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The term Schizophrenia comes from the Greek; Ship meaning split and Phren meaning mind. It was coined by the Swiss psychiatrist Eugen Bieuler who, in 1911, used it to describe patients who he found to have a mind split from reality. Symptoms of Schizophrenia are generally divided into positive and negative. The former occur in all cases of Schizophrenia and can be thought of as added to the individuals behavior: delusions, hallucinations and thought disorders. The latter occur in only some cases and can be thought of as characteristics taken away from the individual. These include social withdrawal, flatness of arrest and cognitive decline.
According to the DSM 4 criteria, in order to be diagnosed as schizophrenic, two or more or the following symptoms must be displayed for more than six months: Delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, negative symptoms. Schizophrenia is the most common of the major mental illnesses and affects around 1 % of the population worldwide. In this essay I shall assess the effectiveness of the most commonly used medical treatments. These are the use of narcoleptic drugs and I shall place a particular emphasis on the more recently developed drugs which have aimed to reduce its side effects.
I shall then outline and evaluate the use of talking therapies in the treatment of Schizophrenia, focusing on Individual therapy, family therapy and cognitive behavioral methods. Throughout the essay I shall take a relapse to mean the following: Readmission to in-patient care as a result of a fresh episode of schizophrenia or Worsening of psychotic symptoms (Scottish Schizophrenia research group, 1992). The first drug used to treat Schizophrenia (in 1952) was Chlorpromazine, a tranquillize that reduces psychotic properties. Soon after this several other similar drugs were developed. While they were relatively successful in treating the positive symptoms of schizophrenia and preventing relapse, they had several serious limitations.
They require continued use to reduce likelihood of relapse and approximately 20 % of patients show no improvement when using them (Kane et al, 1988). They also have major side effects including Tardive Dyskinesia, Askathisia (which can be fatal), tightening of muscles in a manner similar to Parkinsons, weight gain, blurred vision and decreased motivation. In response to these problems, several drugs have been more recently developed. In the! 970 s Clozapine was released. It was found to cause fewer side effects than the previous drugs and did not cause Tardive Dyskinesia.
It was also found to be effective on patients who did not respond to the Traditional narcoleptics. Kane et al (1988) found that out of 200 patients who showed no improvement with the commonly used Haloperidol, 30 % responded to Clozapine with an improvement in both positive and negative symptoms. However, clozapine also has its limitations. It has a very limited availability and is extremely expensive.
It can cause Agranulocytosis, a blood disease that can be fatal, and therefore its users must have their white blood cell counts monitored weekly at great expense. Also, some have argued that it is not particularly effective in treatment of negative symptoms. Goldberg et al (1993) found that while Clozapine improved positive symptoms, it had no effect on cognition, memory or attention and had an adverse effect on visual memory. REFERENCES Kane et al (1988) Clozapine for the treatment resistant schizophrenic, Archives of general psychiatry, 45, 789 - 796. The Scottish 1 st Episode VIII, 5 yr follow up: Clinical and psychosocial findings. British Journal of Psychiatry 161, 496 500.
Journal 4 Goldberg
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Research essay sample on Positive And Negative Symptoms Of Schizophrenia
