Schizophrenia

Index

Criteria
Definition
Inducing Schizophrenia Type Symptoms
Psychotic Disorders
Treatment ( Psychotherapy )
Treatment ( Pharmacotherapy )
Schizophrenia Subtypes
Schizophrenia Diagnosis Flow Chart
Test for Schizophrenia CHN-E
Test for Schizophrenia v3.0
Schizophrenia Drug Checklist

Definition.

Schizophrenia (in Greek, “split mind") is a severe mental illness characterized by a variety of symptoms including but not limited to:loss of contact with reality

• bizarre behavior
• disorganized thinking
• disorganized speech
• decreased emotional expressiveness
• diminished or loss of contact with reality
• diminished to total social withdrawal.

Schizophrenia afflicts approximately one percent of the world's population, making it the most common psychosis. Schizophrenia is characterized by positive and negative symptoms. Fundamental symptoms include thought disturbance, withdrawal, and difficulties managing effect. Secondary symptoms include perception disorders such as hallucinations and grandiosity. Symptoms may also be non-schizophrenic in nature, including anxiety, depression, and psychosomatic symptoms.

Schizophrenia is a severe, chronic brain disorder that alter the way a person acts, thinks, perceives reality, express emotions and relates to other people. Schizophrenia affects people of all gender and races. People suffering from Schizophrenia believe that other people have a capacity to read their mind, control their thought patterns or are scheming to harm them. In other cases, they may smell odors or hear voices that other people don’t smell or hear. These experiences leaves a person withdrawn, frightened of extremely agitated. Just like cancer or diabetes, Schizophrenia is a long life disease that has no known cure but it can be controlled with the correct treatment.

Schizophrenia is a psychotic disorder in that a person may not differentiate the reality from imaginations; this usually leads to change in a person’s behavior and personality. When the change is sudden, it is referred to as psychotic episode. Sufferer of Schizophrenia experience different psychotic episodes during their lifetime, making the severity of the disorder to vary from one person to the other.

Types of Schizophrenia
Based on the Symptoms, there exist different types of Schizophrenia, these are:

• Paranoid Schizophrenia
• Disorganized Schizophrenia
• Catatonic Schizophrenia
• Residual Schizophrenia

Paranoid Schizophrenia
People suffering from paranoid Schizophrenia are preoccupied with delusions about being punished or persecuted by other people. However, their thinking pattern, emotions and speech remains normal.

Disorganized Schizophrenia ( Hebephrenic )
Sufferer of this type are usually confused and illogical, their speech is cluttered. Their behavior is disorganized, emotionless, and inappropriate leading to limited ability to do normal daily activities like eating or taking a shower.

Catatonic Schizophrenia
People suffering from this type of Schizophrenia have limited physical response. They normally become unresponsive and immobile due to their unwillingness to move resulting to increased risks of exhaustion, malnutrition and even self inflicted injuries.

Residual Schizophrenia
This type of schizophrenia characterized by decreased severity of symptoms of schizophrenia; delusion, hallucinations and other symptoms may be presents but are far less than when they were diagnosed originally.

Undifferentiated Type

Signs and Symptoms of Schizophrenia
People suffering from schizophrenia display different personality at different times with symptoms being severe and sudden at the start of the illness. Symptoms of schizophrenia can be classified into three categories namely;

• Positive Symptoms
• Disorganized symptoms
• Negative symptoms

Positive Symptoms
Positive symptoms are characterized by behaviors which are easily spotted. They include delusions, thought disorders, hallucinations and movement disorders. Delusions are weird beliefs which are not based on reality, worse still; a person refuses to give up the beliefs even when they are presented with realistic information. Hallucination involves perception of feelings that are not real. This will include hearing voices that are not heard by other people or smelling strange odors.

Disorganized Symptoms
These symptoms are characterized by the inability of a person to think and respond in an appropriate way. Some of the symptoms include inability to make decisions, losing or forgetting things, use of nonsense words or sentences that have no logic, slow movements, shifting from one thought to the other quickly and repeated gestures and movements.

Negative symptoms
Negative symptoms reflect loss of ability to express emotions, speak and plans initiation. Some of the negative symptoms includes; withdraw from relatives and friends, loss of interest in life, poor hygiene, swing moods and reduced energy.

Causes of Schizophrenia
Schizophrenia is an illness like diabetes or cancer with a biological root although the real cause is not yet known. There are a number of factors that contributes to the development of schizophrenia in a person. This includes; heredity or genetics, abnormality in brain, environment, brain chemistry.

Heredity
There is a high possibility of children developing schizophrenia passed from parents as the illness tends to run in a family.

Abnormality in Brain
Abnormal brain structure is another factor contributing to development of schizophrenia in a person.

Environment
Schizophrenia is likely to occur when a person body is undergoing physical and hormonal change especially when these changes occur under stressful situations or poor social relations.

Brain Chemistry
Lack of chemical balance in the brain is another factor that contributes to the development of schizophrenia. Example is dopamine chemical which act as neurotransmitter that helps in sending of messages between nerve cells. In the case, the brain produce may produce dopamine in limited or excess quantity causing an imbalance which affects the way the brain reacts and responds to stimuli such as smells, lights and sounds.

Epidemiology
Schizophrenia is a common illness affecting people of all cultures and races across the globe. The disease manifests itself in late teenage and early 20s although it can occur at any age. The effect of schizophrenia on men equals that of women although symptoms appear in men in early 20s while in women the symptoms appear in late 20s. Over 2.4 million people, representing 1% of United States population suffers from Schizophrenia.

Diagnosis of Schizophrenia
Currently, there are no specific laboratory tests for diagnosing schizophrenia. When a person exhibit signs of Schizophrenia, doctors perform various procedures like blood test and X-rays aimed at ruling out any other illness that might cause the same symptoms. If no illness is found after the tests, the patient is referred to psychologist or psychiatrist who uses various techniques to assess if the person has psychotic disorders. The person behaviors and attitude is also used as part of the diagnostic report. If the person exhibit schizophrenia symptoms for more than six months, he/she is considered to be suffering from schizophrenia.

Treatment of Schizophrenia
There is no known cure for schizophrenia but there is treatment aimed at reducing the symptoms. Treatment may be in form of medications, psychosocial therapy, hospitalization and Psychosurgery

Medications
Antipsychotics are the primary medications for treating schizophrenia. This medicine reduces disturbing symptoms like hallucinations and delusion. Some of the common medicines include Prolixin, Navane, Trilafon, Clozaril, Geodon and Zyprexa.

Psychosocial Therapy
Psychosocial therapy is considered the most effective in dealing with social, psychological and behavioral problems resulting from schizophrenia. Therapy includes rehabilitation which helps an individual to focus on skills and training to help an individual to be independent. Family therapy enables a person to interact and effectively deal with the family members.

Hospitalization
Hospitalization is preferred when dealing with patients who exhibit severe symptoms of Schizophrenia. The aim of hospitalization is to prevent them from hurting or injuring themselves and gain stability as they take medication.

Psychosurgery
Psychosurgery through an operation known lobotomy is used in very limited cases on patient with chronic and severe schizophrenia. The operation is considered hazardous due to the serious damage it can cause to a person.

Prevention of Schizophrenia
Schizophrenia has no known method of prevention, but early diagnosis followed by appropriate treatment help decrease symptoms of the illness.

NOTE: A second opinion is a good idea in a diagnosis of schizophrenia, "Schizophrenia is probably the most misused psychological term in existence"  ( Carlson, 1995 ). See case studies.

Diagnostic Criteria ( DSM-IV™ ) made easy.

1.  During one month or more, a significant portion of time is taken up by bizarre delusions that are hallucinations consisting of two or more voices conversing with each other or of a voice that affects a person's behaviors or thoughts or at least two of the following:

• delusions
• hallucinations
• grossly disorganized behavior
• catatonic behavior
• negative symptoms

2. For a significant portion of time, due to the disturbance, marked impairment is noticed in academics, interpersonal relationships, self-care, work or any other major area of functioning.

3. Symptoms are continuous and persist for at least six months.

4. The disturbance is not due to a  Pervasive Developmental Disorder, substance abuse, general medical condition or another mental disorder.

Diagnostic Criteria ( Bleuler's )

Fundamental symptoms: thought disorders, blunted effect, indifference, withdrawal, retardation, autistic behavior and mannerisms.

Secondary symptoms - mechanisms patients may develop to cope with fundamental symptoms : hallucinations, paranoid ideation, grandiosity.

Non-schizophrenic symptoms - emotional disturbances not uniquely associated with schizophrenia: thought disorders, blunted effect, indifference, withdrawal, retardation, autistic behavior and mannerisms.

Schizophrenia Subtypes

Paranoid Type
Disorganized Type ( Hebephrenic )
Catatonic Type
Undifferentiated Type
Residual Type.

Psychotic Disorders

Brief Psychotic Disorder
Delusional Disorder
Psychotic Disorder Due to a General Medical Condition
Psychotic Disorder Not Otherwise Specified
Schizoeffective Disorder
Schizophreniform Disorder
Substance-Induced Psychotic Disorder

Treatment ( Psychotherapy )

Adlerian Therapy
Behavior Therapy
Cognitive-behavioral Therapy
Existential Therapy
Gestalt Therapy
Person-centered Therapy
Psychoanalytic
Rational-emotive Therapy
Reality Therapy
Transactional Analysis

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