This is a psychiatric diagnosis which explains a condition associated with abnormalities in the perception or even expression of truth. It can also be defined as a chronic, severe, and a disabling brain disorder. Individuals diagnosed with this condition hear voices which others cannot hear and this is described as auditory hallucinations. The person may feel very suspicious about people around them and this can terrify them and make them prefer solitude (Gottesman, Shields Hanson, 1982). People with schizophrenia may talk without making sense or may even sit at one point without moving or even talking for a long time. At times, it is hard to realize that one has schizophrenia until they speak out. People suffering from schizophrenia have a problem maintaining job and even themselves, therefore they depend on others for help. Seeking medical treatment helps in reducing many signs of schizophrenia though most people who have the disorder can contain the signs all their life.
Causes of schizophrenia
There are various factors which are thought to cause schizophrenia. Among these factors are genes and environment and different brain chemistry structure. Schizophrenia is found in individuals who have first degree relatives with the disorders i.e. a brother, parent, or even a sister (Beebe, 2003). Those individuals who have second degree relatives with the disorder are also likely to develop the disorder. The probability of developing the disorder is high among identical twins when one of the twins has the disorder. Under brain chemistry, it is thought that imbalance in the complicated functioning of the brain might result in schizophrenia. In addition, brain structure of people with schizophrenia is different because it has been found that they have larger ventricles (Farmer Pandurangi, 1997).
Symptoms of the disorder
The symptoms are classified into three broad classes namely positive signs, negative signs, and cognitive signs. Positive signs include psychotic signs which are not observed in normal individuals (Farmer Pandurangi, 1997). The people exhibiting these behaviors have abnormalities in perception or expression of reality. The signs observed may be on and off which may at times become severe while at other times they are hardly noticeable. This also depends on whether an individual is receiving treatments or not. The behaviors exhibited includes auditory hallucinations whereby the individual affected hears voices talking to him, talking to themselves or even ordering them around on what to do. A person may experience such voices for quite sometimes before the people around them realize what they are going through. Other types of hallucinations include seeing imaginary objects or people, smelling things which cannot be smelled by other people, or even feeling imaginary touches when nobody is around (Gottesman, Shields Hanson, 1982).
People with schizophrenia may also feel delusions. Delusions are untrue beliefs that are not part of an individuals culture and do not change. Such people continue believing even after assurance that such things are not possible. They may believe that people around them can control what they are doing through magnetic waves, can see what they are thinking etc. They may even associate other peoples actions to be directed to them like radio stations announcing their thoughts loudly. They may feel so suspicious about people around them thinking that they can be harmed and this makes them get withdrawn to themselves (Hirsch Weinberger, 2003).
People with schizophrenia have thought disorders. They have a problem in arranging their thoughts or even connecting them to make sense. One may not be able to understand what they are saying or may stop talking suddenly in the middle of the thought. In such a case, they believe that what they were thinking about has been snatched away from them. People suffering from Schizophrenia also experience movement disorder which can be noticed by repetition of certain body movements several times. The disorder may get severe until an individual cannot move or even respond to other people around them and this is referred to as catatonia (Fred Lawrence, 2002).
Negative signs of schizophrenia are linked to disruptions to normal emotions and behaviors. These signs are not easy to notice and can be confused with depression or even other problems. The signs exhibited include showing expressionless face while talking, feeling dejected, inability to start and even to maintain planned activities, and talking sparingly even when forced to talk (Gottesman, Shields Hanson, 1982). Such people need assistance with their day to day activities and since they can neglect their body hygiene, someone should remind them so that they do not seem lazy. Cognitive signs, just like negative signs may not be noticed easily unless some tests are done. The signs include poor understanding of information and even inability to use the information given in making decisions, poor concentration, and inability to understand information and use them immediately. Cognitive signs make life difficult and may result into a severe emotional suffering (Maj Sartorius, 2002).
The disorder affects both sexes uniformly. The signs like hallucinations and delusions are observed between the ages 16 to 30 with the male gender showing signs a bit early as compared to the women. The disorder does not develop above the age of 45 (Fred Lawrence, 2002). Though the incidences of schizophrenia in children are very rare, there is an in creasing awareness of childhood schizophrenia. Detecting schizophrenia in teens is not easy since the initial signs of the disorder may only be change of friends, drop in academic performance, insomnia and hyperactivity which are normal behaviors in teenagers (Beebe, 2003).
There are some factors which can be employed in an effort to diagnose schizophrenia in teenagers who are likely to develop the disorder. The factors are preferring solitude most of the times, family history of psychosis, increase in unusual thought and suspicion. This stage of the disorder is called prodromal period especially in youngsters who have the disorder (Fred Lawrence, 2002).
People diagnosed with schizophrenia are never violent though some signs of schizophrenia can be linked to violence like delusion of persecution. A person suffering from schizophrenia and at the same time is involved in drug abuse is likely to be violent (Gottesman, Shields Hanson, 1982). If these people become violent, it is usually targeted at family members and it is likely to happen at home. The risk of these people becoming violent is very low though they are prone to attempting suicide quite often. Research shows that about 10 of young males suffering from schizophrenia die through suicide related cases. It is also not easy to detect which people with schizophrenia are likely to commit suicide making it hard to help these people out (Beebe, 2003).
Since people who abuse drugs may exhibit signs similar to those people suffering from schizophrenia, people with schizophrenia may be mistaken for substance abuse. Drug abuse cannot result into schizophrenia, while people suffering from schizophrenia are more likely to abuse drugs as compared to the normal people. In addition, drug abuse can affect the efficacy of treatment for schizophrenia since some drugs may exaggerate the signs exhibited and even make them more severe. Additionally, drug addicts are likely not to follow their treatment regime. The most encountered substance abuse in people with schizophrenia is nicotine addiction (Hirsch Weinberger, 2003).
Treatment
Since the real cause of the disorder has not been established, the treatment given is aimed at eliminating the signs of the disorder. The types of therapy used include antipsychotic and psychosocial treatments. In antipsychotic treatment, the frequently used drugs include chlorpromazine, haloperidol, perphenazine, and fluphenazine (Gottesman, Shields Hanson, 1982). Clozaril which is a second generation antipsychotic is an effective medication which eliminates psychotic signs, hallucinations, and breaks with reality though the drug causes agranulocytosis and this will force patients to have the level granulocytes checked weekly which is costly. Other examples of antipsychotic which do not cause agranulocytosis are risperidone, olanzapine, paliperidone, aripiprazole, among others. Stopping medication should be a gradual process (Hirsch Weinberger, 2003).
Psychosocial therapy is used in people who have undergone through antipsychotic therapy and have shown stability. The main aim of this therapy is to help patients tackle their every day problems associated with the disorder like personal care, concentration, maintaining work, and also improving relationship with the people around them (Hirsch Weinberger, 2003). Patients who get psychosocial treatment follow their medication regime strictly and are likely to respond well to treatments. The doctor gives education about the condition, emphasizes the significance of treatment.
