Schizoprenia

In 1887 Dr. Emile Kraepelin identified schizophrenia for the first time in history. Dr. Kraepelin used the term "dementia praecox" which means "early dementia," separating it from other forms of dementia usually occurring later in life. Kraepelin believed that "dementia praecox" was primarily a disease of the brain. In 1911, a Swiss psychiatrist by the name of Eugene Bleuler, was the first to use the term "schizophrenia" and the first to describe the symptoms as "negative" or "positive." Bleuler believed that the name given by Kreapelin was misleading, since the disease was not part of dementia since it did not lead to mental deterioration in all cases and it could occur in young age as well as in old age. Since Bleuler specified the term five types of schizophrenia were identified in the Diagnostic and Statistical Manual of Mental Disorders -III (DSM), these include: disorganized, catatonic, paranoid, residual and undifferentiated. In the present DSM IV these defined terms are still being used, yet more and more people are turning to use their own methods of identifying the disease rather than focusing on the given DSM terms.

The onset of the disease is said to be between the ages of 15 and 25, yet there are cases where the disorder does show up in earlier years. Symptoms are divided into two categories: 1. Positive--which include symptoms that are new to one's personality and include hallucinations, delusions, paranoia, agitation, disorganized behavior, and disorganized and incoherent speech. A hallucination can be defined as a perception of a sound, image, smell, or sensation that does not exist. Hearing voices that are not there is a common hallucination in schizophrenia. A delusion is a distortion of reality such as a paranoid belief as the belief the government is out to kill you. 2. Negative-- which are characterized by the loss of the aspects of a person's personality such as lack of emotion or expression.

A psychiatrist generally makes the diagnosis of schizophrenia. Usually the initial diagnosis will require for the individual to be put in the hospital for testing in order to rule out other causes of the individual's symptoms, including metabolic disorders, infections and seizure disorders. The DSM-IV states that in order for the diagnosis of schizophrenia to be made there must be an identification of two "positive" symptoms for at least one consecutive month. These symptoms must interfere with some aspect of a person's ability to function, either at work, school, or in relationships. Yet, if the hallucinations are bad enough the diagnosis can be made by their presence alone.

The course of schizophrenia varies from individual to individual, but is usually characterized by episodes of more prominent psychotic symptoms, which can also be accompanied by relative periods of remission. There are three phases of disease progression: prodromal, active, and residual. These categories are used to come to a more direct diagnosis and try to describe if symptoms continue even during the times the individual may be in remission. Some individuals can go into full remission after a psychotic episode, others have persistent symptoms, which are not as strong as the original ones, and more rarely, others continue to have their psychotic symptoms for a long period of time.

In the predromal phase the individual will present "negative symptoms" which will develop either slowly or suddenly. The individual will also experience social withdrawal in every aspect of their life. Outbursts of anger, anxiety and depression can be part of this phase. The predromal phase can last for days and even months before the actual diagnosis. The individuals in this phase can be misdiagnosed with other problems such as depression or anxiety disorders.

In the Active Acute Phase, the individual will experience the "positive symptoms" of the disease. The symptoms including hallucinations and confused thinking can appear either gradually or suddenly, depending on the individual. In this phase although the "positive symptoms" are now present the "negative symptoms" can continue. During this phase the symptoms will fluctuate between periods of severe psychotic episodes and times of remission, where the individual has no significant signs of the disease. After a certain period of time during the active phase the disease will develop a unique pattern of illness.

The last phase of progress in schizophrenia is the Residual Phase. In this phase the individual will gain some control back of his life. He will be able to gain social and job skills. Their "positive symptoms" will become less intense and the individual will be able to manage their disease with much more ease than before. Yet, even with the treatment being received typically during this phase, about 40% of the individuals will have a chance to relapse within 2 years, without treatment this percentage will increase to 80%.

Many scientific studies have asked what causes schizophrenia, but no single answer has been found. Most studies touching on this problem have stated that the etiology of schizophrenia involves many factors. Many have theorized that things such as viral infections in the womb, birth trauma, a winter or early spring birthday, genes, certain geographic areas, urban settings, stress, and abuse of alcohol, stimulants and hallucinogens may be the cause of schizophrenia. Some combination of environmental and hereditary factors may also give rise to this disorder. Some researchers have even concluded that stress felt at different times during ones life can lead to schizophrenia.

Schizophrenia can run in families and has been said to have a hereditary component. Having a first degree relative with schizophrenia increases a person's chance of developing this disease, but this risk is still relatively low. For example, studies have shown that percentages vary depending on the relative---8% with one sibling affected; 12% with one parent affected; 12% with nonidentical twin affected and 40 % with two parents affected compared to 1% in the general population. Even if an identical twin