Schizophrenia

Schizophrenia – How it Came to be Today  

The condition Schizophrenia is a severe and chronic mental disorder wherein it affects how the person behaves, feels and thinks. People that are suffering from schizophrenia may even show signs of not in touch with reality. Though this condition is not that common compared to any other mental disorders today, the symptoms are quite severe that they are disabling. Leaving it alone can even cause death to the patient.

History

The term Schizophrenia is just about a 100 years old, but the condition itself can be traced back in the past, particularly in Ancient Egypt. The term was first coined only until 1911 when various scientists started studying deeper and wanted to separate the condition from the other mental disorders to avoid confusion. Throughout man’s history Schizophrenia evolved through the test of time.

There are written documents that identify Schizophrenia, and it can be traced back to Pharaonic Egypt in the past, as far as the 2^nd millennium BC. Dementia, depression and many other thought disturbances are the usual symptoms described of schizophrenia, as written in the Book of Hearts. The mind and the heart, according to ancient Egypt is synonymous with each other. These physical illnesses are symptoms of the uterus and the heart and that they originated from the blood or the fecal matter, poison, purulence or demons.

A recent study conducted that dug deep into ancient Roman and Greek literature showed that the general populace might have had an awareness of these psychotic disorders. However, there wasn’t any condition that would meet the diagnostic criteria that the modern world has in relation with schizophrenia.

There was one point in time wherein people diagnosed as “abnormal” because of mental retardation, mental illness or with physical deformities, all of them were treated the same in the medical world. Theories in the past supposed that the mental disorders these abnormal people were getting caused by some demonic possession over the body. The appropriate treatment they find to address this issue was exorcising the demons through different means. These range from the non-harmful treatments like exposing the affected person to a particular type of music. In some cases, they were treated dangerously, like drilling holes into the skull to “release” the evil spirits that have taken over the body.

The first person to classify mental disorders in various categories was Emile Kraepelin, a German physician. Dr. Kraepelin was the one that used the “dementia praecox” term on individuals that showed symptoms on what the modern world identifies schizophrenia.

The concept of this madness has already been around for thousands of years, and it was only recently that schizophrenia is a well-defined mental disorder by the same physician back in the year 1887. He first made the distinction of this psychotic illness between manic depression and what he referred to as dementia praecox. He believed that it was primarily an illness of the brain and it is a form of dementia. He gave the name as such to make it distinct from other dementia forms like the Alzheimer’s disease wherein it usually happens late in life. Then he referred the term in his studies as a focus on the youth going through dementia.

Eugen Bleuler, a Swiss psychiatrist, was the one who coined “schizophrenia” back in 1911. He was also the first to define the symptoms as either “negative” or “positive.” Bleuler changed the dementia praecox name to schizophrenia because the name Krapelin gave was misleading as it never did result in mental deterioration. It can occur early or later years in life.

Schizophrenia comes from the Greek root words schizo, meaning “split,” and phrene, meaning “mind.” When combining these two roots, it is used to explain the fragmented thinking of people who suffer from this illness. It is not meant to portray an idea of multiple or split personalities, which is the common misconception that the public has about this particular disorder. Since the time of Bleuler, schizophrenia’s definition has continued changing, as various scientists have attempted to make more accurate findings to delineate various kinds of mental illnesses. Without the knowledge regarding the definite causes of such diseases, the scientists can only base the classifications for this on observing on some symptoms that usually happen together.

Both Kraepelin and Bleuler have created sub categories on schizophrenia. These are prognoses and symptoms. Through the years, the ones that are working in this field have continued many attempts in classifying various types of schizophrenia. There are five types delineated in the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) – undifferentiated, residual, paranoid, catatonic and disorganized.

Symptoms

The symptoms associated with schizophrenia starts between 16 to 30 years of age. In the rarest cases, children also acquire schizophrenia, too. The symptoms fall in one of 3 categories: cognitive, negative and positive.

Positive symptoms – what “positive” means here is the psychotic behaviors are not the same to those of healthy people. People that have the positive symptoms might lose their touch with some parts of reality. Such symptoms include:

• Movement disorders – body movements are agitated
• Thought disorders – dysfunctional or unusual ways in thinking
• Delusions
• Hallucinations

Negative symptoms – the negative symptoms are those connected in disruptions to normal behaviors and emotions. Such symptoms include:

• Reduced feelings of pleasure in the every day offers of life
• “Flat effect” which pertains to the reduced expression of the emotions through voice tone or facial expression
• Reduced speaking
• Difficulty in sustaining and starting out activities

Cognitive symptoms – in some patients, the symptoms under this category are subtle, although for others they tend to be very severe and the patients may even notice some changes in memory and aspects with their thinking. These symptoms are:

• Have trouble paying attention or focusing
• Have bad executive functioning, which refers to the ability of the person to understand the information and utilize it in making decisions
• Difficulty with the “working memory,” which is the ability of a person to use the information right away after acquiring it

What are the risk factors?

Different factors accumulate into the development of the schizophrenia mental disorder.

Genes and the environment – scientists over the years have known for long that schizophrenia often runs in the families. There are a lot of people that have schizophrenia do not have any other family member with that kind of disorder, and also a lot of people that has one, two or more family members with this mental problem do not develop schizophrenia at all.

Scientists then believe that the genes may have something to do with the increased risk of developing schizophrenia. However, not a single gene has even ever caused the disorder all on itself. It is not even that possible in using the genetic information when it comes to predicting which person will develop schizophrenia.

The scientists have also thought about the interactions in between genes, including the aspects of the environment where the individual is mostly living in, on how it is necessary for the mental disorder to develop. According to their study, this is what they think environmental factors affect a person with a high possibility of developing schizophrenia:

• Exposed to viruses
• Difficulty during birth
• Malnutrition before giving birth
• Other psychological factors

Various brain structure and chemistry – scientists also have another study wherein they think that the imbalance within the interrelated and complex chemical reactions within the brain that involve the neurotransmitters glutamate and dopamine and possibly with others may play a role in the development of schizophrenia.

Other experts also contribute the idea that wherein during the development of the brain before birth may contribute to the faulty connections of the brain. It also goes through major changes during puberty and such changes can also trigger psychotic symptoms in individuals that are vulnerable because of the brain or genetic differences.

Therapies and treatments

Since there are no known causes of schizophrenia, the treatments are all focused on reducing or eliminating the symptoms.

Antipsychotics

Medications designed for anti-psychosis are mostly taken every day in liquid or pill form. Some of these are injections in which they are only given to the patient once or two times a week. Some people experience side effects at the start of taking the medications, but it will go away after a couple of days. Patients and doctors work together to find the most effective medication or the combination of medication best for the former, including finding the right dose. If you want to learn more about the latest warnings on patient medications with schizophrenia, check out the website www.fda.gov for more details.

The antipsychotic medications are the cornerstone of treating schizophrenia, and the doctor commonly prescribes them. They are thought to control the symptoms by getting straight into the brain’s neurotransmitter dopamine.

The main goal of the treatment is to manage the symptoms and signs effectively at the lowest dose possible. The psychiatrist will try out different drugs and doses or in combinations through time to achieve the desired result. Other medications will also help, like the anti-anxiety and anti-depressant drugs. The improvement of the symptoms will take effect after several weeks from the start of the treatment.

Since medications for schizophrenia can have serious side effects on people, the sufferers may not be that up for taking the treatment. The willingness in cooperating with the treatment might affect the choice of drug. It is important that patients ask their doctor to know what are the side effects and the benefits of prescribed medication.

Second generation antipsychotics

The newer medications belonging to the second generation are usually preferred since they have a lower risk of side effects that are very serious compared with the first generation ones. These second generation antipsychotic drugs include the following:

• Cariprazine (Vraylar)
• Aripiprazole (Abilify)
• Brexpiprazole (Rexulti)
• Asenapine (Saphris)
• Clozapine (Clozaril)
• Risperidone (Rispderdal)
• Quetiapine (Seroquel)
• Olanzapine (Zyprexa)
• Iloperidone (Latuda)
• Clozapine (Clozaril)
• Paliperidone (Invega)
• Ziprasdione (Geodon)

Drug Abuse’s Effect on Schizophrenia

There are some cases in which people that induce or are addicted to drugs show symptoms associated with schizophrenia. Majority of the researchers do not believe that drug abuse causes the mental disorder. However, people who have schizophrenia are highly likely to have alcohol or substance abuse problem compared to the general population.

It will be difficult for doctors to treat people that are suffering from schizophrenia and at the same time have drug abuse. Some drugs such as marijuana and the stimulants like cocaine or amphetamines will only make the symptoms much worse. There is research shown that there is a link between schizophrenia symptoms and over-indulgence in marijuana. Added to that, people that are drug abusers are less likely to follow the treatment plan.

Psychosocial interventions

When psychosis recedes from the patient, added to the continuing of medication, psychosocial and psychological interventions are introduced. These include:

Individual therapy – psychotherapy can help normalize the schizophrenic person’s thought patterns. It will also help them manage their problem when they learn to cope with their stress and even define the early signs of relapse.

Family therapy – families are educated and given support on how to deal with a family member diagnosed with schizophrenia.

Social skills training – this concentrates on enhancing communications and the social interactions, plus improving the person’s ability to participate in various daily activities.

Supported employment and vocational rehabilitation – this helps schizophrenic people to prepare their lives, find and keep their jobs.

Most people with schizophrenia need some form of living support done every day. Various communities have programs wherein they help people with this illness to get jobs, crisis situations, self-help groups, and housing. Someone in the treatment team will be finding such resources. Coupled with the right treatment, most people who have schizophrenia can manage their problem.