Table of Contents
Introduction
How a person thinks, behaves, and feels can be affected if a person has a severe mental disorder referred to as Schizophrenia (Häfner, 2015).Despite that, this disorder is not a common disorder like other mental disorders; it makes people seem like they have lost touch with reality, and the symptoms are very disabling.
Unlike other mental disorders which have been discovered a long time ago, Schizophrenia was revealed less than a hundred years ago, although it had been discovered as a distinct mental disease, and the disease is alleged to have convoyed mankind through its history.
Through the evaluation of the Greek and Roman literature by recent researches, it was discovered that the overall populace had cognizance of the psychotic syndromes, but there were no conditions that could bump into the present diagnostic standards of the Schizophrenia. The same treatment was done for those people that had a mental disease, mental retardation, and physical malformations since they were all regarded as abnormal.
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According to the early theories, evil possession by the body was what resulted to the mental disorders and the chief treatments were by means of banishing the demons by several ways vacillating from inoffensive cures which included the exposure of the patient to various kinds of music to hazardous and at times deadly cures such as drilling of holes in the patients skull to remove the evil spirits.
The classification of the mental disorders was first done by Emile Kraepelin, and in his classification, dementia praecox was a term that was used to define persons who had indications that are now related to Schizophrenia.
A distinction of the psychotic disorders was first made by Kraepelin where the disorders were referred to as dementia praecox and manic depression. Dementia praecox is an illness of the brain and was named dementia praecox to differentiate from other types of dementia such as Alzheimer’s illness. Moreover, the term was used since his key emphasis was on young adults with dementia.
Further research of the disease was done by a Swiss psychiatrist known as Eugen Bleuler, who grouped the symptoms of the disease as either positive or negative and he changed the name of the disorder from dementia praecox to schizophrenia as he found the original as not appropriate. He discovered that the disease did not all the time cause mental deterioration, and therefore, dementia was not an appropriate name.
Moreover, he focused on all ages as the disease could also occur at a late age. According to Bleuler, his definition of schizophrenia meant that individuals with the disorder had fragmented thinking. Since Bleuler time, the meaning of schizophrenia has continuous being changed due to the attempts of scientists to define the diverse categories of mental diseases.
The precise causes of the disease have not yet been discovered, and the recent categorizations of the disease are based on the symptoms. Five categories have been discovered, which include paranoid, residual, catatonic, disorganized, and undifferentiated.
Etiology and pathophysiology, risk factors, signs and symptoms, and diagnostic criteria
Etiology and Pathophysiology
The etiology of schizophrenia has not well been discovered, but various researches have proven a wide range of brain abnormalities through post mortem studies, computed tomography imaging, and magnetic resonance imaging technology.
According to the studies, the disease is associated with loss of total gray matter, frontal and temporal lobe volume and the decrease of the size of the brain. Moreover, the etiology of schizophrenia has been discovered to be multifactorial with small-effect and less large-effect vulnerability genes interrelating in various environmental factors. These factors cause the development of mediated alterations in neuroplasticity exhibiting in a cascade of neurotransmitters and circuit dysfunctions and compromised connectivity, which mainly occurs around early adolescence.
Pathophysiology of Schizophrenia has been done by the use of brain imaging and neuro-pathological studies where an attempt to connect the signs of schizophrenia with dissimilar edifices and precise brain regions and circuits has been made.
There has been a success in connection of some facets of the disorder to various underlying neurobiology, and multiple lines of indication associate the involvement of the prefrontal cortex indefinite the cognitive discrepancies.
Moreover, decreases in the volume of the grey and white matter have been established in numerous brain parts and circuits where the reduction of the grey matter developments with the epoch of the disease.
The Risk Factors of Schizophrenia
Many researches for the disease have been done but the exact causes of the disease have not yet been discovered. It has been discovered that that is a strong genetic component to schizophrenia but the genes alone are not the causes of the disease (Howes, 2017). The genes cannot directly cause schizophrenia but they make a person to be vulnerable to the disease.
There are various factors which play a part in the involvement of the diseases the categorization of the factors include: psychological, genetic and social factors. The main risk factors include: a father who is older in the age, family history of the disorder, defects of the autoimmune and drug abuse in the course of the early adulthood and adolescence.
Schizophrenia occurs also occurs as a result of complications during birth or pregnancy, where these difficulties comprise: premature labor, low birth weight, absence of oxygen during birth, and the exposure to toxins and viruses in the utero. Schizophrenia is mostly found in urban areas, and income inequality plays a major role where families with low income have the highest probability of getting the disease. There is no exact gene that has been discovered to cause the disease; many genes have been discovered to cause the disease.
The probability of getting the disease is based on the degree of relationship with the relatives. If the first degree relatives who include the parents and siblings and the second-degree relatives who include grandparents, uncles, and aunts don’t have the disease, then the probability of getting the disease is one percent.
Moreover, if one parent has the disease, then the probability of a person developing the disease is 10%. Despite that genetics provides the factors that can result in the development of the diseases, genetics alone do not explain schizophrenia since the majority of the people with the disease do not have relatives with the disease.
Signs and Symptoms of Schizophrenia
Schizophrenia may appear without warning to some people but for many, it appears gradually with various warning signs where this may result in a gradual decline in functioning before the severe episode. Some early signs include lack of motivation, emotionless, reclusive to others, neglecting the appearance, and the show of a general indifference to life. The appearance of these signs may result in other problems, not only schizophrenia. The significant classifications of schizophrenia symptoms include the positive and negative symptoms.
The positive symptoms comprise: First, delusions, where the people with the disease believe in having superpowers and therefore, despite an idea being given being sincere and having evidence, the individual says, isn’t true. There are various classifications of delusions which include delusions of reference, delusions of grandeur, the delusion of persecution, and delusions of control.
Second, hallucinations where one may hear sounds and other sensations and perceive them as real, but they only exist in their mind. Mainly, the hallucinations occur through the misinterpretation of the inner self-talk as imminent from an external source.
Thirdly, having a disorganized speech because of the trouble in focusing and upholding a train of thoughts where this is manifested externally in the manner an individual speaks. This may result in giving an unrelated answer to a certain topic, start a sentence in the correct way but end it in a totally different manner, and speak incoherently.
Fourth, the disease causes an individual to have disorganized behaviors through the impairment of the capability to take care of oneself, work, and interaction with others. The negative symptoms are the absence of normal behaviors that are found in healthy individuals. They include the absence of concern or eagerness, lack of emotional countenance, speech problems and irregularities, and absence of interest in the world.
Diagnosis of Schizophrenia
Medical history and the physical examination are done by the doctor if schizophrenia symptoms are present. Various diagnostic tests, which include MRI or CT scans or blood tests, are used by the doctor to check for the physical sickness as the source of the signs because there are no specific tests for the diagnosis. The person might be referred to a psychiatrist or the psychologist if the doctor discovers that there are no physical causes for the signs. Well-designed interview and valuation tools are used by the Psychiatrists to evaluate a person with schizophrenia (Mitrofanov, 2019).
The diagnosis is based on the individual’s report of the symptoms and the observations that the therapist observes the individual attitude and behavior. A comparison is then made by the therapist as to whether the individual’s symptoms are related to the ones that are delineated in the Diagnostic and Statistical Manual of the mental disorders. If an individual has one or two of the main symptoms, which include: delusions, hallucinations, and disorganized speech is what marks the diagnosis of schizophrenia.
Other primary symptoms include gross disorganization and reduced emotional manifestation. Moreover, other criteria for the diagnosis include signs of disturbance having lasted to 6 months and a decrease in the level of work and interpersonal relations than what was there before the occurrence of the symptoms.
Facts and Statistics
Regardless of the economic background, ethnic and racial backgrounds, Schizophrenia is found in about 1.1% of the world’s populace, wherein the United States, about 3.5 million individuals have the disease, which is the leading cause of the disability. A higher percentage of individuals with the disease usually develop the disease when they are between the ages of 16-25.
Giving the approximation of the recovery, 25% of the individuals recover entirely, 50% improve with time, and 25% do not improve with time. Moreover, about 50% of the individuals diagnosed with the disease have not yet received treatment because the costs of the treatment for the disease are usually high ranging from 32.5$ and 65$ annually.
Treatment (including therapy, medications)
There is no cure for the illness, but various outlook ways for the individuals with the disease have been discovered to enhance their improvement, which includes: behavioral therapy, psychotherapy, employment, educational interventions, and provision of the social services.
Help is offered to the families and the individuals with schizophrenia by the Psychiatrists, mainly the social workers, professionals of the mental health, and the care doctors on the various ways to explore various sources of treatment. The combination of the use of medication and the therapy facilitates proper treatment. The medications commonly used for the disease are regarded as antipsychotics to ease some of the symptoms, which include hallucinations and delusions. Therefore, the earlier the treatment of the disease the better chances of successful outcomes.
Possible Complications
If the treatment of the disease is not appropriately received, the condition can turn to be a dangerous disease-causing some complications in various aspects of life. These complications include financial, emotional, physical, and legal problems if the disease is not well controlled.
Precisely, the individuals are at high risk of depression and suicide complications, and they may be involved in self-destructive behaviors such as the abuse of cigarettes, alcohol, and drugs. The misuse of cigarettes may result in body complications such as heart disease, and the inability to work or be in a relationship leads to poverty and homelessness. People with the disease may get involved in a violent crime where they can be the victims or the individual committing the crime. Moreover, the use of antipsychotic medications can result in serious side effects where some of the side effects can be permanent.
Possible Outcomes (good and bad)
The outcome of the disease is influenced by various factors, and family history is one of the most relevant factors. A good sign is indicated if no member of the immediate biological family has the conditions of the disease, and a bad sign is indicated when a number of the family members have the disease.
The probability of the individuals with a good sign for complete recovery is very high, unlike for the individuals with a bad sign. Moreover, the chances of the recovery are improved if the disease occurs all of a sudden rather than gradually, and if the disease is treated rapidly and reliably with a good response to the treatment, the result is typically very good.
References
- Häfner, H. (2015). What is schizophrenia? 25 years of research into schizophrenia-the Age Beginning Course Study. World journal of psychiatry, 5(2), 167.
- Howes, O. D., McCutcheon, R., Owen, M. J., & Murray, R. M. (2017). The role of genes, stress, and dopamine in the development of schizophrenia. Biological psychiatry, 81(1), 9-20.
- Mitrofanov, A. A., Kichuk, I. V., Solov’eva, N. V., Kuvshinova, Y. V., Chausova, S. V., Vileanov, V. B., … & Olimpieva, S. P. (2019). The use of eeg discriminant analysis in the diagnosis of schizophrenia. Zhurnal nevrologii i psikhiatrii imeni SS Korsakova, 119(1), 44-50.
