Schizophrenia

Abstract

Schizophrenia is one of the most severe mental health problems in the world.  The paper, therefore, sought to inform on the subject matter using previous research within the field. Schizophrenia is a severe mental health condition that affects a person’s feelings, thoughts, and behaviors. It mainly manifests itself in form of hallucinations, delusions, disorganized thought, unusual motor activity, and negative symptoms. The disease has been in existence throughout history as recorded in Egyptian and Roman histories. It was however fully recognized as a condition in 1887 by Emile Kraepline and later termed as Schizophrenia in 1911 by Eugen Bleuler. Much about the disease is not yet fully understood but research within this field is still intense to uncover the facts.

The causes of Schizophrenia are not yet fully known but the risk factors have been identified to be genetics, neurotransmitters, brain development, and birth complications. Drug abuse and stress are also known as triggers of the condition. Treatment for Schizophrenia happens in two main forms: Medication and Psychosocial interventions. These are used together in varying proportions depending on the patient. In severe cases, the patients are hospitalized. Self-help is also a critical part of the treatment. It ensures that the patient accepts the situation and actively participates in the treatment procedure.

 

 

Schizophrenia

Introduction

Of all the mental health conditions in the country and the world, the one that brings much anxiety and fear to the doctors, media and the public is schizophrenia. It is a severe and chronic mental health condition that affects a person’s behaviors, feelings, and thoughts thus altering their thought process, social interaction, and perception of reality. Statistics by the Global Burden of Disease, Schizophrenia affects 20 million in the world with new cases being 1.5 per 10, 000 people (McCutcheon, Marques, & Howes, 2020). It is also one of the 15 leading causes of disability. It gets worse because 5% of people with the condition die by suicide and 20% of them attempt suicide at least once. Treatment for schizophrenia is available yet many families often find it hard to access it mainly because of misinformation. Information about schizophrenia is important in the battle against myths, misinformation, and the disease itself, this review will therefore provide a proper insight into the condition.

What is Schizophrenia?

Schizophrenia is a mental health condition that affects how a person thinks feels or behaves. It, therefore, makes a patient of the condition appear to have lost touch with reality or interpreting reality abnormally. Therefore, one experiences a combination of hallucinations, disordered thinking, and delusions which affect their daily functions and can disable a patient (Crider, 2020). The field of science on the condition is not well developed and there is no clear definition of the cause and cure of the condition. There is however much research into genetics, behavioral research, and brain imagining to find its cause and thus the remedy. Because of the complexity of the condition, there have been several misconceptions and myths peddled around about it, scientific research is however trying hard to correct.

History of Schizophrenia

The disease was first identified in 1887 by Dr. Emile Kraepelin. There is however a belief that the condition has been in existence throughout history.  Before its discovery, traces of written history find its existence in old Pharaonic Egypt even before Christ. A book from this period, Book of Hearts, records symptoms of dementia, depression, and thought disturbances which are typically those of Schizophrenia (McCutcheon, Marques, & Howes, 2020). The book further explains the source of the diseases as demonic and originating from the blood vessels, poison, and fecal matter. A study into the Roman and Greek history showed that there we also people with abnormal mental conditions but mostly treated as spiritual problems because of the belief that they were caused by demonic possessions (Bentall, 2013). The treatment of this was an exorcism.

Emil Kraepelin was the first person to classify mental disorders into different categories. In the case of Schizophrenia, he classified it as Dementia Praecox. It was a name to distinguish it from other forms of dementia that occur later in someone’s life. The term Schizophrenia was coined in 1911 by Swiss Psychiatrist Eugen Bleuler who first described the symptoms as either negative or positive. The name “Schizophrenia” comes from the Greek words Schizo (Split) and phrene (mind) which in combination meant someone with fragmented thinking (McCutcheon, Marques, & Howes, 2020). The public largely misunderstood it to mean split personality. After Blueuler’s time, the definition of the disease changed as more scientists study its symptoms and observations. In recent times, there has been evidence to support the fact Schizophrenia is a biologically based condition of the brain. They have proven this through dynamic brain imaging that showed the brain tissue destruction in a brain suffering from schizophrenia. The future provides promising prospects as studies are ongoing in genetics to define the underlying cause of the condition.

Prevalence and Statistics

The global burden of the disease stands at 20 million people. The number translates to 1.5 per 10,000 people. It is also a leading cause of suicide as up to 20% of the affected patients attempt suicide with 5% succeeding. In the USA, the affected people are 1.5 million people. It is common among the younger generations during their late teens to early 30s. It is also more prevalent in males than in females. The average life of a person with the disease is 28.5 years. The disease appears to be more prevalent in the black American population (21%), Latinos (19.9%), and whites (13.1%) in the USA. It is lowest among the Asians (5.4%).

Patients of the conditions are identified to be four to six times more likely to commit a violent crime than the unaffected. Western countries show that 6% of their homicide acts are committed by schizophrenic patients. A study in Sweden showed that 13.2% of their schizophrenic patients had committed one violent act; within the first five years of the condition, 10.7% of males and 2.7% of female patients had committed a violent offense.

Symptoms of Schizophrenia

While the symptoms of the disease may vary, there are the major indicators of the condition. They include:

Delusions – a delusion is a falsely held belief that the patient has that is not based on reality. These delusions appear in different scenarios for example persecution; when a patient feels like they are the center of a threat or a conspiracy. Another one is passivity when they think their thoughts and actions are controlled by an external person or force. Other examples include when they think they are being harmed, harassed, another person is in love with them or a catastrophe is about to occur. It is a common characteristic of the disease.

Hallucinations – in this case, the patients see or hear things that do not exist or any other perceptions without a specific real stimulus. In the schizophrenic’s perceptions, they are experiencing a full impact of the stimulus and experience. It occurs in all the senses but hearing is the one most affected.

Disorganized Thought – an illogical thought process is best explained through a disorganized speech (Crider, 2020). In this case, the patient has impaired communication, answers questions partially o gives a completely unrelated answer.  A more severe case is one of the word salad when the patient puts together meaningless words that cannot be understood.

Abnormal or extremely disorganized motor behavior – this symptom appears in different forms ranging from unpredictable agitation to childlike silliness. Their moto movements have no specific goal and thus making it hard for them to perform simple tasks.  It may include bizarre postures, excessive useless movement, resistance to instructions, or complete unresponsiveness.

Negative Symptoms – These include the lack of the ability to function properly such as loss of motivation, self-neglect, social withdrawal, emotional blunting, and the lack of ability to experience a pleasure (Crider, 2020).

The symptoms of the condition vary but the above mentioned are the major signs of schizophrenia. Severity also varies over time as the problem worsens. Men show the symptoms early, within their mid-20s while women start later in the 20s (McNally, 2016). It is uncommon for children and older people above 45 years to be diagnosed with the condition. Teenagers with schizophrenia also display some of these symptoms but their case is harder to identify. Their common traits would be withdrawal from family and friends, performance drop, trouble sleeping, reduced or lack of motivation, and irritability. They are however less likely to display hallucinations and delusions. Suicidal thoughts and behaviors are a common trait among schizophrenics. When someone, therefore, displays such behaviors it is proper to observe them closely or seek assistance from psychological experts because they may also display schizophrenia symptoms.

Causes of Schizophrenia

The exact cause of schizophrenia is not yet discovered. Researchers however speculate that a combination of genetics, psychological, environmental, and physical factors lead to the development of the condition. The risk factors of the disease are, therefore:

Genetics – Schizophrenia has been shown to run in families but no single gene has been pointed out as the responsible one.  It seems therefore that it may be a combination of several genes. The genetics theory has been proven using identical twins. When one twin is diagnosed with schizophrenia, the other twin has a 1 in 2 chance of developing it even if they were raised separately (McCutcheon, Marques, & Howes, 2020). In the case of non-identical twins, the chance was higher at 1 in 8. It, therefore, proved that there is a genetic risk factor.

Brain Development – brain imagining studies have shown that the brains of people with schizophrenia are not similar to normal people. These subtle differences are not similar in all schizophrenics but it is an indicator that the disease is partly a disorder related to brain development.

Neurotransmitters – The connection between schizophrenia and neurotransmitter was made when developing the drugs for the patients. It was noted that these drugs would alter the neurotransmitter levels and thus relieve some symptoms of schizophrenia.  Research has therefore speculated that changes in dopamine and serotonin levels or an imbalance between the two are responsible for schizophrenia.

Birth complications and Pregnancy – Research has proven that schizophrenics are more likely to have developed complications during birth or during pregnancy. The complications include premature labor, low birth weight, or lack of oxygen at birth.

Triggers

Some other triggers accelerate or increase the chances of schizophrenia development among people at risk. The major one is stress. Psychological events such as divorce, bereavement, losing a home or job, emotional, sexual, or physical abuse, or the end of a relationship are some of them. They are not causes of the condition but trigger it among the vulnerable populations. Drug abuse also increases the chances of its development. Certain drugs such as cannabis, LSD, Cocaine, or amphetamines trigger the disease.

Treatment of Schizophrenia

Medicine and talking therapy are the two main forms of treatments given in tailored combinations for individuals. The treatment happens for a lifetime even after the symptoms have stopped.  In some adverse cases, hospitalization is required. Treatment is coordinated by a psychiatrist who is well versed with the field but can also require assistance from a psychologist, nurse, social workers, and a case manager to coordinate the care. A full team patient-centered approach is required to ensure a good recovery of the patient.

Medications

Medications are the cornerstone of the treatment program. Antipsychotic medicines are the most common types of medications offered to these patients. Their functions are to control the symptoms by regulating the dopamine neurotransmitter. The goal is to successfully manage the signs and symptoms with the lowest dose possible (McNally, 2016). A combination of different drugs or doses overtime is required to achieve the desired result. Other medicines such as antidepressants and anti-anxiety drugs can also be used.

Psychosocial Interventions

The psychosocial interventions are used once psychosis recedes but in tandem with medications. These methods include individual therapy that helps the patient to normalize their thought patterns, cope with stress, and identify early signs of relapse (McCutcheon, Marques, & Howes, 2020). The patients also receive social skills training to improve their interpersonal communications and thus their ability to participate in the day to day activities. Family therapy also is important in educating the family members to deal with the patient and schizophrenia. Another psychosocial intervention is through vocational training and supporting them to get employment and secure it.

Hospitalization

Hospitalization is also not ruled out for these patients. Schizophrenics are taken into hospitalization during periods of severe symptoms or during a crisis.  Hospitalized patients also receive good nutrition, basic hygiene, and adequate sleep which is also motivation to hospitalize the patient. It is also an option in ensuring the safety of the patient.

Electro conclusive Therapy

Older or adult schizophrenics who do not respond well to drug therapy are treated with electro conclusive therapy. It is also helpful when the patient has depression.

Self Help

Self-help is also a critical part of the treatment process. Since the majority of the patients recover. Once someone has accepted the condition, it starts the process towards healing. And that is by accepting the treatment options provided. It is important to accept the condition and work towards healing. A positive attitude towards the treatment would produce better results and would bring out a better and helpful relationship with the psychiatrist. The patient should also work towards avoiding stress and taking care of oneself

Summary

Schizophrenia is one of the most severe mental health problems in the world. It is a severe mental health condition that affects a person’s feelings, thoughts, and behaviors. It mainly manifests itself in form of hallucinations, delusions, disorganized thought, unusual motor activity, and negative symptoms. The disease has been in existence throughout history as recorded in Egyptian and Roman histories. It was however fully recognized as a condition in 1887 by Emile Kraepline and later termed as Schizophrenia in 1911 by Eugen Bleuler. Much about the disease is not yet fully understood but research within this field is still intense to uncover the facts.

The causes of Schizophrenia are not yet fully known but the risk factors have been identified to be genetics, neurotransmitters, brain development, and birth complications. Drug abuse and stress are also known as triggers of the condition. Treatment for Schizophrenia happens in two main forms: Medication and Psychosocial interventions. These are used together in varying proportions depending on the patient. In severe cases, the patients are hospitalized. Self-help is also a critical part of the treatment. It ensures that the patient accepts the situation and actively participates in the treatment procedure.

 

 

References

Bentall, R. P. (Ed.). (2013). Reconstructing schizophrenia. Routledge.

Crider, A. (2020). Schizophrenia: A biopsychological perspective. Routledge.

McCutcheon, R. A., Marques, T. R., & Howes, O. D. (2020). Schizophrenia—an overview. JAMA psychiatry, 77(2), 201-210.

McNally, K. (2016). A critical history of schizophrenia. Springer.

 

 

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