Debating the Symptoms of Schizophrenia - Essay Example

Schizophrenia Introduction Frankenberg 2007 describes schizophrenia as a “severe and persistent debilitating psychiatric disorder”. There is limitedunderstanding of schizophrenia, with the possibility that it is a combination of many diseases. Symptoms that are associated with schizophrenia are those that arise from disruptions in the thought process or cognitive abilities, mood, perceptions and the social relationships with other people. The most debilitating symptom of schizophrenia is the deficits of information processing demonstrated by these patients. The major concern with schizophrenia is the reduction of the quality of life that they enjoy with lower rates of employment, disrupted marriages and the reduced ability to live independently (Frankenberg, 2007). Prevalence of Schizophrenia Schizophrenia ranks among the top ten diseases that are responsible for causing disability among the population of the world. It affects all kinds of people irrespective of colour, caste, creed and culture, though there is a trend of higher prevalence in the developed world and among migrants (Saha et al, 2005). Estimates on the worldwide prevalence of schizophrenia put the prevalence rate at 1.1% making for about 51 million people suffering from the disorder around the world. The prevalence rate of schizophrenia in Australia is almost similar to the worldwide prevalence rate, which gives an estimated 285,000 people afflicted with the disorder in Australia (Schizophrenia Facts and Statistics). Aetiology of Schizophrenia The aetiology of schizophrenia still remains an enigma, as there is limited clarity in it. Genetics and perinatal nutritional stress have remained the main postulated aetiologies of schizophrenia. The postulation of a genetic basis in the aetiology of schizophrenia stems from the studies conducted into schizophrenia in dizygotic and monozygotic twins, wherein it was found that the concordance for schizophrenia is nearly ten percent, whereas it was close to fifty percent in the case of monozygotic twins (Frankenberg, 2007). Nutritional deficiencies occur frequently during pregnancies. There is evidence to suggest that in utero exposure deficiencies in nutrition increase vulnerability to schizophrenia, as a result of disruption of neurodevelopment. This is the basis of the perinatal nutritional stress aetiology in schizophrenia. Evidence in support of this postulation has come from the studies into the association of the perinatal stress during the Dutch Hunger Winter of 1944-1945 and the severe famine in China. The nutrients whose deficiency is suggested to be associated with the increased vulnerability to schizophrenia include folate, essential fatty acids, retinoids, vitamin D and iron (Brown & Susser, 2008). This nutritional aspect in the aetiology of schizophrenia has also led to the postulation that dietetic factors have a role to play in the aetiology of schizophrenia and the example provided is diets of vegetable tubers that contain steroidal glycoalkaloids (SGAs), which has possible teratogenic and cell membrane damaging properties (Christie, 1999). Treatment Modalities Schizophrenia is a chronic disease for which there is no definite cure. Hence the objective in the treatment of schizophrenia is to assist the patients with schizophrenia to achieve as far as possible a productive and personally meaningful life. Such an approach requires pharmacological interventions that reduce the manifestations of the disease, psychological strategies that enhance adaptive skills and social support services that optimize functioning and quality of life of the individual (Tandon et al, 2006). Antipsychotic medications or neuroleptic drugs have been the traditional pharmacological intervention for schizophrenia, with its potential to reduce the symptoms of schizophrenia (Frankenburg, 2007). Recent advances pharmacology has resulted in a second generation of neuroleptic drugs. These second generation neuroleptic drugs are clozapine, olanzapine, amisulpride and risperidone. However the benefits of the second generation neuroleptic drugs over the first generation neuroleptic drugs have not been fully accepted and there also issues over side effects. The gains of the second generation neuroleptic drugs over the first generation neuroleptic drugs are small. The side effects associated with clozapine and olanzapine is a substantial increase in weight, while the side effects of amisulpride and risperidone are considerably enhanced levels of prolactin. Taking these factors into consideration the pharmacological interventions in schizophrenia include the need for taking onto consideration the risk benefit ratio and individual patient considerations (Busko, 2008). Nursing Interventions Nursing interventions in schizophrenia need to be considered from two perspectives. The first perspective is the patient and the patient care needs and the second is the family of the patient and the support that could be provided to the family by nursing interventions. The treatment of schizophrenia involves pharmacological interventions, psychological strategies social support services that optimize functioning and quality of life of the individual. Patients with schizophrenia tend to neglect their medications and the nursing intervention in the pharmacological intervention essentially is on encouraging and ensuring that the patient maintains the prescribed drug regimen. It is in the social support services to improve the quality of life that nursing has a prominent role to play. Social skill training can be provided by the nursing professionals. This training includes interpersonal relationship skills and self-assertiveness skills. This training assists in improving not just the social skills of a patient with schizophrenia, but also assists in enhancing the self esteem that the patient has (Seo et al, 2007). An area where nursing intervention stands out prominently is with the family of a patient with schizophrenia. Schizophrenia is a chronic illness, which has lifetime emotional, social and financial consequences that have an important effect on the family of the patient. These families can feel care burden, fear and embarrassment with regard to the signs and symptoms of the disorder, lack of knowledge of the disease and its course, lack of social support and social stigma of the disorder. Nursing interventions with the family members can assist in removing many of these feelings of insecurity and insufficiency in the face of the disorder. Listening to their fears and emotions, communicating with them and educating then on the disorder and the course of the disease and providing them with the support that they require go a long way in making them more self-sufficient in coping with this disorder in a loved one and thereby providing support and encouragement to the patient (Brady & McCain, 2005). Literary References Brady, N. & McCain, G. C. 2005, ‘Living With Schizophrenia: A Family Perspective’, Online Journal of Issues in Nursing, vol.19, no.1 [Online] Available at: http://www.medscape.com/viewarticle/499269 (Accessed on November 30, 2008). Brown, A. S. & Susser, E. S. 2008, ‘Prenatal Nutritional Deficiency and Risk of Adult Schizophrenia’, Schizophrenia Bulletin, vol.34, no.6, pp.1054-1063. Busko, M. 2008, ‘Small Differences in Efficacy Among Second-Generation Antipsychotics for Schizophrenia’, Medscape Medical News, Medscape Today [Online] Available at: http://www.medscape.com/viewarticle/584391 (Accessed on November 30, 2008). Christie, A. C.1999, ‘Schizophrenia: is the potato the environmental culprit?’ Medical hypotheses, vol.53, no.1, pp.80-86. Frankenberg, F. R. 2007, ‘Schizophrenia’, emedicine from WebMD [Online] Available at: http://www.emedicine.com/med/TOPIC2072.HTM (Accessed on November 30, 2008). Saha, S., Chant, D., Welham, J. & Mcgrath, J. 2005,’ A systematic review of the prevalence of schizophrenia’, PLoS medicine, vol.2, no.5, pp.141-142. ‘Schizophrenia Facts and Statistics’, 2008, schizophrenia.com [Online] Available at: http://www.schizophrenia.com/szfacts.htm (Accessed on November 30, 2008). Seo, J. M., Ahn, S., Byun, E. K. & Kim, C. K. 2007, Social skills training as nursing intervention to improve the social skills and self-esteem of inpatients with chronic schizophrenia’, Archives of psychiatric nursing, vol.21, no.6, pp.317-326. Tandon, R., Targum, S. D., Nasrallah, H. A. & Ross, R. 2006, ‘Strategies for maximizing clinical effectiveness in the treatment of schizophrenia’, Journal of psychiatric practice, vol.12, no.6, pp.348-363. Read More