. At Washington University, we are studying what causes the development of illness in families where two or more siblings have already been diagnosed as schizophrenia. Four specific genes have already been discovered that increase the risk of illness by influencing the level of a particular chemical that is crucial for communication among cells in the brain. This chemical is called glutamate. The discovery of other genes is expected from on-going research sponsored by the National Institute of Mental Health. When a person is affected with schizophrenia, they have hallucinations (such as hearing voices when no one is present) and delusions (such as a false belief one is being persecuted or controlled by unseen forces). Research has shown that drugs like PCP block glutamate’s ability to send messages in the brain. If a person without schizophrenia takes a drug like PCP, they temporarily develop the same symptoms that a person with schizophrenia person has without taking PCP. If a person with genes that make them particularly vulnerable to schizophrenia takes a drug like PCP, then they can get very sick with schizophrenia for long time. Some people have so many genes that make them vulnerable to schizophrenia that they get the disease even without taking any drugs like PCP. Improvements are being made in medications used to treat schizophrenia. Without effective treatment with medications prescribed by a psychiatrist, most people with schizophrenia are unable to function well in school, work or marriage. New medications are available now for treating schizophrenia with little or no risk of the side effects seen with older drugs like haloperidol (Haldol). Decisions about medication must always be made in consultation with your personal physician. The recent discovery of specific genes that cause schizophrenia is being used to develop even better medications. Gene testing is not yet available to measure the risk of a particular person. However, families in which two children have already gotten schizophrenia can help to speed up the progress in understanding this devastating disease by participation in on-going research sponsored by the National Institute of Mental Health. Interested families may contact Art Schaffer at (314) 286-1506 or toll free at 1-888-925-7252 to discuss their interest in helping.

C. Robert Cloninger, MD
Wallace Renard Professor of Psychiatry & Genetics
Director, Sansone Family Center for Well-Being
Washington University

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