Schizophrenia: symptoms, onset, and diagnostic approaches

Schizophrenia

Symptoms of schizophrenia

Schizophrenia is perhaps the most harsh and cruel mental disorder because it gives the sufferers views and insights of reality that are extremely uncommon and psychotic. People suffering from schizophrenia tend to hear unusual voices from within and also feel afraid, mystified, nervous and apprehensive on a consistent basis (Taken from; Janssen-Cilag http://www.psychiatry24x7.com/index.jhtml?product=schizophrenia).

Onset and course

Many people believe that people suffering from Schizophrenia actually have "split personalities," however; contemporary research has negated this theory asserting that people experiencing Schizophrenia actually suffer from distorted reality, in laymen's terms (Taken from; Janssen-Cilag http://www.psychiatry24x7.com/index.jhtml?product=schizophrenia).

"Approximately 1% of the population develops schizophrenia during their lifetime -- more than 2 million Americans suffer from the illness in a given year. Although schizophrenia affects men and women with equal frequency, the disorder often appears earlier in men, usually in the late teens or early twenties, than in women, who are generally affected in the twenties to early thirties (Overview of Schizophrenia; taken from: http://www.schizophrenia.com/family/sz.overview.htm)."

Behavioral Manifestations

Recent studies have shown that people suffering from Schizophrenia not only feel afraid, mystified, nervous and apprehensive on a consistent basis, but also, suffer from speech disorders and jumbled behavior. These behaviors often terrify the people around the patient and are also inconceivable to them. The behavior disorders can also manifest tremendous amount of observation and attentiveness on certain occasions and this too can also become petrifying for others.

"People with schizophrenia often suffer terrifying symptoms such as hearing internal voices not heard by others, or believing that other people are reading their minds, controlling their thoughts, or plotting to harm them. These symptoms may leave them fearful and withdrawn. Their speech and behavior can be so disorganized that they may be incomprehensible or frightening to others. (Overview of Schizophrenia; taken from: http://www.schizophrenia.com/family/sz.overview.htm)."

Which drugs are most likely to be misused?

Majority of the people suffering from schizophrenia are considered to be chain smokers and thus greatly abuse nicotine. Approximately one third of Americans are smokers, but people suffering from schizophrenia are found to drink cigarettes three times more than an average American. Research has shown that the relationship between smoking and schizophrenia is complex. Although people with schizophrenia may smoke to self-medicate their symptoms, smoking has been found to interfere with the response to antipsychotic drugs. Several studies have found that schizophrenia patients who smoke need higher doses of antipsychotic medication. Quitting smoking may be especially difficult for people with schizophrenia, because the symptoms of nicotine withdrawal may cause a temporary worsening of schizophrenia symptoms. However, smoking cessation strategies that include nicotine replacement methods may be effective (Overview of Schizophrenia; taken from: http://www.schizophrenia.com/family/sz.overview.htm).

What possible patterns of use may occur?

In 2000, while the director of the "National Institute of Drug Abuse" presented his report to the National Advisory Council on Drug Abuse, revealed; "Of patients with schizophrenia, 70 to 80% smoke. Nicotine corrects certain information processing and cognitive psychomotor deficits seen in many patients with schizophrenia. Clozapine, but not conventional antipsychotics, has been shown to correct some of these deficits. Investigators from Duke University assessed psychopathology and smoking in 70 patients with treatment refractory schizophrenia (55 smokers and 15 nonsmokers) at baseline when they were receiving conventional antipsychotics and again after they were switched to clozapine. Smokers showed significantly greater therapeutic response to clozapine than nonsmokers. Smokers smoked less when treated with clozapine than when treated with conventional antipsychotics. The authors concluded that certain patients with schizophrenia have contributing pathophysiologic mechanisms that respond favorably to either nicotine or clozapine. (Director's Report, 2000)."

3) Treatment issues commonly faced

Janice Fay Kauffman and George E. Woody (1995) assert that people suffering from schizophrenia actually have been very difficult to diagnose, at the early stages, and thus, the treatment methods vary from patient to patient, taking in regard the stage at which they are in (Janice Fay Kauffman and George E. Woody, 1995).

The concept of TIP "Treatment Improvement Protocol" is a relatively new concept. The healthcare providers build different phases that can are considered to be helpful in treating people suffering from schizophrenia. "A patient can be regarded as engaging in a series of successive interventions within a single program, with each intervention building on the other and leading to one or more well-defined goals (Janice Fay Kauffman and George E. Woody, 1995)."

What is the role of medication?

The role of medication is considered to be critical in the development of the health of people suffering from schizophrenia and the most useful and successful drugs are Antipsychotic medications. These medications have been available since the 1950's and have been successful in tremendously augmenting the prospects of people suffering from schizophrenia (Overview of Schizophrenia; taken from: http://www.schizophrenia.com/family/sz.overview.htm).

"Although there is presently no permanent cure for schizophrenia, the symptoms of the illness can be effectively controlled in many patients by the use of antipsychotic (neuroleptic) drugs. Most individuals can obtain improvement in their symptoms with the use of modern drugs and modern approaches to management. Successful drug treatment of schizophrenia is dependent on careful assessment of the individual, careful selection of the antipsychotic drug and dosage, and provision of appropriate information and support for the patients and their family Janssen-Cilag. http://www.psychiatry24x7.com/index.jhtml?product=schizophrenia)."

How does the illness affect client compliance and motivation?

Majority of the people suffering from schizophrenia are inclined to be living in volatile domestic circumstances and homelessness. People from these backgrounds often do not comply with the treatment methods that prescribe medication and embody excessive treatment expenditures. These people are also considered to be less motivated to treat themselves because of consistent substance abuse, such as alcohol and cigarettes. Although some long-term studies have shown that over time people suffering from schizophrenia coming from these backgrounds, tend to give positive results. However, it must be noted that these studies have lasted for approximately 2-3 years (Robert E. Drake and Kim T. Mueser, 2003).

How does the illness affect the client's support system?

People suffering from schizophrenia often cannot think straight and as a result often talk nonsense. This behavior paves way for social embarrassment and, in due course, social isolation and mutilation and destruction of all kinds of relationships. Furthermore, the careers of people suffering from schizophrenia are also affected immensely because they cannot maintain their focus, attention and thoughts on one particular subject for a longer period of time (Overview of Schizophrenia; taken from: http://www.schizophrenia.com/family/sz.overview.htm).

What other interpersonal (work, family, educational) issues does the client face?

Since the people suffering from schizophrenia have distorted perceptions of reality, they end up frightening not only their family members and relatives, but also their friends and colleagues in the office. This is because their behavior tends to vary with the extraordinary realities they acknowledge. "Sometimes they may seem distant, detached, or preoccupied and may even sit as rigidly as a stone, not moving for hours or uttering a sound. Other times they may move about constantly -- always occupied, appearing wide-awake, vigilant, and alert (Overview of Schizophrenia; taken from: http://www.schizophrenia.com/family/sz.overview.htm)."

Conclusion

In the past, the psychological and substance abuse remedy procedures and methods in America had been unconnected, however; in recent times, amalgamation of both these methods is being tried to some extent so that best possible results can be obtained. In addition, contemporary research on this subject has shown noteworthy results, therefore, the healthcare providers need to step up this integration. A much faster way of joining both the methods would be to utilize multi-disciplinary therapy groups, which offer all-inclusive services, as well as, treatments in different phases. Furthermore, many methods that are presently being used need to be tested concerning their individual usefulness and their success in amalgamation (Robert E. Drake and Kim T. Mueser, 2003).

While it is clear that the prospects for people suffering from schizophrenia have brightened in the preceding 2 decades, no successful and straightforward treatment therapy has been devised by the healthcare providers. Several lengthy studies have shown that a number of dissimilar results are attained from people suffering from schizophrenia throughout their lives; therefore, methods to devise a comprehensive plan of action are not easily realized (Overview of Schizophrenia; taken from: http://www.schizophrenia.com/family/sz.overview.htm).

Lastly, "Given the complexity of schizophrenia, the major questions about this disorder -- its cause or causes, prevention, and treatment -- must be addressed with research. The public should beware of those offering 'the cure' for (or 'the cause' of) schizophrenia. Such claims can provoke unrealistic expectations that, when unfulfilled, lead to further disappointment. Although progress has been made toward better understanding and treatment of schizophrenia, continued investigation is urgently needed. (Overview of Schizophrenia; taken from: http://www.schizophrenia.com/family/sz.overview.htm)."