Conditions and Disorders
Schizophrenia is a serious mental disorder in which a person’s thought processes and emotional health have degraded. This usually crops up as auditory hallucinations, delusions, and disorganized speech and thinking. Significant social or occupational ability deterioration is also observed in the schizophrenic. These symptoms usually begin in young adulthood and diagnosis is derived from observations of the patient along with the patients reported experience. Genetics, early environment, neurobiology and psychological and social health are all contributing factors. Certain recreational and prescription drugs such as amphetamines and marijuana can cause or worsen schizophrenia.
Primary treatment for schizophrenics is antipsychotic medications which suppress dopamine and sometimes serotonin in the brain. Psychotherapy and rehabilitation are also important treatment options for the schizophrenic. People with schizophrenia likely have coexisting disorders such as anxiety or depression and drug abuse is common among this group. Schizophrenics may experience hallucinations; hearing voices is the most common hallucination for those suffering from this ailment.
Delusions and disorganized thinking and speech are also common symptoms of schizophrenia. This may manifest as loss of train of thought to saying words that are only loosely connected in meaning. The most severe type of incoherence, known as word salad, is when words are strung together that have no coherence whatsoever. Social deterioration occurs with those suffering from schizophrenia and isolation is common.
Genetic and environmental factors both play a role in the development of schizophrenia. Those with a first-degree relative with schizophrenia have a 6.5% chance of developing the disorder themselves. Those who grow up in an urban environment are two times more likely to develop schizophrenia. Social isolation has also been shown to raise the chances of schizophrenia.
There are many drugs that may cause schizophrenia in vulnerable individuals. Cannabis, cocaine, and amphetamines all have the potential to cause schizophrenia. About half of all schizophrenics use drugs excessively and nicotine is used at much higher rates in this population as well. Infection, stress, or malnutrition in the mother during fetal development may also play a role in the development of schizophrenia. In order for a doctor to diagnose schizophrenia, three criteria must be met. Two symptoms must be present out of the following: delusions, hallucinations, disorganized speech, disorganized behavior and negative symptoms (such as blunted affect). Social or occupational dysfunction is the second criteria and the third criteria is that these must be present for at least six months. If they are present more than a month but less than six, schizophreniform disorder may be diagnosed. Psychosis that lasts less than a month is known as brief psychotic disorder. Schizophrenia should not be diagnosed if the patient is on drugs which may be causing the symptoms.
The subtypes of schizophrenia are paranoid type, disorganized type, catatonic type, undifferentiated type, and residual type.
The paranoid type has delusions and hallucinations however lacks thought disorder, disorganized behavior, or blunted affect. Disorganized type is when thought disorder and blunted affect coexist. Catatonic type is when the subject is almost immobilized and movements lack purpose. Undifferentiated type is when psychotic symptoms are present but criteria for paranoid, disorganized, or catatonic types do not match. Residual type is when positive symptoms are present at a very low level.
Schizophrenia is primarily treated by antipsychotic medications, often accompanying psychotherapy or other social supports. Short-term hospitalization is required for some to stabilize after severe episodes. Antipsychotics have been shown to reduce positive symptoms in about one to two weeks but do very little to treat the negative symptoms of schizophrenia. Atypical antipsychotics such as quetipine and risperidone may cause weight gain, diabetes and risk of metabolic syndrome. Typical antipsychotics have a higher chance of causing extrapyramidal side effects such as movement disorders. For those that are noncompliant with medication or are unable to take medication, long acting versions of antipsychotics called depot injections may be administered.
Schizophrenics have a life expectancy that is 12-15 years less than normal. This is associated with a higher rate of obesity, sedentary lifestyles and smoking. A higher rate of suicide also plays a small factor in these statistics. Schizophrenia is a leading cause for disability in America, led only by quadriplegia and dementia.