Schizophrenia: Pathophysiology and Treatment

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Table of Contents

Introduction
What is Schizophrenia
Studies on the Disorder
Treatment Options
The Success of Treatment Options
Conclusion
Reference List

Introduction

Many different psychological disorders that have been discovered in the medical world tend to afflict human beings thus affecting their day-to-day activities. Psychological disorders come in different ways. At the same time, they are tackled in different ways that can be described as the best in the present-day world of medicine.

Some psychological disorders can be described as acquired while some can be described as genetic depending on their manifestation in the human beings. The treatment and management of these disorders also vary, with some of the disorders being treatable and eliminated completely while some can only be controlled but not eliminated. Different approaches are employed when dealing with psychological disorders.

In fact, although different people can be diagnosed with the same disorder, they will show different signs individually and hence the conclusion that psychological disorders show different indicators that make up a certain disorder when put together. As the study reveals, one such disorder that can be described as complex is schizophrenia because of the different ways it manifests in human being as well as the different forms it afflicts its victims.

What is Schizophrenia

Schizophrenia as a disease or mental disorder has been in existence for a very long time, as long as humans have existed. Previously, the classification of mental illnesses was so poor that almost all mental illnesses were lumped together without trying to sort them out (Sullivan, 2003, p. 1187).

Way back in the year 1911, a Swiss doctor called Eugene Blair coined the name schizophrenia from two Greek words, ‘schizo’, meaning split, and the word ‘phrene’, meaning mind, and hence the term schizophrenia that means a disconnected mind. The disease comes in different forms by exhibiting different characteristics specific to an individual case.

In most cases, an individual would exhibit one or more of the following characteristics, which are pointers to the disease. They include delusions, which are strange and unrealistic beliefs that go on in an individual’s mind in that they tend to see things that other people are not seeing (Lilienfeld et al. 2010). The signs also include hearing of sounds other people cannot hear, and some strange beliefs that something is going to happen to the victims.

The mind of the individual makes them have abnormal a feeling about their surrounding environment. They also have hallucinations, which will make them have a reaction of the presence of things that are actually not there. In this case, people will hear voices that are just in their minds, smell things that are not there, and/or have different tastes from what is expected (Sullivan, 2003, p. 1189).

The individuals will also exhibit strange behavior when viewed by normal people. The behavior that can be described as uncanny. In some cases, the individuals will have a very unsystematic dialogue in that a mature individual will not be able to make a sensible statement due to his or her mixing of different words. The speech of a mature person in this case can be described as that of a small child who is learning to talk.

Some forms of schizophrenia come with disjointed and severely diminished cognitive abilities in that victims lose most of their mental faculties (Lilienfeld et al. 2010). In fact, they cannot therefore do any constructive thing. In some cases, the individual will not be in a position to do anything without being instructed on what do and how to do it.

In case the victims have taken the initiative to do something, they will omit some steps, which make whatever they are doing appear odd (McGlashan, 1988, p. 516). Signs vary from one individual to the other as well as severity of the condition. Some persons can be described as being in a permanent state of the condition while others will oscillate between being fully normal and suffering from bouts of the disease.

Schizophrenia strikes its victims in their late adolescence or in their early stages of adulthood although it is also known to strike anytime of an individual’s lifetime. The real cause of schizophrenia has never been pinpointed to date. However, experts are working on a theory that points it to be a result between biological predispositions, which are genetic in nature and the environment in which one grows up (Daly, 2013, p. 716).

This claim is the line of research that researchers are slowly developing with the belief that it will give answers to the question of its origin. Another cause for schizophrenia can be drug abuse. Effects of drug abuse can lead to the impairment of the cognitive functions of the brain in that the victim will start behaving abnormally due to hallucinations and delusions.

Pregnancy has also been listed as another cause of schizophrenia, with different elements during a woman’s pregnancy acting as a trigger for the same. Schizophrenia comes in different levels such that some types of schizophrenia can be described as acute while others can be described as mild (Sullivan, 2003, p. 1189).

People with schizophrenia can have lucid moments in that sometimes they are fully normal with their mental functions being performed in order. However, in some other times, they are very schizophrenic.

Studies on the Disorder

Scientists have conducted different major studies across the world as they try to find the main causes of schizophrenia as well as solutions to the problem. The biggest challenge that many studies have faced has been the inability to pin point exactly what causes the problem because finding the cause would lead to better solutions to the problem.

The manifestation of the disease is what makes it a big challenge to researchers who are trying to find its exact cause. One of the challenges is that schizophrenia has so many different symptoms. In this case, only when they are put together that the person can be rightly diagnosed as suffering from the disease (Meltzer, 2002, p. 280). Therefore, research in the field of schizophrenia is wide due to the width with which the schizophrenia problem comes.

Each research has been narrowed down to a specific problem that the researchers think is the cause or they think might lead them to a solution. Broad Institute of Harvard, the MIT, and the Massachusetts General Hospital have conducted one of the major studies on schizophrenia under the leadership of Mark Daly.

The aim of the study was to find the genetic difference between people suffering from schizophrenia, bipolar disease, and other unaffected people. The study involved over 10000 people suffering from schizophrenia, 7000 people suffering from bipolar, and a large number of unaffected people. The study was meant to narrow down genetic differences between the three groups as a way of pin pointing the genetic traits associated with schizophrenia.

The study discovered 10 genetic risk factors that are highly associated with schizophrenia and bipolar disorder. Besides, it also discovered three specific genes that are suspected to be the cause of the two diseases (Daly, 2013, p.730). The study was meant to find a common link between schizophrenia and genes, which are usually transferable from one offspring to the other.

Another study on schizophrenia, which is one of the many studies on the same disease, was to find out the relationship between the disease, genetic traits, and the environment. The study found that the heritability liability of schizophrenia was 81%, which means that schizophrenia is a highly heritable disease arising due to genetic traits that can be inherited. 11% of the problem in victims was attributed to common and shared environment.

The study came out with a conclusion that schizophrenia is highly influenced by genes and the environment although it does not show the cause of the disease. The study simply reinforces previous theories that point the origins of schizophrenia to both genes and the environment (Daly, 2013, p. 735). Another study by McGlashan (1988) found that schizophrenia, as a mental disease can be chronic to the extent that its effects become worse in relation to those of other known major mental illnesses.

In these findings, schizophrenia can lead to increased risks of suicide in its victims, instances of physical health, and cases of mortality. According to McGlashan (1988), the disease comes out in the open after a period of between 5-10 years after its manifestation meaning that it can remain unnoticed in an individual for some time, as it develops before it comes out evidently (p. 520).

The study finds that long-term studies on the disease so far have not come up with any conclusion on the history of treatment of the disease, meaning that the treatment of the disease has not been concluded as effective. Studies on the disorder can be described as continuous because no authoritatively conclusive study has been made so far.

Different theories on the disease continue to be studied while new theories also come up at the same time to try to find a solution. Therefore, any information so far being used in the field cannot be described as conclusive, but as part of a continuous study.

Treatment Options

One factor that underlies schizophrenia treatment is that it is a disease whose cause is not yet known and that it comes in different manifestations. This case therefore complicates the treatment regime that any physician has to offer because it is a trial and error at the end of the day. Every single schizophrenic case has to be approached individually because different victims have different symptoms besides having different combinations of symptoms (Meltzer, 2002, p. 280).

This complication therefore restricts the physician to observe case by case in an effort to administer drugs according to their opinion on the individual case. The treatment methods commonly in the application are based on a clinical research that has been conducted on the disease as well as on the experience of the physician on the treatment of the disease.

Usually, the approach that the physician will employ will depend on the ability of the strategy to reduce the effects and symptoms of the disease as well as an approach that is believed will reduce the chances of the disease coming back. Treatment for the condition happens in two ways: medical treatment or psychosocial treatment (Sullivan, 2003, p. 1188). Medical treatment of the disease usually involves the use of antipsychotic medicine, which has been available since 1950s.

These drugs are not known to cure the problem. Rather, they are known to reduce psychotic symptoms to allow the individual to behave like a normal person. So far, this treatment has been identified as the most effective. An experienced physician who specializes in mental cases can administer it. The choices of drugs and dosage are the prerogative of the physician because treatment is done on a case-by-case basis.

Many schizophrenic cases as explained above differ in symptoms and intensity. Although psychotic medication has been known to work well for schizophrenic cases, it sometimes does not work in others in that patients may fail completely to respond to the drug thus making it useless to administer the said drug on them (Sullivan, 2003, p. 1189). Some patients will mildly respond to the drugs being administered.

This case would require higher doses of the drug for them to be effective. Although it is effective in treating and managing schizophrenia, almost all anti psychotic drugs have negative side effects that might not be pleasant at all to the patient. Some of the commonly used drugs include Clozapine, which is registered as Clozaril. It has been touted as the best antipsychotic drug ever to be used.

However, its use comes with severe side effects to the user of the drug with the development of agronulocytocis, which is a condition that diminishes white blood cells thus reducing the individual’s immunity. Risperidone is another drug that can be used to treat psychosis, which in this case is schizophrenia. The drug has fewer side effects compared to Clozapine. However, it is not as effective as Clozapine.

Olazapine is another antipsychotic drug that works like Risperidone but not as effective as Clozapine (Meltzer, 2002, p. 280). Many other drugs are still being developed. Thus, they are not yet in the market. On the other hand, other drugs that can be used in treating schizophrenia have been found to treat specific symptoms. Hence, they cannot be counted upon to treat other symptoms. This makes them less effective.

Psychotherapy can also be used as treatment for schizophrenia in some cases through rehabilitation of the individual, family education, individual psychotherapy, and self-help groups. The use of psychotherapy can only be applicable in cases where the individuals respond to the treatment. The physician can only determine this treatment. Psychosocial therapy is mostly applied when the individual seems to have developed schizophrenia due to environmental influences.

The Success of Treatment Options

The success of treatment options for schizophrenia can only be stated in relative terms due to the manner in which the disease manifests itself and the stage the treatment for the disease has reached. So far, there is no cure for schizophrenia. The only available solution has been to tame the situation as the patient continues to use drugs.

Many patients who have been diagnosed as suffering from schizophrenia have had to live with the condition for the rest of their lives because it is not curable (Sullivan, 2003, p. 1191). The only solution that most of them have had with this condition is that some cases have been able to have the condition suppressed for a longtime without them relapsing.

This far is the closest to cure to which patients with schizophrenia can come close. The biggest challenge that remains is that the disease comes in many different forms with either individual symptoms or a combination of symptoms. This case is a challenge because the psychiatrist has to deal with individual symptoms as they try to sort them because each symptom has its own drug.

A mixture of some of the drugs used can be dangerous to the patient. Therefore, in most cases, the patient is treated for one condition at a time. The use of more effective drugs such as Clozapine has other devastating effects on the patient. The drug is overly effective in its application. However, its side effects are dangerous as well.

For instance, patients under Clozapine need to have their blood tested very often to check the white blood cells count because the drug tends to diminish the white cells (Meltzer, 2002, p. 280). Inadequate white cells mean that the body’s immune system will be lowered because they are responsible for the immune system of the body. Success in treatment options can be described as successful in individual cases where the patient has responded positively to the treatment.

This varies with individual cases because there are those patients who will respond positively to the therapy while there are those who will not respond at all. Treatment of schizophrenia starts with a trial-and-error mode as the physician tries out different treatment plans for the individual. It takes some time before the physician figures out the exact plan for an individual patient.

At the end of the day, the plan might work or fail (Daly, 2013, p. 750). Treatment options offered so far can be deemed successful as far as offering the best they can because that is the best that the industry can offer. They have been known to control the disease in an individual successfully. The only point that should be noted is that the disease never goes away and that the patient has to be on the lookout in case they relapse.

This will force them to go back to treatment. On the other hand, some patients might have to be fully dependent on the drugs for them to behave normally because they might not look properly wired without the drugs. Whereas treatment has worked in some cases, it has failed completely to work for some patients in some other cases (Meltzer, 2002, p. 280).

In these instances, patients have had to be confined in facilities that will allow them to be taken care of, or they have to be heavily sedated as a way of keeping them calm. These two methods can be punitive to the patient. However, at the same time, they can be the only available solutions to them.

Conclusion

Schizophrenia as a mental disorder continues to pose challenges to the medical world on the best solutions that can be found to take care of it. The challenge of finding its main cause remains large because there is still no solution ahead with the present-day technology.

The complexity of the problem has made it worse by complicating its description in that it cannot be described by one or two words. So far, the only hope of finding the main cause of the problem lies with finding the exact genetic connection as well as the environmental connection to the problem.

Reference List

Daly, M. (2013). Genetics connection In Schizophrenia. Nature Genetics, 45(7), 715-841.

Lilienfeld, S. et al. (2010). Psychology: A Framework for Everyday Thinking. London: Pearson Publishers.

McGlashan, T. (1988). A Selective Review of North American Follow Up Studies of Schizophrenia. Schizophrenia Bullettin, 14(4), 515-542.

Meltzer, H. (2002). Suicidality in Schizophrenia: A Review of the Evidence for Risk Factors & Treatment Options. Current Psychiatry Reports, 4(4), 279-283.

Sullivan, P. (2003). Schizophrenia as a Complex Trait Evidence from a Meta-Analysis of Twin. Jama Psychiatry, 60(12), 1187-1192.

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