Schizophrenia is a mental illness that affects a human’s life, adversely, reducing the quality of life. Unfortunately, it is an extremely common and serious chronic disease (NIH, 2017). More than 21 million people all over the world are familiar with it (WHO, 2017). However, schizophrenia can be treated using various approaches. Healthcare professionals tend to define different treatments as the most effective ones, but they do not have a common idea regarding this issue.
Thus, this research will be rather useful because it will discuss the effectiveness of self-management programs for people with schizophrenia and their influence on the reduction of readmissions. For the outcomes to be more clear and precise, this intervention will be compared with individual therapy that is also often used while treating individuals with schizophrenia. On the basis of the information mentioned above, PICOT question can be designed:
In in-patients (P), what is the effect of self-management programs (I) on symptoms relief and readmissions (O) compared with patients who are treated with individual therapy (C) within 30 days (T)?
In this framework, the sample will include in-patients who suffer from schizophrenia. They will be of both genders, as this issue is critical for the whole population. However, adults of different ages will be approached. As men are likely to face this health problem earlier, the sample will include those who are between the ages of 18 and 25. At the same time, females of the ages 25-35 will be included (“Schizophrenia facts and statistics,” n.d.).
In addition to that, it is critical to mention that the sample will have no other issues related to their mental health or those that affect it. People’s personal and demographic characteristics will not be taken into consideration because they do not have much influence on the effectiveness of the discussed treatment options. The sample will include those patients who spent some time at a health care facility where they were under the supervision of professionals and then used therapy for 30 days.
For this research to provide worthy results, the influences of the proposed intervention will be compared with the alternative one. Thus, attention will be paid to self-management programs. Coping and support for the patient and his/her family and friends will be considered. The researcher will define whether the information they learned about schizophrenia and its peculiarities affected the way a person stick to the treatment plan. Assistance provided by support groups will be considered as well as the help of social services. Relaxation and stress management activities will also be discussed (Mayo Clinic Staff, 2016b).
Another psychosocial intervention that will be investigated is individual therapy. In its framework, patients receive information that educates them regarding the ways to cope with stress. It also gives an opportunity to learn to recognize warning signs of relapse, which ensures that the treatment will be obtained in time. Thought patterns are expected to normalize after the therapy (Mayo Clinic Staff, 2016a). Thus, the expected outcomes of these interventions are rather similar, which allows the researcher to compare their effectiveness. The focus will be put on the symptom relief, as patients approach healthcare professionals with this purpose, and reduction of the number of readmissions.
This research question can be answered when assessing the condition of patients for 30 days. It will be advantageous to get the data from the past medical history of the sample. The study is going to be feasible and clinically relevant because it focuses on the currently discussed issues and has a narrow focus (van Schie et al., 2016).
van Schie, D., Castelein, S., van der Bijl, J., Meijburg, R., Stringer, B., & van Meijel, B. (2016). Systematic review of self-management in patients with schizophrenia: Psychometric assessment of tools, levels of self-management and associated factors. Journal of Advanced Nursing, 72(11), 2598-2611.
Schizophrenia is a mental disorder that affects not only the victim, but also the caregiver and the society. Statistics show that about 1% of the world population is victim of schizophrenia (World Health Organization, 2003). In the United States, nearly 2 million people suffer from schizophrenia. It has been proven that more men are diagnosed with this mental disorder than females (Miller & Mason, 2013).
Besides, the age groups that are at higher risk of contracting the disease is between 17 and 35 years (World Health Organization, 2003). However, this does not exclude older and much younger generations from being diagnosed with the disease, though their chances are slightly lower. The purpose of this paper is to discuss the effects of schizophrenia on the victim, caregiver, as well as the society.
Literature Review
A lot of research has been conducted on schizophrenia as a mental condition. This has resulted in numerous pieces of literature on this condition. The effects of the mental illness are less the same throughout the world. It means that the impacts of schizophrenia in, say America, are the same in Europe, Asia, and Africa, according to (Rastad, Martin, & Asenlöf, 2014), who conducted a study on the effects of schizophrenia to caregivers. In the report, the experiences of the caregivers were less the same across the globe. It implies that the experience of schizophrenia is largely the same worldwide.
Victims of schizophrenia go through a devastating experience. Most of them do not even realize that they are suffering from the disease (Tsuang, Faraone, & Glatt, 2011). They come to realize later that something was not right after losing many chances in life. According to Fallahi, Sheikhona, Rahgouy, Rahgozar, and Sodagari (2014), this leaves the patients under conditions of stress and depression, while others might experience social withdrawal symptoms as they feel embarrassed on realizing how much they have lost compared to their peers. Among the major effects of schizophrenia on the victim is the loss of social life (Li, Lambert, & Lambert, 2007).
A patient may cause chaos in his family during the initial stages of critical schizophrenia. The patient might as well be disruptive to the younger siblings. In such a case, the family might have to take the patient to a rehabilitation center, which could break the family bond that the patient may require. According to Knapp, Mangalore, and Simon (2004), most of the schizophrenia victims who have been separated from their families for quite some time do not end up having good social relations with their families. Instead, they choose a solitude kind of life and develop antisocial behavior (Carey, 2008).
The separation is dangerous to the victim as the members of the family might not be able to recognize signs of a relapse of the disease in good time. The result might be that the victim may harm himself and in the end cause permanent damage to his body.
Victims of schizophrenia also develop anti-social behavior towards the society (World Health Organization, 2003). It is mainly triggered by the fact that the victims have not achieved as much as their peers have achieved. The achievement could be in terms of education, job promotion, and financial growth, among others. Tsuang et al. (2011) reveal that some of the victims of schizophrenia prefer socializing with other victims of the disease as they find it easier to cope with such a person than the larger society.
There are negative effects of this situation. For example, part of the recovery process for a schizophrenia victim is social therapy. During social therapy, a victim is required to interact gradually with some of his former friends (Tsuang et al., 2011). Doing so is said to help the victim recover and accept himself and the society. The process is hampered the moment the victim develops anti-social behaviors towards the society. Also, people who withdraw from the society are more likely to be involved in various crimes, as they view the society as their enemies.
As earlier noted, the age group that is mostly affected by schizophrenia is the category of persons between 17 and 35 years. Most members of this age group are students in the upper grades or the college level (Fallahi et al., 2014). According to Small, Harrison, and Newell (2010), the treatment of schizophrenia can take several years for successful recovery to be achieved. It implies that the victim misses on one or several years of education if he is a student, which is not good news for the victim.
His peers move ahead with their education and probably get good jobs, while the victim is in the recovering phase (Knapp et al., 2004). Therefore, it is evident that a student who develops schizophrenia will find it difficult to catch up with his former schoolmates in terms of education. In some cases, the victims do not go back to school for fear of embarrassment and the feeling of failure (Knapp et al., 2004). It is also the case with a victim who had a job prior to contracting the disease. Most of such people lose their jobs never to get them back (Carey, 2008).
In such a case, the victim finds it difficult to cope with life, especially if the family does not show much financial support to the victim. Rastad et al. (2014) say that losing the only source of livelihood impacts negatively on many people. There is a high likelihood that such people might be forced to engage in robbery and other crimes to earn a living.
In worse cases, the victims of schizophrenia may commit suicide, which follows cases of alienation from the family, as well as the society (Knapp et al., 2004). In most instances, the victim does not differentiate what is good from bad. Therefore, he may cause injuries to himself to a point where he bleeds to death. Others may commit suicide thinking that they are doing the correct thing. Some of the victims of schizophrenia were married before they developed the condition (Knapp et al., 2004).
In rare cases, the marriage mate may decide to divorce the victim due to fear and continued embarrassment. In turn, it may cause more harm to the victim, especially in the recovery process (Knapp et al., 2004). Such a victim may indulge in alcoholism or drug use as a way of relieving the stress caused by the divorce. All these examples show that schizophrenia victims go through a lot.
Caregivers of victims of schizophrenia get affected by the condition. Statistics show that caregivers of schizophrenia victims are mostly family members (World Health Organization, 2003). In the US, 40% of patients living with schizophrenia are given care by their relatives. The situation is quite different in China, where the percentages of schizophrenia patients being given care by their relatives are close to 90% (World Health Organization, 2003). The effects of schizophrenia on the caregivers can be divided into three categories; emotional impact, financial impact, and physical impact (Knapp et al., 2004). Emotionally, caregivers may experience guilt and helplessness.
According to Knapp et al. (2004), guilt comes in when the family fails to understand why they have to go through the situation of taking care of the victim. The caregiver feels as if the world has turned against them. In some cases, caregivers feel that they are carrying out responsibilities for which they are not paid for (Li et al., 2007). Therefore, it is common for such people to experience resentment and anger. Small et al. (2010) report that it is possible for caregivers to feel isolated, as they may not be in a good position to achieve their goals as desired. The responsibilities that come with taking care of a schizophrenia victim require that the caregiver be close to the victim.
Thus, there is the likelihood that the caregiver might not have the chance to attend to all his normal chores. Caregivers may also feel that their friends are not giving them the assistance that they require (Small et al., 2010). They may have thought that their friends may offer themselves to take turns in offering assistance and close care to the victim. Failure of the friends and other relatives to do so impacts negatively on the caregiver, where he develops resentment and anger towards the friends and relatives who failed to offer assistance (Fallahi et al., 2014).
Carey (2008) gives another emotional effect that caregivers go through while taking care of schizophrenia victims. He says that caregivers may feel frustrated on many occasions. Living with a person who is mentally unstable can cause frustration. It is not possible to reason with such a person, as chances of such a person initiating a quarrel are very high. Another cause of frustration is the workload that is associated with taking care of the victim. Many a times, caregivers report that they feel tired as they have to carry virtually almost all activities that the victim should have done by themselves (Carey, 2008). Thus, there is the feeling of the loss of personal freedom for the caregiver, who feels that much of his time is being used in taking care of the victim
The physical impacts on caregivers vary from household to household. Miller and Mason (2013) report that some caregivers experience depression, with the rates of depression in caregivers ranging from 38% to 60%. It has been reported that caregivers of victims of schizophrenia normally experience poor health due to stress and depression. In other cases, caregivers do not get time to participate in regular exercises, which can impact negatively on their health as well (Miller & Mason, 2013).
The chances of caregivers contracting diseases are very high as opposed to non-caregivers. The care providers spend most of their time attending to the needs of the victims. As such, they might forget to look after their health. In other cases, the schizophrenia victim contracts other diseases like flu and colds. The caregiver ends with a higher risk of contracting the same diseases that the victim is suffering (Rastad et al., 2014).
Financially, caregivers become affected grossly. The productivity of the family is likely to reduce as a result of the disruption in the normal activities of the family members acting as caregivers to the victim (Knapp et al., 2004). The work routine of caregivers is also affected. If, for example, the caregivers are business people, then the operations of their businesses are affected. If the caregivers are employed, then the numbers of hours that they use in their employment are reduced and the income emanating from the work or business is reduced (Knapp et al., 2004).
According to Carey (2008), the amount of money that is required to treat schizophrenia is quite high. Medical bills multiply many folds compared to other illnesses. The situation becomes worse if the victim was not medically insured. The cost of taking care of the victim at home is high. For instance, the victim may require a special type of diet that may be expensive to acquire (Knapp et al., 2004). All these factors translate to how expensive it can be to take care of a victim of schizophrenia. The financial burden laid upon the shoulders of caregivers is quite heavy.
The effects of schizophrenia on the society cannot be ignored. According to Knapp et al. (2004), the main effect of the disease on the society is the cost that is associated with the schizophrenia. The amount of money that the government spends on drugs to fight schizophrenia is high. In 1979, for example, the cost of treating a schizophrenia patient was close to $14,000 (Knapp et al., 2004). The amount is said to have increased in the current times. According to Knapp et al. (2004), there is a huge amount of money that is being used in research related to schizophrenia. The actual cause of this condition is not yet known. It explains why extensive research is being done to try and identify the cause of the disease.
Better drugs that can help the victim recover quicker have not been discovered (Carey, 2008). Consequently, more research is being carried out to address schizophrenia effectively. The relationship of the victim with the society more often becomes weak. On the other hand, the victim could have been contributing positively to the development of the society. Upon being diagnosed with the disease, the victim cannot continue offering the services that he used to offer to the society before. Thus, the society is affected negatively because the schizophrenia patients do not offer the services that they are good at.
Discussion
The effects of schizophrenia on the victim, caregiver, and the society can be minimized by accepting that the condition has occurred and that there is a need to carry on with life. Carey (2008) admits that schizophrenia is treatable, and the healing process becomes easier the moment caregivers accept the condition of the victim and offer themselves freely to help with the condition. Healing therapy is mainly dependent on the support of the caregiver. If caregivers are to enjoy the full recovery of the victim, then they ought to fully support the victim without having resentment and anger against the family members that do not offer to assist the victim.
The caregivers need to be educated on how such a patient behaves in order to give support to the victims of schizophrenia fully. They should be made aware that the victim is subject to delusions and hallucinations. If the victim exhibits such behaviors, then the caregivers should not be frightened; instead, they should know the next, appropriate step to take. It is recommended that a qualified health counselor is the one to give the required education to the caregivers so as to instill the importance of good patient care.
On rare cases, the family of the victim is forced by circumstances to send the patient to a mental hospital, where he is rehabilitated over a period. Upon recovery, the victim is sent back home, but the bond with the family members may have reduced. It is highly recommended that the caregivers support such a victim to develop social skills and embrace the family like before. Patience is paramount to recovery. The family members acting as caregivers ought to exercise patience and be dedicated to ensuring that their family member recovers fully.
The society should also offer to assist the victim, especially during recovery. They ought to inculcate good social skills on the victim to avoid withdrawal of the victim from the society. In addition, the society has a moral obligation of reporting cases of straying individuals who seem to be mentally disturbed to the relevant offices. This could be one of the victims of schizophrenia, who has run away from his home. Reporting him will not only assist in the identification of the victim, but it will also aid in the family in tracing their member.
The immediate neighbors, as well as relatives, have a moral obligation of offering assistance to caregivers who attend to a schizophrenia victim. Doing so will not only relieve caregivers of the burden, but it will also help in preventing cases of resentment and anger in the caregivers.
In conclusion, it is evident that the effects of schizophrenia are numerous. The victim is denied the chance to go on with his normal life say in education or the workplace, until they recover fully. The schizophrenia patient feels alienated from the society due to embarrassment and feelings of failure. Close relatives of the victim are mainly the caregivers to such victim. They may feel isolated as they are not able to attend to their normal chores. Their businesses may report losses as more attention is given to the victim.
Those employed may work for fewer hours that, which may reflect on low pay as compared to non-caregivers. The health of caregivers may deteriorate as a result of more stress and depression that may accompany the lack of regular exercises and increased risks of contracting diseases. The amount of money that is used to purchase drugs to treat schizophrenia is high. A lot of research is currently being done to reveal the actual causes of schizophrenia and the best drugs that can effectively fight the condition within the shortest time possible. In turn, high amounts of resources are used to research on a single ailment. Such amounts of money can be channeled into other research studies on different health conditions.
References
Carey, B. (2008). From the elusiveness of schizophrenia: New clues to treatment. The New York Times. Web.
Fallahi K. M., Sheikhona, M., Rahgouy, A., Rahgozar, M., & Sodagari, F. (2014). The effects of group psychoeducational programme on family burden in caregivers of Iranian patients with schizophrenia. Journal of Psychiatric & Mental Health Nursing, 21(5), 438-446. Web.
Knapp, M., Mangalore, R., & Simon, J. (2004). The global costs of schizophrenia. Schizophrenia Bulletin, 30(2), 279-293.
Li, J., Lambert, C. E., & Lambert, V. A. (2007). Predictors of family caregivers’ burden and quality of life when providing care for a family member with schizophrenia in the People’s Republic of China. Nursing & Health Sciences, 9(3), 192-198.
Miller, R., & Mason, S. E. (2013). Diagnosis: Schizophrenia: a comprehensive resource. New York, NY: Columbia University Press.
Rastad, C., Martin, C., & Asenlöf, P. (2014). Barriers, benefits, and strategies for physical activity in patients with schizophrenia. Physical Therapy, 94(10), 1467-1479. Web.
Small, N., Harrison, J., & Newell, R. (2010). Carer burden in schizophrenia: considerations for nursing practice. Mental Health Practice, 14(4), 22-25.
Tsuang, M. T., Faraone, S. V., & Glatt, S. J. (2011). Schizophrenia (3rd ed.). New York, NY: Oxford University Press.
World Health Organization. (2003). Investing in mental health. Web.
Health is a critical aspect in our day to day lives. It entails an individual’s mental, psychological as well as physical condition which could be either ill or free from illness or injury. It is a person’s state of the body, mind, and spirit especially in respect to being free from pain, injury or disease.
According to the World Health Organization (WHO), health is the state of absolute social, physical and mental well being as opposed to just mere absence of illness. Physical health on the other hand entails good body health, which is achieved through various ways, for instance, proper diet and nutrition, appropriate exercise as well as adequate rest.
It is closely related to mental health, which entails a state of well being where a person is able to function properly. This essay discusses a mental health issue, Schizophrenia, and the aspects associated with it. This will be deduced from an interview after which a personal reflection will be given.
Schizophrenia: Interview
This is a psychotic mental disorder. It has affected a significant number of people as early as during their young adulthood. Its symptoms involve hallucinations, unexpected fear and distorted thoughts. It is diagnosed through evaluation of symptoms and medical history of the particular patient. Medication and psychotherapy is then given according to the evaluation results.
For the purpose of this assignment, I interviewed Mr. Smith (real name withheld). Mr. Smith asserted that he was diagnosed with schizophrenia five years ago at the age of 26 years.
Mr. Smith told me that it got him by surprise that he had the disease. When I asked Mr. Smith of the changes he has undergone as a result of the mental disorder, he admits having undergone changes in behavior, for instance, the way he thinks and expresses himself, how he relates to various people as well as how he perceives reality ( own observation plus what he is told by others).
It has specifically made his life difficult especially when it comes to work and family relations. What really hurts Mr. Smith is the fact that the disease got him at a time in life when he wanted to settle in marriage and due to the changes brought about by the mental disorder, he lost his then fiancée.
This is because he did not behave as he used to and more so he could not differentiate imaginations from reality making him to differ so much with his lover to an extent of separating completely. Mr. Smith also asserted that he has made many enemies at work as most workmates are unable to cope with his change of behavior.
When I asked him what he does to cope with the mental disorder, I got a strong answer which stated: “Although schizophrenia can not be cured, with the passage of years, I have learnt how to control it.” After asking him for a clarification on the specific ways of controlling the disorder, Mr. Smith stated that the first step he has taken is through accepting the condition and thinking and living positively.
He says this step has helped him greatly as he blames no one for his condition and he understands that it is a disease like any other. He has also been following up treatment and always tries to be active and in the midst of supportive people.
Personal Reflection
In regard to the interview with Mr. Smith, I came up with my own inferences and conclusions about schizophrenia. From the beginning, Mr. Smith seems disturbed with a lot of distorted thoughts and I can clearly see that there is a problem, or rather that he is not mentally okay/well. It is during the interview that I get to know that the interviewee is well versed with all issues that surround his condition including the causes, symptoms and how best it can be controlled.
The sad part of the mental disorder is that no cure has been established so far. There are, however, various ways through which the effects of schizophrenia could be controlled to avoid further damage or uncontrolled behavior of the victim that would make him or her to be a bother to those around him or her.
There are various subtypes of schizophrenia, which are characterized by unique but related symptoms and signs and hence the necessity for medical practitioners to have an effective evaluation of the historical background of a victim alongside the presented symptoms so as to make the correct judgment in regard to the medication and psychotherapy to be administered for better results.
Some of the subdivisions of schizophrenia include disorganized schizophrenia, paranoid schizophrenia, residual schizophrenia, undifferentiated schizophrenia as well as catatonic schizophrenia.
Schizophrenia causes automatic behavioral changes in an individual that makes those around him or her to notice unexpected behavior, for instance, irrational expression of emotions, getting frightened over petty issues and being withdrawn most of the time.
An individual also suffers from a difficulty in differentiating imaginations from reality. In most cases, a victim loses touch with reality an aspect that makes him or her to behave so differently as compared to an ordinary individual who is mentally fit.
It is, therefore, necessary that strategic measures are established to handle the situation to avoid bad effects that could even lead to suicide. The victims should be subjected to proper treatment as early as possible to allow appropriate measures to be taken in an effort to control the condition.
From the above discussion, it is evident that schizophrenia is a disturbing mental disorder that keeps the victims in agony of having to cope with its effects for as long as they live because so far, no cure has been identified.
Some of the ways of coping and handling the mental disorder include accepting the situation which will in turn help the victim to take necessary measures for instance seeking and following up medications strictly.
Staying around supportive people like family members is also a good idea that may help in controlling the mental disorder where the victims feel loved and appreciated as opposed to where they would be segregated.
Creation of awareness of this mental disorder among people including how well the victims can be handled is a relevant measure that would make the world a better place for both the victims and those around them.
Schizophrenia is a chronic mental condition or disorder with a severe effect on the human mind, especially by affecting the patient’s thinking system (Barry, Gaughan & Hunter, 2012). In particular, the condition affects a person’s ability to distinguish between reality and unreality. Schizophrenic patients are unable to think properly and clearly, manage emotions, or function normally (Barry, Gaughan & Hunter, 2012). Moreover, the condition affects personal relations with others, often causing conflicts.
Symptoms of schizophrenia
The primary and obvious type of impairment caused by the condition involves the disruption of the human processes of thinking. Schizophrenic people lose a lot of their ability to evaluate their surroundings and relate with others in a rational manner (Picchioni & Murray, 2011). They tend to believe in things that are unreal or untrue and reject reality. Hallucinations and delusions are common symptoms in schizophrenic patients (Van Os & Kapur, 2012). Both symptoms are disturbing to the patient and their families because they seem bizarre to the normal people, including those who are consistent with the abnormal perceptions and beliefs associated with the condition (Picchioni & Murray, 2011). Noteworthy, hallucinations and delusions are reflections of the distortions of the human mind, which in turn causes distortions of the person’s perceptions and interpretations of reality (Barry, Gaughan & Hunter, 2012).
Individuals tend to develop a fear of anything, including the fear of unknown people, objects, or events. For example, a schizophrenic individual may purchase and use multiple locks due to the fear of theft or harmful individuals, yet the reality is that such fear is unfounded. However, to the patient, the actions are justified because hallucinations occur in the form of heard voices and bizarre and persecutory delusions (Barry, Gaughan & Hunter, 2012). As the condition persists, the individual develops disorganized thinking and speech, which includes loosely connected words that fail to make meaning. Eventually, the disease causes social withdrawal, loss of motivation, poor judgment, and untidiness (Picchioni & Murray, 2011). Some individuals also develop paranoia, inability to work, loss of long-term memory and attention, poor functioning, and slow speed of mental processing.
Conditions such as major depressions, anxiety disorders, and substance use disorders are normally associated with schizophrenia. More than 50% of the patients have are likely to have some of these conditions (Barry, Gaughan & Hunter, 2012).
Prevalence
Currently, about 24 million people in the world are schizophrenic, but only about 1% of the patients have disabilities due to the disease (Barry, Gaughan & Hunter, 2012). The disease causes more than 20,000 deaths per annum (Ayuso-Mateos, 2013). The occurrence is relatively uniform around the world, with Africa, Asia and Japan has about 340, 540, and 378 male patients per 1000,000 people respectively and 370 and 520 female sufferers per 100,000 people in Africa and Europe respectively (Barry, Gaughan & Hunter, 2012).
The peak period for the onset of the condition occurs around late adolescence and early adulthood, which explains why the brain functioning is damaged during its critical period of development. About 40% male and 25% female patients develop the disease before reaching the age of 19 (Kumra, Shaw, Merka, Nakayama & Augustin, 2001).
Moreover, between 0.3% and 0.9% of the total world population are affected by the condition during their lifetime (Barry, Gaughan & Hunter, 2012). Individuals affected by the condition have short life expectancies, often reducing by about 50% (Picchioni & Murray, 2011). The life expectancy of an individual who suffers the condition during childhood, adolescent or early adulthood is likely to be reduced by 10 to 25 years due to the associated physical health problems (Herson, 2011). In addition, it is worth noting that more than 50% of the patients are likely to attempt suicide (Herson, 2011).
Causes
Studies have revealed that schizophrenia occurs due to a combination of factors that affect individuals in any society. In particular, environmental and genetic factors play a significant role in the development of the condition because studies have shown that the condition may run through families (Picchioni & Murray, 2011).
The genetic conditions or factors that influence the condition have been a subject of biomedical studies in the recent past. However, the difficulty of separating the impacts of the environmental conditions and the genetic factors has made it difficult to elucidate the actual estimates of heritability of schizophrenia (Picchioni & Murray, 2011). Despite these difficulties, studies have shown that genetic factors are likely to be associated with the development of the disease because people with schizophrenic first-degree relatives and monozygotic twins have about 6% and 40% risks of developing the condition respectively (O’Donovan, Williams & Owen, 2012). In addition, individuals with one schizophrenic parent and both schizophrenic parents have about 14% and 50% risks of developing the condition respectively (O’Donovan, Williams & Owen, 2012).
With this knowledge, it has been able to carry out molecular studies to examine the actual genes that may be associated with the condition. In this case, a number of candidate genes have been identified or proposed. For example, the histone protein loci and the associated copy number variations and NOTCH4 gene have been proposed (O’Donovan, Williams & Owen, 2012). The Zinc finger protein 804A is an example of genome-wide associations that have been identified and linked with the development of schizophrenia (O’Donovan, Williams & Owen, 2012).
On the other hand, several environmental conditions have been identified and linked with the development of the disease. For instance, substance use is highly linked with schizophrenia. Excessive use of alcohol and hard drugs are the major environmental risks associated with the disease. For example, drugs like cocaine, amphetamine and binge drinking are likely to cause psychosis (Herson, 2011). Noteworthy, psychosis and schizophrenia have similar symptoms are may occur in individuals with the genes identified above.
Cannabis and nicotine have also been associated with the development of the condition. Individuals with the condition may resolve to use cannabis in order to cope with the symptoms (McLaren, Silins, Hutchinson, Mattick & Hall, 2010). In addition, some studies have shown that cannabis use cannot cause the disease but contributes to the development when other factors are present (McLaren, et al., 2010).
Apart from drugs and substance use, developmental and living conditions are associated with the disease. For instance, hypoxia, infections, malnutrition during fetal development and stress are associated with increased risks of developing schizophrenia in later life (McLaren, et al., 2010).
Diagnosis
The American Psychological Association has developed a comprehensive criteria for diagnosis of schizophrenia based on the APA 5th edition of Diagnosis and Statistical Manual of Mental Disorders (DSM 5). In addition, the world health organization recommends the use of the ICD-10 criteria (Picchioni & Murray, 2011). Both methods use the self-reported experiences of the affected individuals as well as reported cases of behavior change and behavior anomalies. A mental health profession is then involved in a clinical assessment to establish the presence of the condition. Before making a positive diagnosis, the observed symptoms must occur continuously within the population and reach a critical level of severity (Picchioni & Murray, 2011).
Management
Antipsychotic medications are the primary treatment methods for the condition. They are combined with social and psychological support methods to ensure effective interventions. It is expected that the psychotic medications will reduce the symptoms within one or two weeks. The most commonly use antipsychotic drugs include olanzapine, clozapine, risperidone and amisulpride. Nevertheless, they have some side effect such as agranulocytosis, extrapyramidal effects and risks of diabetes and metabolic syndrome (Picchioni & Murray, 2011).
References
Ayuso-Mateos, J. L. ( 2013). Global burden of schizophrenia. New York, NY: World Health Organization.
Barry, S. E., Gaughan, T. M., & Hunter, R. (2012). Schizophrenia. BMJ Clinical Evidence, 359(1278), 567-73.
Herson, M. (2011). Etiological considerations. Adult psychopathology and diagnosis. New York: John Wiley & Sons.
Kumra, S., Shaw, M., Merka, P., Nakayama, E., & Augustin, R. (2001). Childhood-onset schizophrenia: research update. Canadian Journal of Psychiatry 46(10), 923–30.
McLaren, J. A., Silins, E., Hutchinson, D., Mattick, R. P., & Hall, W, (2010). Assessing evidence for a causal link between cannabis and psychosis: a review of cohort studies. Int. J. Drug Policy 21(1), 10–9.
O’Donovan, M. C., Williams, N. M., & Owen, M. J. (2012). Recent advances in the genetics of schizophrenia. Hum. Mol. Genet. 12(2), R125–33.
Picchioni, M. M., & Murray, R. M. (2011). Schizophrenia. BMJ 335(7610), 91–5.
Van Os, J., & Kapur, S. (2012). Schizophrenia. Lancet 374(9690), 635–45.
Schizophrenia is among many psychiatric disorders that have been identified my medical professionals. It is a disorder which is characterized by hallucinations, loss of reality, improper reasoning as well as poor social and occupation functioning. A person’s emotions are also affected as it is a psychiatric disorder.
Although research has been conducted, the exact cause of the problem is not actually known. However, the available research illustrates that there is enough evidence to suggest that genetics may have a great role to play in the whole issue.
It manifests mostly in the adolescence stage and it affects men and women equally. The prevalence rate of the disease is around 1% in the whole world and despite the fact that its rate is higher among the poor; there is no much difference from one culture to another (Bustillo, 2008). There is a lot of information on schizophrenia and this essay shall narrow down to signs and symptoms as well as to the main methods of treatment. In addition, the essay shall also focus on the roles of a biopsychologist and neuroscientist in the research.
In the View of the fact that schizophrenia is a chronic illness, it progresses in different phases. In many instances, patients seek treatment after experiencing symptoms for a period of one or two years. The first phase is referred as premorbid phase and is characterized by symptoms such as coping difficulties, anhedonia as well as different perception problems. However, it is important to note that in many cases, such symptoms are too mild to be noticed.
The next phase is known as the prodromal phase and is characterized by subclinical symptoms like disorganization, irritability, disorganization and perceptual distortions, to mention just a few. The middle phase is characterized by the same symptoms but they are usually more severe. In the last phase, the disease may stabilize or start all over again (Bustillo, 2008).
Upon diagnosis, there are several ways that can be used to treat the disorder which are inclusive of antipsychotic drugs, rehabilitation and psychotherapy. The main aim of treatment is to reduce not only the symptoms, but also to enable the patient to continue functioning normally.
The antipsychotic drugs are divided in to two categories; conventional antipsychotics and second generation antipsychotics. The second generation antipsychotics are more advantageous in relation to their efficacy and also due to the fact that they contain less adverse effects.
Nonetheless, it is important to note that they are also associated with a greater risk of a metabolic disorder like hypertension and insulin resistance. The choice of drugs depends on patient’s response to drugs, effects and administration requirement. Even the conventional antipsychotics have effects which are inclusive but not limited to, stiffness of the muscles, weight gain and sedation (Bustillo, 2008).
According to American Psychiatric Association (2006), behavioral therapy is very effective in treatment of the disorder especially due to the fact that it is a chronic illness. In this type of a treatment, the disorder is viewed as a problem behavior which may be influenced by environmental factors like the relationships in the family of origin.
Behavioral family therapy is therefore an effective method of treatment and is usually aimed at reducing or eliminating severity of the disorder. This is due to the fact that research has indicated that negative behaviors that are directed to the victims by their family members contribute greatly to the severity of the symptoms. It is therefore clear that if such behaviors can be dealt with, the problem can be solved.
Neuroscientist and biopsychologists are very significant in the research of various psychiatric disorders like the Schizophrenia. Neural scientists conduct research on psychiatric diseases in human beings at either molecular or cellular level.
In addition, they study the neural psychopathology of various diseases and also conduct genetic studies to investigate their interaction with environmental and other factors related to psychiatric disorders. On the other hand, biopsychologist conducts study of the behaviour of the brain in relation to perception, cognition and feelings to name just a few.
Therefore, it is clear that both a neural scientist and a biopsychologist need to work together not only during treatment procedures but also in research. This is due to the fact that it is through research that better methods of treatment are discovered. More research is required on schizophrenia especially due to the fact that the medications available contain a lot of negative effects.
References
American Psychiatric Association. (2006). American Psychiatric Association practice guidelines for the treatment of psychiatric disorders: Compendium 2006. Washington: American Psychiatric Pub.
According to the US Department of Health and Human Service, 1991, schizophrenia nearly affects one percent of the population. However, the burden on patients, family members, friends, and community is large. There are several competing and complementary views on evaluation. These views face influences from the approach and what is evaluation focuses on.
In this context, no view is better than another. They simply seek to address different issues and in different ways. This paper focuses on evaluating some non-clinical indicators for patients with schizophrenia. Assessing the quality of life for a patient with schizophrenia entails diverse indicators. These instruments guide the evaluator extensively in assessing the quality of life and cases necessitating improvement in severely ill schizophrenia patients.
The generic nature of this assessment enables the assessor to establish routine daily activities and living conditions of the patient (Kelly, 2008). The evaluation monitors the living conditions and daily routine activities of the patient. The schizophrenia condition affects the intelligence of the patient. The evaluator should assess the suicidal tendencies, withdraw signs and any signs of harm to patients.
Patients experience depression which drives them to suicidal actions. Factors such as suicide attempts, treatment compliance, drug abuse, withdrawal signs, mental stagnation, and fear should be evaluated in patients. Abnormal self-indulgence behaviors like over-eating, diabetes, smoking, and addictions should also be used in determining the patient daily life and routine.
These issues also form core concerns of health and safety issues of the patient with schizophrenia (Zullino, Waber & Khazaal, 2008). Relations among family members and society also form a basis of evaluation. The essence of evaluation in family relations is to determine the level of support, compliance with medication, knowledge of the household on the condition and empowerment and supports provided to the family and the patient.
The family environment is essential in improving the recovery of the patient. The collaboration between the clinicians and the family is beneficial to the patient especially in administering the daily routines of the patient. The assessor should evaluate issues concerning education, empowerment and support the family receives.
Studies show that not all schizophrenia patients can care and engage themselves socially. The evaluation should capture the social status, income levels and housing conditions of the patients. The evaluator should assess the daily challenges of the patient about work, communication difficulties, creating and maintaining relationships, and school attendance.
The evaluation should recommend the need for improvement to help patients cope with their social life (Greig & Zito, 2007). The assessment will also focus on the financial situations of the patient. The effects of impairments on the patient often comprise judgment and decision-making skills. There are problems associated with malnutrition, poor living condition, and occasionally untimely deaths.
These situations may arise due to the patient’s inability or refusal to cater to necessities. Cases of financial mismanagement are also issues of concerns for evaluation. Therefore, financial capacity becomes a key theme in the assessment of patients with schizophrenia.
Legal aspects of evaluation usually involve committing schizophrenia patient to a mental facility or forced treatment. The laws protect patients who refuse to be hospitalized. Confining a schizophrenia patient in a mental health facility should be limited to a given period of times, usually a few weeks. The evaluator should assess cases of involuntary commitment and establish whether caregivers protected the legal rights of the schizophrenia patient in the processes of hospitalization.
References
Greig, T. & Zito, W. (2007). Improved cognitive function in schizophrenia. Schizophrenia Research, 96 (1-3), 156-161.
Kelly, P. (2008). Nursing leadership & management, 2nd edition. Clifton Park, NY: Thomson-Delmar.
Zullino, D., Waber, L. & Khazaal, Y. (2008). Cannabis and the course of schizophrenia. American Journal of Psychiatry, 165 (10) , 1357-1358.
There are many conditions and diseases that may affect a child and interfere with normal growth and development. Schizophrenia is a developmental condition characterized by psychotic symptoms as well as by some symptoms that affect adaptive functioning of an individual.
The condition develops in different phases and an individual exhibits different symptoms hence the reason why there are different categories and classifications of the same. With that background in mind, this paper shall focus on describing major classification of schizophrenia, psychosis and lifespan development. In addition, the paper shall also focus on cognitive, biological and behavioral component of schizophrenia.
Major DSM IV-TR categories of schizophrenia, psychosis and lifespan development
Primarily, psychotic disorders include, schizoaffective disorder, shared psychotic disorder, psychotic disorder not otherwise specified, substance induced psychotic disorders, disorder caused by general medical conditions as well as five types schizophrenia.
The five subtypes of schizophrenia include catatonic, undifferentiated, paranoid, and disorganized and the residual type. Patients suffer from hallucinations usually described as condition that occur when a person is able to sense in absence of the right stimuli (Dziegielewski, 2010).
Various classifications of schizophrenia, psychosis and lifetime development
As highlighted in the introductory part, there are five classifications of schizophrenia. As the name suggests, undifferentiated schizophrenia is also referred to as the garbage type and more often than not, it contains symptoms that are usually present in other disorders.
The residue type is a condition that does not display some of the symptoms that were evident initially. In the paranoid type, victims suffer from either one or more hallucinations marked by a single theme. Patients suffering from disorganized schizophrenia experience incoherence, disturbed effect and more often than not, there is lack of systematic delusions. Lastly, patients suffering from catatonic type suffer from negativism as well as disturbances of the psychomotor such as rigidity and stupor (Dziegielewski, 2010).
Although there are five different classifications of schizophrenia, the path physiology is almost the same but symptoms are varied. In the view of the fact that schizophrenia is a chronic illness, it progresses in different phases.
In many instances, patients seek treatment after experiencing symptoms for a period of one or two years. The first phase is referred to as premorbid phase and is characterized by symptoms such as coping difficulties, anhedonia as well as different perception problems. Nonetheless, it is important to note that in many cases, such symptoms are too mild to be noticed.
The next phase is known as the prodromal phase and is characterized by subclinical symptoms like disorganization, irritability, disorganization and perceptual distortions, to mention just a few. The middle phase is characterized by the same symptoms but they are usually more severe. In the last phase, the disease may stabilize or start all over again (Bustillo, 2008).
Behavioral components of schizophrenia
According to American Psychiatric Association (2006), behavioral therapy is very effective in treatment of the disorder especially due to the fact that it is a chronic illness. In this type of a treatment, the disorder is viewed as a problem behavior which may be influenced by environmental factors like the relationships in the family of origin.
Behavioral family therapy is an effective method of treatment and is usually aimed at reducing or eliminating severity of the symptoms. This is due to the fact that research has indicated that negative behaviors that are directed to victims by their family members contribute greatly to the severity of the symptoms. Therefore, it is clear that if such behaviors can be dealt with, the problem can be solved.
Cognitive Component
The condition of schizophrenia affects cognitive ability of a person hence the reason why victims suffer from poor perception of self and of other people in the society. Their thinking is also affected and that is the reason why cognitive therapy is used in treatment.
It bears noting that even though cognitive therapy is used to alleviate the symptoms of the diseases like distorted thinking, the disease is not completely eliminated because there are biological causes of the same. Therefore, cognitive component mainly focuses on treating some of the symptoms and thereby helps the victim to manage some of the life problems.
Biological Component
According to Tsuang (2000), some of the genetic factors increase someone’s vulnerability. Further studies indicate that the main biological component of the disorder include complications incurred during pregnancy and delivery process. Studies have indicated that people having family members who have ever suffered from psychiatric disorders are always at a higher risk of developing schizophrenia. Although it is not clear how genetic factors contribute to schizophrenia, it has a great effect.
Conclusion
Schizophrenia is a complicated condition not only due to its nature but also due to the fact that it results from a wide range of factors. It is classified into five categories mostly according to its symptoms. Since it is caused by a wide range of factors, there are several ways of treatment upon diagnosis.
Treatment methods are inclusive of antipsychotic drugs, rehabilitation and psychotherapy. The main aim of treatment is not only to alleviate symptoms, but also to enable the patient to continue functioning normally (Bustillo, 2008). Schizophrenia, psychosis and lifespan development conditions are serious and ought to be researched on comprehensively.
References
American Psychiatric Association. (2006). American Psychiatric Association practice guidelines for the treatment of psychiatric disorders: Compendium 2006. Washington: American Psychiatric Pub.
The paper analyses the recent researches on the problem of schizophrenia. The works that study the historical, statistical and medical aspects are reviewed. Particular attention is given to the positive, negative, and psychomotor symptoms of schizophrenia like delusions, hallucinations, poor speech, confused thinking, etc. The importance of their early identification is underlined, as timely diagnosing increases the chance for the positive outcome of the illness. The approaches to diagnosing this disorder are presented. It is underlined that not only the symptoms but their duration are essential for diagnosing schizophrenia. The epidemiology and the possible preconditions for this disorder both in men and women are outlined. The gender differences in schizophrenia development are considered. The research reveals that schizophrenia most frequently develops in early adulthood. That is why special attention should be given to the study of this disorder in young men and women. Besides, the treatment methods which take into account the gender peculiarities are stated. The causes of the differences in schizophrenia development in young men and women are analyzed.
Introduction
Many people in the modern world experience depression, panic attacks, and other mental disorders. These symptoms are the subject of abnormal psychology which studies the pathologies of the mind. Schizophrenia is among the common mental disorders. It occurs in people regardless of culture or status. Butcher, Hooley, and Mineka (p.444, 2013) state that this “disorder is characterized by an array of diverse symptoms, including extreme oddities in perception, thinking, action, sense of self, and manner of relating to others.” Still, the major sign of schizophrenia is a critical loss of connection with reality. Miller (2015) mentions that the diagnosis of schizophrenia is usually applied to the people who behave so differently from the way they used to, that they look like different people. This state is also called psychosis, which is a psychological condition of breaking or delusion of the person’s mind. The majority of researchers agree that the symptoms of this condition are hallucinations, incoherent speech, delusions, bizarre behaviors, disregard for personal safety, erratic dangerousness to self or others, becoming immobilized or completely withdrawn, or being uninterested in self-care and personal hygiene (Miller, 2015). The psychotic symptoms (like hallucinations and delusion) usually appear in men in early adulthood, or just after the age of 20. In women, they are revealed between the age of 25 and 30. The occurrence of schizophrenic symptoms after 45 is rare as well as before adolescence. That is why schizophrenia should be considered first of all as the illness of young men and women. The early disclosure of characteristic symptoms, further diagnosing together with adequate treatment increase the chance of the positive outcome. Thus, the research of the problem among the young people is the primary task.
Literature Review
According to Long et al. (as cited in Comer, 2015, p. 467), about 1 of every 100 people in the world has schizophrenia at some time in his or her life. The statistics of 2010 estimated the number of people with schizophrenia in the world as 24 million, among them 2.5 million people in the United States (Comer, 2015, p. 467). Apart from moral and financial resources, this illness increases the risk of other diseases which are often fatal. Laursen (as cited in Comer, 2015, p.467) states that people with schizophrenia live on average 20 years less than other people.
McNally (2016) investigates schizophrenia in the historical context. He studies the symptoms suggested by researchers throughout the history. He also analyses the problem of defining the notion of schizophrenia by different scholars and psychiatrists. He mentions “the historic lack of agreement and inability to find an essential characterization of schizophrenia” (2016, p.199). Still, McNally mentions the numerous approaches to schizophrenia treatment already as of 1936 (2016, p.208).
Abel and Nickl-Jockschat (2016) consider schizophrenia “a severe neuropsychiatric disorder that not only causes a high burden of disease but also challenges our understanding of how the mind and brain work” (p.3). If a healthy person controls actions or thoughts, the one suffering from schizophrenia cannot do it. Thornicroft, Brohan, and Kassam (as cited in Barlow & Durand, 2014, p.477) define schizophrenia as “a complex syndrome that inevitably has a devastating effect on the lives of the person affected and on family members.” This illness disorganizes the individual’s perception, thought, language, and activity. Thus, it affects almost all components of everyday life. In spite of numerous researches and substantial progress in the treatment of schizophrenia, the number of absolute recovery examples is limited. This destructive disorder demands a lot of emotions from the sufferer and the surrounding people. Apart from emotions, it is a very expensive illness. According to Barlow and Durand (2014), schizophrenia costs about $60 billion to the United States every year. This amount includes the cost of treatment, care in the family, and the loss of earnings, for the people with this disorder do not work.
Symptoms
It is certain that schizophrenia is a clinical diagnosis. It has definite symptoms and signs, but there is still no test to discover and prove this disorder. International Classification of Diseases of World Health Organization (as cited in Castle & Buckley, 2015, p.4) states the following symptoms of schizophrenia. If a person observes at least one of those: “thought echo, insertion, withdrawal, broadcast; passivity phenomena or delusional perception; third-person conversing or running commentary hallucinations” or at least two of the following: “persistent hallucinations in any modality, with delusions; disorganized speech; catatonia” or any negative symptoms (which are primary), a visit to a doctor should be planned. Comer (2015) speaks of three types of schizophrenia symptoms. They are positive, negative, and psychomotor.
Positive Symptoms
Positive symptoms usually are the extremities and strangeness in an individual’s behavior. Among these symptoms are delusions, confused thinking and speech, heightened perceptions, and hallucinations. Delusions are observed by most people with schizophrenia. Those ideas seem true but confuse the people. Some patients experience one dominating delusion during the illness. The others may have various delusions. Among the most frequent delusions is that of persecution. People believe they are chased or spied on. Other common delusions are those of reference, grandeur or control. Confused thinking and speech mean that people lose the ability to think logically, and speak unusually. It complicates the communication with the ill person.
As for heightened perceptions and hallucinations, the researchers agree that some people with schizophrenia observe the intensified perceptions and attention (Comer, 2015). Consequently, any important event becomes a torture for them. The problems with attention and perception may appear long before schizophrenia develops. Thus, they can be a signal of the coming disorder. Another frequent symptom of schizophrenia is hallucinations. Auditory hallucinations are the most common. People may hear voices or other sounds in their heads. The voices often give directions, thus stimulating the people for certain actions. Hallucinations can also be tactile, somatic, visual or gustatory (Comer, 2015). Apart from the mentioned above, people with schizophrenia demonstrate emotions inappropriate to the situation. For example, they may smile when telling bad news, or be sad in a situation happy for a healthy person.
Negative Symptoms
Negative symptoms can be explained by the absence of certain characteristics in people, or “pathological deficits” (Comer, 2015, p.474). Among the typical characteristics of schizophrenia are poor speech, weakened affect, lack of volition, and retraction from society. These deficits certainly influence the life of a person. The poor speech, or alogia, is usually characterized by little speech content. The people experiencing this disorder do not speak and think much. Some people may speak more, but their utterances lack sense. A lot of individuals with schizophrenia observe a blunted or weakened effect. It means that they are less sad, angry or happy compared to other people in their reactions to the reality. Some of them are unemotional. They are characterized with little eye contact and monotonous voices. As for the loss of volition, it is also observed among the people with schizophrenia. It is often called avolition, or apathy. The people with this symptom feel exhausted, uninterested, and having no aim. As a rule, it is typical of the people who have had schizophrenia for a long time. As a result, they are drained and purposeless. The feelings of people with schizophrenia are contradictory and uncertain. Another negative symptom is social withdrawal. The individuals with schizophrenia often prefer to retract from the society. They are obsessed with their fantasies and ideas; thus they do not need anyone. This withdrawal takes them even further from reality, as their ideas are disorganized and absurd. Such retraction may result in the loss of major social skills, which in its turn can make the treatment more complicated.
Psychomotor Symptoms
Apart from positive and negative, people with schizophrenia may observe psychomotor symptoms. The examples of those symptoms may be slow or strange movements, repeated grimaces, and unusual gestures. They pretend to have a certain magical or ritual purpose. The ultimate form of the psychomotor symptoms of schizophrenia is known as catatonia. The individuals in a catatonic stupor do not react to the surrounding. They may not move and be silent for long periods of time. People who experience catatonic rigidity can stay in a fixed, upright position for hours. Moreover, they turn down the attempts to move them. Besides, other people with schizophrenia may take clumsy and strange poses and hold that way for long periods of time. Another type of catatonia, the catatonic excitement, is characterized by excited and uncontrolled movements of arms and legs (Comer, 2015).
Diagnosing Schizophrenia
Both physical and mental illnesses have a set of characteristic symptoms. The discovery of symptoms, their correct interpretation, and the resulting timely diagnosing is half the way to the successful treatment. Some mental disorders are harsh. As a result, the people who experience them do not realize that their beliefs are not real. Consequently, they are not aware of the problem at all. Oltmanns and Emery (2015, p.4) define schizophrenia as “a form of psychosis, a general term that refers to several types of severe mental disorders in which the person is considered to be out of contact with reality.” A set of symptoms that are observed simultaneously during a certain period characteristic of a definite disorder is called a syndrome (Oltmanns & Emery, 2015). Every separate symptom is an untrustworthy indicator of a disease. Every feature here is important. The complex of person’s behaviors is unique for every disorder. Apart from the complexity of symptoms, their duration is also significant. Constant inadequate behavior may be a sign of a mental disorder. Some accidental awkward behaviors disappear if ignored. Still, if they are repeated, they may be the symptoms of problems.
A problem with diagnosing mental disorders is that the symptoms are varied. Very often two people diagnosed with schizophrenia experience essentially different symptoms. The American Psychiatric Association (as cited in Awad & Voruganti, 2016, p.3) states that “the degree of suffering and the degree of subsequent disability varies among individuals similarly diagnosed.” Schizophrenia is a symptom-based diagnosis at the moment. The symptoms are confirmed by certain questionnaires. The most significant criterion for diagnosing is the functional decline (Awad & Voruganti, 2016). It means that people see the individuals with schizophrenia as disabled.
The American Psychiatric Association (as cited in Comer, 2015, p.476) considers a diagnosis of schizophrenia true only when the symptoms of the disorder last for at least six months. An individual should be in an active phase in minimum one of these months. This period is characterized by serious delusions, hallucinations, or disorganized speech. Moreover, the degradation of the person’s performance in work and social life is observed. Some scholars believe that there is a possibility to predict the way of schizophrenia development. The so-called Type, I and Type II schizophrenia, should be distinguished (Comer, 2015). The individuals having Type I schizophrenia usually reveal mostly positive symptoms. Among these symptoms are delusions, hallucinations, and some thought disorders. The individuals with Type II schizophrenia observe mainly negative symptoms, for example, those of restricted affect, poverty of speech, and loss of volition. Marchesi et al., Corves et al. (as cited in Comer, 2015, p.478) mention that patients with Type I on the whole show more improvement, particularly with the application of medical treatment.
Epidemiology
Schizophrenia is a widespread disorder and is diagnosed all over the world (Awad & Voruganti, 2016). The illness has influenced approximately 50 million people in different countries. Men show a little higher incidence than women. Also, they may first experience this disorder in the earlier age. They also observe more negative symptoms, greater neurologic deficits, a worse course of illness (Awad & Voruganti, 2016). Thus, sex-specific factors are implied. During one’s lifetime, the risk of having schizophrenia is less than 1 percent, about 0.7 percent in fact (Butcher et al., 2013, 445). Certainly, the statistics do not mean equal risk for everyone and just evaluates the average risk. There are certain categories of people who are under the high danger of developing schizophrenia. Among them are, for example, the individuals whose fathers were aged 45 to 50 years or more when they were born. Most of the schizophrenia cases start in late adolescence or early adulthood, within the age range of 18 to 30 years. There are the cases of schizophrenia onset in the middle age, but they are rare. Speaking of men, schizophrenia is discovered between ages 20 and 24. As for women, the age range is almost the same. Still, the peak is less obvious. As a rule, after the age of 35, the number of schizophrenia cases among men decreases. At the same time, the number of equal women remains the same.
The discovery of sex differences in neuropsychological measures is not new (Li & Spaulding, 2016). It has already been described. Still, the appearance of strong differences on tests could be connected to certain brain systems. The discrepancies discovered look like “sex differences in height and weight rather than sexually dimorphic differences… Men on average are taller and heavier, yet we can readily think of women who are taller and heavier than most men or men who are shorter and lighter than most women” (Li & Spaulding, 2016, p.210).
Schizophrenia in Men and Women: The Difference
Generally speaking, the diagnostic criteria for schizophrenia in men and women are the same. Nevertheless, certain differences can be observed between the two genders. As it was mentioned above, there is a slight difference in the age when schizophrenia first develops. For men, it occurs at the age of 15-20. Women may face the illness later, between 20-25 years. Another fact apart from the earlier occurrence for men is that schizophrenia in men often runs harder than in women. Probably, a female hormone estrogen has a protective function and prevents schizophrenia (McNally, 2016). The symptoms of schizophrenia also have some gender differences. When it comes to men, they observe the lack of will and low energy; they are not able to make decisions and plan their actions. As a rule, men with schizophrenia are less affected by medical treatment. As for women, the symptoms they experience are not so serious. The women are likely to give up the job and not make a problem of it, while men suffer the loss of the job severely. On the whole, men are expected to develop more severe forms of schizophrenia than women. While estrogen is efficient, the women have less risk of severe disorder than men (Butcher et al., 2013). Still, with the beginning of the menopause when the quantity of estrogen decreases, the percent of women observing schizophrenia symptoms increases.
Speaking of the preconditions of this mental disorder, the gender differences are also noticed. Women who were born to mothers with a viral infection have more chances to develop schizophrenia. At the same time for men, a birth trauma is a more probable reason to have schizophrenia in adulthood. It may be interesting to deal with male and female peculiarities of schizophrenia in more detail.
Schizophrenia in Men
Schizophrenia in men is a widespread mental illness. In fact, it is a group of progressing illnesses which can develop both slowly and rapidly, resulting in changes in personality, thought disorders, alterations in emotion and volition. Schizophrenia in men is a chronic illness which demands longitudinal observation of a specialist. The symptoms of schizophrenia in men scare their family and may cause the denial of the sufferer. Still, the disorder may be cured only with the support of the close people.
The reasons for schizophrenia in men may be various. One of them is an inherited predisposition. It results in the functional disorder of brain cells performance. The statistics prove that often the relatives of the man observing schizophrenia also suffer from some mental disorders. Then signs of negative inheritance may be obsessions, character oddness, alcoholism, the seasonal change of mood, suicides in the family. In addition to inheritance theory of schizophrenia development, the autoimmune and virus theories should be reviewed (Castle & Buckley, 2015).
The symptoms of schizophrenia in men can be both positive and negative. The positive ones are evident symptoms like hallucinations. The men start behaving strangely. This odd behavior usually includes delirium, pseudo-hallucinations, automatic actions, catatonia, unmotivated foolish behavior, obsessions, mood disorders, and depersonalization. The negative symptoms result in restraint, indifference, unsociable demeanor, the loss of emotional and volition qualities. They have more diagnostic value that the positive ones. However, these are not the only mental disorders characteristic of men with schizophrenia. Schizophrenia in men is often characterized with alcohol addiction. It can also be influenced by the previous traumatic brain injuries, which interfere the effective treatment (Castle & Buckley, 2015). If the illness develops in adulthood, the functions of memory and intellect are not affected. The non-standard perception and thinking may have striking results. There are famous scientists, writers, musicians or poets among the men with schizophrenia.
Schizophrenia can be diagnosed and treated by a qualified and experienced psychiatrist. The disorder may have various cases, both mild and severe. The modern techniques allow treatment out of clinics. The initial treatment stage includes intensive therapy necessary for the general condition stabilization. It is crucial to reduce the major symptoms as they have negative impact on the quality of life. Nevertheless, the treatment within a specialized clinic may have its benefits. In this case, there is no need to transport the patient who is often inadequate. After the basic stabilization, a further complex therapy is applied. It is aimed at the restoration of mental processes and is designed considering individual symptoms. The necessary corrections should be made in the course of treatment depending on patient’s reactions. In case of early diagnosing and appropriate treatment, the patients can restore their self-care skills and the social status.
Schizophrenia in Women
Schizophrenia in women is a complicated mental disorder with multiform clinical picture. Often it is a smoldering illness characterized by periodic attacks and remission periods. One of the theories of schizophrenia development in women is that of defective gene inheritance. The gene is considered to provoke the personality disorder. The obvious symptoms are observed in adolescence. It may include the low maternal instinct and hormonal disorders. Together they lead to the misbalance of perception, both of the surrounding world and the personality. The initial complex provoking personality pathologic changes is connected with the dissatisfaction of one’s appearance. The denial of the social role is the next step. The first symptoms of schizophrenia in women reveal at the age of 25-30. The development of the disorder after the age of 50 is very rare. Apart from genetics, the roots of schizophrenia in women may be found in the change of family atmosphere, lasting stress, post-natal depression, various phobias and complexes (Castle & Buckley, 2015). Up to 2% of the diagnosed cases have virus or bacterial nature. In this case schizophrenia in women may develop as a result of bacterial or virus meningitis.
Among the symptoms of schizophrenia in women are hallucinations (both audial and visual), the persuasion in the influence from outside, the poorness of thoughts and emotions, apathy, the inability to make decisions, etc. The first symptoms are usually revealed in adolescence. Sometimes they may be conditioned by the lack of attention, both in family and from the opposite sex. In some cases, mental disorders lead to the physical ones. For example, bulimia is diagnosed together with schizophrenia among teenage girls. After some time, the symptoms of schizophrenia are followed by some personality changes. The patient may experience bad depression and aggressive behavior. The other symptoms of schizophrenia in women include the characteristic appearance, repetitive movements, delirium, monotonous voice, poor emotions. The patient is not able to feel joy or grief. The hygiene habits also suffer.
The treatment of schizophrenia in women should be organized in a clinic. However, a long stay in a medical institution may have negative results (Awad & Voruganti, 2016). The treatment usually includes biologic and social therapy. Particular attention should be given to prevention of recrudescence, as they make the illness more complicated.
Conclusions
The examination of schizophrenia symptoms, types, and possible variations of this disorder development gives an opportunity to evaluate the risks of the illness. Generally speaking, the disorder development is characteristic of the young age. The illness is widely spread and is not influenced by the race or place of living. It has certain genetic and gender-related roots. The core idea is that the knowledge of the symptoms and their correct interpretation may help to diagnose the disorder timely. As a result, the probability of the successful treatment increases. The treatment should consider the patient’s peculiarities, which include age, sex, personal characteristics, and the individual symptoms observed by a sufferer. Special approach and the professionalism of a doctor are the factors that influence the illness outcome. Despite the complexity of the disorder, the suitable treatment at the right time may result in the patient’s recovery and the return to the usual life.
References
Abel, T., & Nickl-Jockschat, T. (Eds.). (2016). The neurobiology of schizophrenia. London, UK: Elsevier.
Awad, A.G., & Voruganti L.N.P. (Eds.). (2016). Beyond assessment of quality of life in schizophrenia. Basel, Switzerland: Basel, Switzerland: Springer International Publishing.
Schizophrenia, in contrast to what many believe is not a multiple or split personality disorder. The term refers to the interference with the common contemplation and emotions.
In fact, it is often regarded as an extreme brain disorder. Patients suffering from this brain condition construe things abnormally. It may result in diverse complications such as severe thinking conditions, delusions, hallucinations, and conduct. The purpose of this study is to demystify schizophrenia as is commonly known to individuals as a condition that threatens the lives and wellbeing of those around.
Main Body
Schizophrenia.com
The website was founded in 1995 founded on an awareness of the disease. The web is an internet community that is dedicated to the provision of high-quality data, elucidation, and assistance to the kin, providers, and persons that have been impacted by the condition. The site does not have affiliations with the psychosomatically associated corporate. Instead, the website founders endeavor to offer steadfast and scientific revelations regarding schizophrenia.
The founders of this site hold that schizophrenia is a condition that anybody can contract. Consequently, they urge that the public should seek information on how to handle individuals with the disease. Although they acknowledge that the condition is primarily irreversible, they urge scholars to research on the subject in pursuit of remedies for the condition (Chiko, 2014).
Mayo clinic is another website that gives concentrated efforts towards demystifying the issue of schizophrenia. The website notes that schizophrenia is a chronic condition that requires lifelong treatment. It offers the visitors of the site information requisite for identifying the condition including the symptoms and any other related information.
Schizophrenia is a persistent and disabling mental disorder that primarily occurs in the late years of teenagers and early mid-years. The condition is prevalent with the rate accumulating up to over one percent of the global population.
The condition has profound repercussions on victims and relatives considering the far-reaching financial, social, and personal impacts of the condition. Persons suffering from schizophrenia have an increased possibility of being homeless and unemployed. In essence, schizophrenia costs the US accumulative baggage of more than $65 billion. Unfortunately, the precise etiology of the condition is yet to be determined.
Epidemiology
The beginning of schizophrenia signs primarily happens between late adolescent and mid-thirties. The victims of the condition before the age of 17 years are regarded as having an early start to schizophrenia while others below this age are considered as having very first occurrence of schizophrenia. Epidemiological research indicates that men tend to have an earlier onset of schizophrenia. Also, men stand higher chances of experiencing significantly increased disease discourse.
Etiology
The precise cause of schizophrenia has not been established. However, it is suspected to originate from multi-factorial and heterogeneous elements. In essence, families with the condition do not register psychoses of the same. The probability of schizophrenia increases with the genetic component of parents affected with the same condition. The genetic affinity of a parent suffering from the condition increases the possibility of children getting the condition.
The environmental factors including increased exposure to cannabis during teen years and the disadvantages in social class increase the chances of contracting schizophrenia. Maternal infection and stress in the gestation period are also associated with contracting schizophrenia. Increased paternal age during the conception period is also associated with over a double fold increased risk of the child developing schizophrenia.
Pathophysiology
Neuroanatomical alterations
Magnetic resonance images in neuroanatomical alterations indicate the reduced volume of the brain and grey matter as a whole. However, the ventricles are said to increase. The lobe areas including the superior temporal gyri, thalamus, and hippocampus reduce significantly. Research suggests that disruptions in the growth of the cerebral equilibrium contribute to the etiopathogenesis of the condition (Tandon, Nasrallah & Keshavan, 2009).
Neurotransmitter abnormalities
Among the major causes of schizophrenia sign according to studies is the dopaminergic dysfunction. The dopaminergic dysfunction systems that play an essential role in cognitive and downbeat signs are associated with schizophrenia. Contemporarily, there is empirical evidence indicating that glutatergical malfunction may lead to schizophrenia.
Clinical Progression
Schizophrenia is a mental condition that demands a continuous treatment process. The condition may occur rapidly given that it is mainly gradual in its development. That is, it progressively manifests itself through various signs. The victims of the condition demonstrate divergent cognitive and psychological identifiers of the disease. Besides, patients suffering from the disease indicate slowed language and motor growth.
Also, they have a shorter concentration span given that they experience emotional disconnect and social isolation. The prodromal stage of schizophrenia is indicated subclinical psychotic signs. The patients are moody, negative in feelings, experience operational decline, and lack cognitive aptitude (Javitt, 2014).
Schizophrenia Symptoms
When the condition occurs in men, it manifests itself in the early twenties. However, in women, it occurs in the late twenties while the condition is not common among children. Interestingly, the condition is hardly seen in individuals beyond forty-five years. However, there are signs that an individual has been affected by the condition. Javitt (2014) claims that among the signs experienced are delusions. From the articles, delusion refers to bogus beliefs that are not founded on reality.
One may have the perception that they are being harassed or deliberately injured by another. The condition is popularly referred to as paranoia. The victims feel that specific comments or actions are aimed at them in most cases. In some instances, those experiencing the condition feel that they harbor the capacity to act against these tribulations. Research has identified that four out of every 5 individuals suffering from schizophrenia experience delusions.
Hallucinations are other symptoms of schizophrenia. They entail hearing or seeing things that do not necessarily exist at that moment. However, individuals with schizophrenia experience the influence of a typical human. For instance, audible voices to the victim are the common indications of schizophrenia.
Additional medical considerations
Individuals with schizophrenia are noted to have a higher rate of mortality. Their lifespan is reduced by approximately twenty years. Despite the contemporary improvements in solving the conditions of schizophrenia, the rate of deaths for these specific patients has been increasing in the last thirty years.
Schizophrenia patients have an increased rate of suicide. Most males with schizophrenia have recorded an increase in suicide ideation. In addition, males have poorer adherence to treatment. Interestingly, schizophrenia victims of the female gender are not susceptible to suicide but are more likely to suffer from cardiovascular diseases (Javitt, 2014).
Conclusion
Schizophrenia is a persistent mental condition with various etiologies. It requires long-term treatment irrespective of gender. Modernly, there is no specific diagnosis for schizophrenia. There are many challenges that face both clinicians and victims of the disease. It is imperative to talk to the victims of the condition. Though one cannot coerce the victims to seek medical assistance, offering encouragement and relevant support is essential.
Javitt, D. (2014). Balancing therapeutic safety and efficacy to improve clinical and economic outcomes in schizophrenia: A clinical overview. The American Journal of Managed Care, 20(8): 160-164.
Javitt, D. (2014). Current and emergent treatments for symptoms and neuro-cognitive impairment in schizophrenia. Current Treatment Options Psychiatry. 1:107-120.
Tandon, R., Nasrallah, H., & Keshavan, M. (2009). Schizophrenia, clinical features and conceptualization. Schizophr Res.,110(1-3):1-23.
The concept of schizophrenia as the means of embracing a specific set of disorders causing hallucinations and delusions in patients is not new. A range of theories regarding the nature of the disorder, as well as its effects on the patient and the means of addressing it, have been suggested over time.
Despite the fact that schizophrenia is currently referred to as the disorder that people are supposedly predisposed to genetically, there is a viral theory thereof, which can be considered quite viable. According to a recent study, there is a possibility that schizophrenia can be caused partially by the influenza virus or PolyI:C (Fatemi et al. 1).
One might argue that the research in question did not prove that there was a direct correlation between the contraction of the virus and the development of schizophrenia in patients: “Prenatal viral infection at E7 led to gene expression and morphological changes in the placenta at E16” (Fatemi et al. 9). However, the fact that there might be a connection between the identified variables needs to be borne in mind.
Research Question
How can schizophrenia be diagnosed in a patient, and what methods of treatment can be considered the most efficient ones?
Strengths
A detailed analysis of the factors that affect the patient’s condition, including the internal and the external ones, must be mentioned as one of the essential strengths of the studies that have been conducted on the subject matter so far. The use of the evidence-based approach as the means of locating the essential information about schizophrenia and its nature can be considered the obvious strength of the existing studies.
Finally, the fact that the identified area currently receives significant investments on a regular basis should be viewed as an essential strength. Since the disease has recently become prevalent among the rest of the psychological disorders (Khan et al. E2), there is a consistent need to continue studying the subject matter extensively. Furthermore, the fact that the medications currently used to prevent the patient from having hallucinations, as well as any other symptom of schizophrenia shows that further studies are necessary to improve the quality of the treatment. Therefore, the fact that the target area receives an impressive amount of funding can be listed among the primary strengths.
Limitations
It should be noted that the existing studies on schizophrenia have an array of limitations, which are predetermined primarily by the choice of their methods. Furthermore, because of the lack of understanding of what the nature of schizophrenia is, a range of studies are restricted to reiterating the facts that are already known and making the assumptions that can be deemed as rather far-fetched. Indeed, as Kane et al. explain, “We still do not understand the etiology and pathophysiology of schizophrenia although this remains true of many major illnesses in general medicine as well” (Kane et al. 2).
It would be wrong to assume that the current research has the information that other studies do not. However, the paper aims at reviewing the outcomes of not only one study but a range of clinical trials, therefore, creating the knowledge base that will serve as the foil for making more detailed and accurate conclusions.
Omissions
Past research shows that the process of diagnosing schizophrenia may become rather complicated. Furthermore, the treatment of schizophrenia is likely to become a problem because of the level of denial shown by the patients. Indeed, studies point to the fact that very few people, in fact, manage to admit the problem and be willing to address it (Morrison et al. 1). As a result of the lack of responsiveness, the treatment becomes ineffective.
Moreover, the fact that some of the agents used to manage the disorder are associated with side effects deserves to be mentioned. For instance, weight gain and the following development of diabetes needs to be listed among the most common negative effects of using the antipsychotics that have been designed comparatively recently (e.g., clozapine (Clozaril), quetiapine (Seroquel), etc.) (Leucht et al. 1).
Significance of the Topic, Research Question, and Investigation
Seeing that there are a plethora of gaps in the past studies in the issue of schizophrenia, there is a pressing need to carry out an all-embracive study that will provide an overview of the innovative techniques and suggest that possible tools for managing the problem. Particularly, the improvement of the communication techniques used to help the patient acknowledge the problem and accept the suggested treatment framework although its side effects will have to be considered as the primary goal of the study. By considering the most recent studies along with the primary resources on the subject of schizophrenia, one will be able to draw the essential conclusions and design the framework of communication that will lead to efficient treatment.
Literature Review
According to DSM-V, schizophrenia can be defined as a “prototypical psychotic disorder” (Chapter 2. Schizophrenia Spectrum and Other Psychotic Disorders DSM.PsychiatryOnline.org). However, when considering the identified definition, one must view it with a grain of salt since it was provided by an internet resource. Granted that the identified site is known as the DSM library and, therefore, contains the essential data that is also represented in the DSM-V manual, it is hosted at the.org domain, which devalues the quality of the information to a considerable degree. Therefore, the identification of other resources that provide the definition of the subject matter will have to be considered.
Diagnosis
As stressed above, the very definition of schizophrenia lacks precision. As a result, diagnosing the problem implies running a range of tests. The process of diagnosing, however, relies primarily on the symptoms and the way in which they manifest themselves in the patient. Although the destructive effects that it has on people’s personalities, such as the inability to make decisions, control emotions, maintain positive relationships, etc., are rather hard to identify at the earliest stages of the disorder development, the existing tests are likely to help determine the problem in a comparatively accurate manner.
The first and most obvious, the development of hallucinations, including not only visual but also auditory ones, need to be determined. Afterward, the patient must be checked for possible delusions. The latter is typically defined as the beliefs that do not coincide with the objective reality and that the patient strives to maintain despite the fact that they are clearly false.
Speech issues, such as the lack of consistency in the communication process, the fact that the patient’s statements do not make sense, etc., should also be considered a possible symptom of schizophrenia. One might also add that bizarre behavior can be viewed as the manifestation of schizophrenia; however, the identified characteristic of the disorder does not necessarily apply to all conditions, and vice versa – the development of weird and asocial behavior does not necessarily imply that the patient has schizophrenia (Bull et al. 194).
Nevertheless, the identified characteristics serve as major indicators of the disorder, especially when observed simultaneously. At present, the American Psychiatric Association (APA) suggests in DSM-V that hallucinations and delusions should be considered primary indicators of schizophrenia (American Psychiatric Association, 2012). Therefore, observations can be considered the primary tool for diagnosing the disorder.
It should be noted, though, that some of the recent theories explaining the nature of schizophrenia deserve a closer look. For instance, the suggestion to scrutinize the factors affecting the development of the disorder from the perspective of the Theory of Mind seems rather sensible. Promoting the analysis of changes in the patient’s social behavior as opposed to the cognitive issues that they are likely to have later, the identified approach can be considered a new and improved tool for diagnosing the problem and addressing it at its onset. As a result, the effects of the proposed treatment are going to be much more spectacular than they would be otherwise.
The Theory of Mind (ToM) is often used as the means of considering the factors that contribute to the development of schizophrenia. To be more accurate, the theory suggests that the nature of schizophrenia should be correlated to the social impairments in the patient as opposed to cognitive ones. Put differently, the framework suggests that ToM should be viewed as the primary marker for determining schizophrenia in patients, especially at its onset.
Despite the fact that further studies must be carried out to provide the ultimate proof of the connection between the variables in question, it is safe to say that ToM serves as the foundation for the identification of schizophrenia development in patients along with the symptoms such as delusions and hallucinations (Bora and Pantelis 34).
At present, however, the theory that suggests a biological predisposition to schizophrenia receives extensive support as the most viable framework. Indeed, the specified approach toward understanding schizophrenia has the most substantial evidence and the greatest amount of support. Nevertheless, the idea of using social indicators as the markers for identifying the early symptoms of schizophrenia can be considered a new and promising approach.
Particularly, it is suggested that the idea of using cognitive markers of schizophrenia as the tools for defining the threat of schizophrenia development should be introduced into the contemporary psychiatry realm. As a result, the issue can be addressed within a comparatively short amount of time. To be more accurate, the use of the identified framework is likely to result in addressing the problem when it has not yet developed into a major issue.
When diagnosing the disorder, one must also bear in mind that there are different types of schizophrenia. As stressed above, the disorder manifests itself in a variety of shapes and types; as a result, the process of diagnosing the issue may become rather convoluted. It should be noted, though, that a number of schizophrenia subtypes have been rejected by the American Psychiatric Association (APA). For instance, in DSM-V, only three essential subtypes of schizophrenia are identified (schizoaffective disorder, delusional disorder, and catatonia) (Arciniegas 715-716).
Treatment
As far as the treatment options for schizophrenia are concerned, one must bear in mind that the patient cannot be cured. In other words, it is necessary that the strategy for lifelong treatment must be designed. One must not be mistaken by the fact that the obvious symptoms of schizophrenia subside significantly after the first several sessions of treatment. Instead, one must bear in mind that the symptoms are recurrent and that the improvements in the patient’s well-being are temporary.
In light of the facts mentioned above, a psychiatrist must focus on the following goals when addressing the needs of a patient: addressing the symptoms so that the patient could get rid of them entirely or control them to a greater extent; improving the patient’s quality of life, and reinforcing the process of recovery from the disorder in a manner as efficient as possible (Mental Health Medications NIMH.NIH.gov). The identified objectives are met with the help of a combination of therapy and the use of medications.
As a rule, when addressing the needs of patients with schizophrenia, one must consider the use of antipsychotic drugs. As stressed above, with the discovery of new methods of tending to the needs of people with schizophrenia, new medications were prescribed to manage the disorder and improve the quality of the patients’ lives. The following medications belong to the first generation of drugs for managing schizophrenia and improving the quality of patients’ lives: Chlorpromazine, Haloperidol, Perphenazine, and Fluphenazine (Mental Health Medications NIMH.NIH.gov). Understandably enough, the identified methods of managing the disorder leave much to be desired in terms of not only their efficacy but also the negative effects that they have on the patients’ well-being (Kimhy et al. 865).
The second-generation medications represent a significant improvement in the framework for tending to the needs of patients with schizophrenia and the associated disorders. Although they also imply severe consequences for patients, their effects are considerably milder (Rummel-Kluge et al. 170). The specified property, however, results in the reduction of the medications’ efficacy. Nevertheless, the second-generation drugs should be viewed as preferable to the ones belonging to the first generation because of the opportunity to not only block the production of dopamine in the patient’s body but also increase the levels of serotonin (Hartling et al. 499).
It seems that the promotion of second-generation drugs as the means of managing schizophrenia seems to be a rather legitimate strategy at present. However, in o0rder to improve the quality of the patients’ lives and create an environment in which they can be proactive and retain their mental and cognitive abilities, one will have to consider the adoption of innovative medicine. Granted that the identified step requires further testing so that the efficacy of the medications could be determined, it opens a range of new opportunities to both patients and psychiatrists. However, one must admit that the identified process is fraught with numerous difficulties, the lack of financial resources being the key one (Priebe 2).
Furthermore, according to a recent study on the subject matter, the second-generation medicine, which aligns with the dopamine theory of schizophrenia, may have an adverse effect on the patient due to the inconsistency in the theoretical framework. The theory in question states that the development of the disorder occurs because of the excessive activity of dopaminergic neurons: “The dopamine hypothesis is based on the observation that antipsychotics block D2 receptors, and their affinity for these receptors highly correlates with their ability to ameliorate some psychotic symptoms” (Rubio et al. 9). Therefore, there is a strong need in focusing on studying the nature of schizophrenia so that the factors that contribute to its development could be eliminated successfully.
Among possible medications that can be used in the future, the following medication types need to be mentioned: ABT-107, ABT-126, etc. (Ahnalen 4). However, apart from an update in the use of medicine, psychiatrists will have to consider an improvement of the therapy approach. According to the guidelines suggested by the American Psychiatric Association, four essential stages must be completed so that the treatment process could be accomplished successfully.
Particularly, there is the design of the treatment plan, the process of establishing a therapeutic alliance between the psychiatrist and the patient, the acute phase treatment, the stabilization phase, and the stable phase. To make sure that every single phase is completed, one will have to apply the appropriate assessment system.
Treatment Plan
Therapeutic Alliance
The process of drafting a treatment plan and implementing it includes the identification of the specific factors that affect the patient’s well-being, the stage of the disorder, and the identification of the tools that may help the patient. Another important component of schizophrenia treatment, the identified stage involves the process of communicating with the patient, as well as their parents or guardians.
Although the essential medical records required to diagnose the problem and determine the treatment framework that will, later on, be used to inhibit the development of the disorder can be acquired from the family members successfully, it is crucial that the psychiatrist should engage the patient in conversation and create the foil for successful cooperation. As stressed above, the therapist is likely to face a range of impediments on their way to enhancing the cooperation process, mainly because patients are prone to a denial of their problem (Jonsodottir et al. 24).
To make sure that the patient is aware of the issue and is willing to comply with the guidelines provided by the therapist, one will have to consider the use of techniques such as inviting the family members to support the patient extensively and the perceived daily benefit. According to a recent study, the use of the identified strategy is likely to help in cases of the patient non-compliance: “As per ROMI, perceived daily benefit was the most significant contributing factor to the compliance of medication in our study, which was followed by positive family belief, relapse prevention and pressure or force by the family members” (Chandra et al. 297).
Acute Phase Treatment
As a rule, the acute phase treatment involves the use of medication. At this point in addressing the needs of the patient, a psychiatrist aims at controlling the patient’s aggressive behavior, encourage the patient to return to the functioning that helps sustain the routine activities and facilitate the enhancement of communication between the patient and the family members or legal guardians. At this point, one might argue that the ToM framework mentioned above aligns with the identified goals since it also implies that the patient should regain their ability to socialize and communicate efficiently.
Therefore, it can be assumed that the postulates of the ToM theory can be used in the identified phase. Indeed, a close look at the identified phase will show that it requires that the process of communication between the patient and the family members should be promoted actively; in other words, it is necessary that the patient should regain the essential communication skills: “The acute phase is also the best time for the psychiatrist to initiate a relationship with family members, who tend to be particularly concerned about the patient’s disorder, disability, and prognosis during the acute phase and during hospitalization” (Lehman et al. 12).
Stabilization Phase
The identified stage involves creating the environments in which the threat of relapse could be reduced to zero. The patient is encouraged to engage in active communication with their family members. Furthermore, at the identified stage of recovery, the patient is provided with a fewer number of directions from the psychiatrist; instead, they are invited to engage in a conversation independently. As the Acute Phase described above, the process in question is in line with the provisions of the ToM framework, which suggests that schizophrenia affects primarily the social aspects of the patient’s life.
The cognitive element, however, is not to be underrated, either (Grant et al. 122; Granholm et al. 10). Thus, the emphasis must be put on helping the person suffering from the disorder to regain a connection with their family and community members. As a result, faster recovery is expected. However, one must bear in mind that the patient will still require medications that will sustain their condition and prevent a relapse.
Stable Phase
The Stable Phase implies that the process of treatment is nearly over and that the patient is ready to reenter the community. As stressed above, though, antipsychotic medications must be taken on a regular basis; otherwise, relapse will be inevitable. More importantly, when evaluating the patient’s progress and their ability to produce adequate responses, the psychiatrist must also determine whether the trial of the prescribed antipsychotic medication has been completed.
Complications
When considering the design of the approach that will help convince the target audience to follow the prescribed treatment plan, one must bear in mind that schizophrenic patients are prone to developing severe depression and even suicidal thoughts (Weiden et al. 735). In other words, as a protest against the proposed treatment, the patient may make an attempt of committing suicide (Fleishhacker et al. 185). Therefore, it is crucial to make sure that the communication process should not occur in a persuasive manner and that the arguments of the psychiatrist, though convincing, must not pressure the patient into making a decision.
In fact, it is worth noting that some of the medicine types currently used as the means of addressing episodes of schizophrenia may contribute to the development of suicidal attitudes among patients. Although a study conducted lately of the subject matter did not find the direct correlation between the two factors, it states that there might be a link between the depression rates and the use of the medicine that affects the production of the thyroid hormone:
Though apparently this finding does not appear to be of much significance, in about 40% patients TSH was normal, and a significant number of patients did not attempt suicide, if these are the same patients who had normal TSH without a suicide attempt in early psychosis, then it would be an argument to investigate this relationship further to examine where normal or high TSH level can indicate the presence of risk for suicide in early psychosis. (Shrivastava et al. 65)
Therefore, a more elaborate approach toward the assessment of suicide tendencies among the patients is strongly recommended. As a result, not only the threat of the patient suffering death or an injury because of a suicide attempt will be prevented successfully but also the recovery process may start due to successful communication between the psychiatrist and the target audience. The problem concerning the likelihood of side effects development should also be addressed.
Conclusion
As the analysis of recent studies has shown, the process of determining the symptoms of schizophrenia in patients requires further improvement since it currently implies defining the existence of hallucinations and delusions inpatients only. While other factors are taken into account, the two variables mentioned above serve as the primary means of detecting the problem. Therefore, it is strongly suggested that other opportunities for diagnosing disorder at its onset will have to be introduced.
Among the most recent innovative solutions, the application of ToM as the tool for diagnosing the disorder needs to be mentioned. In other words, although hallucinations and delusions are viewed as the primary markers of schizophrenia, the disorder can be identified at comparatively earlier stages once the ToM framework is applied and the changes in the social behavior of an individual are identified.
Furthermore, the ToM framework must be included in the treatment process as well. Seeing that the theory in question places a very heavy emphasis on the significance of restoring the patient’s social functions, whereas the rest of the theories focus on the cognitive development, it aligns with the principles of efficient schizophrenia treatment. In other words, the framework is crucial to the efficacy of the diagnosis, as well as the success of the treatment process.
Despite the fact that a combination of medicine and therapy remains the primary tool for managing the disorder, new suggestions regarding the means of managing the problem have emerged. Particularly, the reconsideration of the medications used to prevent hallucinations and delusions in patients and the focus on managing the social skills along with the restoration of cognitive functions need to be mentioned as the essential change.
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