Schizophrenia: Disabling Medical Condition - Research Paper Example

? Schizophrenia Introduction Schizophrenia is a disabling medical condition that Eugen Bleuler originally made up in the year 1911.It makes the patient exhibit altered behaviors, emotions, perceptions and thoughts (Tsuang, Faraone and Glatt 2011). Birchwood, Birchwood and Jackson (2001) define it as one of the most frequent psychotic/thinking disorder that significantly tampers with the thinking process of a person, his or her emotional responses, judgment, the capability of recognizing reality as well as the ability to communicate, to the extent that his/her functioning becomes seriously impaired. Essentially, schizophrenia brings major transformations in the patient’s social and psychological functioning, which are generally, enduring or sporadic. In some patients, these changes can occasionally be transient (Birchwood, Birchwood and Jackson, 2001). This mental disorder is accountable for much of the populace's morbidity since it is a regularly immobilizing disorder. It has an annual rate of recurrence of 18 to 20 cases for every 100,000 and its climax age of commencing is different in both women men and (Gilmore, 2010). Schizophrenia normally begins between the late adolescence and the mid-30s, but commencement prior to adolescence is not common (Long, 2009). Podosyan (2009) specifically points out that for men; the typical commencement age is in the late 20s while for women, it is in the early 20s. He further explains that later on in life, women are more likely to have a “first break” and as a result, around one third of them have a commencement of ill health after the age of thirty. Amongst the minor socio-economic groups, the condition is diagnosed disproportionately. Schizophrenia can also commence later in life for example after the age of age forty-five years, although this is not frequent. The disorder generally starts gradually with a pre-psychotic stage of increasing negative symptoms such as explosions of anger, bad hygiene and cleanup, loss of concern in work or in school, strange behavior and social withdrawal. After a few months or years later, a psychotic phase ensues some with delusions, illusions, or disgustingly muddled behavior and speech. Individuals in whom schizophrenia begins in the later years of their 20's or 30's exhibit less evidence of cognitive damage or structural brain irregularities. Moreover, they display a better result and in most cases, women. Typically, this mental disorder persists regularly/constantly or for a lifetime. It is not usual for the patient to return to full normal functioning. In fact, some affected people display a continual worsening connected with brutal disability, yet other patients appear to have a steady course (Long, 2009). Tsuang and his co-authors (2011) further point to the fact that to the patients, the society, as well as the concerned families this mental disorder has innumerable consequences. The affected individual may exhibit several disruptions in their emotions, behaviors, normal thought processes, ability to see, hear, as well as to process information from their surrounding environment. The disturbance of such basic aspects of life can be crippling for the affected individuals and it can culminate into a years of sporadic hospitalizations, incapability, in addition to an interruption of household as well as social relationships springing from the lack of the patient’s ability to communicate and isolation, which may interchange with short episodes of unruly conduct. The stigma that comes with mental illnesses and the strain of taking care of a mentally ill member of one’s family can aggravate the withdrawal of a patient suffering from schizophrenia (Tsuang, Faraone and Glatt, 2011). Causes of schizophrenia The causative factors for schizophrenia are extensively said to have a neurobiological base. A major theory that explains its cause is the dopamine hypothesis. According to this theory, hyperactivity in the dopaminergic pathways of an individual’s brain causes schizophrenia. This theory agrees with antipsychotics’ efficiency along with the ability of such drugs such as cocaine and amphetamines that rouse dopaminergic activity to aggravate psychosis. Additionally, postmortem studies designate that in schizophrenics, there is higher amount of dopamine receptors in particular subcortical nuclei compared to in individuals with ordinary brains. Recent studies document that structural as well as functional abnormalities resulting from brain imaging of control populations and schizophrena patients have posed great concern (Podosyan, 2009). Cardno & Gottesman (2000) explain that experts believe schizophrenia to stem commonly from a multi-faceted contact between numerous genes and various environmental risk factors, none of which brings about schizophrenia autonomously. To start with, researchers have for long deemed schizophrenia as an inheritable disease that runs in families. Despite the fact that this mental disorder takes place in one percent of the general populace, it comes about in ten percent of persons whose immediate (1st degree) relative for instance a brother, sister, or parent suffered from the disorder. Moreover, people whose second-degree family members such as uncles, aunts, cousins, or grandparents suffered from or are suffering from schizophrenia will also most probably develop the illness unlike the general populace. The threat is greatest for an identical twin of a schizophrenia patient (40 to 65%). As Harrison and Weinberger (2005) point out, children inherit their genes from their two parents. According to scientists, several genes are linked to a greater threat of schizophrenia. However, they mention the fact that no gene causes the disorder by itself. Reports from recent research indicate that individuals suffering from this disorder have a propensity for having greater rates of uncommon genetic mutations. Many different genes are involved in these genetic disparities and they most possibly interrupt brain development (Walsh, et al., 2008). Other current studies claim that schizophrenia may arise in part after a particular gene that is very important in making vital chemicals of the brain malfunctions, a hitch that may have adverse effect on the portion of the brain concerned with higher functioning skills’ development (Huang, et al., 2007). As mentioned earlier, the fact that the occurrence of schizophrenia most probably takes more than genes is worth noting. Studies reveal that for this condition to arise, interactions between genes and the environment must have taken place. Environmental factors including problems at birth, undernourishment before birth, contact with viruses in addition to other indefinite psychosocial factors must prevail. Researchers also relate the development of the disorder to different brain structure and chemistry. They believe that a discrepancy in the interconnected, complex chemical reactions of the brain involving dopamine and glutamate, the substances that consent brain cells’ communication (neurotransmitters), and possibly others contribute to the development of this mental condition. Scientists have come to the discovery that in small ways, as opposed to healthy individuals’ brains, the brains of schizophrenia patients have a different appearance. Their ventricles, for example, are oftentimes bigger while their brains have a propensity of having smaller amount of gray matter. Moreover, some areas of the brain of the patient may either have more or less activity. Scientists also believe that defective connections may be another cause of schizophrenia. These defective connections are brought about by problems at some point in the child’s brain development prior to birth. This problem may go unnoticed until puberty, the period during which a person’s brain goes through crucial changes and this may prompt psychotic signs (Mueser and McGurk, 2004). Types of schizophrenia Before the comprehension of much details regarding schizophrenia, a professor by the name Timothy Crow made a proposal of two distinct pathological syndromes in schizophrenia, explicitly type I and type II (equivalent to acute schizophrenia and chronic schizophrenia respectively). This was following his observation of the variability in schizophrenic patients, in both behavioral symptomatology and brain abnormality. Positive symptoms encompassing behavioral excess, for instance hallucinations as well as delusions, characterizes type I syndrome. Additionally, it is hypothesized to stem from a dopaminergic dysfunction. Compared to type II schizophrenics, type I schizophrenics are expected to respond more to neuroleptic drugs. Conversely, unlike type I schizophrenics, negative symptoms for example poverty of speech along with flattened affect characterize type II schizophrenics. Moreover, typical to type II syndrome are poor responses to antipsychotic drugs and abnormalities in brain structure (Kolb & Whishaw, 2008). Scholars have conducted more studies on schizophrenia to date, and are still ongoing. As Miller & Mason (2002) point out, there are five major subtypes of schizophrenia that have been recognized including paranoid, disorganized, residual, catatonic and undifferentiated. All five subgroups have specific distinctiveness. The following is an account of each of these subtypes of schizophrenia. Catatonic Schizophrenia A disturbance in movement is the predominant clinical feature characterizing this subtype of schizophrenia. Patients suffering from this subtype may show an outstanding activity decline to the extent of discontinuing of voluntary movement, as seen in catatonic stupor. Conversely, they may exhibit a dramatic increase in activity, a state identified as catatonic excitement. They may as well display stereotypic behavior, which comprise repetitive performance of actions that seem relatively purposeless. In most cases, this rouses their exclusion of participation in any productive undertaking. This kind of patients may also exhibit stillness or may refuse to give in to attempting to change their appearance and may therefore retain a pose in which someone positions them, at times for extended periods. This symptom is sometimes termed as waxy flexibility. Additionally, patients suffering from catatonic schizophrenia may assume atypical body postures willingly, or exhibit unusual facial contortions or limb movements. Other symptoms associated with catatonic schizophrenia include echolalia, which is parrot-like repeating of what others say, and echopraxia, which is mimicking another individual’s movements (Miller & Mason, 2002) and (Tsuang, Faraone & Glatt, 2011). Disorganized schizophrenia Normally, disorganized behavior (as the name suggests), confused speech and flat or unsuitable affect characterizes this type of schizophrenia. The predominant feature in this subtype is disorganization of the thought process while delusions and hallucinations are less pronounced. Patients suffering from this type of schizophrenia may demonstrate substantial impairments in their capacity to sustain their daily living activities including activities such as bathing, brushing teeth or dressing among others (Miller & Mason, 2002). More often than not, emotional processes in individuals suffering from disorganized schizophrenia undergo impairment. They may exhibit a symptom that mental health professionals entitle flat or blunted affect – for instance, they may fail to express normal emotional responses in situations that arouse such responses in healthy individuals. Their ability to communicate proficiently may in addition undergo substantial impairment and their speech may at times become virtually inexplicable due to their disorganized thinking. As opposed to characterizing their speech with articulation or annunciation difficulties in such cases, problems with usage and ordering of words in conversational statements characterize it (Siegel, Ralph & Ralph 2010). Paranoid schizophrenia The major attribute of this category of schizophrenia is a preoccupation or an obsession with either a single or multiple delusions or unremitting auditory hallucinations. Normally, paranoid delusions are grandiose or persecutory in nature, although other delusions may occur. An individual suffering from paranoid schizophrenia may in addition to these features harbor a sense of unremitting suspicion and may appear to be reserved, guarded and tense to the extent of being vague or even mute. Although patients suffering from this kind of schizophrenia generally exhibits hallucinations and/or delusions, they may also exhibit other clinical features in varying degrees including hostility, aggression and even violence. They normally show only mild impairments if any no neuropsychological tests and in comparison with patients suffering from other schizophrenia subtypes, their long-term prognosis is typically better (Tsuang, Faraone and Glatt, 2011). Undifferentiated Schizophrenia The diagnosis of undifferentiated subtype takes place in the event that a patient manifests symptoms of schizophrenia that are not adequately formed or specific enough to allow categorization of the illness particularly into one of the other schizophrenia subtypes. While some patients with this subtype may exhibit symptoms that show a discrepancy at varying points in time resulting into uncertainty as to their exact subtype classification, others manifest outstandingly stable symptoms over time that yet fail to fall into any of the typical pictures of schizophrenia subtypes. The best account for the mixed clinical syndrome in either of the aforementioned instances is diagnosing undifferentiated schizophrenia (Siegel, Ralph & Ralph 2010). Residual Schizophrenia This form of schizophrenia is diagnosed in a condition where a patient has ceased exhibiting prominent schizophrenic symptoms. Therefore, a general decrease in severity of schizophrenic symptoms characterizes this subtype. In other terms, although idiosyncratic behaviors, hallucinations and delusions may still be evident in a patient, as opposed to the acute phase of the illness, their manifestations are significantly lessened (Siegel, Ralph & Ralph 2010) and (Tsuang, Faraone & Glatt, 2011). Signs and Symptoms of Schizophrenia In most cases, individuals suffering from schizophrenia have such ‘neurological soft-signs’ as ineptness, migration disorders, and dysgraphaesthesia. Current research also indicates that in childhood, soft signs such as dyskinesias and gait commotions might be conspicuous before the beginning of intricate psychotic signs and symptoms. These signs are mostly evident in children who are at the danger of developing schizophrenia. This is an indication that the symptoms of this mental disorder may pre-date the ensuing phase, referred to as the active or psychotic phase of the disoder (Green, 2007). As Long (2009) explains, this psychotic stage mostly lasts for at least one month and if treated productively, it could take less time. Schizophrenia is also known to cause mutilation in occupational and/or social functioning, which lasts for not less than six months. It is important to note that medical condition, the use of illegal drugs or medications do not cause the psychotic phase. Another symptom of schizophrenia is auditory hallucinations. Auditory hallucinations are false perceptions typically in the form of noises or voices talking about the individual or remarking on his/her thoughts or actions in the third person. An individual with schizophrenia in addition develops thinking disorders whereby they may feel as if either someone has put thoughts into their mind or has withdrawn thoughts from their mind. At times, the patient may have the feeling that their thoughts are being broadcast in a way that other individuals are able to hear them, usually over long distances (Birchwood, Birchwood & Jackson, 2001). According to Long (2009), patients suffering from schizophrenia may develop such disposition abnormalities as laughing, unsuitable smiling, anxiety, stupid facial expressions, depression, anger, striking loss of enjoyment or interest, sleeping late into the day and staying up late into the night, declining food because of delusional beliefs or a lack of interest in eating. Moreover, the movement of these patients is usually anomalous for instance, rocking, pacing, or apathetic serenity. Generally, there are striking cognitive impairments such as impaired problem-solving ability, poor memory, as well as poor concentration. Many individuals with Schizophrenia do not have the awareness that they are suffering from a psychotic disorder, a poor perception that is neurologically brought about by illness, rather than simply being a surviving behavior. Moreover, this poor perception disposes the patient to nonconformity with medication, which is prognostic of higher worsening rates, increased number of instinctive hospitalizations, poorer functioning as well as a poorer course of illness. Another major symptom of schizophrenia involves volitional and emotional changes. In this situation, an individual’s feelings as well as emotions become blurred and are usually expressed as being ‘flat.’ The indivudual may also experience a loss of initiative or energy. These changes are from time to time referred to as ‘negative symptoms. Other symptoms according to Green (2007) include insertion, tameness phenomena, broadcasting, thought reverberation, withdrawal, unrelenting illusions, third person hallucinations, in addition to delusional sensitivity. Tsuang, Faraone and Glatt (2011) offer this explanation: negative symptoms of schizophrenia point to imperative behaviors, which are isolated from the behavioral repertoire. These negative symptoms signify lack of emotions and feelings, loss of normal behaviors in addition to blunted effect. These include alogia (speech disruption or poverty), avolition (unwillingness to interact with the world), flattening/affective blunting (lack of the ability to express emotions), asociality (the preference for isolation), anhedonia (lack of the ability to experience pleasure), and catatonia (a group of four motor and cognitive symptoms). Negative symptoms prevail during the prodromal and residual stages of the disorder. The prodromal stage usually precedes the first active phase while the residual stage succeeds the active phase. Tsuang, Faraone and Glatt (2011) further define positive symptoms as symptoms that emerge as unseen behaviors in the normal repertoire of human activities. These symptoms prevail at some stage in the disorder’s active phase, when the individual is most disruptive as well as disturbed. During the active phase, the affected patient is most probable to be referred for hospitalization or care since typically; they will be doing or saying things that worry the people around them. Tsuang, Faraone and Glatt further classify hallucinations as positive schizophrenic symptoms, which designate the production of strange phenomena. Compared to positive symptoms, they explain, negative symptoms are typically less identified and treated and although they bring about significant disability to the victims, they are less disruptive to others. Another symptom of schizophrenia is delusions. Delusions are false personal beliefs about the world, which embody beliefs that the individual’s cultural peer group do not share. Generally, delusions in schizophrenia are of diverse types. The first type is referred to as delusions of identity whereby a person may believe that they have lost their sense of identity or purpose and that they possess extra-ordinary abilities/powers. The second type is referred to as delusions of control or influence characterized by a person feeling and believing that some external force control or influence their behavior. The third type is known as delusion of persecution. In this type, an individual may embrace the belief that in some way, they are being persecuted, followed or watched. Delusions of reference are the fourth type of delusion. In this type, an individual may hold the belief that other people’s comments are directed to them (Birchwood, Birchwood & Jackson, 2001). As is the case with hallucinations, Tsuang, Faraone and Glatt (2011) classify delusions as positive schizophrenic symptoms, which designate the production of strange phenomena. From the aforementioned delusions of identity stems another symptom that is common in persons suffering from schizophrenia, which is the individual’s experience of control. In this situation, the individual feels as if an alien power or force is controlling them. They may also feel as if an external force has come into their mind or body. Usually, this is interpreted as the presence of implanted radio transmitters, X-Rays or spirits (Birchwood, Birchwood & Jackson, 2001). Diagnosis of Schizophrenia There is no laboratory test that has been established for the diagnosis of schizophrenia. All the same, individuals suffering from this mental condition often display a number of non-diagnostic neurological anomalies. For instance, their sequential lobe and thalamus’ volume appears to be lessened, their cavum septum pellucidi is large; they develop a swelling of the lateral ventricles, reduced brain tissue as well as hypofrontality. Furthermore, upon going through psychological testing, these people display such numerous cognitive shortfall s as saccadic eye movements, changes in brain laterality, poor memory, irregular smooth pursuit, complexity in changing reaction set, abnormalities in suggested potential electrocephalograms, poor attention, reduced response time, and impairment in sensory gating (Long, 2009). Before arriving at a diagnosis of schizophrenia, physicians must ascertain that they carry out a thorough psychiatric assessment comprising a physical examination, an examination of mental status, a medical evaluation, along with suitable laboratory tests. They should in addition carry out an evaluation of the illness’ full history, which takes in any variations in thinking, behavior, mood, movement and sensory perceptions that the patient him/herself or their family and friends observe. It is also obligatory to exclude other diagnoses, as a rule – this is in consideration of the fact that other psychotic disorders including substance abuse, bipolar disorder, major depression among other medical illnesses exhibit numerous symptoms analogous to those of schizophrenia. Doctors must therefore eliminate these possibilities before diagnosing schizoaffective disorder or schizophrenia (Miller & Mason, 2002). In order to be able to perform the diagnosis of schizophrenia, two or more of the following symptoms must be identified: muddled speech, delusions, hallucinations, catatonic or grossly disorganized actions. Occupational and/or social malfunction must also be prevalent. Additionally, the patient must have been ill for not less than six months. Conversely, the differential identification of a sensitive incidence of psychosis is not only wide, but it is also challenging. Upon the elimination of a substance-linked or medical case, the greatest task lies in distinguishing schizophrenia from schizoaffective illness. That is, a mood illness with psychotic aspects, a delusional disorder or a personality disorder. Persons suffering from schizophrenia sometimes declare seeing demons especially at night, in addition to often talking to invisible persons and these clearly add weight on the afore-described symptoms and signs (Podosyan, 2009). Gilmore (2010) explains that the diagnosis of schizophrenia is normally achieved with the aid of an individual’s longitudinal examination. This means that the structure of the illness while making a diagnosis is as imperative as its content. Scales such as the brief psychiatric-rating scale can be helpful in ranking schizophrenia. The scales approximate the course of the disorder or its clinical response to treatment. Four known diagnostic characteristics linked with the disorder include ambivalence; loosening of associations (also known as the thought disorder); autism and blunted affect (also known as a restricted range of affect). in untreated conditions, inability to make decisions or ambivalence was a frequently phenomenon. For instance, a patient may drift on the doorsill of a doorway for many hours, uncertain of whether to go out or get in. Autism has to do with a recoil into an internal world, indecipherable to the outsider (Green, 2007). Presently, physicians cannot base the diagnosis of schizophrenia on a diagnostic test or the results of lab assessment owing to the fact that the many theories that abound regarding its causes are yet to be validated. Instead, the modern diagnosis for this disorder is based on descriptive behavior patterns in addition to dependably accessible psychopathology. From the year 1980, definitions of major mental illnesses are catalogued in the form of the American Psychiatric Association’s Diagnostic and Statistical Manual (DSM) and the International Classification of Diseases (ICD) of World Health Organization in other countries. Occasionally, these definitions are revised to reflect contemporary conceptualizations of the relatedness or distinctness of particular illnesses as compared to others, or to reflect knowledge advancements. Some diagnoses are usually revised, others are added from one edition to the other, while others vanish altogether, and are reinstated or listed under others afterward (Siegel, Ralph & Ralph 2010). As majority of the most recent DSM version depicts, schizophrenia’s diagnostic criteria are summed up into six sets labeled A-F. Over a hundred years ago, clinician Emil Kraepelin recognized massive disruption in perception and/or cognition as the major features of schizophrenia. Diagnostic criterion A necessitates the presence of these fundamental features in some form. Therefore, for criterion A to be considered as met, an individual must exhibit particular types of thought disorders, catatonia, delusions, auditory hallucinations, or negative symptoms. Criterion B and C demonstrates clinician Kraepelin’s belief that a chronic and increasingly worsening trend characterizes schizophrenia. For these two criteria to be considered as met; a patient must exhibit a clear indication of deterioration in social or occupational functioning and for a period of at least six months, the patient exhibits ongoing illness signs (Tsuang, Faraone and Glatt, 2011). Criterion D assists in differentiating the disorder from depressive disorder with psychotic features and full maniac thereby seeing to it that the diagnosis of schizophrenia embodies a uniform set of patients who display analogous features. In the event that a patient displays a full maniac/depressive syndrome, he/she would not get a schizophrenia diagnosis, except for when mood disturbance development occurred following the active phase of schizophrenia syndrome, or if it was brief. Both criteria E and F require that a pervasive development disorder, a general medical condition or substance use not to be used better to account for the sickness. The logic behind the requirement of these exclusions is the fact that there exists other well-known conditions whose signs and symptoms resemble those of schizophrenia (Siegel, Ralph and Ralph 2010). The worth of proper application of these criteria of diagnosis is the fact that the ability to depend on clear disturbances reduces inferences thus increasing the likelihood that self-governing clinicians can diagnose the same patient with the same disorder efficiently. This scheme therefore does not give any room for conjecture with regard to the dormant causal factors. All the same, sound clinical judgment is vital besides the assessment of the criterion that was followed in a specific case. This is because the assessment of symptoms’ presence/absence within a specific, explicit criterion with structured criteria calls for the appliance of clinical judgment. The structured diagnostic criterion in the DSM majorly focuses on the data collection section of the diagnostic process (Tsuang, Faraone and Glatt, 2011). Treatment of schizophrenia Since the causes of this disorder are not yet known, endeavors to treat it usually give attention to purging such symptoms of the illness as delusions along with hallucinations. An assortment of psychosocial as well as antipsychotic treatments medications comprises the treatment options for the condition. Antipsychotic treatments have been used since the middle of 1950’s., with the older medications being referred to as conventional/typical antipsychotics. Some of the typical medications commonly used for the treatment of this disorder include Haloperidol (Haldol), Chlorpromazine (Thorazine), Fluphenazine (Prolixin), as well as Perphenazine (Trilafon, Etrafon). In the 1990’s, new antipsychotic drugs (referred to as antipsychotic/ second generation or atypical medications) were discovered. A good example of these kinds of drugs is that of Clozapine/Clozaril. This drug provides treatment for breaks with reality, psychotic symptoms, as well as deliriums. Despite the fact that it is effective, this drug can occasionally bring about a serious problem referred to as agranulocytosis (the deficiency of white blood cells that are responsible for fighting infection). It is therefore recommended that if the patient is using this drug, his/her white blood cells should be examined every week or after every two weeks. The cost problem involved while carrying out the blood tests makes treatment with this drug difficult for many patients. Nonetheless, clozapine is potentially of great use for patients who fail to respond positively to other antipsychotic medications (Gogtay and Rapoport, 2008). Other atypical antipsychotics that do not lead to agranulocytosis include Olanzapine (Zyprexa), Aripiprazole (Abilify), Risperidone (Risperdal), Paliperidone (Invega), Quetiapine (Seroquel) in addition to Ziprasidone (Geodon). These drugs come with various side effects such as drowsiness; skin rashes; rapid heartbeat; dizziness while changing positions; blurred vision; menstrual problems for women, side effects that have an effect on the patient’s physical movement for instance restlessness, sensitivity to the sun, tremors, rigidity, and constant muscle spasms. In most patients, the aforementioned side effects fade away later and it becomes easier to manage them efficiently. Alterations in metabolism of the patient along with major increase in weight can also ensue from using these atypical antipsychotic medications, which may promote the risk of the patient suffering from high levels of cholesterol and diabetes. There is therefore dire need of having the doctor monitoring the weight, glucose and lipid levels of the patient as many times as possible (Lieberman, et al., 2005). Antipsychotic medication restrains the time of psychosis in Schizophrenia, in addition to preventing recurrences. Normally, it takes a significantly long period prior to individual’s admittance of the fact that they have this disorder and that they require medication. Once an individual stops taking their antipsychotic medication, it may take months before he/she suffers a psychotic relapse. An increased cerebral mutilation characterizes the period after each psychotic relapse. For revival from Schizophrenia, enduring treatment with antipsychotic medication is indispensable. Additionally, individuals suffering from the disorder need lasting financial as well as emotional support from their relatives (Long, 2009). In fact, psychosocial therapies, including psycho-education and attention, family support, stable reality-oriented psychotherapy, details of living situation, and vocational skills training are critical to the long-term management of patients suffering from this disorder (Podosyan, 2009). It is important to note that the life expectancy of people suffering from schizophrenia is shorter compared to that of the broad population owing to diverse reasons. For example, about ten percent of patients with this disorder commit suicide and between twenty to forty percent make not less than one attempt to commit suicide. There is an increased danger of the patient engaging in assaultive/aggressive behavior, with the main brutal behavior predictors being younger age, refusal to conform to antipsychotic medication, excessive drugs and substance abuse, male gender as well as history of hostility. On the contrary, most patients suffering from this mental disorder are less dangerous to some individuals as compared to the general populace. Apparently, alcoholism and drug abuse deteriorate the course of schizophrenia – approximately eighty to ninety percent of people with schizophrenia are usual smokers of cigarettes (Long, 2009). Conclusion Schizophrenia is a serious disorder that needs a close and insightful examination. It may kick off in teenage and through to the mid- old age. The disorder’s symptoms as well as its diagnostic criteria vary widely from one individual to the other. It is imperative to take the proper measures to treat the disorder, not just its symptoms by using the normal medication, but through psychological therapies. This is because it is widely believed that various patients suffering from the disorder will often react negatively to some of the medications. Other strategies that healthcare professionals should apply in the management of this disorder include counseling schizophrenic patients and helping them avoid drugs and alcohol as these aggravates the conditions of the disorder. Although over the years scientists have extensively learned about schizophrenia, they still have the challenge of conducting deeper and rigorous research aimed towards elucidating the development of this disorder. This rhymes with Gilmore’s (2010) assertion that the best way of comprehending as well as preventing schizophrenia is not by over-concentrating on the genes or risk factors themselves but by concentrating on the disorder’s developmental route, which is the ultimate usual pathway to the illness. It is very important for the healthcare professionals engaged in this research to determine the way in which the already recognized genetic in addition to environmental risk factors interfere with regular paths of development in individuals suffering from schizophrenia. Furthermore, they should have a good understanding of the epochs of the human brain development that are crucial for synapse as well as circuit development. Additionally, there is dire need to deem schizophrenia as a major concern in public health as Tsuang, Faraone & Glatt (2011) suggests especially so considering the fact that this disorder is so severe and that many individuals happen to suffer from it at some stage of their lives. It is also worth noting the fact that although the cause of schizophrenia is not clearly determined or known, it is very possible to help the affected individuals live better lives than many of them do at present. In effect, one cannot overemphasize that humanity should not stigmatize such individuals suffering from schizophrenia, as is the case in many societies where they are censured to live in jails or in the streets among other severe and/or life threatening conditions. References Birchwood, M. J., Birchwood, M. & Jackson, C. (2001). Schizophrenia. Portland, OR: Psychology Press. Cardno, A. G. and Gottesman II, (2000). 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