Mental Illness: Schizophrenia - Essay Example

Essay Schizophrenia is a biological disease caused due to disorders in the brain. It is one of the most studied disorders in the field of psychology.The history of schizophrenia is quite long and can be dated back to ancient Egypt, Greek and Roman period. The word Schizophrenia itself originated from the Greek words schizo and phrene which literally mean split mind. In the ancient days any person who had a mental illness were referred by this term and people who had a mental illness or retardation were treated likewise. The disorders were not specifically classified according to the symptoms as of today and in general mental disorders were considered to be caused by evil spirits and demons and the treatment concentrated on alleviating the evil spirit. However in 1887, a German physician Emile Kraepelin classified schizophrenia as a specific mental disorder, which then termed as dementia praecox. He believed that it was a form of dementia, which had an early onset as most of he patients were young, and manic depression was also noted as one of the symptoms. Further study on the disease was done by Eugen Bleuler who was a Swiss psychiatrist, and in 1911 he coined the term schizophrenia. He deferred from Kraepelin as he studied that the disease was not a form of dementia and that it could also have a late onset. He also classified the symptoms, some of which were earlier included by Kraepelin, as positive and negative and also subdivided the disease. Many scientists have continued to study these disorders since then and have divided the illness into five broad categories. They include disorganized, catatonic, paranoid, residual and undifferentiated. However with regard to the treatment outcome, this classification has not proved to be of much use and hence scientists are increasingly using the symptoms and progression of the disease to predict their outcome. The major causative factors of the disease is still under study and evidence that it is a biological disease due to disorders in the brain have been recently found out by imaging studies. However, conclusive proof of the cause has still not been made (The history of Schizophrenia, n.d). As the etiology of the disease is still not very clear and since the illness has very bizarre manifestations, several myths have been and are still associated with the illness such as the disease is a curse and a penance for the sins committed in the previous births and that it can only be treated only through rituals and prayers done in places of worship. Several medical misconceptions are also associated with the disease such as people with the illness have split personality, could be dangerous, are only a burden to the family as they cannot perform their normal routine, and the disease is not completely curable (Myths and misconceptions about schizophrenia, 2006). The signs and symptoms of schizophrenia have been broadly classified under three categories as positive, negative and symptoms associated with cognitive behavior. Under positive symptoms, abnormal actions, which are not performed by normal people have been included. Hallucinations are the most common sign when the person imagines hearing voices, being touched by someone or seeing people or objects which are not there. Another common symptom is delusional beliefs about people in the family, neighbors or outsiders. They would suddenly think and believe that someone would harm them or spying on them and in some cases they could even imagine themselves to be a historical figure. All these are generally due to some thought disorder and some people also exhibit movement disorders wherein the person can become very clumsy or can be catatonic, which is a state of unresponsiveness. Negative symptoms refer to reduced emotional and behavioral state and these according to medical professionals are more difficult to identify as they could be misunderstood for laziness or lack of interest. These symptoms include flat facial expressions, inability to perform routine activities effectively, disinterest in the pleasures of everyday life and lack of basic hygiene. In case of cognitive symptoms, these signs can generally be noticed only when certain neuropsychological tests are performed. These include diminished interpreting skills, difficulty in being attentive and inability to retain information or poor memory. These signs can especially affect working people as it would be increasingly difficult for them to concentrate on their work (Signs and Symptoms of Schizophrenia, 2008). Abnormality in the brain as determined by various imaging studies is being considered to be the major cause for the occurrence of the illness. The principle mode of transmission is thought to be genetic. However whether a single or multiple genes are involved is still not been ascertained. Genetic marker studies have noted that there is no major locus associated with the disorder and hence the role of several genes in susceptible people is being considered to be the major reason for the onset. There is however, evidence from neurochemical studies about the role played by three major neurotransmitters in the disorder. Abnormality in the functioning of dopaminergic, serotoninergic and glutamatergic neurotransmitters have been studied in great detail. Hyperactivity of dopamine receptors in the limbic striatum region of the brain has been determined in patients with schizophrenia. This has been found by administering drugs that both increase and decrease the levels of dopamine and this has been correlated with the symptoms. While increased dopamine activities in the limbic striatum regions is believed to cause positive symptoms, reduced levels of dopamine in the prefrontal cortex region is being related to negative symptoms. This imbalance in dopamine levels in the two regions would automatically change in case of normal humans, but if there is a lesion present between these regions then neurotransmitter balance cannot be achieved. Hence the presence of a lesion in the prefrontal cortex region has been suggested in case of schizophrenics. Thus during stressful periods reduced levels of dopamine in the limbic region could lead to psychosis. In case of serotonins, altered numbers of serotonin receptors have been found in the brain of schizophrenics and increase expression of a certain type of receptor which has an affinity for hallucinogens is believed to cause hallucinations in schizophrenic patients. In case of glutamate, the presence of antagonists such as phencyclidine to the glutamate receptor in the brain resulting in reduced glutamate levels in the cortical regions of the brains is considered to cause cognitive and negative symptoms in schizophrenics (Thomas, 2000). Given the complexity of the disease, diagnosis is generally made by performing certain psychological tests, after ruling out the presence of any other medical condition, by a psychiatrist. A general physical examination along with other laboratory test such as a CT scan is taken. The physical findings could determine the presence of the major signs and symptoms of the disease. The facial expression of the patient, their body movements and speech are normally examined. While the lab tests are usually normal for these patients, those people who have a metabolic abnormality as a result of the disease would show the corresponding abnormal result. Diagnosis can be greatly aided by family members and friends by providing the doctor with details about the behavioral changes and other abnormal activities of the patient. Previous history of illness and medication is also obtained. In certain cases, medications prescribed for schizophrenia can cause certain abnormality in the patient, which should be discontinued immediately (Chakraburtty, 2007). Antipsychotic drugs have been the treatment of choice for patients with schizophrenia as patients show a considerable level of improvement. The dosage and type of medication is based on the symptoms of the individual as it may greatly vary from one person to another. Newer drugs such as risperidone are being introduced as older drugs like clozapine usually have higher side effects. The new drugs are believed to have lesser side effects. These drugs work by reducing the delusions and hallucinations but are not very effective for depression related symptoms. In such case antidepressants will have to be included in the medication. Antipsychotic drugs, however do not completely prevent relapses of schizophrenia and hence they would have to be taken as a life long treatment. The dosage would however be less than that which is prescribed during the illness. Discontinuation of medication usually results in relapse of the disease. In addition to drug therapy, other non-medication treatments such as rehabilitation programs which provide work training and to improve social skills of the patient and personality development programs are also provided for those who have had previous episodes of schizophrenia. In addition individual psychotherapy which aims to help the patient cope with the illness through thought sharing process also provides good support to the individual. Cognitive and behavioral therapy to improve the patient’s interpretation of reality is also employed to help the patient come out of the illness. Another important aspect of the treatment is family education through which adequate counseling is provided to family members about patient care and the important role played by the family members in the treatment process (Treatment of Scizophrenia). In conclusion, given the complexity of the illness and the fact that the cause is still not fully determined, considerable advances have been made for the treatment of the disease. The percentage of people treated successfully is much more at present than in the past. This can be attributed to the wide range of additional treatments available at present than in the past. All these help prevent a relapse of the disease thus contributing to better prognosis. Additionally better awareness about the disease is being created due to which the patient gets the support of the family which is extremely vital for the treatment to be successful. This was not the case in past, when a large number of myths and misconceptions were believed to be the cause for the disease. More potential treatment procedures are being developed along with research being carried out to find out the exact cause for the occurrence of the illness. If these are realized in future, more better treatments can be afforded to patients. Reference: 1. The history of Schizophrenia. (n.d). Retrieved August 24, 2009, from http://www.schizophrenia.com/history.htm 2. Myths and misconceptions about schizophrenia. (2006). Mental Health and Substance Abuse. Retrieved August 24, 2009, from http://www.searo.who.int/en/Section1174/Section1199/Section1567/Section1827_8050.htm 3. Signs and Symptoms of Schizophrenia. (2008). Retrieved August 24, 2009, from http://www.schizophreniatreatment.com/articles/140/Signs-and-Symptoms-of- Schizophrenia 4. Thomas, S. (2000). The Aetiology of Schizophrenia. Retrieved August 24, 2009, from http://priory.com/psych/aetioschiz.htm#Introduction 5. Chakraburtty, A. (2007). Schizophrenia Tests. Retrieved August 24, 2009, from http://www.webmd.com/schizophrenia/guide/schizophrenia-tests 6. Treatment of Scizophrenia. Retrieved August 24, 2009, from http://www.psychologyinfo.com/schizophrenia/treatment.htm Read More