Arguably, the best approach to getting treatment for Schizophrenia is getting the correct diagnosis. Schizophrenia is usually characterized by profound disruption both in the emotional and cognition facets, thus affecting the most fundamental personal attributes such as thought, perception, language and a sense of self. In America, effective diagnosis of Schizophrenia is made possible through the use of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, which is popularly abbreviated as DSM-V. This tool serves as the universal authority for the various psychiatric diagnosis and treatment recommendations.
In most cases, the individual diagnosed with Schizophrenia will experience a combination of both the positive, which includes hallucinations, delusions and racing thoughts, and negative effects such as lack of emotions, nonexistent social functioning and absence of emotions. This paper will principally focus on the arguments put across by Peter J Wilson in his diagnosis of Schizophrenia in Oscar Bryan’s case, in his book, Oscar: An inquiry into the Nature of Sanity, and explain how modern American Psychiatrist , faced with a similar case as that of Oscar, may or may not give him the diagnosis of Schizophrenia following a particular set DSM-V criteria.
In his book, Wilson expounds on the case of a Oscar Bryan Newball, an English speaking resident of the island of Providencia, in South west Caribbean administered by Columbia. Oscar is described by the local villagers as mad. He is the object of their laughter, their affection, their fear and awe. Apparently, his diction also suggests that Oscar is educated despite the fact that his meaning in most cases, appears peculiarly elusive. He has been observed to engage in bizarre behavior such as stealing petty Rems, wandering, and also eavesdropping so as to fulfill his frequent public declamations on the various misdeeds of the other villagers.
Oscar has numerous encounters with different individuals whom he spends both good time with but also, at times he would become very violent. For instance, Oscar’s positive relationship with the people of Providencia is manifested during when Wilson and Oscar visits Laura for dinner, When Laura saw Oscar, she excitedly exclaimed his name after which they all joined in the meal of fresh-caught fish (Wilson, 1992, p.27). From a different context, Wilson narrates the story about how Oscar had a machete in his hand and had raised it towards him. The author claims that he grabbed a broom and gave Oscar a wallop that made him run out of the house and across the garden screaming (Wilson, 1992, p.90). This is one of his negative and bizarre behaviors.
Using the DNS Criteria, this paper will further analyze the behavioral aspect of condition as a way of diagnosing him, and where two or more of the following, presents a portion of time during a one-month period or even less when successfully treated:
- Hallucinations
In the whole story, Oscar comes out as a very intelligent man. Although all the people in Providencia consider him to be a mad man, his ideas, thoughts and the way he speaks denotes a man who is perfectly sane. He has not been portrayed to being an individual who undergo instances of hallucinations. In fact, his arguments and thoughts are very reasonable and he therefore relates nicely with most of the people especially with Miss Joan and Laura.
- Delusions
These are the false beliefs that are being held dear in spite of enough invalidating evidence such as the paranoid decisions such as believing that some people are embarking on things that there is no physical evidence of such things taking place. In the case of Oscar’s madness, delusions are prevalent in his day-to-day life. One of the examples is that he is regarding himself to being unusually intelligent, to the likes of Isaac Newton. He therefore fulfils one of the two requirements of the DMS-V criterion. Nonetheless, most of the people acknowledge that Oscar is very intelligent. In page 123, Wilson explains that the people of Providencia said that Oscar had a reputation that extended beyond this locality. The further explained that he clearly knew the history of many parts of the Caribbean Islands and its people.
- Disorganized Speech
In regard to disorganized speech, which entails frequent derailment and incoherence in the speech of the individual, Oscar cannot be categorized under this requirement since his lingo is good and Wilson says that he speaks like an educated man.
- Catatonic or Grossly disorganized behavior
Oscar has also shown various catatonic behaviors such as eavesdropping. Additionally, he has been reported to engage in various bizarre behaviors such as “sanitating” the yards, stealing petty Rems among many more others. This is a fulfillment of one other most prevalent criterion that is used by DSM-V to denote an individual suffering of Schizophrenia.
Scheper-Hughes, in his book Saints, scholars, and schizophrenics: Mental illness in rural Ireland, although he is not adequately and professionally trained in the field of diagnosis, he is well aware of the usual checklist which ranges from withdrawal, perceptual disorder and conceptual disorganization (Scheper-Hughes, 2005, p.146). Scheper-Hughes further analyses Schizophrenia based on the knowledge that he possessed from his Irish community. Using his arguments to analyze the DSM-V that provides the criteria for the analysis of Oscars situation. Through various interviews with the Irish schizophrenia patients, he said that their results supported that the later age of the onset of the problem is as a result of the identity crisis of early adulthood and late adolescence (Scheper-Hughes, 2005, p.140). Additionally, when evaluating Oscars situation using the social or occupational dysfunction, it becomes apparent that there is a significant portion of time, from the onset of this form of disturbance, where his personal life has been greatly interfered with.
Nonetheless, in the process of diagnosis of schizophrenia, and anthropologist may misdiagnosis a patient. Since there are no current physical test can be used to confirm the presence of this problem, and also because the problem of Schizophrenia normally shares a significant number of almost similar symptoms with other types of disorders, therefore, the problem of misdiagnosis is usually rampant. Similar to Oscar’s case, most Schizophrenia patients will experience numerous symptoms related to mental disorders especially in the form of depression that involves obsessive and compulsive symptoms, dissociative symptoms and also somatic concerns.
Therefore, the modern American psychiatrist would also give Oscar the same form of diagnosis as Peter Wilson did to Oscar’s case two decades ago. This is because, this case fulfils most of the DSM-V criteria listed for persons suffering of Schizophrenia. It therefore becomes evident that despite being mad and making the locals happy, Oscars case cannot be termed as the usual Schizophrenia cases. In fact, what the locals refers to as Oscars madness, is actually another form of a despotic power that he has managed to possess over their daily interactive needs. Oscar exemplifies what Wilson terms as the culture’s Schizoid values of reputation and respectability. Generally, Schizophrenics is a problem in our society or culture that makes us reflect our values towards relationships that are meant to benefit us all.
References
Scheper-Hughes, N. (2005). Saints, scholars, and schizophrenics: Mental illness in rural
Ireland. Berkeley [u.a.: University of California Press.
Wilson, P. J. (1992). Oscar: An inquiry into the nature of sanity?. Waveland Press.
