Violence in Schizophrenic Patients - Research Paper Example

Schizophrenia'pg Violence in Schizophrenia College Schizophrenia'pg. 2 This study examines the level of violence in patients of Schizophrenia convicted of serious offences with substance abuse and without substance abuse and the level of violence of violent non-schizophrenic convicted of serious offenses with and without substance abuse. Previous studies have found that the use of certain substances such as butorphanol leads patients of schizophrenia to later episodes of violent behaviors. To determine if violence is related to substance abuse in patients of schizophrenia we designed a 2x2 Factorial design and compared different levels of aggression in 100 convicted patients of schizophrenia and 100 convicted without schizophrenia but with or without substance abuse. The design consisted in the administration of Arabic coffee as a stimulant that created or instigated a condition which provoked episodes of violence on both groups of schizophrenia and the groups of non schizophrenia patients. ' Schizophrenia'pg. 3 Introduction Schizophrenia is one of the most major disorders that is quite devastating to an individual occurring in approximately 1% of the population and comprises of more than a single general disorder. Patients with schizophrenia struggle with many functional impairments including performance of independent living skills, social functioning, and occupational/educational performance and attainment. Sharma T, Antonova L. (2003) Schizophrenia is among the top 10 disabling conditions worldwide for young adults. Jaeger J, Berns SM, Czobor P (2003) &Wu EQ, Birnbaum HG, Shi L, et al (2002) This particular disease is a great cause for concern and research on the subject is a continuous process and runs into billions each year. However, there is no major gender issues involved where the prevalence of the disease is concerned. Therefore, one of the top most priorities today is to provide good mental health services and better support to schizophrenic patients across the globe. Schizophrenia is not a disease relating to a split personality but on the other hand it is a disorder that is closely related to an individual's emotions and thought processes. This condition is amplified further if the individual is under the influence of substance abuse. The Diagnostic and Statistical Manual of Mental Disorders, defines schizophrenia as a Schizophrenia'pg. 4 psychotic "disorder that lasts for at least 6 months and includes at least one month of active-phase symptoms of the following: delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, negative symptoms" (The Diagnostic and Statistical Manual of Mental Disorders. pg.298) some of the very common symptoms schizophrenia are, cognitive and emotional dysfunction involving hedonic capacity, inferential the processes, imbalances in perception, speech and hearing abilities and poor language and communication skills. All these symptoms are classified into two divisions - 1) positive and 2) negative, wherein an excess or distortion of normal functions is classified as positive, while a loss or diminution of normal functions are called the negative symptoms. (The Diagnostic and Statistical Manual of Mental Disorders, pg.299) This study will compare levels of violence in convicted patients of schizophrenia and those convicted but not schizophrenics and with no records of substance abuse with a group of violent schizophrenic and those who are not schizophrenics but with records of substance abuse and another group without substance abuse. Schizophrenia is said to be a psychotic condition which could be triggered by various external factors such as substance abuse, genetically, defects at birth, environmental factors and even if there is an imbalance in dopamine which is a neurotransmitter. Our area of research would encompass the four different groups and we would be investigating the behavior of schizophrenics who involve themselves in criminal Schizophrenia'pg. 5 activities either under the influence of substance abuse or without. This study is going to focus on schizophrenic patients involved in violent crime when under the influence of substance abuse and also of those schizophrenics who are involved in crime but are not associated with substance abuse. In a cohort study of 13,806 schizophrenic patients in Sweden involved with violence and crime, the Cox proportional hazards model was used to examine and investigate such patients over a long duration from January 1, 1973 up to December 31st 2004 based on the familial risk factors (parental crime and alcoholism) In the follow up period of 12 years, results showed that violent risk factors were present in 17.1 % (N = 1519) of the men and 5.6% (N = 273) of the women, but after socio-demographic adjustment, these risk factors were significantly reduced to a great extent. This study proved that familial risk factors had very low to moderate influence on violent crimes and also that 'familial (genetic or early environmental) risk factors have an important role in the etiology of violent offending among individuals with schizophrenia and should be considered in violence risk assessment. (PsycINFO Database Record (c) 2009 In a second study that was conducted on a nationwide basis by analyzing data from the registers from Swedish hospitals, and investigation of Schizophrenic patients involved in criminal convictions between 1973 and 2006 were taken into consideration. The investigation was carried out on the basis of marital and immigration status, age, sex and Schizophrenia'pg. 6 income in addition to substance abuse. In speaking to Medscape Psychiatry, Dr. Fazel (2006) stated that "unaffected siblings had increased rates of violent crime compared with the general population, and this appeared to be mediated through higher rates of substance abuse than general population controls." Many of the reports concluded that patients with schizophrenic mental disorders associated with crime either with or without substance abuse could be prevented from violence and crime if proper treatment is rendered. Diagnosis of schizophrenic patients was carried out and the risk for violent crime was measured and compared to that of the general population. All the above variables were thoroughly investigated and an analysis was drawn up. The research study found that among schizophrenic patients at least one offence that was violent was noted when comparing to the general population of 4276 (5.3%) The schizophrenic patients also involved in substance abuse had a much higher percentage of 27.6%. Methods Aim The aim of the study is to make an investigation on four different groups of people involving schizophrenics and non- schizophrenics, with and without substance abuse to form an analysis on the aggressive behavior patterns of their respective groups. Schizophrenia'pg. 7 Participants The participants were 100 in number consisting of both male and female genders for each group. The first group consisted of 100 participants that belonged to the Schizophrenic category and 100 participants who belong to the non-Schizophrenic category. Experiment Design The experiment was based on a 2 by 2 Factorial design to measure the level of aggression of all the four groups of participants. Materials Used Questionnaires for the participants asking pointed questions on their abuse of alcohol and use of violence. Procedure Schizophrenia'pg. 8 Results Schizophrenia'pg. 9 Discussion ' In the'cases'pertaining to'patients'diagnosed'with'both'the'afflictions,'i.e. schizophrenic and drug abuse the problem becomes'compounded.' It'' is' a'two way''confusing' problem' that' cannot' be' dealt' with' so' easily.' People' who' abuse' drugs' show' similar' problems' and' symptoms'to that' of' a' schizophrenia' patient. Most' researches'show' that' those' who' abuse' drugs' may' not' always' have' schizophrenia' because' substance' abuse' does' not' result' in the' disease,' but on the other hand,'people' suffering' from' schizophrenia' might'' abuse' drugs' or' alcohol'on a regular basis. The most' common' problem' faced' by' the' physicians and' the' relatives' of' the' patient 'is' that' substance' abuse'reduces' the' effectiveness' of' treatment in the case of schizophrenic patients.' Stimulants' like PCP,' marijuana,' amphetamines' or' cocaine' may' cause'major' problems' for' schizophrenia' patients, 'and'the'' symptoms' may' worsen' in' patients' who' abuse' these' substances. Therefore, the treatment of a schizophrenic person who also has a history of drug abuse becomes a very complicated procedure since Substance like' nicotine' interfere' with' antipsychotic'drugs' that have to be administered, and therefore,' patients' addicted' to' it,' need' higher' doses' of' such' medication.' Schizophrenia'pg. 10 One Quitting' substance' abuse' becomes'difficult' especially' for' schizophrenic' patients,' because withdrawal' symptoms' of' nicotine' or' any' other' substances' may' cause' temporary' worsening' of' schizophrenia symptoms. 'So' it is left up to the physician' to' monitor' the' medication'dosage' carefully' in' these' cases' where' the' patient' either'starts' or' stop' substance' abuse. ' Schizophrenia'pg. 11 References . Fazel, S. & Grann, M. (2006). The population impact of severe mental illness on violent crime. Am J Psychiatry, 163, 1397-1403. Jaeger J, Berns SM, Czobor P. The multidimensional scale of independent functioning: a new instrument for measuring functional disability in psychiatric populations. Schizophr Bull. 2003;29:153-168. Sharma T, Antonova L. Cognitive function in schizophrenia. Deficits, functional consequences, and future treatment, Psychiatr Clin North Am. 2003;26:25-40. The Diagnostic and Statistical Manual of Mental Disorders, pg.298.) Read More