A Chronic Mental Disorder - Essay Example

Paranoid Schizophrenia: A Chronic Mental Disorder Introduction The term ‘abnormal’ has been a topic for incessant research because “determining whatis normal is a surprisingly difficult task” (Smoller, 2012, Ch. 1). Schizophrenia is a brain disorder that is characterized by abnormal behaviour and irregular mental functions. Schizophrenia disorders are mostly found in adults. Among the total cases of schizophrenia disorders, children aged fifteen and below constitute only 4% whereas children under the age of ten represent 0.1-1%. Schizophrenia is a chronic psychiatric disorder not easily diagnosed in its initial stages because of many reasons including social stigma. Symptoms of the disorder vary from mild thought disorder to severe hallucinations. The person suffering from Schizophrenia may show risky behaviours like substance abuse and aggressiveness or sometimes suicidal or homicidal tendencies. Studies reveal that both ‘nature and nurture’ contribute to the development of schizophrenia to a great extent, and hence the disorder cannot be attributed to a single cause. This paper will discuss schizophrenia in detail giving emphasis to its subtype paranoid schizophrenia with reference to empirical research findings on the disease’s nature- nurture correlation. This will also analyse major symptoms of the abnormal behaviour and the best treatment approach. Symptoms and characteristics The common symptoms of paranoid schizophrenia include delusions, auditory hallucinations, anger, emotional distance, anxiety, argumentativeness, violence, suicidal thoughts, and self-important or condescending manner. Among these, delusions and auditory hallucinations are the key symptoms of paranoid schizophrenia (Coon & Mitterer et al, 2010, p. 465). According to Diagnostic and Statistical Manual of Mental Disorders, DSM-IV code 295.30, paranoid schizophrenia is defined as a subtype of schizophrenia. Paranoid schizophrenia is the most common type of schizophrenia (Alloy, Riskind & Manos, 2006, p. 402). One of the major characteristics of the illness is that this generally occurs in youngsters in their late 20’s to 30’s. At the initial stage of the disorder, the affected persons may live and function normally in the society. The main features of paranoid schizophrenia are “a preoccupation with one or more delusions or frequent auditory hallucinations, but nothing prominent in terms of disorganized speech, flat or inappropriate emotions” (PsychNet-UK). Results of various empirical researches show that when a person gets affected by paranoid schizophrenia, his ability to think and function in daily life would be better when compared to people with other types of schizophrenia. In other words, the patient with paranoid schizophrenia may not suffer too much problems with concentration, memory, or dulled emotions (Nordahl & Carter et al, 2001). Although, it is a dreadful and chronic disease, affected persons can manage the symptoms of paranoid schizophrenia and lead a happy and healthy life if they get effective treatment on time. It is common in paranoid schizophrenia that the patient may experience the delusion that somebody is pursuing him for harm. For instance, the affected person may believe that his workmate is trying to attack him or someone is monitoring every move he makes. The patient may also feel that he is famous or that he has a strong relationship with a famous person. This type of delusion may lead to aggression or violence since the person is always concerned about self defence. An auditory hallucination is an illusion of sound or voice. This sound may be a single voice or an array of voices. The person may hear rude comments about his real or imagined faults. Sometimes, these unreal voices may command the patients to act violently. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM), the diagnostic criteria for paranoid schizophrenia include frequent auditory hallucinations and a preoccupation with one or more delusions. Researchers converge at the point that diagnosing paranoid schizophrenia is difficult since many other mental disorders have similar symptoms. The patient has to undergo various tests including physical exams, laboratory tests, and psychological evaluation during diagnosis. Nature vs. Nurture Studies point to the existence of a strong link between paranoid schizophrenia and genetic components of an affected person. This means, when compared to the general population, the biological relatives of a patient is more likely to get affected by paranoid schizophrenia. This threat is ten times higher in families with an average rate of 4 and 14 % possibility of life time risk. However, studies conducted on identical twins reveal that schizophrenia is not a strictly genetic disease because if one twin has the disorder, the other has only 53% chances of getting it whereas in fraternal twins, it is about 15 % (Tsuang, Faraone & Glatt, 2011, pp. 35-36 ). The adoption studies conducted by Dr. Ketty nad Schulsinger have also revealed that schizophrenia is often transmitted to biological relatives of the patients through genes, and learning or bad parenting do not contribute to the illness much (Ibid, p. 38). According to some researchers like Andreasen (1999, p. 645), schizophrenia probably is the result of ‘multiple `hits’ which include “inherited genetic factors and external, nongenetic factors that affect the regulation and expression of genes governing brain function or that injure the brain directly" (as cited in Norman et al, 2001). Some recent findings also approve this nature and nurture correlation in schizophrenia. According to the findings of Johns Hopkins University researchers, neither a ‘single genetic risk factor’ nor a single ‘traumatic environment in very early childhood’ alone may cause a person to develop mental illness like schizophrenia (Pederson, 2012). However, the study also points that people having such background are more prone to the disease when compared to others. The study was conducted on genetically engineered mice and the genomes of thousands of patients with schizophrenia. The study results assert that genetic factors together with environmental stress right after birth can cause abnormal brain development and thus increase the risk of developing schizophrenia (Ibid). Although gene-environment interplay is evident in schizophrenia, it is difficult to measure their proportional contribution in this regard. However, some are of the opinion that genetic effect accounts for about 80 % of variance (McGuffin, 2004). When it comes to environmental factors, variety of social stressors like suppressed emotions, unfortunate life events, ‘obstetric complications, and cannabis smoking’ also contribute to the development of the disease (Ibid). Treatment and prognosis Though medical model still exists as the primary way of handling mental health problems, health professionals have started acknowledging the role of social and environmental factors in the illness. Like most other mental illnesses, schizophrenia also is influenced by both internal and external factors. Therefore, it is necessary to ensure the use of medication and management of social and environmental factors. Thus, evidently, an integrative-eclectic approach will be the best approach in the case of schizophrenia. It is not advisable to rely on any particular orientation or treatment, but rather act according to the known situation. This approach in broader sense involves education for the family members, relative group gathering, and family session in home (Kuipers, Berkowitz & Leff, 1985). Other main treatment options for paranoid schizophrenia include medications, hospitalization, vocational skills training, electroconvulsive therapy (ECT), and psychotherapy (Mosher & Menn, 1978). However, among these, medications constitute the important role in the treatment. The most commonly prescribed medication treatment options for this disease are first generation (typical) antipsychotics and second generation (atypical) antipsychotics. Similarly, major psychotherapy options for paranoid schizophrenia include individual therapy and family therapy. Hospitalization is the only recommendable option when the patient’s condition reiterates. This is to ensure the patient’s safety, proper sleep, nutrition, and hygiene. Under ECT method, electric shock is administered to patient’s brain in order to make changes in his brain chemistry. As compared to later-onset schizophrenia, childhood schizophrenia has a more severe prognosis primarily because it poses specific threats to diagnosis, treatment, and personal development. Children with schizophrenia are unable to adapt to their social surroundings and to maintain social skill such as educational abilities. Prevention of childhood schizophrenia is less possible because many of the early signs of this disorder are very similar to the signs of other disorders. In this context it is relevant to quote from Smoller (2012); “The developing brain passes through sensitive periods when experiences can set or redirect the course of our lives”. Medications such as atypical antipsychotics and conventional antipsychotics and psychotherapy are currently employed to control schizophrenia in children. Some recent studies support the use of Aripiprazole for treating childhood schizophrenia mainly because it does not result in hyperprolactinemia. Conclusions Paranoid Schizophrenia is a chronic disease. This disease may lead to a series of complications such as depression, self-destructive behaviour, family conflicts, homelessness, and incarceration. However, this illness is controllable if the patient gets timely and effective treatment along with social support. It runs in families as genetic factors play a major role in the development of this disease. Several social stressors also may contribute to this possibility. Psychological examinations along with physical and laboratory tests can diagnose this mental disorder. Although schizophrenia rarely occurs in children, paediatric schizophrenia is very difficult to manage. People suffering from schizophrenia abstain from social activities and they are likely to live isolated. The victims should obtain better support from family members and treatment team because this mental disorder that can have serious impacts on their daily life. In addition, perfect care may assist individuals with schizophrenia to effectively adapt to their social surroundings and live without depending on others. When considering the complications of the disease, integrative-eclectic approach seems applicable. References Alloy, L. B, Riskind, J. H & Manos, M. J. 1975. Abnormal Psychology: Current Perspectives. New York: Tata McGraw-Hill. Coon, D, Mitterer, J, Brown, P, Malik, R & McKenzie, S. 2009. Psychology: A Journey. US: Nelson Education. Kuipers, L., Berkowitz, R & Leff, J. 1985. “Helping Families of Schizophrenic Patients: An Eclectic Approach”. Epidemiology and Community Psychiatry, 509-515. McGuffin, P. 2004. “Nature and nurture interplay: Schizophrenia”. Psychiatr Prax. 31 (2):S189-93. Mosher, L. R & Menn, A. 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