Schizophrenia

Schizophrenia Schizophrenia, a chronic and disabling psychological disorder, affects individuals from all walks of life, all social, economic, and education classes. Although schizophrenia has long been a topic of extensive research, an exact cause has yet to be determined. Schizophrenia typically affects an individual’s thoughts, feelings, percetions, and relationships with others. Although there are many different symptoms of schizophrenia, not all are present in every patient suffering from the disorder. Delusions, distorted speech, and hallucinations are common symptoms. Additional symptoms, such as ususual behavior, lack of hygiene, and withdrawal from social activites may often be dismissed as a phase. The onset of schizophrenia typically occurs between the late teens to mid 30s; however, later onset may occur. Although symptoms are the same no matter the age of the individual, schizophrenia is difficult to diagnose at early ages. Women tend to have later onset of symptoms. The median age for onset of symptoms in women is the late 20s; while the median age for onset of symptoms in men is the mid 20s. Depending upon the rate of onset, schizophrenia can be divided into two main types (Gulli, 2001). Individuals classified as having Type I schizophrenia have rapid onset of symptoms, such as delusions or hallucinations, and respond well to medication. Individuals classified with Type II schizophrenia experience slower onset of symptoms as well as slowed physical and mental reactions. Schizophrenia can also be divided into subtypes (Gulli, 2001) based upon the symptoms presented. Paranoid schizophrenics suffer from delusions and auditory hallucinations, but tend to function at a higher level than other subtypes. Although this subtype has nearly normal emotions and cognitive abilities, their behavior can become violent when delusional and are at a higher risk for suicide. Disorganized schizophrenics display disorganized behavior patterns, thought processes, and speech. They tend to have little or no emotional response. As a result, these individuals often withdraw from society. Catatonic schizophrenia is marked by disturbances in movement, including bizarre posture and repetitive mimicking of others. Catatonic schizophrenics may appear to be in a stupor or display extreme agitation. Individuals who do not fit into any of the aforementioned subtypes are referred to as undifferentiated schizophrenics. This group includes individuals who have experienced at least one psychotic episode but are not currently showing signs of schizophrenia such as hallucinations or delusions. Undifferentiated schizophrenics may be slightly withdrawn, which suggests their issues have not be resolved. Although excess levels of dopamine have been attributed to schizophrenia, the exact cause is not known (Dewan, 2001). Schizophrenia is ten times greater in first degree biological relatives than is found in the general population. Likewise, monozygotic twins suffer from schizophrenia more often than dizygotic twins. Yet another theory is that schizophrenia is caused by a virus that attacks the hippocampus, and antiviral medications are being tested in some schizophrenics. Schizophrenia may also be caused by a combination of genetic and environmental factors. Stress can lead to psychotic episodes in schizophrenics (Dewan, 2001). Unfortunately, there is no specific test to diagnose schizophrenia. Other brain disorders such as epilepsy and Huntington’s chorea, must be ruled out before an individual can be diagnosed as schizophrenic (Gulli, 2001). Antipsychotic medication, social support, and therapy are the main components in managing schizophrenia. Mental health professionals recommend using the minimum effective dose of a medications in order to avoid side effects (Apiquian et al, 2003). Use of multiple medications is not recommended. In order to avoid a relapse, medication should be withdrawn gradually. The most common medication used to treat schizophrenia, Haloperidol, was developed in the 1950s, and originally used as an anesthesia. Subsequent research indicating its effectiveness on psychotic disorders led to the use of Haloperidol as an antipsychotic medication (Irving et al, 2006). Haloperidol, as with most of the older antipsychotic drugs, can cause side effects much like Parkinson’s disease. Newer medications such as Sulpiride and Amisulpiride block the D2 dopamine receptor and are becoming more widely used because they do not cause side effects similar to Parkinson’s disease. Another medication, Clozapine, is becoming more commonly used in individuals requiring hospitalization, but has been shown to cause major weight gain. Within the last ten years, the FDA has approved the medication Abilify for treatment of schizophrenia. Abilify appears to be very effective in treating schizophrenia and has far fewer side effects than earlier antipsychotic medications. One of the major problems in treating schizophrenics with medication is ascertaining that the individual is taking the medication. Research has begun on a device that could be surgically implanted and would deliver a steady amount of medication into the individual’s system. Most schizophrenics respond well to psychotherapy once symptoms are controlled with medication (Gulli, 2001). Behavior therapy helps schizophrenics deal with day to day living, as well as social interaction. Families are encouraged to attend therapy as well, in order to understand the problems the schizophrenic faces and to learn to help deal with the problems. Family therapy also provides support for the other members of the family.                            Conclusions       Schizophrenia is a group of disorders in which the patient suffers from disordered responses to their sensory environment. Its cause is not yet known, but it can be treated and the symptoms kept under control in many cases. Treatment involves a combination of medications, psychotherapy, and family and social support for the patient. The later the onset of schizophrenic symptoms, the better the prognosis, but even so, the recovery rate is only about 30 percent.             References      Clozapine for treatment refractory schizophrenia. (2003). Brown University Child & Adolescent Psychopharmacology, 5, 4.      *Dewan, N. (Annual, 2001). Schizophrenia. Clinical reference System, 1702.      FDA approves ABILIFY for treatment of schizophrenia. (2002). Mental health Weekly, 12, 7.      *Gulli, L. F. (2001). Schizophrenia. In The Gale Encyclopedia of Medicine. 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