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Schizophrenia is a serious mental disorder, resulting in the patient hearing voices and noise inside his or her mind. Historically, this disorder has been a serious barrier to proper functioning in society. In the past many people were simply locked up in mental institutions because they were a danger to themselves and others. In some cases that is still necessary, but medications and treatments have come a long way. They allow some people with schizophrenia to live relatively normal lives. There are disagreements regarding what, specifically, causes the disease to manifest, although its onset is generally in young adulthood and it tends to run in families. That suggests a genetic component. Treatment generally involves medication, and there is no cure or prevention methods for schizophrenia. Both cultural and biblical issues play into a person's understanding of the disorder and the treatment he or she will receive. Future research must focus on ways in which the disease can be better diagnosed and treated, along with how the disease actually manifests and what causes it to appear.
Schizophrenia is characterized by inappropriate emotional responses and a breakdown in proper thinking. Many people with the disorder hear voices and suffer from delusions (Aziz, Bellack, & Rosenfarb, 2006). They are often paranoid, and lack both motivation and emotion (Pijnenborg, et al., 2013; Ungvari, Caroff, & Gerevich, 2010). Additionally, they have very disordered thinking to the point they cannot function properly in both social and work relationships (Baier, 2010). The DSM is used to diagnose the disorder, as it must meet specific criteria. The criteria are based on self-reported issues by the patient and experiences of behavior that is not normal, followed by a clinical assessment (Aziz, Bellack, & Rosenfarb, 2006). There is no official, objective test, and the symptoms must be at a certain level of severity before a diagnosis is made (Ungvari, Caroff, & Gerevich, 2010).
Psychiatrist Kurt Schneider listed what he called first-rank symptoms of schizophrenia in the early 20th century (Aziz, Bellack, & Rosenfarb, 2006). These symptoms were used to distinguish schizophrenia from other mental health issues, but there were many reports of the disorder and the symptoms surrounding it before Schneider's time. There were few formal diagnoses, but writings detailing symptoms and the difficulties they presented were very common. The earliest cases seen in medical literature date back to 1797 and 1809, where it was considered to be more of a dementia that was caused by the ending of puberty (Hor & Taylor, 2010; Masterpasqua, 2009). There was a belief that the entire body was affected by the disorder, and that there was a cascade that came together all at once in a person's life to cause the disorder to manifest at that time (Baier, 2010).
Throughout the years, the diagnostic criteria of schizophrenia have been a point of contention. Many believe that Schneider's first-rank symptoms are too specific to be appropriate, and that there are better ways to determine whether a person has schizophrenia (Gorczynski & Faulkner, 2010; Hor & Taylor, 2010). Today, operational criteria are used instead, but it was not until the 1970s that these were agreed upon (Masterpasqua, 2009). Part of the difficulty stemmed from the idea that there were many more cases of the disorder diagnosed in the U.S. than were being diagnosed in Europe, which led people to believe that the U.S. had more mental health problems. Upon examination, it was determined that the real cause of the issue was not mental health problems but differences in diagnostic criteria (Pijnenborg, et al., 2013; Stafford, et al., 2013). When those were adjusted to be more similar in nature, the number of cases also balanced out to be more similar between countries (Pijnenborg, et al., 2013). Many people think of Schizophrenia as "split personality," but the two issues are distinct from one another are separate when it comes to a diagnosis (Aziz, Bellack, & Rosenfarb, 2006).
Cause of the Illness
It is currently believed that there are both environmental and genetic factors that cause schizophrenia to manifest in a person. Genetics can be quite serious when it comes to who will develop the disorder. People who have two parents with schizophrenia have a nearly 50% chance of developing it themselves (Pijnenborg, et al., 2013; Stafford, et al., 2013). Those with only one schizophrenic parent have a 13% chance, and people with a first-degree relative with the disorder see chances of nearly 7% (Stafford, et al., 2013). For those with more distant relatives who have schizophrenia the risk is much lower, but still notable. There are many possible candidates discussed when attempting to determine which gene causes the disorder, but so far there is no agreement on the issue.
Environmental factors are also a concern. Prenatal stress, the overall living environment, and drug abuse have all been cited as risk factors (Aziz, Bellack, & Rosenfarb, 2006). Parenting style does not appear to have an effect on the development of the disorder, but those who live in an urban environment are more likely to develop it than those who live in more suburban or rural areas (Ungvari, Caroff, & Gerevich, 2010). Social isolation is another factor that has been discussed as having a possible link to schizophrenia, as have unemployment, poor living conditions, and dysfunction within the family (Hor & Taylor, 2010; Stafford, et al., 2013; Ungvari, Caroff, & Gerevich, 2010).
Antipsychotic medications are the main treatment protocol for people who have schizophrenia (Stafford, et al., 2013). These take one to two weeks to work, but they can reduce the positive psychosis symptoms drastically (Aziz, Bellack, & Rosenfarb, 2006). However, there are still problems with cognitive dysfunction and negative psychosis that these medications do not improve (Aziz, Bellack, & Rosenfarb, 2006). There is a relapse risk, but this drops for those who remain on antipsychotics consistently (Hor & Taylor, 2010).
Unfortunately, the likelihood of these medications working beyond the two to three-year mark is a serious concern that must be more carefully addressed in order to fully realize (Masterpasqua, 2009; Pijnenborg, et al., 2013). People who do not have symptoms for a year or longer may be able to stop their antipsychotic medications (Masterpasqua, 2009). In addition to medications, it has been suggested that psychosocial interventions such as family therapy can be beneficial (Pijnenborg, et al., 2013). These options can help to reduce relapses, but they are generally used in combination with medication, as they have proven to be completely effective on their own (Hor & Taylor, 2010).
It can be very difficult to address any method of prevention when it comes to schizophrenia (Aziz, Bellack, & Rosenfarb, 2006). There are no strong markers that can be used early in life that will help determine whether a person will develop the disorder later (Baier, 2010; Gorczynski & Faulkner, 2010). So far, there has not been any conclusive evidence regarding methods to prevent the disorder based on early interventions (Baier, 2010). Avoiding drugs that have been associated with a higher risk of the disorder may be beneficial, but there are no actual recommendations regarding attempting to prevent schizophrenia in the general population (Baier, 2010). It is generally not considered to be a preventable disorder, even in those with no family history. Cognitive behavioral therapy and other intervention techniques have been used, especially in those who have had a psychotic break or episode (Aziz, Bellack, & Rosenfarb, 2006). While there were short-term benefits at the time, there were no long-term advantages seen (Gorczynski & Faulkner, 2010).
How a person with schizophrenia is treated and how he or she is looked upon depends largely on culture (Aziz, Bellack, & Rosenfarb, 2006). In the United States and many other developed cultures, there are a number of people who hide mental illness as much as possible because there is still a strong stigma attached to it (Ungvari, Caroff, & Gerevich, 2010). While unfortunate, there is little that can be done to mitigate the issue, especially where schizophrenia is concerned. In the U.S., many people still associate a diagnosis of schizophrenia with someone who is or will be violent (Ungvari, Caroff, & Gerevich, 2010). There are higher levels of violence seen in those with schizophrenia, but that often comes from the drug use that can bring on the disease (Aziz, Bellack, & Rosenfarb, 2006). Studies regarding violence in schizophrenia patients without drug use have been controversial.
In Japan, the name for the disorder has been changed to one that translates to "integration disorder" in order to lower the stigma for the patient and the general population (Stafford, et al., 2013). Lowering the stigma is important, but unfortunately the media appears to be taking the opposite tactic. Since the 1950s, the public perception that people with schizophrenia were violent and dangerous has more than doubled, largely based on how these individuals are portrayed (Stafford, et al., 2013). Most people with schizophrenia are not violent, and in fact are not even able to make decisions on things like their…[continue]
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