Schizophrenia and Its Most Common Forms and Symptoms - Coursework Example

Understanding Schizophrenia by This paper speaks about schizophrenia, its most common forms ad symptoms. Schizophrenia is acomplex mental disorder that has negative as well as positive symptoms. Usually people suffering from this impairment experience hallucinations, delusions, hear voices, have catatonic behavioral patterns, depression and irritability. Patients with schizophrenia are not able to lead normal social life and most often are withdrawn from society. The paper also examines most frequent concepts which explain the appearance of this disorder. Scientists distinguish genetic, environmental, and biological causes of this mental disorder. Earlier schizophrenia as considered incurable, nevertheless now a combination of medications that restore natural neurotransmitters level and psychotherapy people with schizophrenia have high chances of turning back to a normal life. The aim of the paper is to provide with treatment variants and to forecast possible outcomes for patients with schizophrenia. Introduction Schizophrenia is considered to be one of the most frightening and interesting mental illnesses of our time. No other mental illness gives patients so much suffering and attracts so much attention from doctors, relatives, and society. Despite the fact that schizophrenia is well known for centuries and its many symptoms are well documented, there are still many unresolved issues, such as exact reasons of its appearance and the ways of its treatment (Castle & Buckley, 2012). The term “schizophrenia” was formulated less than a century ago; however, humanity is familiar with this illness since ancient times. Emilie Kraepelin was probably the first who noticed the difference between schizophrenia and other mental disorders and described the symptoms of the illness using the term “dementia praecox”. He thought that schizophrenia would almost always result in long and serious dementia and did not see many options for its treatment. Any improvements the psychiatrist viewed as temporary because it was impossible to define the causes of the illness before neurochemistry wide introduction (Frese et al., 2003). Later Eugen Bleuler made up a term “schizophrenia” which came from Greek “schizo” meaning split and “phrene” meaning mind. However, most people understand this term is too literally now thinking of schizophrenia as of multiple personalities which is not correct (History of Schizophrenia, 2012). Schizophrenia describes a state when the person is “split off” from reality and social world. The definition of the term was also upgraded many times when some new information about the symptoms appeared. The disorder is studies thoroughly nowadays with advances and new possibilities of neurochemistry. There were a number of studies dedicated to the connection of drugs and schizophrenia as in the beginning of the XX-th century the scientists presupposed that LCD and has mechanisms that can cause schizophrenia for example (Frese et al., 2003) Schizophrenia is a mental disorder that impairs person`s ability to differentiate between reality and his own delusions, obsessions, and hallucinations. Schizophrenia also presupposes serious social and occupational dysfunction which means that a person is not able to achieve the onset level of working, social, and personal relationships (Jackson & Birchwood, 2001). Psychologists differentiate between positive and negative symptoms of schizophrenia. There are no approved ways of schizophrenia prevention because there are no concrete markers of its development. However, since most of the patients experience schizophrenia in young age, and the most risky period is between 18 and 25 it is important to follow those who have genetic predisposition to this mental disorder. Scientists claim that early intervention may have positive effect if cognitive-behavioral therapy is applied on time (Jackson & Brichwood, 2011). For a long time doctors or religious people who faced with symptoms of schizophrenia considered it to be the mental illness provoked by demons or spirits and the variants of treatment were sometimes rather radical. As for now experts claim that there are mostly genetic and physiological factors that influence this mental disorder. Now doctors have learnt how to distinguish the symptoms of schizophrenia from the symptoms of other mental disorders from the symptoms of other mental disorders. Body The Symptoms of Schizophrenia Among the most frequent symptoms psychiatrists distinguish positive symptoms such as hallucinations, delusions, thoughts disorder, and movement disorders, and negative symptoms such as social withdrawal, self-neglect, loss of motivation, emotional blunting, paucity of speech, and “flat affect” (Pichionni & Murray, 2007). Auditory hallucinations are most significant symptoms which are mostly described by the patients as noises or voices talking to each other, ordering the patient what to do or even discussing and criticizing him (Jackson & Birchwood, 2001). Delusions presuppose unreal beliefs about the world, such as persecution, references meant for the patient or grandiose (Jackson & Birchwood, 2001). Uncontrollable thinking process, when thoughts change their direction dramatically and suddenly can also serve as the symptom of this mental illness (Pichionni & Murray, 2007). The patient is also prone to feel difficulties memorizing things, keeping attention for a long period, and performing certain tasks (Os & Kapur, 2009). Emotions lose their brightness and are often blurred; the patient suffers from lack of energy and motivation (Jackson & Birchwood, 2001). Some persons often mark catatonic or disorganized behavior of the patients with schizophrenia (Castle & Buckley, 2012). If these symptoms are observed during 6 months it is possible to diagnose this mental disorder: The idea that thought are echoed or broadcasted and visible to the others; Delusions of control or some abnormal influence; Imaginary voices that give comments on the person`s behavior or criticize him; Cultural delusions that can be socially awkward and unacceptable; a patient may say that he sees spirits, flies to the moon at night; Problems with reasoning that result in inconsistent speech, difficulties in expressing thoughts and neologisms utilization; Paucity of speech; the patient may stop at unexpected places while giving a speech; Catatonic behavior; the patient may still sit in the same pose for hours; Social withdrawal and apathy; the patient does not support any social contacts; Loss of enthusiasm in previous hobbies; apathy to personal or social relationships (Bailey & Dolan, 2004). Forms of Schizophrenia There are five types of schizophrenia that are classified according to American DSM-5 classification: Paranoid schizophrenia is characterized by presence of auditory hallucinations so that the patient can hear voices talking to him but there is no thought disorder. The emotions are not flattered as well. A person may have grandiose delusions but there are no signs of somatization and religiousness. Disorganized schizophrenia is marked by changed patterns in thinking and feeling. The person my feel anehdonia, inability to receive positive emotions from anything. Catatonic schizophrenia is visible mostly through changed behavior. The patient may stay immobile during a long time, which is regarded as stupor or demonstrate sharp, anxious movements. Undifferentiated schizophrenia is characterized by hallucinations, delusions but the patient does not experience catatonic stupor or paranoia. A patient with residual type has hallucinations, delusions, thoughts disorder, and movement disorders which appear rarely but is not socially withdrawn (APA Schizophrenia Forms, 2010). Psychiatrists in the repost of World Health Organization also distinguish between other two subtypes such as post-schizophrenia depression which is characterized by repetitive schizophrenia episodes appearing long after treatment. Simple schizophrenia is characterized by hallucinations, delusions, and social withdrawal with no psychotic episodes (Classification of Mental Disorders, 2012). Schizophrenia and other Mental Disorders Castle & Buckley underline the necessity to distinguish between schizophrenia and such disorders as alcoholic hallucinations, schizoaffective disorder, delusional disorder, and Axis II disorders (2012). Absence of laboratory tests or pathognomonic symptoms capable to indicate schizophrenia directly makes diagnosis more difficult (Castle & Buckley, 2012). Pichionni & Murray claim that an average general practitioner in England faces two cases of schizophrenia out of two thousands patients a year (2007). Schizophrenia and such mental impairments as psychosis and bipolar disorder are often confused because some symptoms can coincide. Most often the doctor decides whether he deals with schizophrenia or not relying on the bizarreness of hallucinations, history of drugs abuse, and the symptoms of depression (Os & Kapur, 2009). It is also necessary to differentiate between acute and chronic schizophrenia. Acute and Chronic Schizophrenia Acute schizophrenia is often the result of some dramatic and stressful event in the life of a patient which causes serious nervous breakdown. This type of disorder is easily recognized because the person is mostly normal, and it is some extreme situation influences him in such a way that he starts experiencing the symptoms of schizophrenia. They may appear rather unexpectedly for the patient himself. Some stimulant drugs, such as cocaine and amphetamines, can also provoke schizophrenia. Most often medications turn out to be rather effective for treatment this disorder. Chromic schizophrenia has longer periods of symptoms development, symptoms progression, and more negative symptoms appearance as a result (Taylor, 2011). Causes of Schizophrenia Genetic Factor It was noticed several centuries ago that families can be affected by schizophrenia that is why scientists paid attention to a genetic factor. Generally only 1% of the world population suffers from schizophrenia but for those who have close relatives, such as parents or siblings, affected by this disorder chances rise up to 10%. People whose ants, grandparents or uncles, so to say second degree relatives, have schizophrenia have higher chance to experience schizophrenia. 40% -60 % of risk is for those who have a twin brother with this diagnosis (What is Schizophrenia, 2011). Generally some genes by cause the impairment but it is a specific combination of mother`s and father`s genes that plays a dramatic role in schizophrenia development. Scientists explain that the patients with schizophrenia usually have some rare form of genes mutation that causes disruption in normal brain work. Unfortunately, it is impossible to calculate yet which exact combination and variation of genes will result in creation of the specific gene responsible for schizophrenia. Since genetics is still developing it is impossible to find out which exact gene causes malfunctions but scientists claim that there is the central gene which is responsible for higher functioning skills. Moreover, schizophrenia most probably develops as a result of combination of several factors where genetic is just on. So problems during birth, exposure to some viruses in early childhood, special behavior in adult age may provoke schizophrenia (What is Schizophrenia, 2011). Brain Chemistry Neurochemists claim that alternations and imbalance in the chemical reactions which include such neurotransmitters as dopamine, glutamate, and some others most probably cause schizophrenia. The most important function of neurotransmitters is to create effective communication between brain cells, so when this process is disrupted some neurotransmitters fail to perform their function. Schizophrenia is often explained by the alternations in brain structure and shifts of dopamine neurotransmission (Os & Kapur, 2009). The excess of dopamine received necessary evidence to be connected to schizophrenia. One of the functions of dopamine is to add “salience” by transforming neutral representations into more attractive. Thus, with constant dopamine excess the brain of schizophrenic turns insignificant thoughts into obsessive and minor sounds into noises (Pichionni & Murray, 2007). Moreover, there are some visible abnormalities in the brain structure of those who suffer from schizophrenia. Researchers suggest that some distributions in brain cells are likely to happen even before birth with some peculiarities of puberty development leading to faulty connections. For instance ventricles, which are responsible for transportation of cerebrospinal fluid are supposed to guarantee chemical stability of the brain. It is estimated that they are larger in those suffering from schizophrenia. There is also imbalance in grey matter which result in changed activity in several locations of the brain (What is Schizophrenia? 2011). Moreover, according to Jackson and Brichwood even family environment can have predictive power for schizophrenia. A combination of negative behavioral patterns and abnormal communication in family may increase the risk of schizophrenia development in children and teenagers(2011). Drugs Abuse Some people are prone to relate substance abuse to the symptoms of schizophrenia. It is sometimes difficult to differentiate between those symptoms which appear as a result of getting high and those that are pure “schizophreniac”. Scientists do not find evidence that drugs can develop this mental disorder, however, they cannot be completely excluded as the factor that can trigger schizophrenia. Many people with this mental disorder abuse such drugs as marijuana, alcohol, cocaine, and amphetamines and often have negative reactions on them. The treatment for those abusing drugs cannot be as effective as for those who do not use drugs because they disrupt the balance of neurotransmitters regularly (Schizophrenia and Substance Abuse, 2011). Treatment of Schizophrenia The views on treatment of schizophrenia have changed during past centuries beginning from seriously pessimistic, when schizophrenia was considered incurable to quite promising these days. As soon as the diagnosis is made the doctor has to prescribe antipsychotic drugs to the patient. These agents, often referred to first generation antipsychotics, block dopamine D2 receptors but have certain adverse reactions in patients(Os & Kapur, 2009). “Typical” antipsychotics are the least used nowadays because they are the first generation of these type of drugs. Psychiatrists more often prescribe the following medications nowadays: Chlorpromazine (Thorazine) Haloperidol (Haldol) Perphenazine (Etrafon, Trilafon) Fluphenazine (Prolixin). Second generation of antipsychotics was tested and approved in the late 1990s. Clozaril is one of the most common drugs of this type because it helps patients to get back to reality treating such symptoms as hallucinations and delusions. It is usually prescribed when no other drugs prove to effective in schizophrenia treatment. But this drug sometimes has negative side effects connected with blood and people who take it must count their white blood cells regularly which can be sometimes difficult for many people.There also other kinds of antipsychotics which do not cause problems with white blood cells. Risperidone (Risperdal) Olanzapine (Zyprexa) Quetiapine (Seroquel) Ziprasidone (Geodon) Aripiprazole (Abilify) Paliperidone (Invega) (What is Schizophrenia, 2011). But these drugs also have multiple side effects such as hypertension, insomnia, sedation, hypersalivation. Thus, the medication depends on the patient`s concomitant dysfunctions and doctor`s preferences (Pichionni & Murray, 2007). Psychosocial treatment is necessary because it helps people in leading a normal life at home, school, and work, and also habituates patients to taking medication regularly. Psychosocial approach in treatment is also important because it helps people who were already returned to a norm with the help of drugs to adapt to a normal social life. Patients with schizophrenia experience difficulties in keeping close contact with other, performing daily tasks, and taking care of themselves. Psychiatrists teach patients how to use coping mechanisms to manage with these problems. There is a need to educate relatives and friends of patients with schizophrenia on how to react and how to behave with those who suffer from this mental illness. Relatives must be involved into teaching patients coping strategies and how to react in critical situations. So family education is compulsory for those who live with those who experience negative symptoms of schizophrenia. There appeared a new method of schizophrenia treatment recently, group therapy, and it is becoming more and more common. People gather in groups which allow them feeling more relaxed because they understand that the others have the same problems. Even psychiatrists are not involved into group therapy sometimes. Patients can share their coping strategies and relieve the psychological burden of each other. These groups also attract the attention of society to those suffering from schizophrenia (What is Schizophrenia, 2011). Cognitive-behavioral therapy helps those patients who do not feel relief from medications and re-experience the symptoms regularly. The psychotherapist teaches patients how to “check” the reality and how to react when such symptoms as voices and hallucinations appear. Conclusion ` The concept of schizophrenia is absolutely enigmatic as it has changed during past 100 years since the time when the disorder was first defined. It was perceived as biological dysfunction, psychological illness, and a social construct. The advances of the sciences allowed combining different approaches to the disorder and providing with coherent explanation of its reasons. Schizophrenia is mostly associated with severe hallucinations, delusions, social withdrawal, and sometimes the symptoms of this disorder overlap with other mental illnesses. People suffering from schizophrenia have difficulties with leading normal social relationships and conducting stable way of life. Earlier schizophrenia was considered incurable but nowadays scientists and psychiatrists are optimistic about the results. Schizophrenia now is explained by a combination of several factors: genetics, environment and imbalance of brain work. Most often schizophrenia is attributed to the imbalance of neurotransmitters in brain with excessive quantity of dopamine. Treatment of schizophrenia includes antipsychotic drugs which block dopamine receptors and prevent dopamine excess. Family therapy and art therapy are sometimes used as additional psychosocial ways of treatment. References American Psychiatric Association DSM-5 Work Groups (2010). Proposed Revisions – Schizophrenia and Other Psychotic Disorders. Retrieved 5th October 2014 from: http://www.dsm5.org/MeetUs/Pages/WorkGroupMembers.aspx Bailey, S., & Dolan, M. (2004). Adolescent forensic psychiatry. Boca Rotan: Castle, D., & Buckley, P. (2012). Schizophrenia. Oxford: Oxford University Press. Classification of Mental and Behavioral Disorders (2012). World Health Organization. Retrieved 6th October 2014 from: http://www.who.int/classifications/icd/en/GRNBOOK.pdf Frese, F., Knight, E., & Saks, E. (2009). Recovery from schizophrenia: with views of psychiatrists, psychologists, and others diagnosed with this disorder. Schizophrenia Bulletin, 35 (2). History of Schizophrenia. (2012). Schizophrenia Educational Site. Retrieved 5th October 2014 from: http://schizophrenia.com/history.htm# Jackson, H., & Birchwood, M. (2001). Schizophrenia. East Sussex: Psychology Press Ltd. Os, J., & Capur, S. (2009).Schizophrenia. The Lancet, 374, 635-645. Pichionni, M., & Murray, R. (2007). Schizophrenia. British Medical Journal, 335(7610), 91-95. Schizophrenia and Substance Abuse (2011). National Institute of Mental Health. Retrieved 06th October 2014from: http://psychcentral.com/lib/schizophrenia-and-substance-abuse/000710 Taylor, V. (2011). Acute schizophrenia. About schizophrenia. Retrieved 5th October 2014 from: http://www.schizophrenic.com/articles/schizophrenia/acute-schizophrenia What is Schizophrenia? (2012). National Institute of Mental Health. Retrieved 5th October 2014 from: http://www.nimh.nih.gov/health/topics/schizophrenia/index.shtml Read More