Introduction
Schizophrenia is psychotic disorder whereby an individual’s performance in regards to social and occupational welfare is negatively affected due to disturbed thought process, motor abnormalities, unusual emotions and strange perceptions (Javitt & Coyle, 2004, p. 49). It may also refer to the situation whereby there are certain psychiatric irregularities in people’s discernment and representation of reality. The symptoms can often be detected during late adolescence or on the onset of adulthood, where the poor people are more likely to experience the disorder. There are several indicators that one can look for in order to determine whether a person is a victim of schizophrenia. The symptoms can be categorized into three broad categories as illustrated below.
Symptoms
Positive symptoms
These refer to pathological excesses in a patient’s behavior. They include disorganized speech and thinking, hallucinations, delusions, inappropriate affect and heightened perceptions.
Negative Symptoms
These refer to the characteristics that lack in an individual. These may include poor speech, loss of purpose, social withdraw and flat affect.
Psychomotor symptoms
These may include awkward movements, odd gestures and repeated expressions which seem to have a private purpose. Individuals with these symptoms demonstrate extreme forms (catatonia), where they may even stop responding to their environment (Javitt & Coyle, 2004, p. 50).They may remain motionless or silent for a long duration. Others remain in awkward positions for a very long time.
Subtypes of the Schizophrenia Disorder
Hebephrenic Schizophrenia
It is also referred to as disorganized schizophrenia. It is characterized by confusion and incoherence, attention or perception problems and social withdrawal. It occurs when an individual reveals some signs of thought disorder alongside affective or inappropriate flattening.
Paranoid Schizophrenia
In this type of schizophrenia, the patient experiences hallucinations and delusions but shows minimal or no signs of thought disorder, flattening affect and disorganized behavior.
Residual Type of schizophrenia
This occurs where the positive symptoms of schizophrenia can be depicted but in low intensity.
Catatonic schizophrenia
It occurs where the individual indicates agitation and senseless movements. This may include waxy flexibility and catatonic stupor.
Undifferentiated schizophrenia
Undifferentiated schizophrenia occurs where there is existence of psychotic symptoms while the conditions for paranoid, disorganized and catatonic types have not been met.
Diagnosis
The diagnosis can only be based on information about personal experiences and also from observation of behavior change in the affected individuals by family members and friends. After the information is taken to a psychiatrist, an assessment may then become necessary (Torrey, 2008, p. 112). People diagnosed with this disorder more often show signs of acoustic hallucinations, obsessed or weird images, disorganized communication, a peculiar way of thinking and dissatisfaction in their social and occupational life. Usually, they lose their path of thought and flow of ideas while they talk. In severe cases, an individual can hardly construct meaningful sentences.He/she does this by loosely connecting the words. Most often, social seclusion is common in the individuals with this disorder. They may lack motivation in life and exhibit purposelessness, disturbance and irritability. However, psychoses maintain that the symptoms of disturbed functioning need to be present in a period of six months or more for the diagnosis to be varied. Individuals perceived to be affected must also portray a notable trend of deterioration in their social relations, work and personal hygiene. The five types of schizophrenia (paranoid, catatonic, disorganized, residual and undifferentiated) should be put into consideration during diagnosis. You should also consider the central symptoms of each type as illustrated.
Biological explanation of schizophrenia
Biological and genetic factors have made a tremendous impact in the study of schizophrenia. Studies indicate that schizophrenia is more common in families of people with this disorder. According to research, inheritance and brain activity play a major role in the development of the disorder (van, Burns, & Cavallaro, 2006, p. 93). An individual may inherit a biological predisposition to schizophrenia from the family lineage, making him/ her more prone to the disorder when faced with by stressful conditions in life. This is more likely to happen if the individuals are in the late adolescence or early adulthood stages in life. The more one is closely related to the schizophrenic person, the greater the chances of developing this disorder. For instance, an identical twin is at a greater risk of developing the disorder than a fraternal twin.
Psychological explanation of schizophrenia
The psychodynamic approach is an important psychological aspect in explaining schizophrenia. According to the psychodynamic theorists, schizophrenia develops from two psychological processes; degeneration to a pre-ego stage and from the efforts to restore the ego control. According to these scholars, when exposed to a cruel and taxing environment, people are likely to develop the disorder by going back to the most primitive stage in their development, where they only meet their own needs. This might lead to self centeredness where the individual portrays symptoms such as loose associations, fantasies and neologisms. Once these individuals attain the climax level of this regression, they then try to return back their ego control. These efforts then deteriorate the condition as more symptoms of the disorder arise. For instance, an individual may develop aural hallucinations in the endeavor to substitute for a lost sense of reality.
Sociocultural explanation of schizophrenia
Theorists in this approach argue that people experiencing this disorder are victims of societal forces. They believe that incorrect social labeling and family problems are the major sources of this disorder. According to them, the society labels people who do not follow its norms as schizophrenic after which schizophrenic symptoms start developing in the individual’s life. Research indicates that incorrect tagging of people as schizophrenic can have very detrimental effects on how we analysis them as well as how they view themselves. Studies have also indicated that family stress can also be a source of the disorder due to the intense stress and anxiety that are involved.
The psychological and the social-cultural accounts have been found complex to understand although clinicians acknowledge that both theories play an important role in explaining the disorder. However, the biological explanation has been found to be more varied
Treatment of schizophrenia
According to research, schizophrenic medication is 70% successful in controlling the disorder’s symptoms (Torrey, 2008, p. 114). However, majority of the people have to try more than one drug in order to control all the positive symptoms which are not as effective to control as the negative ones. This notwithstanding, several patients together with their families opt to go for supplemental therapies which include rehabilitation programs and support groups. Even though the disorder is considered to be very hard to treat, clinicians use antipsychotic drugs to help people experiencing this disorder to think clearly and profit from therapies that would otherwise be very hard to administer.
Lobotomy
These are psychosurgical procedures that involve destroying the nerve fibers that bring abnormal thoughts to the brain or the already affected brain tissue. They include Prefrontal and transorbital lobotomy. These procedures are greatly refined and they are used on individuals with more serious problems such as loss of motor harmonization, brain spasms, massive weight gain, incontinence, partial paralysis weak expressive and logical receptiveness and endocrine breakdowns. However this method is used as the last option as it is not advisable to destroy the brain tissues making it inappropriate and even unethical.
Milieu Therapy
This is an approach that has been adopted by psychotherapy institutions. They base their treatment on humanistic principles. The approach establishes that institutions can create a favorable social climate which can boost self respect, responsibility, productive activities, and among the individuals affected. Here, the patients are given the freedom to make their own decisions. Generally, the care givers at the hospitals together with the patients establish a mutual respect, support and frankness amongst themselves. From these interactions, the patients improve drastically as compared to those in custodial institutions.
Token economy program
This is an approach adopted by institutions that is based on behavioral principle. This is a behavioral program whereby the patients desirable behavioral are reinforced steadily. This is achieved through awarding incentives for the patient’s good behavior. Such behaviors may include the maintaining good hygiene and self control.
According to research, the use of both psychotherapy and medication has proved to be more effective than the use of medication alone. Psychotherapy alone can also not be used to substitute for medication. Cognitive and Behavioral therapy when used together with medication have shown to be more effective in dealing with the schizophrenic disorder.
Conclusion
In conclusion, experts argue that schizophrenia is caused by a combination of psychological, social and biological factors.
Most importantly we need to take prevention measures to reduce the risks of developing schizophrenia. These measures may include maintaining friendships, maintaining an optimistic attitude in life, avoiding the use of drugs, reducing the levels of stress and elimination of anxiety and depression.
Reference List
Javitt, D. C., & Coyle, J. T. (2004). Decoding schizophrenia. Sci Am, 209:48-51.
Torrey, E. F. (2008). The insanity offense: how America’s failure to treat the seriously mentally ill endangers its citizens. New York: W.W. Norton.
van O. J., Burns, T., & Cavallaro, R. (2006). Standardized remission criteria in schizophrenia. Acta Psychiatrica Scandinavica, 113(2): 91–5.