A mental disorder whose characteristics include hallucinations, delusional behavior, disorganized speech, social isolation, intellectual deterioration, and emotional blunting
- No single cause
- Contributing factors include prenatal, perinatal, brain abnormalities, and genetic predisposition factors
- Prenatal and perinatal factors are about defects in brain development as experienced by fetus
- Complications during delivery
- Brain abnormalities
- Reactions to a particular experience or situation or stresses
- There is a belief that the earliest existing history about the disorder was written in early Egyptian manuscripts in 1400 BC.
- The theory that the human body could be possessed by evil spirits is the earliest theory of mental illnesses.
- Victims were burnt to death in the 14 and 15th Centuries
- Physicians began to use different methods of diagnosing and treating mental illnesses by late 1700s
- Doctors and scientists started to differentiate mental illnesses during the last part of the 1800s.
- The description and identification of this disorder as a distinct mental illness was done by Dr. Emile Kraepelin in 1887
Naming of Schizophrenia
- Emile Kraepelin was the first person to classify mental disorders
- The first person to use the term “schizophrenia” was Eugen Bleuler in 1911
- He reasoned that the disorder deserved an own name for it was not a form of dementia
History of Treatment
- Various treatments have been there over the years
- Exorcising victims and burning them to death in the 14 and 15th Centuries
- The treatment of mental illness in the middle ages was religion whereby patients were encouraged to confess their sins to God
- Locking patients in “insane asylums” and flogging them in the 1800s
- Fever therapy in 1900s
- First successful treatment done in the 1950s Thorazine medication
- Since then, many more treatments have been developed
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- Significant advancements in the diagnosis and treatment of the disorder over the past few decades
- Confirmation that the disorder is a biological disease of the brain
- Effectively treated with antipsychotic medications
- In severe situations, patients may need to stay in hospital for as long as the episode lasts
- Recovery may be enhanced through teaching skills and support groups
- Schizophrenia is so serious a mental disorder that if not well handled, can completely disrupt the life of a victim.
- The hope for those who suffer from it lies in correct diagnosis, treatment through antipsychotics, and proper long-term management.
Schizophrenia is a mental disorder whose characteristics include hallucinations, delusional behavior, disorganized speech, social isolation, intellectual deterioration, and emotional blunting. A person is said to be delusional if they have false beliefs, including believing that people can read their minds or that people are trying to harm them. Hallucinations happen when one hears voices that are nonexistent. Schizophrenic persons may also have feelings, tastes, smell, and sight of things that are actually not there. Disorganized speech is when one’s speech is not easily understandable or is broken.
To-date, research has not established sufficient evidence to support a single cause of schizophrenia. Research has however shown that there are factors that make an individual more vulnerable to the disorder. These contributing factors include prenatal, perinatal, brain abnormalities, and genetic predisposition factors.
Prenatal and perinatal factors are a leading theory, which is about defects in brain development as experienced by fetuses. Variations in neural development occur due to interference of genetically-programmed brain development by environmental influences (Flack, Miller & Wiener, 2012). It has for example been reported that viral infections during pregnancy contribute to schizophrenia development. These reports are based on a study that was conducted in Finland about pregnant women who, in their second trimesters, were exposed to the A2 influenza virus. The babies they delivered were diagnosed with increased schizophrenia. According to Flack, Miller and Wiener (2012), compared to the control group, children of women who were exposed to the virus during their first and third trimesters were not affected any higher.
Increased schizophrenia chances may also be attributed to complications during delivery. Flack, Miller and Wiener (2012) explain that complications here may be in the form of prenatal and perinatal hypoxia as well as a difficult delivery. Studies have shown that hypoxia can effectively alter the functioning of brain dopamine. Studies have also established that one may be at increased risks if they are born in the months of winter, especially February and March. The months of the year least associated with the disorder with respect to delivery have been shown to be August and September.
Brain abnormalities are also associated with schizophrenia. Understanding the neurotransmitters dopamine in the brain is one of the key factors to understanding the disorder. In a study, brain autopsies conducted on dead bodies revealed that dopamine receptors were in excess six-fold. At this rate, brain signals could be intensified by dopamine and this could create positive symptoms of schizophrenia (Abel & Nickl-Jockschat, 2016). This theory is supported by the fact that when such drugs as cocaine and amphetamines known to enhance levels of dopamine are used by diagnosed individuals, they sometimes intensify symptoms of the disorder. It is such activity that may be triggering overreactions by victims to external and internal stimuli that are irrelevant.
Further, an individual’s probability to develop schizophrenia increases if they are genetically predisposed. There would be about an eighth chance of developing the disorder for a child whose biological parent(s) suffer from it (Abel and Nickl-Jockschat, 2016). The risk is also increased if one is a twin, with the concordance rate for monozygotic twins ranging between 30% and 50% while that for dizygotic twins is about 15%. Compared to the 1% rate that is found in the general population, these are considerably very high rates (Abel and Nickl-Jockschat, 2016). It is however noteworthy that an individual may not necessarily manifest the disorder even if they carry its predisposing genes. Such cases are attributed to the predisposing genes not being sufficient for schizophrenia to develop.
One may also develop schizophrenia when they react to a particular experience or situation since the disorder may be carried. Another contributing factor may be stress. For instance, Noll (2009) points out that there are three times higher chances for American youth immigrants with no family members to develop the dreaded disorder because they have no one to ease their stresses.
It is hard to pinpoint where or when schizophrenia started because generally, the same treatment was administered to people who suffered from physical deformities, mental retardation, and mental illness. There is a belief that the earliest existing history about the disorder was written in early Egyptian manuscripts in 1400 BC. Other historical evidence about schizophrenia-like disorders can be found in archaeology in that burr holes were drilled into Stone Age skulls so that spirits could find a way to escape from them. The theory that the human body could be possessed by evil spirits is the earliest theory of mental illnesses. According to Mueser and Jeste (2008), this theory posits that one could be possessed if they got involved with evil spirits or the devil.
It was common for the society to burn to death people who were believed to be possessed in the 14th and 15th Centuries. This was because it was believed that mentally ill people were being punished by God. The argument that mental illness was a natural state and not a punishment from God or possession by the devil was written in De praestigiis daemonum by Johann Weyer in 1563. This message was harshly criticized by the Church which went on to call Weyer a sorcerer and even forbade the book (Mueser & Jeste, 2008). Effectively, this brought a stop in scientific research about mental illness during that time.
Physicians began to use different methods of diagnosing and treating mental illnesses by late 1700s. A call for a moral treatment for mentally ill people was made by Physician Phillippe Pinel who opined that social and psychological stressors could be the cause of mental illness. It was around this time that the British Isles opened the first mental institution (Mueser & Jeste, 2008). Doctors and scientists started to differentiate mental illnesses during the last part of the 1800s. A description of the “cognitive disorganization and silliness” symptoms was given by Ewald Hecker in 1871 and is still being used in disorganized schizophrenia diagnosis. Although it was not called schizophrenia at the time, the description and identification of this disorder as a distinct mental illness was done by Dr. Emile Kraepelin in 1887.
Naming of Schizophrenia
Dr. Emile Kraepelin was the first person to classify mental disorders. He referred to the symptoms of schizophrenia as early dementia or “dementia praecox”. He named it this way so that he could create a distinction between the disorder and dementia. The first person to use the term “schizophrenia” was Eugen Bleuler, a psychiatrist from Switzerland, in 1911. He noted that mental deterioration symptoms that were the hallmarks of dementia were not often shown by patients with dementia praecox. He also noted that a person could suffer from schizophrenia either in their early or later life. It was out of these reasons that he opined that the disorder deserved an own name for it was not a form of dementia hence the name schizophrenia (Noll, 2009). Schizophrenia loosely means a mind that is split and thus describes the manner in which people with the disorder think fragmentally.
History of Treatment
Over the years, there have been various treatments of schizophrenia in line with what people believe causes the disease. For example, the treatment was to drive out spirits out of a person by drilling a hole into their skull when the belief was that the disorder was caused by possession by evil spirits. Alternatively, people were burned to death, starved, flogged, or exorcised if driving away the spirits was not successful. Lieberman, Stroup and Perkins (2012) note that a hypothesis was formulated by Hippocrates that it was an imbalance in the four bodily humors that caused madness and as such; rebalancing the humors was enough to cure it. As per this hypothesis, the rebalancing was to be done through bloodletting, purgatives, and special diet. However, a patient would often die from bloodletting.
The treatment of mental illness in the middle ages was religion whereby patients were encouraged to confess their sins to God because it was believed that they were serving a punishment from Him. The treatment in 1800s was worse as it involved locking patients in “insane asylums” and even flogging them. By the start of 1900s, schizophrenia was being commonly treated by fever therapy and such other treatments as prefrontal leucotomy, electroshock or electroconvulsive treatment, gas therapy, and sleep therapy (Lieberman, Stroup & Perkins, 2012). However, these treatments did not cure the disease but rather just controlled behaviors of the patients. Still in 1900s, Sigmund Freud developed the argument that schizophrenia resulted from unconscious conflicts that started from one’s childhood. The first successful treatment of the symptoms of the disorder was done in the 1950s through a medication known as Thorazine and since then, many more treatments have been developed.
There have been significant advancements in the diagnosis and treatment of schizophrenia over the past few decades. As pointed out by Noll (2009), it has been possible to confirm that the disorder is a biological disease of the brain through molecular genetics and advanced imaging studies. There is however also an understanding that the illness could be associated with psychological factors and that its episodes could be triggered by social stressors.
Currently, schizophrenia is most commonly and effectively treated with antipsychotic medications. In severe situations, patients may need to stay in hospital for as long as the episode lasts for their own safety as well as that of others. Once one develops it, schizophrenia stays with one for their lifetime hence a need for continued medication and treatment (Lieberman, Stroup & Perkins, 2012). Recovery from symptoms may be enhanced through teaching skills and support groups in addition to medications.
According to Lieberman, Stroup and Perkins (2012), the most effective treatment tool for schizophrenia has been medications. The antipsychotic medications help in controlling some symptoms by changing chemical balancing in the brain. Medications however attract side effects such as weight gain, tremors, slow movements, feeling tired, restlessness, and dizziness. It is possible to manage some side effects and therefore patients should not shy away from treatments due to side effects. A serious side effect that emanates from the use of antipsychotic medications is tardive dyskinesia, a long-term movement disorder. It commonly affects the mouth and causes uncontrollable movements. If other medications are unsuccessful, Clozapine which is the most effective medication is used in spite of having the strongest side effects.
This research paper has revealed that schizophrenia is so serious a mental disorder that if not well handled, can completely disrupt the life of a victim. The absence of absolute knowledge about what exactly causes it as well as its specific treatment only makes it a more complicated disease. From this research, it is clear that the hope for those who suffer from it lies in correct diagnosis, treatment through antipsychotics, and proper long-term management. If diagnosed correctly, the appropriate antipsychotic drugs would be prescribed and the patient would attain a stable phase if they are consistent with their medication. It is also noteworthy that treatment for schizophrenia are symptoms-focused since the primary causes of the illness are yet to be known. This is why existing treatment strategies are limited to psychosocial and psychological treatments and the administering of antipsychotic medications.