Diagnosis and Treatment of Schizophrenia - Coursework Example

Schizophrenia

Definition

According to Insel, schizophrenia is a form of psychotic disorder usually referred to as mental illness. It is a long-term persistent brain condition disorder, which manifests differently in every individual and can cause disability hence limiting the patient’s productivity. This condition can be traced to mental health in health science discipline where the patient is unconscious of his/her thoughts, memories, perceptions and feelings (189). According to Parekh Ranna’s article in America Psychiatric Association, about 1% of the world’s population has schizophrenia condition and according to gender, males are more affected than female but the reasons for this are still under research thus not clear yet (53). He adds that the life expectancy for schizophrenia patients is approximated to be 25 years minus of those who do not have the condition. Schizophrenia has been ranked the third cause of disability because it is associated with suicide and obesity because it comes with a life style with limited physical activity. Bademl points out that schizophrenia causes burden in the family. This is evident because of the expensive cost of management hence causing strain in family finances. Patients require constant care from family members and at times even the community at large. To the parents and caregivers, it can lead to stress hence giving way to other opportunistic diseases and conditions like ulcers (53).

Coyle extensively explains that in Eugen Bleuler’s attempt to distinguish memory, personality, thinking and perception based on function, he came up with the word schizophrenia in 1908. He originated the word from Greek specifically the words schizein and phrēn meaning split and mind respectively hence schizophrenia patients were initially referred to as people with split personality. The history of schizophrenia cannot be traced because of limited literature but disorderly behavior coupled with a physical disability was evident in the past. Schizophrenia occurs worldwide and has no definite geographical or race existence (920). International Classification of Diseases (ICD-10) manual classify schizophrenia as below:

• Paranoid schizophrenia- is the most common and develops at later developmental stages characterized by positive symptoms but at times negative symptoms can be evident
• Disorganized or hebephrenic schizophrenia- characterized mostly by both cognitive and negative symptoms with short lasting positive symptoms and it develops between ages 15-25 years.
• Catatonic schizophrenia- this is the rarest type compared to other types. The patient may be extremely withdrawn but at times excessively happy and, at times on the contrary, because it is believed to have been developed from untreated schizophrenia condition.
• Undifferentiated schizophrenia- the patient shows symptoms of all the above classifications and hence cannot be identified in any specific one.Residual schizophrenia- this is considered hereditary predisposing negative symptoms.
• Simple schizophrenia- characterized by negative symptoms with high progress rate and rare positive symptoms. Though schizophrenia has no geographical boundaries, it is reported to be rare in the UK.
• Cenesthopathic schizophrenia- a patient has abnormal bodily sensation.
• Childhood early schizophrenia- it is a serious kind but rare occurring to children who are 10years and below
• Schizophrenia spectrum disorder- characterized by both positive and negative symptoms.

Signs and symptoms

Rotarska-Jagiela classified schizophrenia symptoms into cognitive, negative and positive symptoms (27). These are differentiated in the table below:

Cognitive

Negative

Positive

Patients have scanty ability to understand information to make rational decisions. They have difficulty in lasting focus and or paying attention thus has limited ability to memory.

Patients have limited speech and emotional expressions like facial and voice expressions commonly called “flat effect.” They also pose reduced feelings of pleasure with difficulty beginning and sustaining activities.

The patient lives in an illusion world far from reality thus hallucinating and disillusions making them have dysfunctional thinking and Movement Disorders.

According to the above table, Rotarska-Jagiela said that most patient experience moderate server- positive symptoms as opposed to the negative symptoms. Patients with this condition present warning signs and behaviors like: nonsensical speech, being over the conscience of oneself, unusual body stature, change in personality, emotional imbalance, withdrawal, irritation, low concentration levels, insomnia and being over-religious (27).

Causes

Van Os highlights that the predisposing factors of schizophrenia are not known but they have been theoretically classified broadly as environmental and genetic factors. He further classifies environmental factors in terms of developmental factors and substance abuse as possible influencers (200). Lisman informs that like other conditions like sickle cell, scientists believe that schizophrenia is inherited from carriers. They argue that it is caused by a collection of defective neurotransmitters or genes in the body. Despite this, up to date genetics cannot prove genes that are capable of causing schizophrenia. Because it thrives well during late adolescent to the early adult hood in young teenagers, it is believed to develop when the body is undergoing hormonal and physical changes (540). van Os informs that women who engage in substance abuse like alcohol, cigarette and cocaine among others put their children at risk of having schizophrenia. It is also proposed that a combination of environmental and genetic factors one is exposed to put one at higher risk of developing schizophrenia (210). Scientist state that too much stress and information and or knowledge in terms of education can cause someone develops this condition because the brain cannot contain the capacity of thoughts someone has when undergoing stress. Lisman list exposure to the virus or radioactive rays, malnutrition before birth, maternal stress and problems during birth are some of the additional environmental factors that can make an individual develop this condition because these can alter their gene make up thus developing this condition (539). Some scientists have come up desired age for human beings to have a child and past that, the child stand a risk of developing medical conditions and schizophrenia has been identified as one of the possible conditions (Van Os 207).

Diagnosis and treatment

Kane says that treatment of psychotic patients is considered to encompass psychosocial interventions majorly involving antipsychotics, psychosocial treatment, Coordinated Specialty Care (CSC). Understanding psychosocial background helps the doctor to determine appropriate drug for a patient. CSC encompasses medication, family systems therapy, Assertive Community Treatment (ACT) and Cognitive Enhancement Therapy (CET). Medically, antipsychotic medications like Thiothixene, Thioridazine, Risperidone, Clozapine and Olanzapine are prescribed as first line of managing the symptoms in addition to the above-mentioned interventions. Antipsychotic medications are categorized as typical which only manage the positive symptoms and atypical which manage both positive and negative symptoms. Unfortunately, antipsychotic drugs come with side effects from mild like dizziness, loss of appetite, constipation, unclear vision and drowsiness to serious effects like tremors, reduced white blood cells count, continuous muscle contractions, diabetes risk and or obesity but help in reducing the symptoms by stabilizing chemical balances in the brain in about one to two weeks.

For patients who are unable to take medication, depot injections, which are mostly intramuscular injections like decanote ester, are preferred to control schizophrenia effects. According to American Psychiatric Association, medication should be stopped if the symptoms are not evident over a period of a year. During this period, patients are given constant guidance and counseling coupled with love and care from the people around them. In case of addicts, enrollment in rehabilitation centers is necessary where they will get wholesome guidance to quit their drug use. In our modern world, research through several clinical trials has been conducted to come with advanced solutions to deal with this condition. The clinical trials entail introduction of new drugs or trying a combination of drugs to see how the patient responds. New surgical operations are also done to determine the cause of schizophrenia and to determine which part of the brain is of main interest when prescribing treatment to patients. National Institute of Mental Health (NIMH) located in Bethesda, Maryland is known for its several researches in psychiatry, cognition, epidemiology and genetics. They also fund schizophrenia studies across the world, people can identify, and schizophrenia patients enroll in their research centers through their site called ClinicalTrials.gov or Join a Study: Adults- Schizophrenia (1115).

Prevention

Coyle explains that schizophrenia prevention has proved to be challenging over the past years because there are no base tangible markers. Nevertheless, drug abuse especially cannabis, cocaine and their derivatives should be avoided. Stress has also been identified to be one of schizophrenia causes to be managed effectively. Though caring for schizophrenia patient is challenging, in personal capacity, one can find out and enroll a patient in support group. Besides this, one can encourage them to attend to their treatment effectively and offer a listening area when needed and not showing them that their opinion is irrelevant (920). People should also advocate for more rehabilitation center and support groups to offer sufficient support required for the patients. For patient’s caregivers, they should be taught how to deal with the patient so that it does not become severe. This will help them to calm down and reduce their chances of becoming violent (Klosterkotter 169).