Symptoms of schizophrenia



Background ReadingSchizophrenia is a mental illness that usually occurs in late adolescence or early adulthood, but it can occur at any time in life. In the Diagnostic and Statistical Manual (DSM) it is classified as a psychosis, as the sufferer has no concept of reality. Essentially the illness is due to a breakdown of the patient’s personality.Schizophrenia is a worldwide disease i.e. culturally universal; however, both the symptoms and the incidence (how common it is) vary from culture to culture. Approximately 1% of the population develops schizophrenia during their lifetime, which is an enormous number. More than 2 million Americans suffer from the illness in a given year.The peak of incidence for onset is 25-30 years and cases prior to adolescence are extremely rare. Overall there are no gender differences: a similar number of men and women are diagnosed with the disorder. However, the disorder often appears earlier in men than women (Warner 1994). Twice as many men as women between the ages of 15 and 24 years are diagnosed, but between 25 to 34 years the incidence of females rises, until after 35 years of age the two sexes are similar in rate of incidence. Available treatments can relieve many symptoms, but most people with schizophrenia continue to suffer some symptoms throughout their lives; it has been estimated that no more than one in five individuals recovers completely. Although recovery from schizophrenia is rare (1% of the population suffer from it), recent research has given hope to sufferers and their family members. Research has identified new, safer medications and has started to unravel the complex causes of the disease. New insights into the disorder have come from several areas of Psychology such as molecular genetics, the study of populations, brain imaging (e.g. MRI Scans) and brain function studies.Schizophrenia is a?severe long-term mental health condition. It causes a range of different psychological symptoms. Doctors often describe schizophrenia as a type of psychosis. This means the person may not always be able to distinguish their own thoughts and ideas from reality.Symptoms of schizophreniaSymptoms of schizophrenia include:?hallucinations?– hearing or seeing things that don't exist delusions?–?unusual beliefs not based on reality? muddled thoughts based on hallucinations or delusions changes in behaviour Some people?think schizophrenia causes a "split personality" or violent behaviour. This is not true.The cause of any violent behaviour is usually drug or alcohol misuse.Schizophrenia changes how a person?thinks and behaves. The condition?may develop slowly. The first signs can be hard to identify as they often develop during the teenage years.?Symptoms?such as becoming socially withdrawn and unresponsive or changes in sleeping patterns can be mistaken for an adolescent "phase".People often have episodes of schizophrenia, during which their symptoms are particularly severe, followed by periods where they experience few or no symptoms. This is known as acute schizophrenia.Positive and negative symptoms The symptoms of schizophrenia are usually classified into:positive symptoms?– any change in behaviour or thoughts, such as hallucinations or delusions negative symptoms?– a withdrawal or lack of function that you would usually expect to see in a healthy person; for example, people with schizophrenia often appear emotionless and?flat Schizophrenia can cause ‘positive symptoms’, which are symptoms that are not usually present in a normal person. Positive symptoms reflect an excess or distortion of normal functioning. People with schizophrenia often suffer terrifying symptoms such as hearing internal voices not heard by others, or believing that other people are reading their minds, controlling their thoughts, or plotting to harm them. These symptoms may leave them fearful and withdrawn. Their speech and behaviour can be so disorganized that they may be incomprehensible or frightening of others.Delusions are false beliefs that are firmly held despite being completely illogical, or for which there is no evidence. Common types of delusions in schizophrenia include the following:Delusions of persecution: The belief that others want to harm, threaten or manipulate you. Schizophrenics may believe that they are being spied on, that nasty rumours are being spread about them or that people are plotting to kill them.Delusions of grandeur: This is the idea that you are an important individual, even god-like and have extraordinary powers. One of the most frequent of this type of delusion is the belief that they are Jesus Christ.Delusions of control: Individuals may believe that they are under the control of an alien force that has invaded their mind and/or body. This may be interpreted, for example, as the presence of spirits or implanted radio transmitters.Hallucinations involve disturbances in perception (rather than disturbances in thought). They are false perceptions that have no basis in reality. The most common hallucinations are auditory ones (hearing voices) but can include smell, touch and sight. There may appear to be a single person talking or many, and they may be familiar or unfamiliar. Many schizophrenics report hearing voices that instruct them to do something, or that tell them they are wicked and evil. Sometimes they instruct the patient to do something that could be harmful to themselves and others.Negative symptoms of schizophreniaSchizophrenia can cause ‘negative symptoms’ which cause a decline in functioning. Negative symptoms appear to reflect a loss of normal function. For example, sufferers may not be able to work at a job that requires the same level of skill or concentration as the job they held before they became ill, or they may lose all ability to withstand the stress of working. The illness can also affect their ability to function at home; for instance, they may be unable to complete household chores, raise their children or maintain an active social life.Speech poverty is the inability to speak properly, characterised by lack of ability to produce fluent words; this is thought to reflect slowing or blocked thoughts. It can manifest itself as short and empty replies to questions.Avolition is the reduction, difficulty, or inability to start and continue with goal-directed behaviour. It is often mistaken for apparent disinterest. Examples of avolition include: no longer being interested in going out and meeting with friends, no longer being interested in activities that the person used to show enthusiasm for, no longer being interested in anything, sitting in the house for many hours a day doing nothing.Negative symptoms experienced by people living with schizophrenia include:losing interest and motivation in life and activities, including relationships and sex? lack of concentration, not wanting to leave the house, and changes in sleeping patterns? being less likely to initiate conversations and feeling uncomfortable with people, or feeling there's nothing to say The negative symptoms of schizophrenia can often lead to relationship problems with friends and family?as they can sometimes be mistaken for deliberate laziness or rudeness.The exact causes of schizophrenia are unknown. Research suggests a combination of physical, genetic, psychological and environmental factors can make a person more likely to develop the condition.Some people may be prone to schizophrenia, and a stressful or emotional life event might trigger a psychotic episode. However, it's not known why some people develop symptoms while others don't.Increased riskGeneticsSchizophrenia tends to run in families, but no?single gene is thought to be responsible. It's more likely?that different combinations of genes make people more vulnerable to the condition. However, having these genes doesn't necessarily mean you'll develop schizophrenia.Evidence that the disorder is partly inherited comes from studies of twins. Identical twins share the same genes. In?identical twins, if one twin develops schizophrenia, the other twin has a one in two chance of developing it, too. This is true even if they're raised separately.?In non-identical twins, who have different genetic make-ups, when one twin develops schizophrenia, the other only has a one in seven chance of developing the condition. While this is higher than in the general population, where the chance is about 1 in 100, it suggests genes aren't the only factor influencing the development of schizophrenia.Brain developmentStudies of people with schizophrenia have shown there are subtle differences in the structure of their brains. These changes aren't seen in everyone with schizophrenia and?can occur in people who don't have a mental illness. But they suggest schizophrenia may partly be a disorder of the brain.NeurotransmittersNeurotransmitters?are chemicals that carry messages between brain cells. There's a connection between neurotransmitters and schizophrenia because drugs that alter the levels of neurotransmitters in the brain are known to relieve some of the symptoms of schizophrenia.?Research suggests?schizophrenia may be caused by a change in the level of two neurotransmitters: dopamine and serotonin. Some studies indicate?an imbalance between the two may be the basis of the problem. Others have found a change in the body's sensitivity to the neurotransmitters is part of the cause of schizophrenia.Pregnancy and birth complicationsResearch has shown people who develop schizophrenia are more likely to have experienced complications before and during their birth, such as: a low birth weight premature labour a lack of oxygen (asphyxia) during birth It may be that these things have a subtle effect on brain development.TriggersTriggers are things that can cause schizophrenia to develop in people who are at risk. These include:StressThe main psychological triggers of schizophrenia are stressful life events, such as: bereavement losing your job or home divorce the end of a relationship physical, sexual or?emotional abuse These kinds of experiences, although stressful, don't cause schizophrenia. However, they can trigger its development in someone already vulnerable to it.Drug abuseDrugs don't directly cause schizophrenia, but studies have shown drug misuse increases the risk of developing schizophrenia or a similar illness. Certain drugs, particularly cannabis, cocaine, LSD?or amphetamines, may trigger symptoms of schizophrenia in people who are susceptible. Using amphetamines or cocaine can lead to psychosis, and can cause a relapse in people recovering from an earlier episode. Three major studies have shown teenagers under 15 who use cannabis regularly, especially "skunk" and other more potent forms of the drug, are up to four times more likely to develop schizophrenia by the age of 26.Key Study: Rosenhan (1973)Aim: To investigate how situational factors affect a diagnosis of schizophrenia. Sane confederates went into psychiatric hospitals and told medical health professionals they had a hallucination, and observed whether staff would realise that they were sane. If staff did not detect their sanity, it would have implications for methods of diagnosing mental illness and show that situational factors affect diagnosis.Method: 8 confederates acted as pseudopatients, going to 12 different hospitals. The real participants were the hospital staff who did not know about the experiment. The pseudopatient called the hospital for an appointment. When they arrived they complained of hearing voices saying “empty”, “hollow” and “thud”. They said that the voices were unclear, unfamiliar and of the same sex as the pseudopatient. Pseudopatients gave false names, occupations and symptoms, but gave real life histories. Once on the ward, the pseudopatients stopped pretending symptoms, behaved normally and wrote observations. Pseudopatients were discharged only when they convinced staff that they were sane.Results: On admission, staff diagnosed 11 pseudopatients with schizophrenia, and one with manic-depression. Staff never detected their sanity. Nurses reported their behaviour as showing “no abnormal indications”, but did interpret their behaviour in the context of their diagnosis (see conclusion). The average hospital stay was 19 days. All pseudopatients were discharged with diagnosis of schizophrenia ‘in remission’. 35 real patients detected sanity (e.g., saying “You’re not crazy”).Conclusion: Psychiatric staff cannot always distinguish sanity from insanity. Any diagnostic method that makes such errors cannot be very reliable or valid. However, physicians may not identify sanity because it is less risky to diagnose a healthy person as sick than vice versa. So therefore situational factors do affect diagnosis. Normal behaviour was interpreted in the context of illness (e.g., nursing records suggest writing is pathological). Staff reversed some diagnoses due to the situation (expecting pseudopatients). Staff may be more likely to reverse diagnoses when risks are high (e.g., loss of professional esteem). Essentially Rosenhan’s research showed that psychiatrists cannot reliably tell the difference between an insane and sane person, calling into question the reliability of a schizophrenia diagnosis. ‘Normal’ behaviour was misinterpreted as ‘abnormal’ to support their idea that the pseudopatients had a mental illness. This suggests the validity of psychiatric diagnoses was low and the DSM was flawed. ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download