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What is Schizophrenia?

-Schizophrenia is a chronic, debilitating disorder that touches every facet of the affected person’s life. People who develop schizophrenia become increasingly disengaged from society. They fail to function in the expected roles of student, worker, or spouse, and their families and communities grow intolerant of their deviate behavior (Nevid, 407).

-An individual that is diagnosed with schizophrenia can experience the following symptoms: delusions, hallucinations, illogical thinking, incoherent speech, and bizarre behavior.

 Did you know?

Schizophrenia affects men and women equally.

Causes

It is still unknown what exactly causes schizophrenia. Experts believe that it may be caused by:

  • Genes and the Environment
  • Different brain chemistry and structure

Prevalence: about 1% of U.S. population and about 0.3% to 0.7% of the global population (Nevid, 407).

There are positive and negative symptoms associated with schizophrenia.

Positive symptoms- involve a break with reality, as represented by the appearance of hallucinations and delusional thinking (Nevid, 408).

Negative symptoms- affect the person’s ability to function in daily life and include such features as lack of emotions or emotional expression, loss of motivation, loss of pleasure in normally pleasant activities, social withdrawal or isolation, and limited output (Nevid, 408).

Did you know?

Men have a slightly higher risk of developing schizophrenia than women and also tend to develop the disorder at an earlier age (Nevid, 407).

 

Signs Of Schizophrenia

There are many signs of this disorder. Below are the most common signs of developing schizophrenia (Andreasen).

  1. Delusions (believing things that are not true)
  2. Hallucinations (seeing or hearing things that are not there)
  3. Disorganized thinking
  4. Agitation
  5. Disorganized speech (e.g., frequent derailment or incoherence)
  6. Grossly disorganized or catatonic behavior
  7. Lack of drive or initiative
  8. Social withdrawal
  9. Apathy
  10. Emotional unresponsiveness


Symptoms of Schizophrenia

Symptoms of schizophrenia may include:

  • Hallucinations -- hearing or seeing imaginary things
  • Delusions -- wildly false beliefs
  • Paranoia -- the fear others are plotting against you

Some symptoms, such as lack of enjoyment in everyday life and withdrawal from social activities, may mimic depression (Webmd).

Types of Schizophrenia

 

1.Brief Psychotic Disorder-applies to a psychotic disorder that lasts from a day to a month -characterized by at least one of the following: delusions, hallucinations, disorganized speech, or grossly disorganized or cationic behavior -full return to the person’s “normal” state

 

2.Schizophreniform Disorder-consists of abnormal behaviors identical to those in schizophrenia that have persisted for at least a month but less than six months -do not justify diagnosis for schizophrenia

 

3.Delusional Disorder-applies to people who held persistent, clearly delusional beliefs, involving paranoid themes

-very rare, affecting 20 people in 10,000 during their lifetimes

-delusions usually bizarre: aliens attacking

 

4.Schizoaffective Disorder- also called “mixed bag”

-includes psychotic behaviors associated with schizophrenia (hallucinations and delusions) occurring at the same time as a major mood disorder

-Delusions or hallucinations must have occurred for at least two weeks during some point of the disorder

-often respond to schizophrenia drugs

Diagnosis and Assessment

-There is no test that can make a schizophrenia diagnosis. People with schizophrenia usually come to the attention of a mental health professional after others see them acting strangely.

-Doctors make a diagnosis through interviews with the patient as well as with friends and family members.

-Doctors will make a diagnosis of schizophrenia only after the patient has expressed signs and symptoms of schizophrenia for over six months (Nevid, 413).

-This six month period must include at least one month of symptoms (Nevid, 413).

Theory about the Development of Schizophrenia

-Developmental theories of schizophrenia simply say that something may or may not go wrong with the brain when it is developing. 

     The following have been proven true: (Nevid, 423)

  • schizophrenia is more common in winter and spring births.
  • Children whose mothers experienced famine during the first trimester are more likely to develop schizophrenia.
  • Pregnancy and birth complications increase the risk of developing schizophrenia.

Treatment

There is NO real treatment for schizophrenia! However, there are antipsychotic medications available for patients to control symptoms, such as hallucinations and delusions.There are biological treatment approaches, sociocultural factors in treatment, learning-based therapies, psychosocial rehabilitation, and family intervention programs that an individual can partake in.

 Listed below are some of the different treatments that are available.

Medications

-Because the causes of schizophrenia are mostly unknown, the treatments for this disorder focus on eliminating the symptoms (NIMH, 2013).

-The most common antipsychotic medications that are used to treat the symptoms of schizophrenia include: Chlorpromazine (Thorazine), Haloperidol (Haldol), Perphenazine (Etrafon, Trilafon), and Fluphenazine (Prolixin).

What are the Side Effects of Taking Antipsychotic Medications?

The side effects include:

  1. Drowsiness
  2. Dizziness when changing positions
  3. Blurred vision
  4. Rapid heartbeat
  5. Sensitivity to the sun
  6. Skin rashes
  7. Menstrual problems for women
  8. Rigidity
  9. Persistent muscle spasms
  10. Tremors
  11. Restlessness

Effectiveness of Antipsychotic Medications

-A study was done Jeffrey A. Lieberman, M.D and other doctors about the effectiveness of taking antipsychotic medications.The study included a total of 1493 patients aged 18 to 65 years of age and who had received a diagnosis of schizophrenia.Patients were initially randomly assigned to receive olanzapine, perphenazine, quetiapine, or risperidone under double-blind conditions and followed for up to 18 months or until treatment was discontinued for any reason The study took place from January 2001 to December 2004 across the US. The study found that the patients that received olanzapine for the period of the study was associated with more discontinuation for weight gain or metabolic effects, and perphenazine was associated with more discontinuation for side effects (Lieberman).

How are Antipsychotics Taken and How do People Respond to Them?

-Antipsychotics are usually in pill or liquid form. Some anti-psychotics are shots that are given once or twice a month (NIMH, 2013).

-Some people may have a relapse. Their symptoms come back or get worse.

Nicotine Use in Schizophrenia: The Self Medication Hypotheses?

-This was a study done by Veena Kumar about if nicotine can be used to cope with schizophrenia. The study shows that there is considerable empirical support for the idea that smoking in schizophrenia may represent an attempt to self-medicate some of the cognitive deficits of this disorder (Kumari).

Schizophrenia Complicated by Chronic Hepatitis C Virus and Hepatic Encephalopathy

-A study done by Mark Viron, M.D and others shows that there is an elevated prevalence of liver disease, alone with heptatis C virus, in populations with serious mental illness.

-Chronic HCV infection is present in 8.5%−30% of people with serious mental illness, a rate 5–16 times higher than in the general population (Viron).

-Substance use, particularly injection drug use, is an important vector for transmission of HCV (Viron)

-Nearly 50% of patients with schizophrenia meet criteria for a substance use disorder in their lifetime (Viron)

-Rates of lifetime injection drug use in samples of patients with serious mental illness range from 5% to 35%, compared with 1.4% in the general population (Viron).


Biological Approaches

-Antipsychotic medications help individuals control their patterns of schizophrenia, such as delusional thinking and hallucinations (Nevid, 429).

-The Diathesis-Stress Model

Sociocultural Factors in Treatment

-It has been questioned rather or not ethnicity plays a role in a family's involvment in treatment.

-Maintaining connections between the person schizophrenia and the family and larger community is part of the cultural tradition in many cultures (Nevid, 429).

Learning-based Therapies

-Learning-based interventions have been proven to be effective in modifying schizophrenic behavior and in helping people with the disorder develop behaviors that help them adjust more effectively to living in the community (Nevid, 430).

Therapy Methods May Include:

  1. Selective reinforcement of behavior
  2. Token economy
  3. Social Skills Training

Psychosocial Rehabilitation

-It has been proven that people with schizophrenia typically have difficulties functioning in social and occupational roles and performing work that depends on basic cognitive abilities involving attention and memory (Nevid, 431).

-There are a number of self-help clubs (clubhouses) available for use

Music Therapy

 -Music therapy may provide a means of improving mental health among people with schizophrenia, but its effects in acute psychoses have not been explored (Talwar, 2006). It has been proven that with music therapy, patients symptoms improved over a period of 3 months (Talwar).

 -Music therapy is relatively cheap and available to any patient.

The above video plays very calming music for a period of time. This music helps an individual go into a relaxed mode. Listen for yourself and relax.

Family Intervention Programs

Coping Guidelines for the Family (John M. Grohol) 

1. Establish a daily routine for the patient to follow. 

2. Help the patient stay on the medication. 

3. Keep the lines of communication open about problems or fears the patient may have. 

4. Understand that caring for the patient can be emotionally and physically exhausting. Take time for yourself. 

5. Keep your communications simple and brief when speaking with the patient. 

6. Be patient and calm.

 

Where to go for Help

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