Schizophrenia

Schizophrenia-

A Dysfunction of the Brain: Why They Can’t Help Their Behavior

Schizophrenia is a serious and chronic mental illness that affects one person in a hundred at some point in their life. It can start at any age but most commonly begins in the late teens or early twenties for men and mid twenties to mid thirties for women. Women and men are diagnosed with this illness equally throughout the world. A person with schizophrenia does not have a split personality as many people believe. Schizophrenia is one of the psychotic disorders with symptoms such as delusions, hallucinations and distorted thoughts that indicate the person has lost touch with reality. The symptoms of schizophrenia vary from person to person and are generally divided into positive symptoms, which are abnormal experiences, and negative symptoms that are more an absence of normal behavior. It is typically the positive symptoms that cause the most problems with the individual. These are also the symptoms that cause other individuals to consider those with schizophrenia as bizarre, mad or crazy. Evidence indicates strongly that schizophrenia is a severe disturbance in the brain's functioning. It's believed to be caused by many factors; these include changes in the chemistry of the brain, structural changes of the brain, and genetic factors.

The Concept of the Diagnosis

Psychiatric illnesses are diagnosed by meeting criteria from the Diagnostic and Statistical Manual Fourth Revision, (DSM IV вЂ"TR). The diagnosis of schizophrenia- paranoid type according to the DSM IV вЂ"TR is having preoccupation with one or more delusions or frequent auditory hallucinations. For this subtype; disorganized speech, disorganized or catatonic behavior, or flat or inappropriate affect are prominent symptoms. The criterion for the main category of schizophrenia includes having two or more of the following symptoms in a one-month period: delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, and negative symptoms. These symptoms must cause a disruption in major areas of the individual’s life, such as social and work life. Duration of the symptoms must be at least six months. There must have also been and exclusion of schizoaffective and mood disorder. Medication or substance use cannot be the cause of the occurring symptoms. Diagnosis is excluded if there is a relationship to a pervasive developmental disorder a profound disruption in cognition and emotion; disturbing thought, perception, affect, and sense of identity.

What are the symptoms that schizophrenics have? There is no single symptom for a diagnosis; rather, a pattern of signs and symptoms, combining with impaired occupational or social functioning. Symptoms are separated into the two main groups the positive and negative. Diagnosis requires at least one-month duration of two or more positive symptoms, unless hallucinations or delusions are especially bizarre, in which case one of the symptoms is enough to meet the diagnosis. Positive symptoms are ones that appear to suggest an excess or distortion of normal functions. Symptoms that appear to be an indication of a diminished or loss of normal functions are said to be negative.

Positive symptoms include delusions, hallucinations and grossly disorganized thinking, speech and behavior. A delusion is a persistent false belief despite strong opposing evidence. Delusions can be of a paranoid or persecutory nature, they can be grandiose and may occur out of the blue, and are often quickly recognized by others to be abnormal beliefs. A hallucination refers to the experience of hearing, seeing, smelling, or feeling in the absence of an actual stimulus. Hearing voices when there is no one there is the most frequent hallucination in schizophrenia. The voices are so real that they are convinced that it is coming from a real person. In schizophrenia the voices typically talk about, as well as to, the person. Other positive symptoms include experiences of the person's thoughts being read by others or others put thoughts into the person’s mind.

Negative symptoms often persist when people with schizophrenia are having periods of minimal positive symptoms. Negative symptoms are difficult to assess because they are not as grossly abnormal as positives ones and may be caused by other factors; such as medication. However the newer drugs use to treat schizophrenia show more encouraging outcomes. The negative symptoms tend to develop slower. They include feeling of emotional numbness, difficulty in interaction with others, lack of motivation, social withdrawal, lack of general care or personal hygiene, and a altered sleep pattern.

Cognitive symptoms are attention problems, aspects of memory, and the information processing - decision-making functions that allow us to plan and organize. Cognitive deficits, which tend to be stable over time, may precipitate psychotic and negative symptoms that adversely affect a patient's ability to cope. Cognitive deficits can also be difficult to recognize as part of the disorder but are the most hindering in terms of leading a normal life. The affective and cognitive problems associated with schizophrenia may be important factors in long-term outcome.

Tests/Treatments/Therapies/Medications

The primary goal of medical intervention is to reduce what are called the positive symptoms of schizophrenia: hearing voices, the thought disorder and other problems in thinking, changes in mood. Antipsychotic or neuroleptic medications are primarily utilized for their efficacy in decreasing the positive symptoms (textbook). Counseling, psychotherapy and psychosocial rehabilitation can help with more of what we call negative symptoms. It is crucial to understand the different roles that each medical intervention is playing. Individuals should be educated to know that the medications, therapies and treatments are not able to cure schizophrenia but are used to manage the symptoms.

Medication is so much about treating the positive symptoms, that people often lose motivation, the ability to relate socially, and the capacity to organize themselves as they used to do before they see the affects of the therapies and other treatments. Antipsychotics help relieve the positive symptoms of schizophrenia by helping to correct an imbalance in the chemicals that enable brain cells to communicate with each other. The new drugs also have different side effects. Clozapine (Clozaril) was the first atypical antipsychotic in the United States. Although clozapine seems to be a very effective medication, particularly for people who have not responded well to other drugs, it requires blood monitoring every