Introduction
Schizophrenia is a severe mental illness characterised by the inability to distinguish between what is real and what is not. People suffering from schizophrenia have a distorted insight about the real world and they may hear or see things that other people around them cannot see. Due to the divide between their imaginary world and the real world, the people suffering from schizophrenia have a hard time carrying out daily tasks. As a result, of their limited ability to perform conventional tasks, people suffering from schizophrenia pull out from the society and act out of unease and panic. This leads to problems when relating with the members of the immediate society. Schizophrenia is a permanent mental illness and it requires continued medication throughout the life of the patient.
Onset
The first symptoms of schizophrenia begin to manifest in the pubescent stage. However, some researchers suggest that schizophrenia begins even before the children are born. Men have a higher predisposition to suffer from schizophrenia compared to women. The onset of the symptoms of schizophrenia happens earlier in male patients. Cases of young children showing symptoms or suffering from schizophrenia are very rare. In addition, it is rare to diagnose people aged 45 and older with this mental illness. Therefore, the onset of the manifestation of the symptoms associated with schizophrenia is in the ages between 19 and 45.
Causes
Up to date, the scientific community has not reached to a consensus on the definite single cause of schizophrenia. There is an agreement within the scientific community that this mental illness originates from an amalgamation of several causes that together lead to the onset of schizophrenia. Three factors are commonly associated with causing schizophrenia. These are environmental factors, genetics and the brain structure. The interaction of any two or all of these factors culminates into the onset of schizophrenia. With reference to the three factors associated with causing schizophrenia, scientists have developed three hypotheses to explain the causes of schizophrenia. These are the genetics hypothesis, the brain anomaly hypothesis and the environmental hypothesis (Steven E. Meier, 13).
First, the genetic hypothesis credits schizophrenia to the genetic makeup of the patient. The fact that parents suffering from schizophrenia have a higher chance to give birth to schizophrenic children compared to normal parents supports this hypothesis. Statistical data shows that children from schizophrenic parents have a 0.1 chance of suffering from schizophrenia. Unlike with most genetic disorders, the origin of schizophrenia does not stem from a single gene. Instead, multiple genes at different locations on different chromosomes are responsible for the onset of schizophrenia (Steven E. Meier, 14). Some of the chromosomes identified to bear genes associated with schizophrenia include chromosome 6 and 22 (Steven E. Meier, 14). In addition, if the age of the father is greatly advanced, there are higher chances of suffering from schizophrenia for the children. However, the genetic makeup of an individual is not enough to lead to schizophrenia. The genetic makeup only predisposes the individual to schizophrenia.
Secondly, the environmental hypothesis suggests that the environment surrounding an individual during the earlier stages of development is a factor that can lead to schizophrenia. The environment can affect the individual even prior to birth. Such environmental factors at birth include stress of the mother during pregnancy, shock to the foetus caused by an accident or an electrocution, a severe viral illness of the foetus at or before birth and excessive drug abuse by the mother. Another environmental factor that may predispose an individual to schizophrenia includes neglect and maltreatment at a younger age and a severe emotional trauma like loss of parents or a major accident. The probability of suffering from schizophrenia for these individuals is higher if they have a family history of schizophrenia.
Lastly, the brain anomaly hypothesis suggests that schizophrenia may arise from the deformation of the brain tissue leading to effects to the brain chemistry and ultimately the brain function. These abnormalities include reduced brain volume and damaged frontal lobes of the brain. The frontal lobes are the brain centres for perception and this explains why their malformation leads to schizophrenia. In addition to this, some tumours may affect the brain chemistry. This includes effects such as increased levels of dopamine. Studies have shown that increasing the levels of dopamine in healthy individuals achieves the same effects such as the symptoms manifested by the people suffering from schizophrenia (Steven E. Meier, 18). The use of dopamine receptors blockers such as chlorpromazine reduces the symptoms of schizophrenia in patients. In addition to this, the use of drugs that enhance the production of dopamine achieves the same symptoms such as the ones displayed by schizophrenic patients. Such drug substances include cocaine.
Symptoms
There are a myriad of symptoms associated with schizophrenia. These symptoms range in the intensity of their severity and an individual suffering from schizophrenia may not display all these symptoms at the same time. Some symptoms manifest during psychotic episodes while others do not. In addition, some of these symptoms are present in other mental illnesses. Therefore, the diagnosis for schizophrenia should be intensive and not based only on the presence of the symptoms but also the degree of severity and the duration. The schizophrenic symptoms fall into three categories.
The first category of symptoms consists of positive symptoms (National Institute of Mental Health, 3). Those close to the patient can perceive these behavioural changes. They include hallucinations, incoherent speech, delusions, disruption of thoughts and movement limitations. The treatment of these symptoms using antipsychotic drugs is usually successful in most cases. Hallucinations refer to the perception of things by the patient that others cannot perceive. This includes visualisation of strange images and hearing strange imaginary voices (National Institute of Mental Health, 3). In extreme cases, some patients usually have long conversations with dead relatives and this can be confused for insanity.
Incoherent speech involves the patients lacking the ability to construct continuous sentences that make sense. Patients showing such symptoms have a problem sticking with one topic during conversations. This leads to difficulties in communication at the workplace and this renders schizophrenic patients unemployable. Delusions are deeply rooted imaginations about things that are not factual. Patients displaying such symptoms usually give animate qualities to inanimate objects. For instance, they may believe that the walls have eyes or that the stones are talking to them. In addition to this, patients experiencing delusions always accept as true the fact that they are in danger at all times. This is paranoia. It leads to unnecessary panic attacks. They may also take a conventional conversational to be rude leading to excessive irritability.
The disruption of thoughts is evident in severe cases of schizophrenia. Patients displaying this symptoms lack the ability to carry out a task to completion. Such patients also become irrational. In addition, limitation in the motor function is also evident in schizophrenic patients especially those in the advanced stages. Such limitations include the inability to maintain a form grip, repetition of a certain routine of movements uncontrollably e.g. tapping the feet and shakiness. At this stage, these patients have to undergo confinement to a care centre or a hospital because they pose a risk not only to themselves but also to other people.
The second category of symptoms is negative symptoms (National Institute of Mental Health, 4). These symptoms affect the patient’s ability to function normally but are not easily discernible to the intermediate people. In most cases, these symptoms are usually mistaken for something else like stress, boredom or mild depression. These symptoms do not manifest during the psychotic episodes hence the likelihood of confusing them for something else. The negative symptoms consist of the inability to show emotions such as smiling, withdrawal from the rest of the society, loss of interest in activities that were previously a favourite for the patient e.g. sporting activities, insomnia, loss of appetite and being deficient in maintaining eye contact (National Institute of Mental Health, 4).
The third category of symptoms consists of impairment to the cognitive function of the patient (National Institute of Mental Health, 4). These symptoms are the greatest reason why the people suffering from schizophrenia cannot take up jobs. The inability to learn new skills and information characterises these symptoms. In addition to this, the schizophrenic patients displaying these symptoms have a difficulty remaining attentive to a task assigned to them. The patients also display the inability to make informed decisions based on prior experiences. As a result, these patients are not fit for employment.
Diagnosis
The world health organisation and the American Psychiatric Association have manuals that direct the doctor on the elements to look out for during the psychiatric assessment. In order to make positive diagnosis, the patients should display some of the symptoms of schizophrenia for a period of two weeks and have a history of the same within six months. However, this is not enough to complete the diagnosis of schizophrenia. Additional assessments and tests are necessary to compliment or contest the findings of the psychiatric assessment.
The gathering of the medical and family history attempts to find out whether there are environmental or hereditary factors that predispose the individual to schizophrenia. This assessment also tries to find out whether the individual has previous diagnosis with other medical conditions whose treatment may produce side effects similar to schizophrenic symptoms. In addition, the doctor also looks out for other mental conditions with symptoms similar to those of schizophrenia. The physical laboratory tests on the other hand serve the purpose of ruling out the possibility of drug and substance abuse. The blood tests help to establish this. In addition, blood hormonal assays conducted help to find out the relative levels of dopamine in the circulatory system. CT scans are necessary in order to identify brain anomalies that are associated with schizophrenia.
Management and treatment of schizophrenia
Schizophrenia is an eternal mental condition and therefore there is no cure for it. However, patients suffering from schizophrenia can live normal lives using treatments that help them to manage their condition. There are various treatments used in the management of schizophrenia. The best treatment for a patient depends on the most evident symptom and the cause of the schizophrenia. The treatment involves the use of a combination of antidepressant drugs and antipsychotic drugs.
The most commonly used antipsychotic drug is chlorpromazine. The patients must have knowledge of the numerous side effects of the medications used. The patients should also know that they are required to continue with the medication infinitely. In addition to the medications given to the patients, therapy is also a successful intervention in the treatment and management of schizophrenia. The success of this approach relies on the support of the immediate family members. The therapy involves participation in support group activities and training in social skills.
Effect of Schizophrenia to the brain
The main effect of schizophrenia to the brain culminates from the use of the antipsychotic drugs used in the management and treatment of the mental illness. The most profound effect is the reduction in the volume of the brain tissue of the patient. This reduction increases the severity of schizophrenia and this explains why it is difficult to cure schizophrenia completely. According to a research conducted at the University of Iowa by Professor Nancy Andreasen, the brain tissues of schizophrenia patients suffered shrinkage. There was maximum shrinkage within the initial 24 months of the onset of the symptoms of schizophrenia. The study also established that the patients under antipsychotic medication had more pronounced shrinkage compared to those under no medication.
Works cited
Mayo Clinic. Diseases and Conditions Scizophrenia. 24 January 2014. 20 October 2014 <http://www.mayoclinic.org/diseases-conditions/schizophrenia/basics/definition/con-20021077>.
Melinda Smith, M.A., Jeanne Segal, Ph.D. Understanding Schizophrenia Symptoms, Types, Causes, and Early Warning Signs. October 2014. 20 October 2014 <http://www.helpguide.org/articles/schizophrenia/schizophrenia-signs-types-and-causes.htm>.
National Institute of Mental Health. Scizophrenia. U.S. Department of Health and Human Services, n.d.
Steven E. Meier, Ph.D. Schizophrenia; lecture notes. University of Idaho, n.d.
