Schizophrenia Affects Development & Aging

¶ … Schizophrenia Affects Development & Aging Although schizophrenia is a mental disorder known for developing in late adolescence or early adulthood, recent studies reveal differences in brain chemistry beginning much earlier. While children at risk for developing schizophrenia may function along the "normal" range of the continuum, early signs and signals such as excessive shyness, lack of interest or attention, blank stares and awkward movements, or avoidance of affection may hint at a more serious illness to come (Heinrichs, 2001).

From adolescence through early adulthood, the burgeoning disorder becomes unmistakable and treatment is necessary; later in life some symptoms may become less severe. But regardless of when a formal diagnosis is made, there is evidence that schizophrenia affects all stages of development and aging -- from birth through death. While schizophrenia is known to be genetically-based (at least in part), environmental factors taking place as early as birth seem to be necessary for full-blown development of the disorder.

Some scientists believe stresses at birth, such as oxygen deprivation or low birth weight, can be precursors (Nicole, 2007). Others believe the injury takes place before birth, during the second trimester when the hippocampus is most vulnerable to selective damage. In schizophrenic patients, the hippocampus often shows signs of abnormality. (Heinrichs, 2001) Additionally, schizophrenic patients may have brain differences in shrinkage or enlargement of specific areas, or dopamine and glutamate neurotransmitter anomalies (Nicole, 2007).

While these may be causes or effects, and while these theories of origination may never be proven, still experts have identified and outlined four separate phases of schizophrenia corresponding to development and aging: the premorbid or prodromal, early, middle, and late stages. (Csernansky, 2001) In the premorbid or prodromal phase, or the time period from birth through official onset of the disease, sociobehavioral, emotional, and neurocognitive eccentricities may appear.

In infants these can include a lack of emotional responsiveness and expression; in childhood symptoms may include excessive shyness or discomfort with affection, delayed social-sexual development, impulsivity, poor attention span, disinterest in social activities, disruptive behaviors, poor school performance, or even faulty motor coordination. Interestingly, however, high IQ and academic overachievement are also often associated with schizophrenia, and particularly with the risk of suicide in schizophrenic patients. (Csernansky, 2001) The prodromal phase is the period of time leading up to official diagnosis, when more serious signs begin to surface.

This period of time can range from weeks to months to a full year. Typical symptoms during this stage are marked and can include impaired role functioning, social isolation, peculiar behavior, lack of interest in grooming or hygiene, poverty of speech or inappropriate speech with abnormal affect, depression, anxiety, paranoia, magical thinking, lack of energy and initiative, sleep disturbance, and motor disfunction. Although these warning signs often lead up to the onset of schizophrenia, they are not considered part of the disorder itself.

However, the severity of these early abnormalities often indicates the severity of the future disorder. (Csernansky, 2001) in summary, early signs of schizophrenia are often dramatic and necessarily result in striking social impairment for affected individuals, at a time when social interaction and development are critical to self-esteem and overall success. The next stage is called the early phase, in which the actual onset of schizophrenia takes place. This is generally between the ages of 17 and 37, and can be gradual or acute.

In fact, some patients may experience subtle psychotic symptoms for up to 20 years before receiving proper treatment. In many cases, the onset of schizophrenia is triggered by a major life stressor such as leaving home for college. An initial psychotic episode is often the result, with immediate in-hospital treatment recommended for testing and observation. Treatment includes anti-psychotic medication and patients often respond well, particularly in milder cases of the illness. (Csernansky, 2001) However, a general inability to adapt socially will persist and prevent a "normal" existence for these individuals.

In one case, a female patient described her general personality despite medication as characterized by "low self-esteem, hypersensitivity to criticism, hyperempathy, excessive generosity, susceptibility to manipulation, and social awkwardness" (Reichenberg-Ullman, 2010). In addition, substance abuse, inability to hold a job, risk of suicide, and unwanted pregnancy are typical themes in these patients' lives.

(Csernansky, 2001) in the case of pregnancy, females often suffer complications beyond their mental illness, such as poor prenatal care, risk of violence during pregnancy, and reduced likelihood of having a male supportive figure (staff, 2007) In the middle phase of schizophrenia, or the first several years after onset, the severity of the disease can be determined.

How well a patient will respond to different forms of treatment (psychotropic medication, psychotherapy, or supportive group therapy, to name a few) becomes apparent, and appropriate plans can be made for coping with the illness on a daily basis. This leads to a stabilization of symptoms that can be expected to last until the patient enters their fifties. However, during the middle stages, successful employment and fulfilling relationships continue to be nearly impossible for schizophrenic patients (Csernansky, 2001).

In addition, while positive and outward symptoms may become more subtle, there is often a worsening at this point of more inward symptoms. These can include a further reduction in ambition or initiative, occupational skill level, emotional responsiveness, and ability to maintain a proper appearance (Csernansky, 2001). It is these deteriorating symptoms that may lead to the "burned out," apathetic appearance characteristic of schizophrenic patients as they continue to age (Collier, 2007). The final phase, the late stage, refers to schizophrenia among the elderly.

Unfortunately, research for the benefit of older patients is scarce, even though over the next twenty years the number of elderly schizophrenic patients is expected to double. However, it is.