Category: Schizophrenia

Chase, the schizophrenic patient, exhibits both positive and negative symptoms during the interview. Regarding positive signs, he reveals auditory hallucinations, which are evident when he says that there are people he talks to, but they are now asleep. The scenario means that Chase hears them talk and makes comments in the conversation of the unknown people, thus acting as a third party. He also exhibits delusions because he firmly believes that a first and second party speak as he makes false comments; they do not exist. Concerning the negative symptoms, Chase exhibits alogia, evidenced by his short responses made to the interview when the interviewer informs him that he wants to speak to him. Moreover, he reveals apathy as he is not interested in the conversation with the interviewer. Chase says he has been speaking all day already, which points to disinterest. Asociality is another negative symptom displayed by Chase when he shows disregard for his interviewer, which is interpreted as reduced social interactions.

The interviewer respectfully handled the interviewee; for example, he starts by seeking Chases consent before speaking to him. Additionally, he uses open-ended questions, giving Chase a chance to express himself, and, in that way, manages to capture the negative, positive, and any other symptoms expressed. The interviewer also allows Chase enough time to respond without intervening or presenting additional questions, enabling the collection of adequate information.

Interacting with this patient would induce empathy for him because I understand that schizophrenia comes with high social and economic costs, and it is a leading mental disorder that causes chronic disability (An der Heiden et al., 2016). Second, schizophrenic patients have a 50% probability of committing suicide (An der Heiden et al., 2016). All of these issues are happening to a youthful college student who once had a bright future before the disease.

Reference

An der Heiden, W., Leber, A., & Häfner, H. (2016). Negative symptoms and their association with depressive symptoms in the long-term course of schizophrenia. European Archives of Psychiatry and Clinical Neuroscience, 266(5), 387-396. Web.

Howard R. & Goldsman A. (2001) The movie A beautiful mind. United States Of America: Universal Studios.

The Producer uses this movie to bring out a story of a man who was a genius in mathematics, John Forbes Nash Jr. as he entered Princeton who was a clever student with an infinite future ahead of him. In college, Nash met with Alicia (Jennifer Connelly) a beautiful lady and fell in love with her and got married. However his passion and hunger for excellence in the future was shattered when he discovered that he had schizophrenia (a mental condition) but Nash fought to overcome the challenges with the help of his devoted wife Alicia.

Howard, the producer unfolds a beautiful story of love, despair, perseverance, pride and compassionate whereby throughout the movies, he significantly shows the effects and developments of psychosis on the patient (Nash), the patients family and the community at large. Thus as his illness progressed, he became more scared and as a result his productivity at work was affected as he was not functional at work, also other aspects of his life appeared to be built on paranoia, grandiosity and ideas of allusion. He was however committed to his treatment a fact that led to an improvement to his health, although later his path was marked by disabling negative symptoms and non adherence. Despite this he eventually succeeded in his struggle to reintegrate the communitys education program.

Jones C. (2009). Australian story. All in your mind. Brisbane , Australia: ABC.

Jones, uses the broadcast All in your mind a 30 minute DVD that was first broadcasted on 11^th of May 2009 to discuss the issue of Professor Cyndi Shannon Weickert whose dream of becoming a famous chef were shattered when she discovered that her twin brother Scott Shannon was diagnosed with schizophrenia in his teens.

The broadcast notes that Professor Shannon on witnessing the distressing symptoms of delusions and hallucinations from her own twin brother whom she loved so much, embarked on a mission to find a cure for the disease. Now a world-leading neurobiologist, she was invited to guide a top schizophrenia study program in Sydney two years ago whereby the team discovered that mutations in a particular estrogen gene were connected to schizophrenia. Out of the research Clinical drug trials programs were initiated which were to start later. Despite her research and advancement in the world of schizophrenia, her brother was still confined to his condition back in the USA. From her research it notes that estrogen modifies human emotion and cognition and impacts symptoms of schizophrenia. Hypothesis show that the variation in the estrogen receptor alpha (ESR1) gene and cortical ESR1 mRNA is linked with schizophrenia. (Jones 2009)

Costain, W.F. (2008). The effects of cannabis abuse on the symptoms of schizophrenia: Patient perspectives. International Journal of Mental Health Nursing 17, 227-235.

Costain analysis the connection between the continued abuse of cannabis and its relation to schizophrenic persons, especially persons who continuously continue using the drug. He notes that cannabis is known to worsen positive symptoms, mix the effects of negative symptoms and lead to deterioration in health hence resulting in a negative effect on the quality of life of a given individual. In addition he analyzes previous studies exploring this fact that used quantitative methodology where questions were asked which had been preset by researchers whereby, the subjective skills of the patients were analyzed. He observes that qualitative methodology was used less in this study in order to give voice to the patients perspectives and to add to the knowledge of the frameworks of meanings used by patients. From the article one can note that majority of participants in this study did not realize they had mental illness and they held strong beliefs concerning the use of cannabis. Constain (2008) notes reasons given for their continuing cannabis use included; they required the effects of cannabis use to control the symptoms, to feel normal, apparent improvement in cognitive function, reduced psychological pain and increased energy.

Hence these beliefs could influence a persons devotion to treatment and their future cannabis use. This article also analyzed the clinical performance of clinicians and found out that they lacked insight into the importance of the phenomenal beliefs of a person with schizophrenia. The author further notes that lack of insight by the clinician into the phenomenal beliefs would impact on development of a therapeutic relationship between them and the patients.

Schizophrenia research institute (2010). The Key Facts. Sydney Schizophrenia Research Institute.

Schizophrenia research institute deals with investigations of understanding the causes, diagnosis, prevention, and treatment of schizophrenia and other mental disorders, which badly affect millions of people. Thus the schizophrenia library is structured around nine categories identified through the available information. They cover topics pertinent to schizophrenia including treatments, its risk factors, physical features, symptoms of the disease, disease course and its outcome, family considerations and diagnostic measures of the disease. Schizophrenia research institute (2010)

According to research from the institute, it shows that schizophrenia has no single cause but rather it appears that there are multiple causes to the disease such as genetic factors, environmental and psychological assaults and possible hormonal changes that alter the brains chemistry. Much has been learned concerning mental disorders and their effects on the brain due to researches done by the institute. The institute is working on finding the cure of this disease and updates are made regularly to ensure access to the latest information about schizophrenia. The author adds that the institutes aim is to serve as a resource to scientists, clinicians, government, consumer and career groups and the public and to help inform policy and clinical guideline development. The institute also aims to be a resource that can be used by scientists to identify relevant research questions.

ABC. (2010). All in the mind-schizophrenia: personal confrontations and philosophical investigation. Melbourne: ABC program.

The program, All in the mind-schizophrenia: personal confrontations and philosophical investigation was a show that was aired to highlight the issues of individuals living with schizophrenia where a Philosopher, poet and writer Dr Paul Fearne was a guest in the program that was presented by Natasha Mitchell. The show talked about Dr. Pauls first psychotic episode that occurred while he was just a young university student. Dr.fearne noted that during that stage in his life, he kept a diary which he entered notes concerning his life on a daily basis. From the show, he noted that one of his favorite entries into the diary was To live is to take a leap into a sea of daggers, each one stabbing the fabric of your being. ABC (2010) observes that one can note that his experiences and diary entries encouraged a unique PhD investigation into the philosophical questions posed by schizophrenia whereby later the diary was published and is known as Diary of a Schizophrenic.

ABC (2010) notes it was brave for Dr. Fearne, to go public with something so intimate but publishing anything from those anxiety-tinged years of his early adulthood life is even braver. What makes his diary exceptional is that throughout his first psychosis, he was reading grand classics of literature, whereby his intellect could construe well what was going on. However with treatment and right support, Dr.fearne completed his honors degree and a master in the philosophy of aesthetics and beauty, got married, and has a child he concludes in the show that, talent, love and acceptance can take all of us a long way in the face of adversity.

The article An Assessment of Five (PANSS, SAPS, SANS, NSA-16, CGI-SCH) commonly used Symptoms Rating Scales in Schizophrenia and Comparison to Newer Scales (CAINS, BNSS) by Suneeta Kumari and Mansoor Malik was published in the Journal of Addiction Research and Therapy on 11th May 2017. The authors are psychiatrists who work at Howard University Hospitals Department of Psychiatry and Behavioral Sciences (Kumari & Malik, 2017). The objective of this essay is to analyze and review scales used in the diagnosis of schizophrenia by relating the article to the movie A Beautiful Mind which is based on the real-life story of John Nash, a mathematics professor who was suffering from Schizophrenia (Howard, 2001). The movie A Beautiful Mind stars John Nash, a mathematics genius who suffers from Schizophrenia but can beat all odds and go on to win the Nobel Peace Prize.

At Princeton University, John Nash excels well in mathematics. He proceeds on to graduate school, where he excels and starts to teach. While teaching at Princeton University, he gets married to one of his students, Alicia. Due to his mathematical abilities, the United States Department of Defense hired him to break some codes. While working at the Department of Defense, he starts to develop hallucinations and starts to run away, saying he is being chased by the Soviets. His condition worsens, and while at home, he tells Alicia, his wife, that Charles, their friend, wants to kill their son. He leaves their son in the bathroom, but luckily Alicia saves him and calls emergency medical services. Nash is taken to a psychiatric hospital, where he takes antipsychotic drugs. Initially, he suffers from side effects, but his condition improves, and he resumes teaching and eventually wins the Noble Peace in Economics due to his astonishing work on game theory.

In the movie, Nash suffers from hallucinations. At the Department of Defense, he runs away while writing a report on the Soviet Codes when he starts to hallucinate that the Russians are chasing him. Later at Harvard University, Nash starts to hallucinate that hostile people are watching him while he is giving a lecture and tries to run away. He is sedated and rushed to a psychiatric hospital. In the movie, Nash appears worried and is always hearing voices in his head. While at home, Nash manifests negative symptoms such as avolition when he leaves their son in the bathtub after claiming that his friend Charles wants to kill him. According to Kumari and Malik (2017), the DSM5 for diagnosing Schizophrenia is the Scale for the Assessment of Negative Symptoms (SANS) and the Scale for the Assessment of Positive Symptoms (SAPS), which measure the positive symptoms and negative symptoms such as hallucinations and avolition respectively (Kumari & Malik, 2017). Based on the SANS and SAPS tests, Nash is suffering from Schizophrenia which manifests itself in the form of the positive symptom hallucination and the negative symptom avolition.

The purpose of the article is to show the effectiveness of different diagnostic tests for schizophrenia. According to Kumari and Malik (2017), the objective of their article is to assess the effectiveness of the Scale for the Assessment of Positive Symptoms (SAPS), the Negative Symptom Assessment (NSA-16), the Clinical Global Impression Schizophrenia (CGI-SH), and the Scale for Assessment of Negative Symptoms (SANS) and compare them with newer diagnostic tests, the Brief Negative Symptom Scale (BNSS) and the Clinical Assessment Interview for Negative Symptoms (CAINS) (Kumari & Malik, 2017). This will help to improve the diagnosis of Schizophrenia and increase positive outcomes through early detection, accurate diagnosis, and the right treatment intervention.

The results of the study show that CAINS and BNSS are better diagnostic tools for Schizophrenia compared to SANS, CGI-SH, NSA-16, and SAPS. The results show that CAINS and BNSS are effective in developing and evaluating negative symptoms, which provides a more accurate diagnosis of Schizophrenia than evaluating the positive symptoms. The main reason is that negative symptoms help to show the extent of structural and chemical changes within the brain.

The study is important for understanding John Nashs condition since it would have helped to provide an accurate diagnosis and early detection. In the movie, the psychiatric hospitals tested his positive symptoms since they used SANS and SAPS tests. These two tests are not as effective as CAINS or BNSS because they evaluate positive symptoms. The study by Kumari and Malik (2017) showed that the use of CAINS and BNSS is better since they provide an accurate diagnosis of Schizophrenia by evaluating negative symptoms such as avolition which helps to show the extent of structural and chemical changes within the brain of the patient (Kumari & Malik, 2017). The study is important because it will help to increase the number of positive outcomes among Schizophrenic patients by ensuring accurate diagnosis and administration of the right treatment intervention.

When relating the study conducted by Kumari and Malik (2017) to John Nash and his schizophrenic episodes, it should be noted that the biggest indicator that can be met in both the article and the movie is the presence of grand delusions. The latter interferes with the clients life and ultimately leads them to develop an unhealthily exaggerated sense of knowledge and significance. In A Beautiful Mind, John Nash believed he was superior to his surroundings, claiming that the work of one of his classmates was unoriginal and that he would create something inventive instead (Howard, 2001). With the help of the study carried out by Kumari and Malik (2017), one could also get a better view of the early onset of schizophrenic symptoms in John Nash. In his thirties, the client finally met with the display of schizophrenia face to face.

Numerous parallels can be drawn between the article written by Kumari and Malik (2017) and the fictional character of John Nash. It is valid to state that schizophrenia remains one of the main reasons why people suffer from a significant decrease in their quality of life and even have trouble differentiating real-life events from certain fiction (Howard, 2001). The best way to describe the impact of Kumari and Maliks (2017) study on my view of John Nash is to reference their portrayal of delusions that set constant traps for the affected persons consciousness. A perfect example of this in the movie is when John sees the alleged soviet spies who capture him, but then he finds himself in a psychiatric hospital. The advancing nature of a schizophrenics delusions is going to make it harder for people around them to take adequate care of them.

The study on nursing practice implies that nurses will be able to provide better treatment interventions and accurate diagnoses of schizophrenia by using CAINS and BNSS tests. The study will have positive implications for my future nursing practice since I intend to become a mental health nurse. In graduate school, I will conduct more research on how to improve the current BNSS and CAINS tests to ensure that nurses can provide quality care to their patients. I believe that nurses can increase the number of positive outcomes by coming up with better scales that will assess both negative and positive manifestations of schizophrenia in a simpler and user-friendly manner.

References

Howard, R. (2001). A Beautiful Mind [Film] IMDb: Movies & TV Shows. Web.

Kumari, S., & Malik, M. (2017). An assessment of five (PANSS, SAPS, SANS, NSA-16, CGI-SCH) commonly used symptoms rating scales in schizophrenia and comparison to newer scales (CAINS, BNSS). Journal of Addiction Research & Therapy, 8(324). Web.

Sexual Dysfunction

Diagnosis

In the case study under consideration, there is a man with evident sexual dysfunctional problems. The beginning of the conversation is unclear and pointless because truth can hardly be identified. The client admits that his GP and urologist have not discovered any physical problems. Still, his wife notices his computer dependence and the inability to avoid its usage every night. In a short time, the client confesses to his dependence on regular masturbation (even at work where he was punished because he visited porn sites). A DSM diagnosis for this client is an erectile disorder (302.72  F52.21) with marked difficulty in obtaining an erection during sexual activity and, as a result, maintaining an erection at the end of the sexual activity (American Psychiatric Association, 2013).

Rationale

The rationale for such diagnosis can be the following factors: the erectile dysfunction may not be dependent on the hormone levels or other outside sources but some personal male characteristics (Wallen & Graves, 2007). Many psychologists conclude if there are no physical explanations of the problem, and there are frequent cases of men climax during viewing porn, it is necessary to search for some psychological problems in such inabilities.

Additional Information

To introduce an accurate diagnosis, it is possible to find the answers to such questions as if the client tries to combine viewing pornography and having sex with his wife, if the client attempts to avoid masturbating, or what kind of pornography sites he prefers to watch. This additional information should help to clarify the reasons why sexual affairs with his wife cannot satisfy him and what the wife can do to change the situation.

Additional Individuals

In the current assessment, it is possible to include several individuals. If there are any, it is possible to ask an ex of the client to share her experience with him and clarify if the same problems took place before. Besides, it is possible to address a co-worker and share his opinion about the picture observed at the working place. Such information can deprive the client of the desire to use porn again and focus more on his wife.

Environment

The most comfortable environment that can lead the client to discuss his issue is a private conversation with his wife (Wincze & Carey, 2012). The psychologist should never try to divide the couple but educate them to discuss their sexual problems together. The husband should stop hiding something from his wife, and the wife should learn how to understand and interpret the behavior of her husband. The couple should be offered to use some sexual advertising or watch porn together. The client has to be provided with an environment where he can learn how to discuss his sexual preferences with his wife.

Gender Dysphoria

Diagnosis

There is a 13-year-old female patient, whose parents bring her to a psychologist because of their anxiety about her unhappiness of being a girl. She faces numerous problems and misunderstandings at school caused by her looks and the desire to behave like a boy. She does like her breasts and wants to be a boy. Regarding such a situation, the girl can be diagnosed with gender dysphoria (302.6  F64.2) with a strong dislike of female sexual anatomy and preference to wear typical masculine clothing (American Psychiatric Association, 2013). Gender Identity Disorder is a frequent problem of many children that has to be solved in a short period of time by means of providing appropriate care and explanations (Giordano, 2013).

Rationale

There are many reasons for such diagnose. First, the girl demonstrates her intention to change her gender openly. In addition to her desire to have male-like clothing, she tries to participate in male contact kinds of sport and use any possible means to underline her intention to deprive herself of any male characteristics. Finally, her desire to remove breasts should be considered as one of the main signs of gender dysphoria. All these symptoms and observations help to diagnose the girl as the client with Gender Identity Disorder with a more than six-month duration.

Additional Information

To prove the chosen diagnosis, it is also possible to gather more information about the client. For example, it is necessary to learn the circle of her friends, identify if there are more male or female friends, and clarify the level of the relations that take place between them. According to Drescher (2013), it is wrong to identify the problems of the girl as a mental disorder based on label variations of gender expression. Besides, the young age of clients should be considered when attempts to diagnose people are made. Paris (2015) suggests paying more attention to the connection between gender and culture to interpret the behavior of the girl properly.

Additional Individuals

To understand the reasons why the 13-year-old girl prefers to be a boy, more information can be gathered using additional sources. For example, teachers and fellows of the girl may be involved in conversations. They may be asked about the conditions under which the girl should study and cooperate with her mates and the reaction she demonstrates to different events in the school.

Environment

The courses taken with a psychologist should aim at the identification of the reasons for why the girl decided to neglect her female nature and be attracted by male characteristics. The girl should be treated during private conversations with an expert. It is also possible to provide the girl with some video presentations where the peculiarities of a transformation process are described.

Psychosis-Related Symptoms in Schizophrenia

To comprehend if psychosis-related symptoms are always indicative of a diagnosis of schizophrenia, it is necessary to understand what schizophrenia is, and what its main symptoms are. Schizophrenia is a serious mental disorder that affects the ways of how a person can think, feel, and acts (Mental Health America, n.d.). People, who suffer from schizophrenia, maybe at a loss while making attempts to comprehend if everything around is real or imaginary. Besides, it is hard for schizophrenics to express their emotions in different social situations. In brief, the main symptoms of schizophrenia are delusions, hallucinations, disordered speech, apathy, and a kind of emotional unresponsiveness (Mental Health America, n.d). In other words, schizophrenia is a mental disorder that usually causes psychosis. However, schizophrenia may have other symptoms except the already psychosis-related symptoms mentioned. That is why it is not correct to define all psychosis-related symptoms as the indicative symptoms for the diagnosis of schizophrenia.

Alternative Diagnoses for Psychosis-Related Symptoms

Psychosis is defined as a syndrome that consists of a group of symptoms inherent to such diagnoses as bipolar disorder, personality disorder, depression, etc. Therefore, some possible alternative diagnoses may be offered for psychosis-related symptoms. People with such psychotic-related symptoms as loss of appetite and social withdrawal may suffer from depression. People, who have catatonia or sleep paralysis, may be diagnosed with narcolepsy.HIV infections may be also present with psychosis and have to be treated properly as soon as they are discovered. Brain problems may also be caused by some psychosis-related symptoms. Sometimes, Alzheimers disease is confused with psychosis when it is correct to consider psychosis as a part of the disease.

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5^th ed.). Arlington, VA: American Psychiatric Publishing.

Drescher, J. (2013). Gender identify diagnoses: History and controversies. In B.P.C. Kreutels, T.D. Biteensma, & A.L.C. de Vries (Eds.). Gender dysphoria and disorders of sex development: Progress in care and knowledge (pp. 137-150). New York, NY: Springer.

Giordano, S. (2013). Children with gender identify disorder: A clinical, ethical, and legal analysis. New York, NY: Routledge.

Mental Health America. (n.d.). Schizophrenia. Web.

Paris, J. (2015). The intelligent clinicians guide to the DSM-5 (2^nd ed.). New York, NY: Oxford University Press.

Wallen, K. & Graves, F.C. (2007). Sex hormones and male sexual behaviour. In F.R. Kandeel (Ed.) Male sexual dysfunction: Pathophysiology and treatment (pp.69-78). Boca Raton, FL: Taylor & Francis Group.

Wincze, J.P. & Carey, M.P. (2012). Sexual dysfunction (2^nd ed.). New York, NY: Guilford Press.

Introduction

Schizophrenia: the “cancer” of mental illness. Schizophrenia is the most severe and debilitating psychiatric disorder that exists. This disorder affects about 1% of the population worldwide (Owen & Mortensen, 2016). Although the percentage may not seem significant, the actual number of people affected is huge. While there are several different causes of schizophrenia, most of them aren’t preventable. There are many signs and symptoms of the illness, but there is no way to foresee the onset of it. As of right now, a cure has not been discovered, but treatment has come a long way from where it used to be. Most people believe schizophrenia is just hallucinations and people acting out of the ordinary, but the truth is that it is an extremely complex, unpreventable mental illness. So, what causes schizophrenia?

Understanding Schizophrenia as a Debilitating Disorder

There isn’t an exact reason people develop schizophrenia, but there are many factors believed to contribute to the disorder, and most of them are things that aren’t preventable. Some of the believed causes happen early in life and even before birth. If a mother has complications or stress during pregnancy or a child develops a serious infection, it could lead to the onset of schizophrenia. Abuse in early childhood could lead to schizophrenia as well. Genetics are believed to be another major cause of people developing schizophrenia. There is a higher risk of a child developing this disorder if one or both of their parents have it. According to Laurens and Cullen (2015), “anywhere between 10% and 15% of children will develop schizophrenia if they have an immediate family member diagnosed with it.”

The final major reason for people developing schizophrenia is the differences in the biological makeup of the brain. Their brains generally have less grey matter than a typical brain, and if left untreated, the grey matter will continue to decrease. The ventricles in their brains tend to be enlarged, which means there is more fluid in the spaces around them. Also, the amygdala is enlarged, and they have decreased function in the prefrontal cortex. There are excessively higher amounts of the hormone dopamine in the frontal lobes than in the average brain (Solanki et al., 2008).

Symptoms of Schizophrenia

Schizophrenics generally have two types of symptoms: positive and negative. Positive symptoms are things such as disorganized speech, hallucinations, catatonic behavior, delusions, and disorganized behavior. With positive signs and symptoms, the person may be unresponsive to their surrounding, see or hear things that aren’t really there, or not be able to care for themself. Types of negative symptoms seen are the flat effect, avolition, and algogia. A person with negative signs or symptoms may show little to no emotion, have a limited vocabulary, or be unable to do everyday tasks such as cooking or tying their shoes.

All of these symptoms, positive and negative, are important to the diagnosis of schizophrenia. “The positive symptoms tend to relapse and remit, though some patients experience residual long-term psychotic symptoms. The negative and cognitive symptoms tend to be chronic and are associated with long-term effects on social function” (Owen & Mortensen, 2016). Both positive and negative symptoms of schizophrenia are devastating and can range in severity. Positive symptoms were named because they are thought of as being added to a person’s psyche. The brain is more stimulated than before the onset of the illness. Negative symptoms occur when the brain has less stimulation, and the person loses the ability to do things they used to be able to, such as routine hygiene or normal emotion.

How the Illness Can Be Treated

Even though there is no cure for schizophrenia, there are many medications and therapies used to help people function and have a life as close to normal as possible. Antipsychotic medicines are the number one type of medication used to reduce symptoms of schizophrenia. The most commonly used medications are as follows:

Zyprexa is used to treat schizophrenia in people 13 and older. It has been shown to block or lessen the effects of several chemicals in the brain. Risperdal is used to treat schizophrenia by changing the activity of certain natural substances in the brain. Seroquel helps to lessen the effects of the neurotransmitter dopamine in the brain. Geodon is an antipsychotic that blocks certain neurotransmitters in the brain that heighten the symptoms of the disorder. Haldol helps with the treatment of schizophrenia by decreasing abnormal excitement in the brain. Thorazine changes the activity of chemicals in the body.

Clozaril is the last resort medication. It is used in patients who couldn’t be helped with any other medication. It helps the patients who have attempted suicide or are likely to attempt it again. Like the majority of the other medications, it is used to lessen the effects of the chemicals and neurotransmitters in the brain. While medications can greatly reduce problems associated with schizophrenia, they all come with a risk of their own side effects. As Millier et al. (2014) have noted, “The most harmful side effects reported are weight gain, diabetes, metabolic syndrome, sexual dysfunction, osteoporosis, and physical impairments such as tardive dyskinesia.”

Using therapy techniques along with medication is the best way to help a patient (Ben-Zeev et al., 2011). Psychotherapy is a major form of therapy used with schizophrenics. With psychotherapy, the patient meets with the therapist or counselor regularly. The therapist helps them to be able to differentiate between what is real and what is imaginary. Also, the therapist helps them to be able to better understand their illness and how to handle themselves properly. Another form of therapy is family therapy. This type of therapy is important because, a lot of times, the families have to help care for the person with the disorder, and they need to understand and know how to cope with the symptoms they have to deal with. With family therapy, the families will learn all about the disorder and know how to manage it. Cognitive behavior therapy can be very effective for a schizophrenic. It would help them to recognize unhealthy behaviors and develop more beneficial ways of doing things.

Quality of Life for a Schizophrenic Patient

The quality of life for someone with a diagnosis of schizophrenia is reduced significantly compared to a healthy person. Historically, about 60% of people living with schizophrenia attempt suicide, and close to 15% are successful (“Negative Symptoms,” 2017). Many times, schizophrenics go into depression because they are so handicapped by the illness. It can lead to social withdrawal and unemployability. Depending on the severity of the diagnosis and how well treatment works, it’s not uncommon for the person to require 24-hour care. Almost half of people with schizophrenia live with their parents or another family member their entire lives (Takamatsu et al., 2009).

Conclusion

Schizophrenia can be a scary mental illness if you don’t know much about it. With so many affected by it in our world, being aware of what it is and what can be done to help people diagnosed with it will make it less frightening. Even though there is no way to see the onset coming, having so many treatment options available makes it much more manageable. Schizophrenia is not just hearing voices, hallucinations, or acting out. It is a complex illness that cannot be prevented in people who are diagnosed with it. The more aware we are about it, the further research can go and hopefully lead to a cure someday.

References

1. “Schizophrenia: Cognitive Theory, Research, and Therapy” by Aaron T. Beck and Neil A. Rector
2. “Divided Minds: Twin Sisters and Their Journey Through Schizophrenia” by Pamela Spiro Wagner and Carolyn S. Spiro
3. “Madness: A Bipolar Life” by Marya Hornbacher

Introduction

How would you react if you woke up one day and just felt off? You’d probably go about your day and carry on as usual. Days and weeks would go by, and you probably wouldn’t notice that feeling worsening or even notice anything different at all. Over time, you might start distancing yourself more from the things you once loved, whether it be from social occasions, hobbies, your close friends, or even possibly your loved ones. You might start to experience abnormal behavior and a lack of emotions.

Eventually, you end up having an episode where you might start to experience hallucinations or delusional thoughts. All of this could add up to being diagnosed with Schizophrenia. Schizophrenia is a mental disorder that is typically associated with disruptive thoughts, perceptions, and behaviors. One might experience delusional thinking, loss of emotions, and possibly different hallucinations (Schizophrenia, 2018). This paper will discuss the following information regarding this disorder: history and prevalence, diagnosis and symptoms, contributors and mechanisms, biological components, social effects, and treatments.

Prevalence and History

One of the first forms of possible evidence of mental illness dates back to the Stone Age. Some of the archaeological discoveries that were found were skulls that had burr holes drilled into them, possibly put there to release evil spirits from their remains (Burton, 2017). While researchers believe that mental illness has been around for as long as we have, it wasn’t until 1887 that German psychiatrist Emil Kraepelin first distinguished this illness from other forms of psychosis. He called it ‘dementia praecox’. The name ‘dementia praecox,’ meaning ‘dementia of early life,’ was chosen because, at the time, he had believed it only occurred in adolescence. Later, the title was changed to ‘Schizophrenia’ by Swiss psychiatrist Paul Eugen Bleuler in 1910 (Burton, 2017).

The term is derived from the Greek word schizo, meaning split, and phren, meaning mind. Due to this, It was often mistaken as an unrelated disorder known as Multiple Personality disorder (Burton, 2017). Schizophrenia is now a commonly known disorder in the United States but only occurs in about 1% of the population (Spielman et al.,2016). Having a first-degree relative gives a 6-10% greater risk of developing the disorder. If only one parent is affected, they have about a 13% chance, while having both parents affected puts one nearly at 50% (Pedersen, 2018). For most sufferers, symptoms usually start to appear during late adolescence or early adulthood. While the disorder could begin to show signs in childhood and late adulthood, it is extremely rare (Pedersen, 2018). Research has shown that males often show symptoms at a younger age than women tend to. Before the age of 19, women experienced signs of the disorder at 23%, while men were recorded at a higher rate of 40% (Pedersen, 2018).

Diagnosis and Symptoms

Most cases of Schizophrenia usually develop slowly and over an extended period of time. Other cases have shown signs of starting almost instantly (Nordqvist, 2017). Diagnosing the patient can be a long process, and different tests must be done to acquire a final diagnosis. Blood tests might be in order to rule out any other causes of Schizophrenia symptoms, such as the use of drugs like marijuana or psychedelics. They might also perform imaging studies to look for tumors or other problems in the structure of the brain that might be causing these symptoms. If no issues arise, they will give a psychological evaluation of the patient.

A specialist will observe and ask the patient about his or her mental state. Questions concerning their thoughts, moods, and violent tendencies will be asked. Along with whether they are experiencing any hallucinations or suicidal thoughts (Nordqvist, 2017). The patient must meet the requirements stated in the DSM (Diagnostic and Statistical Manual of Mental Disorders). This manual is used to help diagnose mental illnesses by healthcare professionals. They must be experiencing at least two of the symptoms from the criteria, and the symptoms must persist for at least six months or more (Nordqvist, 2017).

Conclusion

Patients diagnosed with Schizophrenia may experience many unpleasant symptoms daily. Some symptoms that persist are disorganized thinking, hallucinations, delusions, and negative symptoms as well. Auditory hallucinations are most common and occur in about two-thirds of patients diagnosed with Schizophrenia. They hear voices in their head that can make it hard to concentrate on everyday tasks (Spielman et al., 2016). They can also experience different delusions, such as paranoid delusions, grandiose delusions, and somatic delusions. All deal with firm beliefs that are contradictory to their reality.

References

1. “The Center Cannot Hold: My Journey Through Madness” by Elyn R. Saks
2. “Surviving Schizophrenia: A Family Manual” by E. Fuller Torrey

Introduction

Schizophrenia is a mental disorder in which a person’s ability to think, feel, and behave appropriately is affected. A person who is schizophrenic may experience delusions, hallucinations, suicidal ideation, and other cognitive difficulties. Schizophrenia usually appears between late adolescence and early adulthood and can often be a lifelong struggle. In Cechnicki, Bielańska, Mętel, Susz, Błądziński, Plencler-Bańczyk, and Kalisz’s research article Comparison of the long-term treatment outcomes of women and men diagnosed with schizophrenia over a period of 20 years, gender is mentioned as a demographic prognostic factor of schizophrenia. This article explains its research and results about the difference in schizophrenia between women and men diagnosed with schizophrenia over a period of 20 years and how they are responding to long-term treatment.

Summary of Article

There were three objectives identified for this study: to assess and compare the demographic, social, and clinical indicators between women and men during their index psychiatric hospitalization and to assess and compare the clinical and social outcomes of treatment in women and men after 7, 12, and 20 years from index hospitalization and to assess and compare subjective quality of life in women and men after 7, 12, and 20 years from index hospitalization.

The study initially began with 80 individuals hospitalized at the Psychiatric Clinic of the University Hospital in Cracow who were diagnosed with schizophrenia. The 80 individuals had to meet certain criteria that included being over the age of 18, living in Cracow with family, lack of organic brain disorder and dependence on substances, and the exclusion of mental retardation. Over the course of 20 years, the follow-ups were conducted after 7, 12, and 20 years. However, out of the 80 individuals, 57 patients took part in all the follow-ups.

The total of women equaled 57, and the men equal 23. The study consisted of assessing the number of relapses, the number and duration of rehospitalizations, and the evaluation of social relationships, family, and employment. The researchers invented the Anamnestic and Catamnestic Questionnaire. Additional instruments included the Brief Psychiatric Rating Scale (BPRS), the Global Assessment of Functioning Scale (GAF), The Cognitive Flexibility Inventory scale (CIF), the Lehman Quality of Life Interview, and the DSM III Axis V social scale.

The article stated that during short and mid-term treatments, women cope better with schizophrenia compared to men.“ Clinical experience indicates that psychotic symptoms in women differ in quality from those displayed by men in terms of their hallucinatory content…….Moreover, calmer behavior of women tends to arouse less unease in their immediate circle, and they have more favorable responses both to pharmacological treatment and in compliance “ (Cechnicki et al. p. 63)

Strengths and Weaknesses of Article

One weakness this article had was that it failed to mention the kind of treatment the patients were receiving. It did not say if they were on any medication or doing any therapies, such as behavior therapy or cognitive therapy. Knowing the kind of treatment each patient was getting may have given a more accurate result for the experiment and can help understand why women cope better than men who are schizophrenic. Another weakness included the women-to-men ratio. There were more women than men. Sixty percent of the individuals were women.

Recommendations

I would not recommend the study to other colleagues. It lacks certain information and still leaves the reader or researcher with an unanswered question. The course of the experiment and study was 20 years, which is a long experiment.

Conclusion

As time progressed, the study concluded that the symptom severity in favor of women faded out after about 20 years of the illness. There was no significant difference in symptoms between men and women after 20 years. Compared to men, women, in terms of terms of social functioning, employment, and subjective quality of life, have a more favorable outcome. The study also showed that men get married more frequently, which improves their social status. (Cechnicki, Bielańska, Mętel, Susz, Błądziński, Plencler-Bańczyk, & Kalisz p. 66)

References

1. Cechnicki, A., Bielańska, A., Mętel, D., Susz, K., Błądziński, P., Plencler-Bańczyk, E., & Kalisz, A. (Year). Comparison of the long-term treatment outcomes of women and men diagnosed with schizophrenia over a period of 20 years. Journal Name

Introduction

At around age fifteen, I was browsing around YouTube and found myself looking at various random video clips. Soon enough, I found a specific video that caught my attention. The video was a schizophrenia simulation, and I found it interesting because the video showed different aspects of a psychotic episode from a patient with schizophrenia. This sort of point of view blew my mind because it was like I was put in the shoes of an individual who has this illness. At that point in my life, I did not know what schizophrenia was, so this mental illness was fairly new to me. Eventually, I read numerous academic articles, essays, and videos that revolved around schizophrenia because the illness was very bewildering in my view of it.

Pathology

Schizophrenia is a persisting or constantly reoccurring severe mental disorder. This mental illness affects many things in an individual, which can include the way someone thinks, conveys emotions, acts, associates with others, and perceives reality. The dysregulation of multiple pathways is what causes schizophrenia. Dopaminergic, GABAergic, and glutamatergic are all neurotransmitter systems that are subsequently affected in individuals with schizophrenia. The connections between these receptors contribute to the pathophysiology of schizophrenia. The epidemiology of schizophrenia is around one percent internationally, which is approximately 2 per one hundred thousand people. The age of onset of schizophrenia is around adolescence, and it affects both men and women equally.

Signs and Symptoms

Schizophrenia symptoms can be put into three different categories: positive, negative, and cognitive symptoms. Positive symptoms are symptoms that make people feel sensations that are not real. Positive symptoms include hallucinations, delusions, unrealistic beliefs, or struggling to organize ideas and speech. Negative symptoms refer to the lack of normal behaviors. Negative symptoms include anhedonia, affective flattening, no usual facial expressions, and not being able to follow through. People with schizophrenia may also struggle to sustain activities in time or even start them at all.

Cognitive symptoms involve problems with memory and awareness. Cognitive symptoms include attention troubles, difficulty understanding problems, and inability to follow complex instructions. There are seven common signs of schizophrenia. The signs include being hostile, having poor personal hygiene, overreacting to criticism, being expressionless, saying irrational things, having insomnia or oversleeping, and being forgetful or unable to concentrate. Social withdrawal is also a sign of a person with schizophrenia. For example, a person with schizophrenia may not attend social events and may stay alone most of the time. Individuals with this illness may also suffer depression, which has several similar symptoms. Schizophrenia can affect the body and the mind, and some complications can be depression, self-harm, or suicide. The poor personal hygiene sign affects the body because people with this illness may get sick more often or have poor oral hygiene.

Medical Specialists

Medical specialists that people with schizophrenia should be referred to are psychiatrists and psychologists. Psychiatrists are doctors and can diagnose those with schizophrenia as well as specialize in treatment for this mental illness. Psychiatrists can prescribe medications as well as do psychotherapy. Psychologists, unlike psychiatrists, cannot prescribe medicine. Psychiatrists are able to give tests to see how well people with schizophrenia are able to function in their normal daily lives. Schizophrenia patients should be referred to psychiatrists because they are able to prescribe medication to them and professionally do “talk therapy” with patients, which is effective in maintaining their symptoms. Patients should also be referred to psychologists because they are able to do cognitive rehabilitation, remediation, or enhancement. These sorts of therapies teach patients how to be communicative as well as create an understanding of the necessities of others.

Diagnostic Tests and Treatment

There are really no laboratory tests used to precisely diagnose those with schizophrenia. Therefore, medical specialists might use diagnostic tests in order to rule out that the symptoms are not caused by things like medications, substance misuse, or a medical condition. Some major diagnostic tests used to rule out other things that might cause similar symptoms include magnetic resonance imaging (MRI) or computerized tomography (CT) and a psychiatric evaluation. An MRI or CT scan may help medical specialists rule out a possible brain tumor that might be causing similar symptoms of schizophrenia.

A psychiatric evaluation helps by checking if the patient has any hallucinations, substance misuse, delusions, or is probable for viciousness or suicide. The reasons for schizophrenia are still unidentified. Therefore, the treatments for this illness are mainly to eliminate symptoms caused by this disease. A recent treatment for schizophrenia is dopamine D2-receptor blockers, as well as psychotherapy. Dopamine D2-receptor blockers are effective because they reduce the outcome of dysregulated striatal dopamine release. Psychotherapy is useful by managing the symptoms of a patient, and therefore, the patient would be able to enhance their coping skills and pursue life goals.

Prognosis and Psychosocial Issues

After ten years of treatment, about half of the people with schizophrenia would recover enough so they can live independently. A quarter recovered partially, still needing support, fifteen percent remained unchanged, and ten percent would end up killing themselves. After thirty years, more people become independent. However, the suicide rate goes up fifteen percent. People with schizophrenia are not always able to take care of themselves; they tend to have poor hygiene, poor diet, smoke, sedentary lifestyle, or become obese, resulting in their life expectancy being reduced by 20 years. The majority of people with schizophrenia are unemployed, and thus, most of them live with community support. A person with schizophrenia has various medications. Therefore, it usually becomes a financial issue since most individuals with schizophrenia are unemployed. Patients also need to attend psychotherapies, so the schedules of the caregivers are subject to change in order to keep up with appointments.

Assistive Technology (AT)

Two forms of assistive technology (AT) are smartphones and recording devices. Smartphones can help patients diagnosed with schizophrenia by setting alarms or reminders for medication management as well as having music in order to block out voices. A smartphone also has many other useful applications, like apps specifically made for those with schizophrenia. A recording device is also an AT for those with this illness because patients with schizophrenia are often very forgetful and have trouble with their memory. Therefore, recording devices are beneficial by being able to record certain things that the patient might find extremely important, as well as being easily navigational. The cons of both smartphones and recording devices as AT is that people living with schizophrenia are often unemployed and therefore in need of financial assistance than those who do not have the condition. AT can be expensive to purchase, and this causes problems for those who are financially unstable.

Although the findings from this research prove positive for AT, certain key considerations must be addressed before AT progresses. People living with schizophrenia are more likely to be unemployed and in receipt of social welfare when compared to individuals who are not living with this condition (Brown, 2011). AT can be expensive to buy and maintain. This could be problematic for individuals who are not financially secure. Services would have to explore how they can ensure that they can equitably provide modern mental health care thatis in alignment with our current technological environment. There will be a need for appropriate pathways and procedures to ensure AT is available to people who could benefit from it.

Although the findings from this research prove positive for AT, certain key considerations must be addressed before AT progresses. People living with schizophrenia are more likely to be unemployed and in receipt of social welfare when compared to individuals who are not living with this condition (Brown, 2011). AT can be expensive to buy and maintain. This could be problematic for individuals who are not financially secure. Services would have to explore how they can ensure that they can equitably provide modern mental health care that is in alignment with our current technological environment. There will be a need for appropriate pathways and procedures to ensure AT is available to people who could benefit from it.

Although the findings from this research prove positive for AT, certain key considerations ust be addressed before AT progresses. People living with schizophrenia are more likely to be unemployed and in receipt of social welfare when compared to individuals who are not living with this condition (Brown, 2011). AT can be expensive to buy and maintain. This could be problematic for individuals who are not financially secure. Services would have to explore how they can ensure that they can equitably provide modern mental health care that is in alignment with our current technological environment. There will be a need for appropriate pathways and procedures to ensure AT is available to people who could benefit from it.

Although the findings from this research prove positive for AT, certain key considerations must be addressed before AT progresses. People living with schizophrenia are more likely to be unemployed and in receipt of social welfare when compared to individuals who are not living with this condition (Brown, 2011). AT can be expensive to buy and maintain. This could be problematic for individuals who are not financially secure. Services would have to explore how they can ensure that they can equitably provide modern mental health care that is in alignment with our current technological environment. There will be a need for appropriate pathways and procedures to ensure AT is available to people who could benefit from it.

Although the findings from this research prove positive for AT, certain key considerations must be addressed before AT progresses. People living with schizophrenia are more likely to be unemployed and in receipt of social welfare when compared to individuals who are not living with this condition (Brown, 2011). AT can be expensive to buy and maintain. This could be problematic for individuals who are not financially secure. Services would have to explore how they can ensure that they can equitably provide modern mental health care that is in alignment with our current technological environment. There will be a need for appropriate pathways and procedures to ensure AT is available to people who could benefit from it.

Although the findings from this research prove positive for AT, certain key considerations must be addressed before AT progresses. People living with schizophrenia are more likely to be unemployed and in receipt of social welfare when compared to individuals who are not living with this condition (Brown, 2011). AT can be expensive to buy and maintain. This could be problematic for individuals who are not financially secure. Services would have to explore how they can ensure that they can equitably provide modern mental health care that is in alignment with our current technological environment. There will be a need for appropriate pathways and procedures to ensure AT is available to people who could benefit from it.

Although the findings from this research prove positive for AT, certain key considerations must be addressed before AT progresses. People living with schizophrenia are more likely to be unemployed and in receipt of social welfare when compared to individuals who are not living with this condition (Brown, 2011). AT can be expensive to buy and maintain. Thiscould be problematic for individuals who are not financially secure. Services would have to explore how they can ensure that they can equitably provide modern mental health care that is in alignment with our current technological environment. There will be a need for appropriate pathways and procedures to ensure AT is available to people who could benefit from it.

Research Sources

The first reference source by Goldberg was extremely helpful because it efficiently gave detailed information on the symptoms of schizophrenia. Goldberg was thorough throughout the entire source, and it included an overview of early signs, symptoms, tests, and medication, all pertaining to schizophrenia. Its content was well organized by putting the overview of the illness first and gradually going down to the medication that people with schizophrenia take. I relied on this reference because it gave me various amounts of information relating to schizophrenia as a whole. What I did not find useful about this website was that it was quite broad, and I would have liked it to be more specific on what exactly happens in a schizophrenic mind. My second source by McCutcheon, Marques, and Howes, I found to be very credible because it was published by JAMA Psychiatry, which focuses on mental illnesses.

This source was very detailed, from the medication to the actual genetic factors of schizophrenia, and was fairly easy to comprehend. The source ensured an in-depth look at what exactly schizophrenia is, as well as observations, treatment, and the neuroscience portion of schizophrenia. What I did not like about this source was that it was not really organized because I found that some information should have come before others and vice versa.

My last source, the National Institute of Mental Health, was also credible because this organization is concentrated on mental health. I found this source to be helpful because they have small sections of topics they were going to discuss; for example, they had risk factors, treatments, and therapies, as well as information on how to join a study. What I found neat was that the National Institute of Mental Health provided a Join a Study subtopic, which addressed ways to get into clinical trials, and they gave informative details. This source was straightforward, but I believe they did not dig deep enough for me to completely understand the complex illness of schizophrenia.

Conclusion

Therefore, I would end my case study by referring to the source by Mccutcheon, Marques, and Howes as my primary source of information on schizophrenia because they very accurately described what exactly is schizophrenia as well as provided details exclusive to schizophrenia. This information helped me distinguish this mental illness from others. This source was up to date, as well as offering material that would help treat those with schizophrenia.

References

1. “The Center Cannot Hold: My Journey Through Madness” by Elyn R. Saks
2. “The Soloist: A Lost Dream, an Unlikely Friendship, and the Redemptive Power of Music” by Steve Lopez

Introduction

According to Gray and Zide (2013), Schizophrenia is characterized by a broad range of behaviors marked by a loss of a person’s sense of self, significant impairment in reality testing, and disturbances in feelings, thinking, and behavior. There are five subtypes of Schizophrenia: paranoid, catatonic, disorganized, undifferentiated, and residual type. The causes of the disorder are still unknown. In the story of Mary and Gina Thomas, it is believed to have occurred because of a mental breakdown and high-stress levels.

For example, Gina did not exhibit high signs of Schizophrenia until she divorced her husband and was stuck raising two daughters with a low-paying job and a high cost of living. She had never been placed in this situation before. Therefore, her stress levels were high, which is believed to have triggered severe episodes of hallucinations and paranoia. Betensky (2009) found “that there is an interplay between domestic environmental stressors, a need to act constructively, and resulting depressive symptoms in patients recently diagnosed with schizophrenia.”

Subtypes and Complex Symptoms

According to the American Psychiatric Association (2013), Schizophrenia is diagnosed when two or more of the following, each present for a significant portion of time during a 1-month period: delusions, hallucinations, disorganized speech, grossly recognized or catatonic behavior, and or negative symptoms (diminished emotional expression or avolition). Gina met the criteria and was diagnosed with Schizophrenia. She had auditory hallucinations for many years prior to being diagnosed, and she would scream, “Get the cameras off me.” She would exhibit catatonic behavior, such as banging the broom against the ceiling at two o’clock in the morning. At one point, she became so paranoid that she bought a gun and carried it everywhere, including in the bathroom while she took baths. Gina was an educated woman with two degrees. It took a highly trained expert to recognize her disorganized speech.

Many people who are diagnosed with Schizophrenia are in denial. APA (2013) found:

Some individuals with psychosis may lack insight or awareness of their disorder. This lack of “insight” includes unawareness of the symptoms of Schizophrenia and It may be present throughout the entire course of the illness.

Gina being in denial about her mental health disorder made it hard to receive treatment. Although the cause of Schizophrenia is unknown, recognizing the signs is key to receiving treatment and living a normal life.

Assessment tools related to Schizophrenia

Schizophrenia is a lifelong mental health disorder. It is a strain on not only the person with the disorder but families, co-workers, and friends. When diagnosed, the disorder must be monitored to determine which treatments are effective. There are many assessment tools used to measure the negative and positive symptoms of Schizophrenia. The main assessment tool used is the Diagnostic and Statistical Manual of Mental Disorders. The DSM-V measurement scale is an extraordinary and dependable guide utilized by mental health professionals.

Sadly, a major issue utilizing the DSM-V measurement scale is that Metal Health professionals provide the test, but many individuals who experience depression would prefer not to go to a mental health provider because they are afraid they may be viewed as a disgrace or maybe ashamed to admit to other people that they are in need of mental health treatment. There are other tools used to assess Schizophrenia and its symptoms. According to Kumari (2017):

There are relatively fewer articles on the utility of newer scales like CAINS (Clinical Assessment Interview for Negative Symptoms) and the BNSS (Brief et al.) that compare them to the older scales PANSS (Positive and Negative Symptoms Scale), SAPS (Scale for the Assessment of Positive Symptoms) SANS (the Scale for the Assessment of Negative Symptoms), NSA-16 (Negative Symptom Assessment-16) and CGI-SCH (Clinical Global Impression Schizophrenia.

The Scale for the Assessment of Negative Symptoms or Positive Symptoms (SANS) (SAPS) are the most frequently used tools to assess Schizophrenia. These tools were developed in 1980 to measure the severity of symptoms, whether positive or negative. Both SANS and SAPS use a point scale. SANs use a 6-point scale to measure negative symptoms. The symptoms are rated on 25 items to include emotional response, alogia, motivation or avolition, anhedonia, and attention. The SAPS uses a 6-point scale measurement as well. Symptoms are rated on 34 items to include delusions, hallucinations, bizarre behaviors, and positive thoughts. Both tools have rating scales that are clearly defined.

The Positive and Negative Symptoms Scale (PANSS) is another scale used to measure the positive and negative symptoms of Schizophrenia. According to Giesbrecht (2016), “The Positive and Negative Syndrome Scale (PANSS) is a clinical instrument principally developed for use in schizophrenia to identify the presence and severity of psychopathology symptoms.” During a study, Giesbrecht determined that PANSS is an appropriate and valid clinical measure for more heterogeneous marginalized persons in which substance misuse is ubiquitous. The PANSS is made up of 30 items and placed into sub-categories in which scores range from 30 to 210 points.

The NSA-16 is a semi-organized interview containing 16 items that thoroughly survey the negative disorder of Schizophrenia, and it incorporates the accompanying components: correspondence, feeling/influence, social association, inspiration, and hindrance. These elements are surveyed through an organized meeting and are broad and well-defined to help institutionalize evaluation. The assessments use a 6-point scale that rates five factors. The higher the score reflects the severity of Schizophrenia.

Clinical Global Impression Schizophrenia is a tool used to assess five different symptoms: depressive, negative, cognitive, and positive. The CGI-SCH is a less difficult scale as it comprises just two classes: seriousness of illness and level of progress. There has been great criticism when using this scale. Many critics believe that the scale lacks reliability.

Differential Diagnosis

Differential Diagnosis is the procedure of determining the difference between two conditions that have similar symptoms and signs. Schizophrenia mimics depressive disorder, bipolar with psychotic features, schizoaffective disorder, delusional disorder, schizotypal personality disorder, obsessive-compulsive disorder, and body dysmorphic disorder. According to APA (2013), “The Diagnosis of Schizophrenia is made when the psychotic episode is persistent and not attributable to the physiological effects of a substance or medical condition.

Prevalence

Prevalence is the number of people with a certain characteristic at any given time. Prevalence is estimated by a sample of people to help identify the characteristic. The data is determined by the number of people with the characteristic divided by the number of people randomly selected. A review of most literature shows that only around 1% of adults have Schizophrenia. There is a higher percentage of males versus females that have Schizophrenia. Studies have shown that Schizophrenia has had an effect throughout one’s lifespan. According to Dombeck and Nemade (2013):

It is fairly rare for children and older adults to develop Schizophrenia, but it does happen. The rate of Diagnosis of new cases increases in the teen years, reaching a peak of vulnerability between the ages of 16 and 25 years. Men and women show different patterns of developing the disorder. Males are more likely to have their first episode in the early to mid-20s. Females have two points where the first episodes are most likely to happen. The first is in the late-20s, and the second is after 40 years of age.
Studies have shown that many of the people diagnosed with Schizophrenia go without treatment.

Evidence-Based Treatment

An Evidence-Based treatment is a treatment that is backed by scientific research that proves effectiveness. Although, the patient must be willing to participate in their treatment in order for any treatment to work. There are few evidence-based treatments. The main evidence-based treatments that are used in society are Family Psychoeducation, Psychotherapy, and Pharmacotherapy.

Family members tend to play an important role in the treatment of someone with Schizophrenia. Many people diagnosed with Schizophrenia may present as ashamed and in denial about the disorder. They may even distance themselves from family due to being embarrassed. Family Psychoeducation is an evidence-based treatment that provides families with education and knowledge about mental illness. During this treatment program, families are taught coping, problem-solving, and communication skills to manage someone with mental illness.

In the story of Gina, the family may have been able to help Mary if they had more knowledge about Schizophrenia. Gina, on the other hand, had a daughter who was young but willing to attend the educational classes. It appeared that Gina was less of a burden on the family once they were able to recognize the signs and symptoms of Schizophrenia. According to Dasousa (2012), “It has been estimated across studies that 30-85% of adults with schizophrenia have a family member as a caregiver.”
Psychotherapy is individual counseling to help an individual address the signs and symptoms of the illness. Most sessions last anywhere between 30 to 60 minutes. According to APA (2016):

Research shows that most people who receive psychotherapy experience symptom relief and are better able to function in their lives. About 75 percent of people who enter psychotherapy show some benefit from it. 1 Psychotherapy has been shown to improve emotions and behaviors and to be linked with positive changes in the brain and body. The benefits also include fewer sick days, less disability, fewer medical problems, and increased work satisfaction. Psychotherapy also can have therapy sessions that include family members.

Pharmacotherapy is an evidence-based treatment that entails the use of prescription drugs. In many instances, antipsychotic medications are prescribed to assist with controlling the symptoms of Schizophrenia. During Genevieve’s acute episode of Schizophrenia, she was prescribed Abilify to manage her auditory hallucinations and paranoia. There are other oral medications for Schizophrenia, such as Olanzapine, Aripiprazole, Asenapine, and Paliperone. If a patient is uncooperative with oral antipsychotics, there are intramural injections. Like any other Evidence-Based treatment, the patient must be aware and understanding of a Schizophrenic diagnosis.

Course of Treatment

In the story of Gina, it has been proven with proper treatment and family support, a person with Schizophrenia may live a normal life outside of psychotic episodes. Gina exhibited signs of Schizophrenia in her early thirties. She went without treatment for many years. When she was diagnosed with Schizophrenia, she was in denial. Her family enabled her disorder to the point that it destroyed relationships. Gina was in the hospital involuntarily several times during psychotic episodes. It was Gina’s lack of cooperation that led her to live in a homeless shelter for nearly a year before deciding to get help. She is currently receiving psychotherapy and medications to manage the symptoms. She lives in her own apartment and has a full-time job.

Schizophrenia is not truly recognized until after severe odd behaviors occur. Many people are able to receive treatment and live normal lives. According to APA (2013), “Approximately 5%-6% of individuals with Schizophrenia die by suicide, 20% attempt suicide on more than one occasion, and many more have suicidal ideations.

Conclusion

According to research, there is not a cure for the schizophrenia disorder. Schizophrenia requires treatment throughout one’s life. Many people with the disorder are able to live a meaningful life. Studies have shown that many people with Schizophrenia struggle with social and occupational skills. They tend to make lower wages than their parents. According to APA (2013), “There is a strong contribution of genetic factors in determining risk for Schizophrenia, although most individuals who have been diagnosed with Schizophrenia have no family history of psychosis.

Reference

1. Gray, S. & Zide, M. (2013). Psychopathology: A Competency-Based Assessment Model for Social Workers (4th Ed.) Brooks/Cole.

Abstract

Schizophrenia is a mental disorder that results in fake beliefs and hallucinations, they might be auditory, visual or even gustatory hallucinations where this disease is usually targeting adults, men tend to be diagnosed at a younger age than women, it causes difficulty in social interacting as patient lacks motivation and loses ability to form facial expressions also, their emotions and concentration are negatively impacted by the disease leading to their sentences to be complicated and one might not be able to understand them, disturbed sleeping patterns and anxiety are also common symptoms, the patient is mostly in denial or unaware of their condition (Newman, 2017)& (Hurley, 2019).

Some scientists state that cultural beliefs affect the symptoms shown by schizophrenic patients which is convincing as the hallucinations and delusions are originating from the brain so they will be affected by the person’s thoughts that are mostly related to the person’s culture however, my paper will continue research to check for the presence of a link between culture and schizophrenia. Some may experience violent voices others may believe that they are a religious figure and it depends on the patients’ origin and beliefs. This issue will be discussed from a range of perspectives, global one from China, USA and India, national one from Egypt’s point of view and the local one.

Global perspectives

India:

In India it is believed that a patient’s cultural beliefs affect their schizophrenia symptoms as it is a disease in mind, the auditory hallucinations are heavily affected, Indians mostly value their families and collectivism therefore leading to the patients hearing the voices of family members, friends or partners (Davis, 2019). The voices heard among patients were mostly positive and some described them as intimate, they behave as if they care about the patient by guiding them and lecturing them, even though some people may not be fond of them, they still think of them as personal relationships as they do not need to go out to have someone to talk to as they have them by their side whenever they need (Robb, 2014). When patients were asked how they would describe the voices, most used the words entertaining, magical or interesting, very few Indians faced threatening or violent voices compared to other cultures leading to the fact that they do not describe the voices or see them as a sign of illness or troubled mind but are comfortable with them (Parker, 2014). Two tests were made on patients, the first one was reading the emotions on faces of people, Indian patients found it harder to read emotions on faces of people from other races, the second test they were shown faces and were asked to sympathize with their emotions, patients responded less negatively to sad pictures but noticeably more positively to happy pictures proving that ethnicity affect emotional reading in schizophrenia (Lundbeck Institute Campus, 2016). It is also common that patients cover their illness in fear of abandonment or not being married because marriage in India is a necessity that it is even arranged by elders before adulthood (Loganathan & Murthy, 2011). Therefore, Indians overall are positive about their symptoms as their cultural beliefs and lifestyle allows them to hear friendly voices unlike other cultures which proves that culture has an effect on the disease.

USA:

USA shows various signs that prove that culture does in fact affect schizophrenia. Symptoms of the disease are not the only thing affected by culture, in fact the whole process of people at risk of developing the disease more than others, research found that in USA, African Americans are five times at higher risk of developing schizophrenia rather than a simpler brain or mood disorder in relation to Caucasian Americans (Lundbeck Institute Campus, 2016). The process that occurs after being diagnosed with schizophrenia in USA differs from other countries as they mostly face negative symptoms than positive for starters they believe in thought addition and removal, these are hallucinations about not having the ability to command your thoughts, in thought addition the patient gets the false impression that a person or a thing put thoughts in their head, for thought removal it is quite the opposite where the patient believes that someone removed thoughts out of their head (Davis, 2019). Americans tend to refer to their auditory hallucinations using medical terms and psychiatric unlike other countries that refer to them as people and relationships as they mostly encounter violent and aggressive voices and most of the time they were unaware about they were having a conversation with, according to the research deducted, 70% of the patients heared people ordering them to injure themselves or others in messed up and extremely violent ways even worse than those seen in movies, the cause of this is thought to be that Americans see them selves as independant individuals pushed by self identity (Parker, 2014) & (Robb, 2014) & (Khazan, 13). Some doctors treat the voices as useless products of the disease which should be neglected, the differences between voices heard across cultures led to the realization that the way people focus on their voices affects what they hear (Parker, 2014). Also in visual hallucinations it is shown that westerners focus mainly on the objects in the image rather than its background as their culture mainly focuses on the information provided and not the back story of how it came to be (Lundbeck Institute Campus, 2016). USA further confirms the link between the two variables.

China:

China is another country who furthermore supports the claim that schizophrenia is in fact affected by culture. It is believed that people’s hallucinations and delusions originate from fears and worries that are related to their culture, in China people value family and reproduction so the main fear is loss of fertility by ascendance of the penis into the abdomen which is a medical state where the penis is present but hidden in the skin of abdomen (Lundbeck Institute Campus, 2016). Also, visual hallucinations differ in China where the schizophrenic person relates and focuses their attention more to the images background than the objects found in the image as their culture focuses on the backstory of the information provided rather than the information itself which will most likely lead to kinds of hallucinations that differ than other countries who focus on objects in image instead like USA (Lundbeck Institute Campus, 2016). When experiencing voices Chinese patients will be able to know the person they are speaking to as it is believed outside the west that people’s minds are intertwined together through relationships leading to hearing mostly familiar voices (Parker, 2014). It is also shown that non westerners do not have a strong ability to differentiate between real life and imagination unlike other cultures which might be due to the fact that the voices they hear are familiar to them same as the visual hallucinations therefore might report many hallucinations while some might be real life incidents which is a result of their culture as it doesn’t occur in other cultures which furthermore supports my claim (Larøi, et al., 2014).

National perspective

Egypt:

Egyptian culture doesn’t affect symptoms of schizophrenia however it affects the diagnosis of the disease itself. In Egypt, consanguineous marriages are common and study has found that this has a very noticeable effect on schizophrenia, offspring that come from blood related parents are at higher risk of developing schizophrenia than children of non-consanguineous marriages therefore leading to studies showing that it’s mostly common that schizophrenia patients in Egypt are related even through distant family ties specially in the Nile Delta region, as research showed that consanguineous marriages do not only cause genetically complex disorders but also, mental disorders schizophrenia included (Mansour, et al., 2011).To conclude, culture and its beliefs affect schizophrenia in more than one way, affecting the symptoms faced is one way but it can also affect the diagnosis of the illness from the start.

Local perspective:

For the local perspective I interviewed ten people including family and friends but I decided to start off with interviewing my biology teacher as she might have more background on the topic according to her studies however, she did not provide me with the answer expected as she agreed that culture has an effect but was not able to provide reasons and evidence for her opinion so, I started interviewing family and friends. The higher percentage stated that they don’t believe that culture has an effect as it is a disease so, is the same wherever the patient is just like any other illness. The few who believed that there is a link between the two variables had very similar reasons most of them being that it is a disease in the brain therefore, if a person has certain beliefs which are usually a result of different cultures, the voices they hear will be related to their beliefs which is similar to opinions provided by the different countries stated above. One noticeable fact is that most people state their opinion that is not based on any knowledge but, personal opinions which shows lack of education about a serious mental illness.

Personal perspective

Originally before conducting my research I was rather confused and had different opinions surrounding the link between schizophrenia and culture, half of my mind supported that it does in fact have an effect due to different voices heard so, if a person does not have close family or friends they probably will not hallucinate about familiar voices as they do not hear them often. However, another part of me believed that it is not affected by the origin of the person as it is a disease and diseases have the same symptoms and medications worldwide so, i could not think of a reason why this specific disease would differ than others. This research aided me into deciding which part of me was true and that is that there is a large effect of culture on the disease due to different sources used which are written by professionals in the field and supported by evidence and provided experiments and statistics which resulted in more reliable information to help me understand more the effect of culture on the symptoms faced.

Problems and solutions

The most significant problem faced was the fact that after conducting a primary research for the local perspectives, the majority of the people were found to be unaware about the disease itself which leads to troubles as anyone might be subject to this disease so, without the right knowledge, the patient might experience worse symptoms due to incorrect method of dealing with the disease. This was not shown in the global or national perspectives as reliable sources were used so, were written by professionals but, other than professionals many people were uneducated about the topic and to solve this, medical actions like awareness campaigns might be raised in order to spread information about the disease and how to deal with it.

After the sources proved the link between culture and the disease, some countries face violent and negative symptoms unlike others as in the global perspectives so, in order to prevent the negative symptoms to enhance the patients’ experiences, the aspects that provide positive symptoms could be studied by therapists so that they could be introduced into countries with negative symptoms so that future generations do not face the troubles that patients faced in older generations.

One drawback was that i was not able to write more into visual hallucinations and was more focused on auditory ones due to the lack of reliable sources to use to get into this information which made it difficult to search through all aspects of the disease which might be solved by primary research by interviewing professional psychologists to collect the needed data but i was not able to do so because i do not have access to professionals so would not have been able to collect the true and reliable facts to use.

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