This paper looks at the how schizophrenia affects the brain, the person, & the family, also looking at the history of the subject and its role within society. Bibliography cites four sources
Schizophrenia is one of a range of mental conditions that is widely misunderstood. May see it as a relatively recent disease, and the term has only been in use for about a century. However the condition is not new. This disease, which is one of the most disabling of the range of metal conditions, can be traced back for millennia. The first documented cases appears to have occurred in Ancient Egypt, where a discretion of the condition is described in the Eber papyrus, in the Book of Hearts (Okasha, 1999). The condition was not understood in detail, and the treatment was usually incubation, this was an achieved by spending the night in the temple, and the dreams would then be interpreted in seeking the answer to the cause of the illness (Okasha, 1999).
Hippocrates saw the condition as an hormonal imbalance, and with the work of people such as Kraeplin and Bleuler the understanding of the disease has developed greatly. The illness is now divided into five subcategories; catatonic, paranoid, disorganized, undifferentiated, and residual (National Institute of Mental Health, 2002). Typically, the disease will be evident before the age of forty five and the symptoms must be present for at least six months. There are a range of symptoms, and these will present in different combinations, with only some, but not all evident.
There are some difficulties with diagnosing schizophrenia, as the onset may be gradual when it occurs in industrialised nations, in developing nations the same condition tends to have a more sudden appearance (National Institute of Mental Health, 2002). One tool used for the diagnosis of the condition is the DSM tests. Here the symptoms are considered, and there needs to be a history of six months with at least two of the symptoms present during the last month. These symptoms are;
Delusions; these are beliefs that are false and do not appear to have any logical grounding or basis in reality (Anonymous, 2002).
Hallucinations; This means seeing, feeling or hearing things that are not there (Anonymous, 2002).
Disorganised speech (Anonymous, 2002).
Disorganised behaviour or catatonic behaviour; unusual motor behaviour marked with a decline in "reactivity to the environment," or hyperactivity which is not related to stimulus (Anonymous, 2002).
Negative symptoms; these may be a lack of reactions or apparent lack of emotions (Anonymous, 2002).
The difficulty may not only be with a gradual onset, but also the way it may be, missed, as an onset nay result in an increased isolation and withdrawal form society, so that there are less possibilities for the symptoms to be missed (National Institute of Mental Health, 2002).
If we look at the different categories of schizophrenia they are differentiated by the symptoms, catatonic schizophrenia has the symptoms of motor disturbances, stupor, rigidity and negativism, lack of personal care, excitement, and potential also a decrease in response to painful stimulus (National Institute of Mental Health, 2002). As already noted not all symptoms will be present in any single patient.
Paranoid schizophrenia is marked with symptoms such as delusions thoughts, such as persecution or even grandeur, anger, anxiety and/or violence and a tendency to be augmentative (National Institute of Mental Health, 2002). Disorganized schizophrenia has the symptoms of regressive behaviour, incoherence, delusions and/or hallucinations, laughter at inappropriate times, unusual mannerisms and a social withdrawal (National Institute of Mental Health, 2002). Undifferentiated schizophrenics may display symptoms form more than a single subcategory, and residual type can be seen as a type where the most dominant symptoms of the disease have reduced, but some symptoms, for example hallucinations, may still continue (National Institute of Mental Health, 2002).
Schizophrenia has an incidence rate of roughly 1% of the population spread equally between men and women. In terms of prognosis some may recover completely and for the majority of cases there can be an improvement to the level of regaining independent living, but ten percent of suffers will commit suicide (National Institute of Mental Health, 2002).
The causes are unknown, but it is known there is a strong genetic link. With two parents that do not have the condition the likelihood of incidence is 1%, however, where one of the parents has the disease this probability increases to 13%, where both parents have the disease the probability increases to about 35% (National Institute of Mental Health, 2002). It has also been noted that twins have a higher likelihood of incidence, likelihood is increased by 17% for dizygotic twins, and between 40% - 60% for monozygothic twins, however, these are not fully conclusive figures (National Institute of Mental Health, 2002)
In most cases the initial psychotic episode in late adolescence or early adulthood. Onset after the age of thirty is unusual, and after the age for forty it is very rare (Anonymous, 2002). In men the onset will usually be between 16-25, with a greater onset being present in males in this age category. However, in the females there is a higher appearance of the disease in the age group 25 -30 (National Institute of Mental Health, 2002). By the age of thirty there is an roughly equal spread of the disease according to gender.
The recovery rates also vary, only between 20% - 30% have a recovery to the extent they may continue to live a normal life, the same percentage probabilities also apply to the number of sufferers that will have only moderate symptoms, between 40% - 60% will still remain significantly impaired (National Institute of Mental Health, 2002).
Most patients will respond well to drug treatment's, with only 15% unresponsive (Anonymous, 2002). In acute cases there will usually be a need for hospitalisation in order to protect the patient and also allow a more accurate diagnosis (Anonymous, 2002). Where a patient is in hospital this will also be able to medicate the patient. Drugs used are the antipsychotic drugs, which are also known as neuroleptics, these have been used since the 1950's and can have a marked effect, with an average of a 75% improvement (Anonymous, 2002, National Institute of Mental Health, 2002).
There are two types of antipsychotic drugs, traditional antipsychotics and new antipsychotics. The traditional drug operates by reducing the symptoms such as hallucinations and delusions. Examples of these types of drug include chlorpromazine, haloperidol and fluphenazine (RXlist, 2002). The drugs operate by the blocking of the dopamine receptors and are effective for the treatment of positive symptoms (RXlist, 2002).
The drugs are not without side effect, these may include mild side effects such as dry mouth, the blurring of vision, constipation and dizziness (RXlist, 2002). There are also some more serious potential side effexr such as those similar to the onset of symptoms similar to Parkinson's disease with muscle tremors or rigidity, Dystonia; unusual movements, Akathisia; agitation and restlessness and a possibility of the accordance of Tardive dyskinesia, this is a movement disorder that appears later in life (Anonymous, 2002). Prolonged usage may also create facial ticks, lip licking and panting.
The newer antipsychotics are serotonin-dopamine antagonists (SDAs) (RXlist, 2002). These alleviate the same symptoms, but on a different way, this time they block the dopamine receptors, as seen with the traditional antipsychotics, but they also block the serotonin receptors, and as such it is treating not only the positive symptoms, but also the negative symptoms (Anonymous, 2002).These are seen as better drugs for some cases as the side effects are lower and the range of symptoms that they treat are wider.
Once the worst symptoms are controlled the patient may be released from hospital, however, there are often many…