Schizophrenia: Psychological and Psychiatric Views


Schizophrenia has been described as among the top causes of morbidity in both men and women. It has been said to be second in the factors leading to international terrorism, as well as a major of war. By definition, schizophrenia is a chronic severe brain disorder characterized by altered perception and the manner of expression of reality. The effects are manifested as hearing of voices (auditory hallucinations), paranoia, and disorganized speech and thinking. Individuals suffering from schizophrenia claim to hear voices that others don’t hear, they are of the view that the rest of the people are telling their thoughts and even get the feeling that other people are planning to harm them. About 1.1 percent of the people living in the US display these qualities every year. The characteristics cause other people to fear schizophrenics and making them to be reserved and hence have difficulties forming relationships (Cardwell & Flanagan 2007).

Symptoms

Schizophrenia is diagnosed by understanding its symptoms which are categorized under positive symptoms, negative symptoms and cognitive symptoms. Under positive symptoms we have hallucinations, delusions, thought disorder and movement disorder. Hallucinations are described as voices that the person hears and which are usually not present and hence the others can’t hear them. The voices usually describe the person’s behavior or command the individual to do things and sometimes give warnings of danger to befall the person. Scezophrenics may also experience hallucinations such as seeing non-existent images of people, claiming to smell odors and even experiencing feeling of being touched by fingers when in solitary. Delusions experienced by schizophrenics are usually manifested as bizarre and paranoid believes that are neither true nor logical. These delusions manifest themselves differently in the individual. For instance the individual may feel that other people are controlling his thoughts or that the TV is broadcasting what’s on his mind or sometimes make them believe that they have assumed the identity of another person usually a prominent historical figure. These delusions are the same ones that make them feel that others are plotting to harm them. Thought disorder is manifested when the individual displays disorganized form of thinking. The person is challenged when it comes to planning his thoughts in a logical manner. The effect of this that the person utters words in a manner that fails to make sense. Thought disorder can also be manifested as thought blocking which is when the individuals stops talking all of a sudden before finishing speaking his thoughts and thereby claiming that the thought had been stolen from inside their head. Movement disorders is displayed as the person repeating the same movement over and over or in the extreme the person may enter a state where they do not move or respond to anything, a condition in which the person is described as catatonic (Strauss & Carpenter 1981).

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Negative symptoms are described as those symptoms that manifest as interruptions from normal way of behaving. They are often confused to depression and other mental states making them hard to single out. They include symptoms such as flat effect, where the person is often dull and often the face remains still as he talks in normally a flat voice that lacks tone variation. Another negative symptom is a display of lack of interest in life. It also manifests itself as inability to initiate an activity and maintain commitment in an organized task. The person also appears reserved even in social places and functions and keeps his speech at a minimum.

Cognitive symptoms are usually mild and hard to detect. Schizophrenics are unable to comprehend and organize presented information and drawing logical conclusions from the information. They usually find it hard to concentrate and show sustained interest in a matter. They also have problems applying knowledge a short time after acquiring it (working memory).

Diagnosis

The very first step to coming up the right treatment method for schizophrenia is coming up with the correct criteria for diagnosis. The main reason for this is to avoid any confusion of the condition with other mental disorders which often manifest themselves as similar symptomatically. The other reason for proper diagnosis is to determine the presence of schizophrenia medically since sometimes the paranoia in the patient may cause them to deny that they have a problem causing them to resist seeking professional help. Diagnosis of schizophrenia is based primarily on the reported symptoms. The symptoms could either be reported abnormalities in behavior by the person, or reports of unusual behavior by the family members or colleagues which are approved through medical assessment carried out by a mental health professional. A standard criteria for diagnosis of schizophrenia exists which draws its guidelines from the Diagnostic and Statistical Manual of Mental Disorders, version DSM-IV-TR a guideline based on the decisions taken by the American Psychiatric Association. According to the manual, for a person to be diagnosed with schizophrenia, the displayed symptoms must meet the three diagnostic criteria. The first step to accurate diagnosis of schizophrenia is the presence of the characteristic symptoms and the negative symptoms discussed above. The requirement is that at least two of these symptoms must be present for a majority of the time in over a one month period, or less if medical treatment is administered. Secondly, the disrupted social and functional capability displayed by the person, must show a significant level of deterioration in at least one major area functioning from the time of the symptoms were first reported. The criteria in social dysfunction require that these signs continue to disrupt social behavior for a period of not less than six months. However, schizophrenia cannot be diagnosed if the behavior is as a result of direct abuse of medical substances such as drug abuse.

Causes

Evidence from a careful examination of the symptoms of schizophrenia; indicate that the mental disorder is as a result of a combination of both genetic and environmental causes that bring about the symptoms. These are genetics, chemical explanation, social interaction, and abuse of drugs. The genetic explanation of schizophrenia bases its main reason on the argument that the disorder is directly inherited from the parent’s genes. It has been proven that schizophrenia usually runs amongst families. According to Gross& Rolls (2005), the evidence to support this is the proven fact that the closer a person is in terms of relations to a schizophrenic, the higher the chances are of that person suffering from schizophrenia disorder. Medics have shown this relation to be caused by a defective gene in PPP3CC gene in humans. The highest rate of prevalence in relation to family ties has been found to be among twins, despite the differences in the atmosphere they are brought up in. The chemical explanation for schizophrenia is based on the know fact that the brain messages are transported by neurotransmitters which carry the thoughts. Any significant problem with the neurons receptors leads to a chemical imbalance leading to schizophrenia. These are controlled by a chemical referred to as Dopomine, whereby any significant rise in Dopomine leads to disrupted thoughts which in turn affects the speech and causes incoherent behavior. It is the disruption in levels of Dopomine that has been found to result to delusions and hallucinations. Evidence to back this up has compared the prevalent relations between cannabis and schizophrenia and the results totally supports the idea as cannabis was found to block the neuron receptors and triggering a rise in Dopomine levels causing hallucinations and delusions. A further discovery into the neurodevelopment during the early stages in life led to a very reliable discovery that a large population of those diagnosed with schizophrenia were found to be born in the winter or spring season. The explanation to this was that the exposure of pregnant mothers to extreme cold conditions has an adverse effect in the development of the neurons of unborn babies leading to an increased chance of developing schizophrenia in later stages. There is proven evidence linking challenges in social interactions and occurrence of schizophrenia. These factors have linked the possibility of prevalence of schizophrenia to individuals of lower social classes. The reason seeking to explain this discovery is that life in lower social classes is marred with a lot of stress stemming from poverty, lack of food, unemployment or low wages, poor living conditions and constant family dysfunction. In places like the US, cases of schizophrenia are mainly reported among the black communities owing to the fact they are most likely to fit this category coupled with prejudice and discrimination. Cases of schizophrenia have also been linked to unhealthy interactions amongst family members. Research has linked growing up in a family where hostility, criticism and controlling parents are the order of the day to the possibility of the children relapsing to schizophrenia. Statistics show that half of all the patients diagnosed with schizophrenia are constant abusers of drugs. It is however difficult to link use of drugs as a cause of schizophrenia with some people arguing that abuse of substances is caused by prevalent of schizophrenia. Some drugs induce psychoses symptoms that are similar to those displayed by schizophrenics but cannabis is the best known substance that upon dependent causes psychotic disorders.

Treatment

The issue of treatment method for Schizophrenia remains a controversial affair up to date. Treatment of schizophrenia is not to be confused however with the recent criteria of suppressing the symptoms. Finding an exact cure for the mental disorder has proven to be hard which has then inspired the invention of methods to manage or keep the symptoms at a minimum as well as the several ways of improving the social function. This has been achieved by the invention of drugs to reduce the psychosis behavior. However some communities still emphasize on informal ways of treating the condition through social interventions. The result is two broad categories of treatment namely medication and psychological and social methods.

The biggest breakthrough in medical treatment of schizophrenia came by when antipsychotic medication invented. These are drugs that act by relatively reducing the length of time that the psychosis behavior is evident as well as significantly reducing the chances of the behavior occurring again. Relapse into previous mental condition is however still very much possible with stress and after a persons stops taking the antipsychotic medication. Evidence has shown that with each relapse into schizophrenia, there is an increase in intellectual impairment. The exact manner, in which the medication works is by suppressing the suicidal tendencies, reduces the chances of being hospitalized and results in a rise in social functioning. The intellectual impairments resulting from schizophrenia are however not treatable medically and this still poses dangers in social adaptability with the person not being able to regain employment owing to the poor span of concentration, altered memory banks, inability to make decisions and lack of interest. For relatively long positive effects of antipsychotic, the individual should commit to a life-long continued use of the medication. For better chances of the individual recovering from schizophrenia, emotional and financial support from family and colleagues should be present. Most people who suffer schizophrenia experience negative side effects when they start taking antipsychotics. These side effects include feeling sleepy, lightheadedness, unclear vision, disrupted menstrual flow in women, increased heartbeat, and increased skin sensitivity to sun rays. Most of these side effects usually do not last and disappear after sometime. The seriousness of these side effects is a major contributor to non-compliance to the medication and often results in relapse.

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An alternative to treating schizophrenia is by the use of psychosocial treatments. These usually work well on people who are already on medication and the psychotic behavior has stabilized. The basic method used here is offering of support mostly emotional to the individual through social groups, in families and through psychotherapy where the individual seeks the help of a professional. Through psychosocial treatment, the person is able to deal with the daily life challenges that result from or fuel the condition. These are communication, daily tasks, as well as making it possible for them to form relationships and help them maintain the relationships. The support offered in psychosocial treatments is also a major contributor in the patients continuing to take medication hence reducing the chances of hospitalization and consequently reduced chances of relapse. Since patients of schizophrenia also most likely have a substance abuse problem, a good treatment program would incorporate drug treatment programs when dealing with schizophrenics. Well designed programs are normally found in rehabilitation centers where the patients are engaged in training and counseling to help them better fit in their communities. A schizophrenia patient can also use the services of a professional therapist who offers counseling adopted to fit the individuals points of help. A common form of seeking help for schizophrenics is registering in self-help groups. In such groups, people suffering from schizophrenia and their families form a group where with the absence of a professional they interact with other members and offer support and comfort amongst themselves (Rice & Haralambos 2000).

In conclusion, schizophrenia is a mental condition that is often associated with the individuals displaying psychotic behavior which causes them to be feared and isolated/discriminated against in the community. Most people have associated he rise in violent criminal cases with prevalence of schizophrenia which studies in the UK proved to be a fallacious claim. In most countries, people with schizophrenia are entitled to disability pensions or government insurance. In the debate for the effective treatment of the condition, studies have shown that the symptoms can effectively be managed through integration of both medical treatment and psychosocial form of treatment to reduce the chances of relapse and ensure continued use of medication.

Reference

Cardwell, M. &Flanagan, C. (2007). Higher Psychology. Cheltenham: Nelson Thornes Ltd.

Gross, R. & Rolls, G. (2005). Classic Case Studies in Psychology. Warren: Arnold Publishers.

Rice, D., & Haralambos, M. (2000). Psychology in Focus: AS Level. Edinburgh Gate Harlow Essex,UK: Causeway Press.

Strauss, S.J. & Carpenter T.W. (1981). Schizophrenia: Critical Issues in Psychiatry. New York: Springer Publisher.

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