Schizophrenia Essay, Research Paper

Schizophrenia

Josh Gutzwiller

Schizophrenia is a debilitating mental disorder characterized by a dysfunctional thinking process and withdrawal from the outside world. The word schizophrenia comes from two Greek words schizo which means split and phrenia, which means mind. This doesn’t mean that a person with the disorder has multiple personalities, but rather parts of the mind seem to be operating independent of each other. The disease affects approximately 1 in 100 people and there are thought to be over 2 million schizophrenics in the United States today. Schizophrenia has been found to be a biologically based brain disease due to the imbalance of two of the brains chemicals dopamine and serotonin. In the brain of a schizophrenic there are elevated dopamine and serotonin activity. The cause of the disease is still unknown, but some of the most accepted theories are genetics, a biochemical imbalance, an early viral infection, or birth trauma. Generally, schizophrenia has a major impact on thinking and functioning, impairing a person’s ability to care for themselves and to respond to surroundings in a civilized manner.

In the diagnosing of schizophrenia, there are 5 different types to be diagnosed as. One of the major types is Disorganized Schizophrenia. This is characterized by disorganized thinking, speech, and poor concentration. There is also a lack of emotional expression and inappropriate emotional response to certain situations. There are also no really well established delusions that may characterize it. One other major type of schizophrenia is Paranoid Schizophrenia. The main character of this is delusions. The delusions are usually paranoid, but tend to occasionally be grandiose. There are also hallucinations and there frequently episodes of voices inside the head. One other symptom is high anxiety and a high level of argumentativness. Catatonic Schizophrenia has more of a physical notability. A rigid body, a very odd posture, and repetitive motioning are the main characteristics, which are together called catatonia. A Catatonic Schizophrenic is also very unresponsive to surroundings. There are 2 other types of schizophrenia, and they are Undifferentiated and Residual. Undifferentiated is characterized by symptoms that tend to match either none or more that 1 of the above types of schizophrenia. Residual Schizophrenia is characterized by rare episodes of attack and there are less severe symptoms after the initial attack.

The diagnosis of schizophrenia is not an easy process and diagnosis is looked into very seriously and extensively. Characteristic symptoms are one are looked into for the diagnosis. These symptoms must be present for a significant period of time during a one-month period. The characteristics used for the diagnosis include delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, and negative symptoms. Social or occupation dysfunction is another are for diagnosis. This may be characterized by a disturbance in one or more areas of functioning such as work, interpersonal relations, or self-care way below a level a person may have previously been at. Duration, or continuous disturbance for 6 months of which 1 month must show symptoms, is also used to diagnose the disease. Schizoaffective and Mood Disorder exclusion are also criteria used to diagnose schizophrenia. These features have been ruled out recently though because no major depressive, manic, or mixed episodes have occurred at the same time as active-phase symptoms.

A major theory in the cause of schizophrenia is that it develops in the fetal brain. When the fetal brain is being developed and wired in, the nerve cells grow, divide, and build connections with each other. The basic physical flaw in the brains of many people affected with the disease is that certain nerve cells migrate to the wrong areas when the brain is first beginning to form. This leaves small regions of the brain permanently out of place or miswired. These errors in the development of the brain’s architecture have not yet been discovered, but one theory is that these misconnections might develop when the mother catches a virus early in her pregnancy. Evidence to support this was found when 7 out of 20 schizophrenics were found to have misplaced neurons in the prefrontal area of the brain. Some of the neurons were oddly stacked and some were missing in this area. This is opposite of the 0 out of 20 normal people with misplaced neurons. These out of place cells are unexpectedly large residues of the neural subplate, a structure in the brain, which guides neurons to their proper place in the brain. What causes this failure is not yet know, but it could be anything from genetics to environment.

The chemical dopamine is a neurotransmitter in the brain that is thought to have some effect on the symptoms that make up schizophrenia. These symptoms are thought to be result of an excess of dopamine in the brain. Serotonin is also a neurotransmitter in the brain that has just recently been found to have an effect of schizophrenics. Serotonin’s purpose in the brain is to act as a bridge between nerve cells of the brain so that they can communicate with each other. It’s current role in schizophrenia isn’t yet known, but there is evidence that there is an overabundance of it in the brain based on the fact that drugs with only dopamine blockers showed little or no effect of schizophrenics. Drugs with both dopamine and serotonin blockers have proven much more affective in the suppression and calming down of the symptoms of schizophrenia.

In schizophrenics there are both Positive and Negative symptoms. Negative symptoms are those with more inward signs and Positive symptoms are those with more outward, or visible signs. Some of the negative symptoms are blunted emotions or blunted affect. With this symptom, the individual may feel less connected emotionally to what is happening around them, and they may feel less connected emotionally to what is happening around them, and they may appear less responsive on an emotional level. Emotional withdrawal is another Negative symptom that makes the individual detached and uncommunicative. They will have few interests and personal relationships. They will also have the symptom of poor rapaport. This may make them avoid eye contact or appear bored or lacking in warmth during conversation. More Negative symptoms are passiveness or apatheticness. There will be a lack of interest or concern for their surroundings and they may be unable to perform certain simple tasks other than sleeping or eating. It may appear as though they want nothing and are lazy and sluggish. They may also be withdrawn socially and have great difficulty in abstract thinking. They can only think in concrete terms and are unable to see the underlying meaning in details. They may also be very rigid in their attitude and have stereotyped thinking. Physically, they would be very slow and appear blank.

Positive symptoms, on the other hand are the more visible signs of schizophrenia. These include delusions, in which one may believe that something is present that really isn’t. There are also hallucinations where people can see, hear, smell, taste, or feel something that doesn’t exist. This is the most commonly of the auditory type where people where people will hear voices in their head. Other symptoms are thought disorders or conceptual disorganization, excitement and grandiosity where one feels they have great wealth, power, or fame. Finally, the Positive symptoms include suspiciousness, persecution, and hostility.

The treatment for schizophrenics has changed a great deal from the early treatment that was standard for schizophrenics. In the early days of treatment, schizophrenics often endured electroshock therapy that was very painful and was of little good to the well being of the patients. Billions of dollars of the publics money was spent on these efforts and many people were cheated out of their money. The main drug now for the treatment of schizophrenia is Clozaril. This drug has been revived from it’s form of the 70’s and 80’s, but has been modified to lessen the side effects. There are many methods people choose to cure schizophrenia, but there is still no definite cure. Another problem with the treatment of schizophrenia now is the low-quality care many schizophrenics receive at the clinics that they visit. In a study published in the Archives of General Psychiatry, it was found that the clinics were providing poor care because there was no follow-up care or any way of monitoring quality of treatments. There have been and currently are problems with the care distributed to schizophrenics, but further developments in background and causes of the disease should help schizophrenics for years to come.

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Lewine, Richard R.J.

W.W. Norton & Company

New York

www.ama-assn.org/public/journals/jama/jamahome.htm – Journal of American Medicine

www.mentalwellness.com

www.nimh.nih.gov – National Institute of Mental Health

www.schizophrenia.com