Schizophrenia is a serious, chronic mental disorder characterized by loss of contact with reality and disturbances of thought, mood, and perception. Schizophrenia is the most common and the most potentially sever and disabling of the psychosis, a term encompassing several severe mental disorders that result in the loss of contact with reality along with major personality derangements. Schizophrenia patients experience delusions, hallucinations and often lose thought process. Schizophrenia affects an estimated one percent of the population in every country of the world.
Victims share a range of symptoms that can be devastating to themselves as well as to families and friends. They may have trouble dealing with the most minor everyday stresses and insignificant changes in their surroundings. They may avoid social contact, ignore personal hygiene and behave oddly (Kass, 194). Many people outside the mental health profession believe that schizophrenia refers to a split personality. The word schizophrenia comes from the Greek schizo, meaning split and phrenia refers to the diaphragm once thought to be the location of a persons mind and soul.
When the word schizophrenia was established by European psychiatrists, they meant to describe a shattering, or breakdown, of basic psychological functions. Eugene Bleuler is one of the most influential psychiatrists of his time. He is best known today for his introduction of the term schizophrenia to describe the disorder previously known as dementia praecox and for his studies of schizophrenics. The illness can best be described as a collection of particular symptoms that usually fall into four basic categories: formal thought disorder, perception disorder, feeling/emotional disturbance, and behavior disorders (Young, 23).
People with schizophrenia describe strange of unrealistic thoughts. Their speech is sometimes hard to follow because of disordered thinking. Phrases seem disconnected, and ideas move from topic to topic with no logical pattern in what is being said. In some cases, individuals with schizophrenia say that they have no idea at all or that their heads seem empty. Many schizophrenic patients think they possess extraordinary powers such as x-ray vision or super strength. They may believe that their thoughts are being controlled by others or that everyone knows what they are thinking.
These beliefs are caused by delusions. Most specialists agree that symptoms are provoked by chemical disturbances of the brain, but no exact mechanism is known (Mueser, 102). Those with schizophrenia regularly report unusual sensory experiences, especially when the illness is in an acute stage. Often these experiences are in the form of hearing voices. Persons may hear one or two voices making comments on their behavior. They may not know the voice, or they may believe it is the voice of God, the Devil, or a friend.
When the voice issues orders to behave in a particular way, the experience is known as a command hallucination. These hallucinations can be very dangerous to the sufferer and others. When the voice commands the person to do something, the schizophrenic person will perform that task as instructed (Kass, 188). Particular, repetitive movements sometimes are seen in schizophrenics. Victims might swing one leg back and forth all day, or constantly shake their heads. Catatonic behavior is another symptom; a victim might keep the same position for hours, unable to talk or eat.
Catatonic schizophrenia is marked by striking motor behavior. Some victims may be overly intrusive, constantly prying into the affairs of those around them (Gingerich, 64). When compared to other people in general, those with schizophrenia are less likely to marry or remain married; more likely to have school problems; often unable to keep their jobs; more prone to suicide attempts. People with schizophrenia also tend to fall into other groupings that can help in diagnosis. The majority range in age from adolescence to the mid twenties at the time the psychosis begins.
No single patient is likely to show all the symptoms associated with the illness or fall into all of the categories listed. One person may experience only auditory hallucinations and exhibit only inappropriate emotions. Another might become reclusive and suffer from delusions (Arasse, 210). The modern era of medical treatment for schizophrenia began in 1952 with the use of the tranquilizer chlorapromazine. This drug, for the first time, controlled acute systems, reduced hospitalization from years to days, and lowered the rate of relapse by more than fifty percent.
Not everyone responds to these drugs. Long term control is less successful than short term alleviation. Prolonged medication may bring harmful side effects, especially the neurological muscle disorder known as tardive dyskinesia (TD), which causes involuntary facial movements. Dopamine is the primary neurotransmitter that appears to be involved in this disorder, and most medications used to treat schizophrenia target this neurotransmitter and its receptors in the brain. Schizophrenia seems to be a syndrome of multiple causes and types.
Genetics seem to play a role, but there is no single schizophrenia gene. While it is clear that a supportive family can be helpful in preventing relapse, it is also agreed that family strife does not cause schizophrenia (Young, 35). One of the most recent advances in treating schizophrenia is the drug clozapine. This drug has been used in Europe and China for a number of years and now has been approved by the Food and Drug Administration in 1990 for use in the United States. Clozapine is sometimes effective in cases where other drugs have failed to blunt systems.
This drug appears to have fewer side effects than some of the anti-psychotic drugs. A major drawback to its use is that it can dangerously lower the count of white blood cells. Other new medications that have beneficial effect similar to clozapine but that appear to be safer are now undergoing testing and may be available in the near future. Various medications are handled by the body in different ways, so one drug may be selected over another because it has less chance of damaging a diseased liver, worsening a heart condition, or affecting a patients high blood pressure.
For all the benefits that anti-psychotic drugs provide, clearly they are far from ideal. Some patients will show marked improvement with drugs, while others might be helped only a little, if at all. Ideally, drugs soon will be developed to treat successfully the whole range os schizophrenia symptoms. Roughly one third of schizophrenic patients make a complete recovery and have no further recurrence, one third have recurrent episodes of the illness, and one third deteriorate into chronic schizophrenia with severe disability (Kass, 206).