Biopsychosocial Model of Schizophrenia: Causes and Treatment

Introduction

Schizophrenia can be a debilitating condition that adversely affects the quality of life of sufferers and their families. Clinicians in some parts of the world view schizophrenia as a brain disease that is incurable, while most practitioners in the Western world view the condition as having a genetic or organic basis that can be successfully treated with prescription medications and psychosocial interventions. To address this complexity, this paper provides a review of relevant peer-reviewed and scholarly literature concerning schizophrenia using a biopsychosocial model. The review includes evidence supporting brain localization for schizophrenia, the genetic factors in the onset of this disorder, and an evaluation of the environmental factors that contribute to its onset.

Review and Discussion

On the one hand, some researchers have suggested that schizophrenia is a disease of the brain that is common to all human societies and that it is a chronic condition without a cure (Saleeby, 2001). On the other hand, other researchers maintain that the condition is a cultural product that carries significant positive effects in certain contexts. For instance, Saleeby emphasizes that "in some cultures, schizophrenia is regarded as bringing uncommon insight and power [and] as a connection to a supernatural world, or a temporary alteration of the senses and consciousness that brings with it special acumen into the very nature of things" (p. 54). From a biopsychosocial perspective, schizophrenia exists somewhere along a continuum between these two extremes. In this regard, Grover and Trevini (2014) report that a biopsychosocial view of schizophrenia is that it is "often a chronic, disabling condition, associated with impairments in multiple domains of functioning" (p. 119).

Given the significant impairments that can occur across multiple domains associated with schizophrenia, the biopsychosocial model would appear to represent an optimal framework for formulating efficacious interventions. However, some authorities argue that the condition requires a more holistic approach to treatment than the biopsychosocial model provides. According to Gallagher (2014), the biopsychosocial model maintains that mental disorders have genetic or organic roots and stresses the importance of both pharmacological and psychosocial treatments, but does not fully account for other life factors. The conventional interventions for schizophrenia — based on the biopsychosocial model — include pharmacological and psychosocial elements as well as family interventions (Grover & Truvini, 2014). As Grover and Truvini point out, however, "this model of schizophrenia does not take into account the religious beliefs of the patient. However, religion and spirituality exert a significant role in the lives of people with schizophrenia" (2014, p. 119).

Notwithstanding this limitation, the biopsychosocial model does take into account environmental factors that may exacerbate the schizophrenic condition. Bemak and Epp (2007) report that "schizophrenia as a biopsychological model goes beyond current biological etiology and considers psychosocial stressors that exacerbate this condition" (p. 14). Based on their analysis of environmental stressors and schizophrenia, Bemak and Epp found that high levels of dopamine may exacerbate schizophrenia by inciting psychological stress. This process results in what these researchers term "loosened thought" that "contributes to the mind-body interaction and, at times, creative processes" (p. 15). This finding is highly congruent with the view of schizophrenia as an enabling condition in some cases, as described above. Irrespective of the pharmacological intervention used, Bemak and Epp conclude that "psychotherapeutic interventions are considered indispensable to the treatment of schizophrenia" (2014, p. 19).

Similarly, Farmer and Pandurangi (1999) cite the usefulness of the biopsychosocial model in developing a more informed understanding of the etiology of schizophrenia — one that can help practitioners develop effective interventions. Farmer and Pandurangi emphasize that "in the area of major mental illness, specifically schizophrenia, excluding biological or neurological factors from research is a liability for research and clinical efforts because schizophrenia is such a complex biopsychosocial phenomenon" (1999, p. 110). Because schizophrenia can be a debilitating condition if left untreated, recognizing the multifaceted nature of the disease represents an important element of both diagnosis and treatment.

Although there are organic sources of schizophrenia, there are also genetic sources that can increase an individual's risk of developing the condition. Farmer and Pandurangi add that the vulnerability-stress model holds that rather than inheriting the disease itself, the vulnerability for schizophrenia is what is inherited. This genetic predisposition places some individuals at much higher risk of developing a clinical case of the condition. Farmer and Pandurangi conclude that "vulnerability, in combination with relevant stressors, leads to the development of symptoms of schizophrenia" (1999, p. 112). The biopsychosocial model thus provides a comprehensive view of the condition that accounts for a wide range of contributing factors. As Farmer and Pandurangi emphasize, "this perspective integrates biological characteristics with psychological and social aspects of human behavior, providing a biopsychosocial understanding of the variables that lead to a schizophrenic illness" (1999, p. 112).

Conclusion

The research showed that from a biopsychosocial perspective, schizophrenia is considered to have genetic or organic roots, and the condition can be successfully treated using a combination of prescription medicines and biopsychosocial interventions. The research also showed that while there is no universal consensus on this perspective — with some researchers viewing schizophrenia as an incurable "brain disease" — the biopsychosocial model provides a useful framework for better understanding the etiology of the condition and for formulating optimal clinical interventions. The growing body of evidence concerning the brain localization of schizophrenia contributes further to this understanding. In the final analysis, it is reasonable to conclude that the biopsychosocial model represents a useful and evidence-based approach for clinicians who treat patients with schizophrenia.