Schizophrenia
From Drug Rehab Wiki
Schizophrenia is a category of severe, chronic brain disorders in which an individual is disabled by abnormal perceptions of reality that delude his or her normal thinking. It is characterized by symptoms of psychosis (delusions, multiple hallucinations—-most commonly auditory hallucinations), symptoms of disorganization (incoherent or agitated behavior, disordered thinking and incongruous speech known as positive formal thought disorder), and negative symptoms (affective flattening, alogia, anhedonia, asociality, avolition). Because schizophrenia is a group of mental disorders that are categorized by diverse symptomatology, it is separately classified from affective psychoses in both the DSM-IV and the ICD-10.
Individuals with this psychiatric disorder experience extreme social dysfunction, and may be unable to cope with normal interaction with others including relationships and employment. They instead withdraw into an “inner world” surrounded by their own delusions manifested from psychosis. Typically, the affected individual will hear voices that they may believe are telling them instructions or are controlling their thoughts. They may also develop the idea that others are reading their minds or scheming to harm them. Hearing these voices may be terrifying for the individual and cause them to develop paranoid behavior like losing trust in others, withdrawing, or acting erratically and agitated. Because of this constant fear and retreat into isolation, many affected individuals become incapable of even providing care for themselves—from finances to hygiene. Their speech may seem jumbled, nonsensical, or spontaneous due to their loss of association. Their behavior may seem irrational, extreme, and unpredictable. However, people with schizophrenia display different levels of severity at periods of time; some may lead productive lives every day while others become extremely dependent and require long-term intensive care. The onset of the illness might occur suddenly, while in other cases the symptoms grow gradually over time.
Signs and Symptoms
Obvious signs of schizophrenia include catatonia; lack of emotion; inappropriate emotional response or unusual behavior; angry outbursts; hebephrenia; paranoia; delusions; hallucinations; unfounded, illogical beliefs; awkward, uncoordinated movements; disorganized, incoherent speech; difficulty at school and work; social isolation; and neglect of personal hygiene.
Symptoms are usually described as belonging to one of three general categories: positive (i.e., psychotic) symptoms, negative symptoms, and cognitive symptoms. Positive symptoms are the intensification of normal emotional or behavioral responses. These include hallucinations such as seeing things that do not exist or hearing voices giving instructions or messages; delusions such as beliefs of conspiracy and paranoid feelings of being watched; thought disorders such as jumbled speech known as “word salad”; and movement disorders such as involuntary jerks or repetitive actions. Negative symptoms are the lack of normal emotional or behavioral responses. These include the lack of emotion or concern, loss of interest or pleasure, loss of motivation, flat affect, disorganized reactions and planning, and lack of interaction or response. Cognitive symptoms may be subtle, but describe the incapacitation of executive functioning, difficulty concentrating, and marked decrease in working memory.
Causes
Although many factors such as genetics, substance abuse during fetal development, environmental influence, and social and psychological development have all been recognized as contributors to the disorder schizophrenia, no single cause has ever been identified. Research has revealed schizophrenia to be highly heritable, as the genetic degree can often determine the likelihood of occurrence among family members (80 percent of cases of schizophrenia are considered to be inherited). Yet classification is not completely restricted to heterogeneity characteristics since no biological indicator is yet known, nor are the multiple symptoms temporally exclusive or pathognomic. However, research does indicate that schizophrenia is a malfunction occurring in the brain since antipsychotic medication has proven to be effective in treating schizophrenic symptoms. The presence of these symptoms reveals the existence of either an anatomically pathological or a pathophysiological imbalance caused during brain development. The term schizophrenia (schizo = to split, phrene = mind), coined by Swiss psychiatrist Eugene Bleuler, itself is intended to characterize the ‘split’ that occurs between the affected individual’s cognitive thought and associations with reality.
According to the National Institute of Mental Health, schizophrenia affects over 1.1 million American adults every year. Statistically, schizophrenia affects more men than women, and it tends to affect men at an earlier age. The population of people suffering from schizophrenia has a much higher mortality rate than the general population, due to the fact that schizophrenics are more likely to die prematurely from other illnesses or by suicide.
Although they are commonly confused, schizophrenia is not the same as split personality disorder or multiple personality disorder. Some substance abuse disorders can share the same symptoms as schizophrenia, yet schizophrenia is not believed to be caused by substance abuse. However, people with schizophrenia are more likely to abuse alcohol and other substances—especially nicotine—than the general population. According to the NIMH, substance addiction makes treatment less effective, particularly by having an adverse effect on prescribed medication.
Treatment
The actual cause of schizophrenia still has not been identified; therefore, treatment for the illness is focused on eradicating the symptoms of affected individuals by biological, cognitive, developmental, and psychological intervention through the use of antipsychotic medication and psychosocial therapy. Because of advancements in antipsychotic medications, schizophrenia can be properly managed and enable affected individuals to lead fulfilling and productive lives. Although schizophrenia may be experienced as an ongoing illness or as periods of remission, proper medication and professional support will successfully allow individuals to overcome symptoms and encourage growth. Schizophrenia is a chronic illness that requires lifelong treatment; affected individuals may experience periods of self-sustaining control under their current treatment, then later require hospitalization to help cope with periods of serious symptoms. Because schizophrenics have trouble thinking clearly or having a lucid memory, proper treatment may be difficult to mandate. Relapse is likely to occur. The best chance of successful treatment involves improving lifestyle and environment, family and medical support, and persistence.
