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The World Health Organization estimates that schizophrenia affects 20 million people worldwide.
世界卫生组织估计，精神分裂症影响全世界二千万人。
Other sources suggest that the actual number is three or more times that.
其他资料显示，实际数字是该数字的三倍或更多。
And people with schizophrenia are two to three times more likely to die prematurely, largely because of preventable illnesses and suicide.
精神分裂症患者过早死亡的可能性是正常人的2到3倍，主要是因为可以预防的疾病和自杀。
So it's considered a serious global health issue.
所以，它是一种严重的全球性健康问题。
Medications and treatment programs can help people, but they don't always.
药物和治疗计划能帮助患者，但并不总是如此。
And while they can relieve symptoms, they cannot cure them.
虽然这些可以缓解症状，但却无法治愈。
The thing is, it's proven hard to develop better treatments because, well, we don't actually know what schizophrenia is.
事实证明，很难开发出更好的治疗方法。因为，我们实际上并不知道精神分裂症是什么。
We don't know how it develops, or what exactly causes it.
我们不知道它的发展机制，也不知道确切的病因。
But a hypothesis that the immune system is a major player has been gaining traction.
但是，一种认为免疫系统是主要因素的假说越来越受到重视。
And if it's right, it could give doctors new ways to treat schizophrenia, or even prevention from developing in the first place.
如果这种说法正确，它可以给医生提供治疗精神分裂症的新方法，甚至可以从一开始就预防该病的发展。
People with schizophrenia have a different interpretation of reality than most of us– they experience hallucinations, delusions, and disruptions in typical thought processes.
精神分裂症患者对现实的理解与大多数人不同，他们在典型的思维过程中会产生幻觉、错觉和混乱。
And though there's no medical test that can confirm a person has schizophrenia,
尽管没有医学测试能证实一个人患有精神分裂症，
there tend to be some structural differences in the brains of people who receive the diagnosis.
但在接受诊断者的大脑中往往存在一些结构上的差异。
In particular, several regions vary in size from what's expected.
特别是，有几个区域的大小与预期不同。
And initially, scientists thought that such abnormalities were neuro developmental meaning,
最初，科学家们认为这些异常具有神经发育的意义，
they grew that way in utero and during childhood.
它们在子宫内和童年时期都这样生长。
Though, some scientists thought they might be neurodegenerative instead - the result of deterioration of brain tissue later on.
尽管如此，一些科学家认为它们可能是神经退行性变，这是后来脑组织退化的结果。
And over the past fifteen years or so, the scales have been slowly shifting that way.
在过去15年左右的时间里，其大小一直在缓慢地转变。
Some research suggests that both processes are involved.
一些研究表明涉及两个过程。
But the increased emphasis on the role of degenerative processes has brought a decades-old hypothesis back to the forefront.
但是，对退行过程作用的日益重视把一个几十年前的假说重新带回到人们眼前。
See, if schizophrenia arises or progresses because of a loss of brain tissue,
如果精神分裂症的发生或发展源于脑组织，
then the question becomes why that tissue is disappearing.
那么问题就变成了为什么脑组织在消失。
And growing evidence suggests that may be the result of a person's immune system attacking their brain.
越来越多的证据表明，这可能是人体免疫系统攻击大脑的结果。
In other words, schizophrenia may be an autoimmune condition.
换句话说，精神分裂症可能是一种自身免疫性疾病。
There's lots of evidence that the immune system is somehow involved in at least some schizophrenia cases.
有很多证据表明，至少在一些精神分裂症病例中，免疫系统会在有某种程度上参与其中。
Like, the symptoms of schizophrenia are often tied to inflammation,
比如，精神分裂症的症状通常与炎症有关，
one of the ways the immune system can try to thwart what it sees as unwelcome guests in the body.
而炎症是免疫系统试图阻止体内不受欢迎物质的一种方式。
Inflammation isn't bad, per se.
炎症本身并不是坏事。
It can be part of a healthy immune response to pathogens.
它可能是对病原体健康免疫反应的一部分。
It's just that you don't want too much of a good thing.
只是你不想要太多好东西。
And that seems to be what's happening.
这似乎就是正在发生的事情。
People with schizophrenia have higher levels of inflammatory markers in their blood, for example.
例如，精神分裂症患者血液中的炎症标志物水平更高。
Whether that's because inflammation causes schizophrenia or the other way around isn't clear.
究竟是因为炎症导致精神分裂，还是正好相反，目前还并不清楚。
But some experts believe that inflammation in the body could signal changes to the brain which, in turn, trigger or exacerbate schizophrenia symptoms.
但一些专家认为，身体的炎症会向大脑发出信号，引发或加剧精神分裂症症状。
That may also explain why infections in general increase the likelihood of someone developing schizophrenia.
这也可以解释为什么感染通常会增加患精神分裂症的可能性。
Infections can result in the blood-brain barrier becoming permeable, allowing inflammation into the brain.
感染会导致血脑屏障变得通透性，使炎症进入大脑。
Like, a study that looked at over three million people in Denmark found
例如，一项针对丹麦300多万人的研究发现，
that being hospitalized for an infection increased a person's risk of developing schizophrenia by 60%.
因感染而住院的人患精神分裂症的风险增加了60%。
And infections have been known to trigger autoimmune conditions, too.
众所周知，感染也会引发自身免疫性疾病。
In fact, in that same study, people who were hospitalized for an infection and had had an autoimmune condition at some point
事实上，在同一项研究中，那些因感染而住院并在某些时候有自身免疫系统疾病的人。
were more than twice as likely to develop schizophrenia.
患精神分裂症的可能性是前者的两倍多。
And by itself, having an autoimmune condition increased the risk of schizophrenia by 29%.
自身免疫性疾病本身就使患精神分裂症的风险增加了29%。
That's a common theme.
这是一个共同的主题。
Decades of research has found a lot of overlap between schizophrenia and autoimmune diseases.
几十年的研究发现，精神分裂症和自身免疫性疾病之间有很多重叠。
Though there are some notable exceptions, overall,
虽然也有一些明显的例外，但总体来说，
the likelihood of developing schizophrenia is higher in people with autoimmune disorders, and vice versa.
自身免疫性疾病患者患精神分裂症的可能性更高，反之亦然。
Even having a parent or sibling with an autoimmune condition can raise a person's risk of schizophrenia by 20%.
即使父母或兄弟姐妹患有自身免疫性疾病，也会使一个人患精神分裂症的风险增加20%。
And as far back as the 1970s, doctors noticed that people with schizophrenia have a lot of central nervous system auto antibodies,
早在20世纪70年代，医生们就注意到精神分裂症患者体内有大量的中枢神经系统自身抗体，
or antibodies that bind to their own cells in their brain and spinal cord.
或是与大脑和脊髓中自身细胞结合的抗体。
These are a hallmark of certain kinds of autoimmune disease.
这是某些自身免疫性疾病的特征。
So it may be that the symptoms of schizophrenia also stem from the immune system attacking the body
因此，精神分裂症的症状也可能源于免疫系统对身体的攻击。
- or, in this case, immune cells in the brain overstepping.
或在本病例中，大脑中的免疫细胞越界。
Multiple studies have noted that the central nervous system's immune cells, called microglia, tend to be more active in people with schizophrenia.
多项研究指出，精神分裂症患者的中枢神经系统免疫细胞（称为小胶质细胞）往往更活跃。
And among other things, these cells play a huge role in synaptic pruning - the process by which the brain eliminates unneeded connections.
除此之外，这些细胞在突触削减中扮演着巨大的角色，大脑通过该过程消除不必要的连接。
Pruning happens to all of us, but it seems like the brains of people with schizophrenia prune more than they should,
所有人都会发生这种削减，但精神分裂症患者的大脑中似乎削减得更多，
which may explain why some parts end up smaller.
这也许可以解释为什么有些脑区最终会变小。
And researchers might finally be zeroing in on exactly what triggers microglia to get so snippy.
研究人员最终可能把注意力集中在，到底是什么触发了小胶质细胞变得如此反常。
A January study in mice found that coaxing cells to overproduce one protein in the complement system
一月份，在老鼠身上进行的一项研究中发现，诱使细胞在补体系统
- a part of the immune system that boosts the response to pathogens — was enough to send microglia into overdrive.
（免疫系统的一部分，能够增强对病原体的反应）中过度产生一种蛋白质，足以使小胶质细胞过度活跃。
That led to overeager synaptic pruning and schizophrenic symptoms.
这导致过度兴奋的突触削减和精神分裂症症状。
There may be more than one thing that sets microglia off, of course.
当然，可能不止一件事会让小胶质细胞兴奋。
Which is why a person's immune system, genes, developmental conditions in utero,
这就是为什么一个人的免疫系统、基因、子宫内的发育状况，
and reaction to psychological stress can all converge to trigger the condition.
以及对心理压力的反应，都能汇聚在一起触发这种疾病。
But, the connection between autoimmunity and schizophrenia is pretty convincing.
但是，自身免疫和精神分裂症之间的联系相当令人信服。
And if an overactive immune system is a big part of schizophrenia, then effective treatments could lie in getting it to calm down.
如果过度活跃的免疫系统是精神分裂症的重要组成部分，那么有效的治疗方法就是让它平静下来。
For instance, scientists are already trying to figure out
例如，科学家已经在试图找出针对大脑自身抗体的疗法，
whether therapies that target auto antibodies in the brain can help people with schizophrenia.
能否帮助精神分裂症患者。
And it turns out that NSAIDs - pain relievers and fever reducers that also reduce inflammation
结果发现，非甾体抗炎药是一种止痛、退烧药，也能减少炎症反应，与传统抗精神病药物一起使用，
- can help treat the symptoms of schizophrenia in tandem with traditional antipsychotic medications.
有助于治疗精神分裂症的症状。
Eventually, we may even be able to predict who will develop schizophrenia based on immunological markers
最终，我们甚至可以根据免疫标志物预测谁会患上精神分裂症，
- or prevent symptoms from developing altogether.
或者完全阻止症状的发展。
In the meantime, just knowing about the overlap between autoimmunity and schizophrenia could make a big difference.
同时，仅仅了解自身免疫和精神分裂症之间的重叠，可能也会有很大的不同。
The authors of one study urged clinicians not to automatically dismiss complaints
一项研究的作者敦促临床医生，
that might be symptoms of autoimmune disease as hallucinations or delusions.
不要忽视可能是自身免疫性疾病症状的幻觉或妄想等。
And hopefully, the more we unravel the role of autoimmunity in schizophrenia,
希望我们越是弄清自身免疫在精神分裂症中的作用，
the better equipped we'll be to help tens of millions of people worldwide.
越能帮助全世界数以千万计的人。
Thanks for watching this episode of SciShow Psych! If you're hungry to learn more about autoimmune conditions,
感谢收看本期《心理科学秀》！如果你想了解更多关于自身免疫疾病的知识，
you can pop over to our main SciShow channel to watch our episode explaining why they're more common in women.
可以到《科学秀》主频道观看我们的节目，解释为什么这些疾病在女性中更常见。
But don't forget to click that subscribe button and ring the notification bell first! Here on SciShow Psych, we're all about brains
但记得点击订阅按钮，先按一下通知铃！在《心理科学秀》中，都是关于大脑的节目。
- so if you want to understand yours a bit better, you won't want to miss an episode.
所以，如果你想更好地理解自己的大脑，每集节目都不要错过。
