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Schizophreniais one of the most chronic and incapacitating forms of mentaldisorders. Interpreted loosely, Kruse and Schulz (2016) point outthat schizophreniais the Greek word for splitmind.Because of this, an individual suffering from schizophrenia is oftenmisconstrued for having multiple or split personalities. EugeneBleuler, a 1900s Swiss psychiatrist, was the one that gave thismental disorder its title. Historical documents show thatschizophrenia has plagued the human race for thousands of years. Eventhough schizophrenia affects both genders with equal occurrence itis manifested earlier in men than in their counterparts (Andreasen,2015). The author draws attention to the fact that schizophreniausually develops in the mid-20s in males and the late-20s orearly-30s in females. Classified as a psychotic disorder, this braindisease affects 1 in every 100 persons roughly 1% of the world`sadult population. In the U.S., approximately more than 2 millionAmerican adults live with this disorder in any given year (Andreasen,2015).
Theindividuals that suffer from this disease experience petrifyingsymptoms like hearing an internal voice that others cannot hear, orcan harbor the thoughts that others are reading their minds tocontrol or harm them (Shad, 2012). In consequence of thesedistressing symptoms, the people with this disease often withdrawfrom reality. The disconnection from reality to seeing, hearing, andbelieving things that are not real is what doctors clinically referto as psychosis which explains why schizophrenia is a classified asa form of psychotic disorder (Andreasen, 2015). Being a mentaldisorder, the author perceptively states that schizophrenia makes ita challenge for someone to distinguish between what is real and whatis not real, function normally, manage their emotions, and relate toothers. The severity of the long-lasting symptoms of this mentaldisease often elicits a high degree of mental debilitation, whichspills into the social lives of patients. However, medications andalternative treatment remedies can be used to manage the disturbingsigns and symptoms of schizophrenia efficiently.
Goghariand Harrow (2016) draw attention to the fact that there are six typesof schizophrenia
Accordingto Goghari and Harrow (2016), this is the most common form ofschizophrenia. Paranoid schizophrenia, also known as schizophreniawith paranoia, is often accompanied by an altered perception ofreality manifested as delusions and/or prominent hallucinations.These delusions affect an individual`s personal relationships androutine activities like eating, socializing, bathing, or runningerrands (like going to work or school). However, Shad (2012) observesthat a patient`s emotions and speech may be unaffected.
Alsoknown as disorganized schizophrenia, Goghari and Harrow (2016)perceptively state that hebephrenic schizophrenia is an expression ofthe disorganizationsyndromein addition to the basic psychomotor and delusional symptoms ofschizophrenia. Disorganized schizophrenia is manifested by illogical,irrational, and incoherent thoughts and mannerisms. In other words,the authors note that hebephrenic schizophrenia is essentiallyexhibited by purposeless, disinhibited, and agitated mannerisms.
Andreasen(2015) states that catatonia is a group of motor symptoms that candevelop in some patients with paranoid schizophrenia. In addition tothe delusional and psychomotor symptoms of schizophrenia, patientswith catatonic schizophrenia exhibit a set of unusual and excessivesigns known as catatonicexcitement symptoms.These movements include movement mimicking (echopraxia) and soundmimicking (echolalia), stupor, mutism (limited verbal responses),mannerism, agitation, and other variants. These symptoms keepshifting from hyperactivity and under activity (Goghari & Harrow,2016).
Accordingto Goghari and Harrow (2016), residual schizophrenia is the leastdebilitating and severe type of schizophrenia. Residual schizophreniais mainly characterized by the presence of more negative thanpositive symptoms. A patient with residual schizophrenia experienceswaning (decrease in overall symptoms intensity) and waxing (increasein overall symptoms intensity) phases of the disease.
Justlike other types of schizophrenia, patients with schizoaffectivedisorder exhibit other symptoms in addition to the primary symptomsof schizophrenia. With this kind of schizophrenia, Goghari and Harrow(2016) observe that a patient suffers from the mental syndromes of amood disorder such as mania. The long-term symptoms of this mentaldisease are severe and therefore need close monitoring.
Goghariand Harrow (2016) observe that undifferentiated schizophrenia isdescribed by the occurrence of the universal symptoms that do not fitthe diagnosis of either of the types of this mental disease. Theauthors observe that this happens because patients exhibit afluctuating array of both positive and negative symptoms over anextended period.
Kruseand Schulz (2016) observe that like all mental disorders, thecausative factors of schizophrenia are not entirely comprehensibleand research is still ongoing. However, similar to other mentalillness, schizophrenia is also caused by the interplay of acombination of genetic factors, external (environmental) factors, andbrain factors.
Eventhough research on the relation between genetic factors andschizophrenia is ongoing, Kruse and Schulz (2016) perceptively statethat the mental disease has long been assumed to run in families. Theauthors continue to say that studies have shown that children born toparents who have schizophrenia have 15% more odds of developingschizophrenia themselves. Moreover, Shad (2012) warns that thechildren that have second-degree relatives with the mental diseasedevelop schizophrenia every so often than the general population.
Scientistshave proven that genes only increase the risks of an individualdeveloping schizophrenia, but no DNA segments are known to cause themental disease. Additionally, Kruse and Schulz (2016) note thatperinatal factors like complications and viral infections seem toinfluence the development of this mental illness. However, it is notcomprehensively proven how the condition develops from perinataldynamics.
Withthe rapid advancement of neuroimaging technology, scientists havemanaged to study the brain structure and normal functioning of thebrains of people with schizophrenia. Many studies on the brains ofindividuals with this mental condition have found significantabnormalities in their brain structure (Andreasen, 2015). Forinstance, the ventricles (the central fluid-filled cavities of thebrain) are significantly larger in people with schizophrenia.Consequently, such people tend to have less gray matter, which causesdifferent parts of the brain to have more or less activity dependingon the direction of the expansion of the ventricles. Studies havealso shown that this uneven distribution of brain cells may be inpart, an underlying cause of schizophrenia (Kruse & Schulz,2016).
Developmentalneurobiologists have proven that the uneven distribution of graymatter leads to inappropriate neuron connections that lie dormantuntil they manifest themselves as schizophrenia in puberty when brainchanges occur in tandem with maturation (Goghari & Harrow, 2016).In other studies, scientists found evidence that biochemicalactivities in the brain affect the onset and development ofschizophrenia. One such brain chemical is dopamine, aneurotransmitter that helps to carry messages between brain cells.Brains imaging techniques and molecular science have shown thatpeople with schizophrenia have more dopamine in their brains, or thatit has exaggerated effects on their systems. More research suggeststhat other brain chemicals influence the developmental ofschizophrenia apart from dopamine (Kruse & Schulz, 2016).
AsKruse and Schulz (2016) observe, these are the external factors thatfuel the onset and development of schizophrenia. Studies show thatlife-changing or extremely stressing events may sometimes triggerschizophrenia. These factors include having money problems, becominghomeless, losing a job, being abused, feeling lonely, the death of atreasured person, and so much more. Additionally, lifestyle factorsalso fuel the development of schizophrenia. Andreasen (2015) observesthat research shows that some people develop this mental diseaseafter using recreational drugs like highly potent Cannabis Sativa(skunk) and methamphetamine (meth). If someone already hasschizophrenia, hard recreational drugs only work to make the symptomsworse. What`s more, drinking stops medication from treating thesymptoms of this mental disease which eventually intensifies thesymptoms (Kruse & Schulz, 2016).
AsAndreasen (2015) notes, there the symptoms of schizophrenia can beclassified into two categories: positive and negative symptoms.
Accordingto Andreasen (2015), the positive (psychotic) symptoms ofschizophrenia are those that are added to the character andpersonality of an individual. They include experiencing things thatare not real, and they include
Delusions.A delusion is a perception held by a person despite the fact thatvisible evidence proves that it is not true. In other words, they arethe false beliefs centered upon concepts that are non-existent in thereal world. As indicated initially, people with schizophrenia harborstrong feelings that other people are reading their minds with anintention to control or harm them. These delusions include those ofpersecution, reference, control, and grandeur (Andreasen, 2015).
Hallucinations.The same work by Andreasen (2015) defines hallucination as thesensations experienced and identified as real when they only exist inthe confines of a person`s mind. This often happens after innerself-talk (sounds and voices) that seems to be coming from an outsidesource are revealed in any of the five human senses. Most of thetime, Kruse and Schulz (2016) warn that the voices are abusive,vulgar, and critical. Hallucinations have meaning and value only tothe persons experiencing them. It is on these grounds that people whohave schizophrenia are assumed to have split or multiplepersonalities.
Disorganizedspeech.As Andreasen (2015) notes, a patient with schizophrenia can havedifficulties concentrating and maintaining a constant train ofthought which is externally inferred as disorganized speech.Therefore, a person with this mental condition can irrationallyrespond to questions, put words together to form meaninglesssentences (wordsalad),or start sentences with one topic and end somewhere completelydifferent.
Extremelyabnormal motor control or disorganization. Schizophreniais a mental disease that disrupts everyday goal-directed activitieslike taking a bath, eating, socializing, going to school or work, andmuch more. Therefore, one of the symptoms of schizophrenia isimpairment in overall daily functioning. What`s more, schizophreniais manifested by erratic emotional responses, bizarre behaviors thathave no tenacity, lack of impulse control, and useless or excessivemovements (Andreasen, 2015).
AsShad (2012) states, the negative signs and symptoms of schizophreniaare those that are subtractedfrom the normal behavior or character of an individual (absence ofnormal mannerisms). These symptoms are long-lasting compared topositive symptoms. They include lack of emotional expression lack ofmotivation withdrawal from family and friends (social withdrawal)extreme irritability low sex drive difficulties in speech lack ofsleep poor hygiene or grooming difficulty in setting goals andgeneral planning, and seeming lack of interest in the universe inentirety. Andreasen (2015) observes that many people withschizophrenia identify more with the negative than positivemanifestations of the mental disease. However, these symptoms varyfrom individual to individual and can differ in severity as well.
Castleand Buckley (2015) note that in many cases, it is family members orclose friends that notice the strange symptoms associated withschizophrenia. Even if there are no lab tests that can prove thepresence or absence of schizophrenia, the authors observe that bloodtests and screening procedures are done as part of the firstdiagnostic protocols to exclude other probable causes for the strangesymptoms. Once they are ruled out, full psychiatric assessments areperformed by psychiatrists who either use the Diagnostic andStatistical Manual V (DSM-5) or the International Classification ofDiseases (ICD) to diagnose the symptoms of mental diseases (Castle &Buckley, 2015). These diagnostic manuals guide psychiatrists onwhich symptoms should be manifested and for how long they should bepresent to make a positive schizophrenic diagnosis. Once a diagnosisis confirmed positive, further observations are done to determine theexact subtype of schizophrenia an individual has. The psychiatricassessments are conducted by observing and interviewing a patient, inaddition to acquiring more data from family members who can providecrucial background information on the psychotic state of theirbeloved one.
SocialImpacts of Schizophrenia
AsShad (2012) argues, the symptoms of schizophrenia often negativelyaffect many, if not all, aspects of an individual`s life includingtheir perceptions, thoughts, the ability to do everyday activities,and social interactions. Therefore, it is not unusual for people withschizophrenia to become extremely agitated, socially withdrawn, anderratic, especially when the symptoms are not treated or if a patientdiscontinues their medication.
Accordingto Castle and Buckley (2015), schizophrenia requires lifelongtreatment even with the fading of psychotic symptoms. However, theauthors observe that there are two schizophrenia treatmentapproaches: medication and psychosocial therapy. First-generationdrugs like Haloperidol,Chlorpromazine,and Fluphenazineare the cornerstone of the management of schizophrenia. These drugsare designed to influence the normal functioning of the brainneurotransmitter dopamine. The goal of medical intervention is tomanage the signs and symptoms of schizophrenia with the lowest dosepossible. Antipsychotic drugs can be used in combination with othermedication like anti-depression or anti-anxiety remedies (Andreasen,2015).
Insome cases where drugs fail to manage the signs and symptoms of thismental disease effectively, hospitalization might be required for apatient to have electroconvulsive therapy (ECT) done on them.Psychosocial interventions are used alongside continued antipsychoticmedication to help patients overcome their communication,motivational, relationship, and daily activities problems. Theyinclude social skills training, individual and/or group therapy,vocational rehabilitation, and family therapy (Castle & Buckley,2015).
Inconclusion, schizophrenia is one of the most chronic andincapacitating forms of mental disorders. Even if the disease affectsboth genders equally, it is manifested earlier in men than in women.The people that suffer from this mental disease experience symptomsthat disconnect them from reality (psychosis). As this paper hasexemplified, there are six types of schizophrenia caused by theinteraction of genetic, environmental, and brain factors. Regardlessof the absence of lab procedures to diagnose the symptoms ofschizophrenia, psychiatrists use physical observation and psychiatricassessments to confirm the presence or absence of this mentaldisorder. Schizophrenia can be treated by medication and/orpsychosocial therapy aimed at managing the symptoms of the mentaldisorder efficiently. Schizophrenia is a mental disease thatnegatively affects the social lives of patients. It should thereforebe managed from the moment it is discovered.
Andreasen,N. C. (2015). Positive and Negative Symptoms: Historical andConceptual Aspects1. Schizophrenia:Positive and Negative Symptoms and Syndromes Modern Trends inPharmacopsychiatry,1-42. doi:10.1159/000418010
Castle,D. J., & Buckley, P. F. (2015). Psychological and psychosocialtreatments. Schizophrenia,69-76. doi:10.1093/med/9780198712831.003.0009
Goghari,V. M., & Harrow, M. (2016). Twenty year multi-follow-up ofdifferent types of hallucinations in schizophrenia, schizoaffectivedisorder, bipolar disorder, and depression. SchizophreniaResearch,176(2-3),371-377. doi:10.1016/j.schres.2016.06.027
Kruse,M., & Schulz, S. C. (2016). Overview of Schizophrenia andTreatment Approaches. Schizophreniaand Psychotic Spectrum Disorders,3-22. doi:10.1093/med/9780199378067.003.0001
Shad,M. U. (2012). Unmet medical needs in schizophrenia treatments.PharmacologicalTreatments in Schizophrenia,26-38. doi:10.2217/ebo.11.277
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