An Analysis of the Etiology of Schizophrenia and Its Impact on the Mind and Body
Perhaps no other human condition has received so much publicity, but remains so misunderstood by the general public as schizophrenia. Schizophrenia is widely believed to be associated with multiple personalities and other acute symptoms that would make sufferers readily apparent; however, the reality of the condition is that people can have schizophrenia and never know it. However, while much has been learned about the disease and its etiology over the last hundred years, much remains unclear about who is at risk and precisely how the disease progresses. Nevertheless, a number of efficacious treatments have been identified, and today, some schizophrenics recover completely or sufficiently enough to lead normal and productive lives. This paper provides an overview of schizophrenia and its incidence, the etiology of the disease and its symptoms, followed by an assessment of the disease's impact on the human body and mind. Finally, a discussion of effective treatment approaches is followed by a summary of the research in the conclusion.
Review and Discussion
Background and Overview. According to Alanen and Leinonen (1997), schizophrenia is a serious mental illness that usually becomes manifest in adolescence or in early adulthood. The condition is generally characterized by partial disorganization of personality functions, developmental regression, and a tendency to withdraw from interpersonal contacts into a subjective internal world of ideas, frequently accompanied by hallucinations or delusions. Schizophrenia is widely regarded to be the most chronic and disabling of the severe mental disorders (Beebe 2003). Unfortunately, even with early intervention and treatment, some people who are diagnosed with schizophrenia continue to suffer lifelong symptoms. According to Beebe, in response to the deinstitutionalization initiatives of the last part of the 20th century, the majority of people with schizophrenia reside in community settings; regrettably, service limitations and poorly coordinated care continue in many communities in the U.S. today (Beebe 2003).
The disease process itself may begin suddenly or gradually, and its symptoms either improve or become chronic to different degrees. Further, a number of patients have better periods with only minor symptoms and worse periods when the symptom are re-aggravated. Schizophrenia is differerent from the mental illnesses of definite organic origin in that it does not involve dementia or disorders of memory, orientation, or intelligence comparable to the latter (Alanen & Leinonen 1997). Schizophrenia affects about one percent of the population; it affects males and females equally, frequently occurring between adolescence and young adulthood (Mason & Miller 2002). As noted above, schizophrenia is largely misunderstood and carries a heavy social burden with it as a result. "All illnesses are hard to talk about, but schizophrenia seems even harder. For many people the term schizophrenia carries a stigma so powerful that just thinking about it is frightening. "It reminds them of the strange thoughts, feelings, and behaviors that resulted in their needing treatment. They remember their weird beliefs and hallucinations or their disorganized, isolated, or moody ways" (Mason & Miller 2002:1).
According to Irving B. Weiner (1997), the clinical concept of schizophrenia was originally labeled as a syndrome by the Belgian psychiatrist Morel, who introduced the term dementia praecox (demence precoce) in 1860 to describe an insidious, progressive personality decompensation in a 14-year-old male patient; however, the formal study of schizophrenia can be traced to Emil Kraepelin's publication of his classical discussion of dementia praecox in 1896; Kraepelin went on to propose causative factors for the condition as well (Weiner 1997).
Etiology of Schizophrenia. Based on the complexity of the disease of schizophrenia and the multitude of factors influencing the course of the illness, as well as the variety of responses to treatment, have resulted in numerous models being proposed to describe and explain the disease (Beebe 2003). According to Grinspoon (1992), the current emphasis in research on schizophrenia is on the biological etiology of the illness. The concept that some cases of schizophrenia originated in events that occurred prior to birth or during the delivery of the individual is not a new one. According to Dr. Llewellyn B. Bigelow (1994), genes have been claimed by many researchers to be important contributors to the cause of schizophrenia in the early years of the 20th century. "The effects of chemicals and infectious agents," Bigelow writes, "specifically alcohol and syphilis, on the developing fetus were proposed as possible causative factors for schizophrenia by Emil Kraepelin" in 1919 (42). By the last half of the 20th century, researchers began to emphasize the biological aspects of major mental illness. According to the vulnerability-stress model proposed by Zubin and Spring (1977), the vulnerability for schizophrenia is what is inherited, rather than the disease itself. Likewise, Farmer and Pandurangi (1997) report that "The vulnerability, in combination with relevant stressors, leads to the development of symptoms of schizophrenia" (109). This view serves to integrate biological characteristics with psychological and social aspects of human behavior, providing a biopsychosocial understanding of the variables that lead to a schizophrenic illness (Farmer & Pandurangi 1997).
Symptoms of Schizophrenia. Since it is a disease of the brain, schizophrenia disturbs how the brain functions to various degrees and in different ways; these disturbances are called symptoms, and can include delusions, confused thinking, and hallucinations (Mason & Miller 2002). Because it is chronic, because it resembles organic forms of psychosis, because its symptoms are difficult to comprehend psychosocially, and because its experience can cause significant suffering to individuals and their families, schizophrenia has long been regarded as a progressive brain disease and is often compared to neurodegenerative diseases such as Alzheimer's or multiple sclerosis; however, no known single brain disease has such a substantial spontaneous recovery rate: almost 25% of patients in the dozen long-term (more than 10-15 years) follow-up studies to date have demonstrated full recovery, and virtually 50% evinced substantial social improvement (Cohen 2002). Given the complex range of schizophrenic symptoms and outcomes, it seems probable that the symptoms of schizophrenia are produced through interacting processes. Today, many expert practitioners believe that schizophrenic symptoms are produced by a complex interaction among biological, environmental, psychological, and cultural factors (Beebe 2003). Schizophrenics display a wide array of symptoms, but four main types of schizophrenia, differing in their specific symptomatology as follows, are recognized by some authorities:
The simple (or undifferentiated) type of schizophrenic manifests an insidious and gradual reduction in a patient's external relations and interests;
The hebephrenic (or disorganized type) of schizophrenic displays shallow and inappropriate emotional responses, foolish or bizarre behavior, false beliefs (delusions), and false perceptions (hallucinations);
The catatonic type of schizophrenia is characterized by distinct motor behaviors that may manifest in virtually complete immobility; likewise, mutism (the inability to talk), extreme compliance, and absence of almost all voluntary actions are also common;
The paranoid type; this type of schizophrenia generally develops later in life than the other types, and is primarily characterized by delusions of persecution and grandeur combined with unrealistic, illogical thinking, frequently accompanied by hallucinations (Schizophrenia 2004).
Impact of Schizophrenia on the Human Body and Mind. As noted above, schizophrenia has been associated with certain brain characteristics. The brain areas that have been implicated in this illness are the frontal lobe, temporal lobes, limbic system, and basal ganglia. However, there is probably not one single area of the brain associated with the illness; interconnections among brain parts probably play the greatest role in the development of symptoms. A consistent finding to date has been that in some people with schizophrenia, the lateral and third ventricles are enlarged and the temporal lobes are reduced in size (Weinberger 1987). According to Marley (1998), schizophrenia can negatively affect the individual's cognitive, emotional, perceptual, and interpersonal skills and experiences. People who suffer from schizophrenia also experience difficulties with supervisory level functions, including difficulties in ordering sequential behaviors, establishing goal-directed plans, maintaining task when interrupted, monitoring personal behavior, and associating knowledge with required responses; Beebe adds that difficulties with daily activities are especially evident when nonautomatic actions are involved (2003).
The heavy toll the illness takes on the individual can also impair the person's ability to interact with others and the social and physical environment. "The emotional, psychological, social, and financial costs to the individuals, their families, and society have led researchers and clinicians to look for the causes of the illness, what influences the illness, and how best to treat individuals and their families" (Marley 438). The research to date on the brains of people with schizophrenia has also identified some structural and functional differences compared with people without schizophrenia; however, there is no single difference found in all people with schizophrenia (Marley 1998). One potential explanation for the lack of clarity arising from the biological research is that schizophrenia may be more than one illness. Marley reports that schizophrenia is actually an umbrella term, like a number of disorders, but each episode will have a unique biological etiology (Marley 1989). All such cases may be merged together under the single heading…