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For many years the word schizophrenia has provoked enormous discomfort. Invested with meaning at once surreal and feared, it is still used as an instrument of ridicule in ordinary conversation, in the media, and even among professionals themselves. The word itself is ominous and evokes visions of madness and asylums. It is a discordant and cruel term, just like the disease signifies. Schizophrenia continues to be an illness about which the public at large remains unaware even though, along with other psychiatric disorders, it has become more susceptible to modern scientific investigation yielding information that has clarified the origin, progress, and outcome of the disorder (Orey). Brilliant advances in brain and behavioral research over the last couple of decades have armed scientists and clinicians to such a degree that both diagnosis and therapeutics now rest on more solid ground than ever before.
Schizophrenia is a complex disorder characterized by a constellation of distinctive and predictable symptoms that are most commonly associated with the disease. It is one of the most disabling and emotionally devastating illnesses known to man (Orey). It is a relatively common disease with an estimated one percent to one and a half percent of the United States population being diagnosed with it over the course of their lives (Torrey 6). Schizophrenia usually begins by the individual having a psychotic episode, which is a serious onset of symptoms. The symptoms are divided into two main categories, positive and negative. Positive because these are new experiences and negative because these are every day parts of life, at a reduced level.
These may occur together, separately or alternately. The positive symptoms are hallucinations, delusions, disorganized speech. Most commonly a person with schizophrenia will hear his own thoughts, for example, as if they have been spoken aloud within his head. The thoughts can appear to be so loud that the person may believe that people nearby will also be able to hear them.
The mind usually adjusts to this very rapidly and as a result the thoughts then appear to come from some external source. These spoken thoughts are then called voices or, more technically, hallucinations. There can also be other kinds of hallucinations such as visual, smell or taste. A person who experiences hallucination will naturally attempt to find an explanation for what is happening. Which kind of explanation they decide on depends very much on the person involved and the culture in which he lives.
These are attempts to make sense of experiences that most people do not have. To the outside world these explanations are regarded as delusions. Delusions can take many forms: persecutory, telepathic, grandiose, religious, sci-fi or paranormal. Another common symptom of schizophrenia is disorganized speech. This means they leap from one idea to another even though the two ideas are not connected in any logical way. Negative symptoms include profound apathy and loss of interest, marked withdrawal, reduction in spoken communication, lack of drive and interest in work, friends, family, or career, a fall in self-esteem leading to personal neglect, and a loss in enjoyment in activities that were previously a source of pleasure.
In extreme cases, people with schizophrenia may become almost totally unresponsive and will not move, speak or respond, a condition known as catatonia. This is most common in people with chronic schizophrenia. There is no objective way to diagnose schizophrenia, such as there are no chemicals in the blood, the brain, or the spinal fluid. X-rays and examinations of cells do not show it, either.
Psychiatrists rely on symptoms, but many diseased may have similar symptoms. The requirements for diagnosis are found in the third edition of Diagnostic and Statistical Manual for Mental Disorders (DSM III), which is the official diagnostic system of the American Psychiatric Association. At least one of the symptoms from the list of symptoms must be present for six months or more to be a schizophrenic symptom (Torrey 86). If a person does not meet DSM III criteria, he or she is does not have schizophrenia. During the last half of the nineteenth century different subtypes of what we now call schizophrenia were described as separate diseases. Thus paranoid psychosis was characterized in 1868, hebephrenia in 1871, and catatonic in 1874.
In 1896 a German psychiatrist, Emil Kraepelin, recognized these three sub-groups from patients in asylums who developed their illness in early adult life, had initially rather varied symptoms, and who shared a tendency for their condition to deteriorate over time. He termed it dementia of early life, and in 1919 published a set of clinical characteristics for it that remain largely valid today. Renamed schizophrenia by Eugen Bleuler in 1908, it is more common than people realize (Keefe-Harvey 97). Not all people with schizophrenia have the same symptoms. With this illness there are often very different groups of symptoms. For that reason schizophrenia is subdivided into types, based on particular clusters of symptoms that appear together.
Disorganized type is based on confusion, disorganized speech, and blunted or inappropriate effect. Catatonic type is where the person is completely unaware of and unable to respond the outer world. Paranoid type is an organized system of delusions and auditory hallucinations that often guide a persons behavior. Residual type is symptoms of schizophrenia are less significant in intensity and number but are still present. Undifferentiated type describes those who do not fall neatly into any other categories (Friedman 17). Sometimes people have symptoms of a mood disorder in addition to symptoms of schizophrenia.
A mood disorder is a disorder that affects a persons emotions. The Diagnostic and Statistic Manual of Mental Illness defines schizo affective disorder as the occurrence of symptoms of major depression or mania concurrent with the symptoms of schizophrenia (Torrey 90). The course of schizophrenia varied tremendously between different people. Two individuals with the same symptoms at the onset of the illness many have completely different outcomes. About twenty-five percent of those with schizophrenia respond very well to treatment and can return to their lives they led before (Friedman 21).
Most people with schizophrenia, however, continue to experience symptoms throughout their lifetime. Scientists have developed dozens of theories to explain what causes this disease, but researchers are focusing on four leading theories. They are the Genetic Theory, the Environmental Theory, the Biochemical Theory, and the Bio-Psycho-Social Theory. The Genetic Theory argues that schizophrenia is caused by traits in a person's genetic makeup.
As we all know, a person has twenty-three pairs of chromosomes. Each pair contains one chromosome from each parent. In corresponding locations, called loci, of each chromosome the genes for specific traits are located. Some researchers believe that problems with these genes can cause schizophrenia. We inherit our genes from our parents but this does not mean that the parents of a schizophrenic are mentally ill.
Problems in a persons genetic make up could come from mutated chromosomes or recessive genes. In an attempt to prove this theory scientists study identical twins. Due to the fact that identical twins have the exact same genetic make up researchers will be able to determine if heredity is the main cause of schizophrenia. However, evidence seems to disprove this theory. This is because on some occasions both identical twins are schizophrenics and other times only one is inflicted. To defend the theory, it should be noted that this research is difficult and complicated.
Identical twins are relatively rare, especially twins who are both diagnosed with schizophrenia. Further defending the theory, studies have shown that children with one parent diagnosed with schizophrenia have a ten percent chance of suffering from schizophrenia (Keefe-Harvey 82). When both parents are schizophrenic their risk raises to about forty percent (...
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