Essay on "Schizophrenia Severe, Chronic, Little Understood & Poorly"

Essay 9 pages (2509 words) Sources: 1+ Style: APA

[EXCERPT] . . . .

Schizophrenia

SEVERE, CHRONIC, LITTLE UNDERSTOOD & POORLY

TREATED

Schizophrenia

Facts and Figures

Schizophrenia is a severe, chronic, complex and baffling mental health disorder, characterized by brain disturbance (Greystone Program Team, 2009). Previously regarded as a psychological disease, it is now viewed as a brain disease. It is a most devastating condition for both the ill and their family The National Institute of Mental Health said that approximately 2.4 million Americans suffer from schizophrenia (Greystone Program Team). This means 7.2 for every 1,000 persons or 21,000 for every 3 million will be diagnosed with schizophrenia in the United States. Worldwide incidence is 1% of those over 18 or 51 million globally (Nemade & Dombeck, 2006; Scchizophrenia.com, 2004). Outside the United States, this means 6-12 million in China; 4.3- 8.7 million in India; 285,000 in Australia; more than 280,000 in Canada; and more than 250,000 in Britain. It is among the 10 top causes of disability in developed countries. Every year, an additional 4,000 can expect to be diagnosed with schizophrenia. Worldwide this year, there should be 1.5 million afflicted. It can develop in individuals belonging to any class, color, religion and culture with some differences in incidence and outcomes (Schizophrenia.com).

It was believed to occur throughout a person's life span, but recent observations say that it is likeliest to occur in early adulthood (Nemade & Dombeck, 2006). Those aged 16 to 25 are the highest risk but with differing susceptibility between the genders. Males appear more vulnerable to the illness between ages 18 and 25 while women tend to develop it between 25 and 30 and return around age 40 (Greystone Program Team, 2009). In prevalence, one out of 10 who commit suicide suffers from depression, schizophrenia or another mental illness. Schizophrenia is also very costly for affected families and society in general. Overall expenditures in 2002 alone reached $62.7 billion. These were broken down into $7 billion outpatient expenses; $5 billion in drugs; $2.8 billion inpatient expenses; and $8 billion outpatient expenses (Schizophrenia.com, 2004).

Causes, Symptoms, Course and Personal Experience

Causes

Schizophrenia is little understood and its causes are unknown. Some experts believe that these causes are multifactoral or both genetic and environmental (Greystone Program Team, 2009). Parental genes and unknown environmental factors combine to set the stage for the disorder. One gender has been observed to be more affected than the other as possessing different thresholds of expression. One gender is more likely to express his or her problem than the other. More males develop schizophrenia in childhood and more females in adulthood. But occurrence in adolescence is comparable between them (Greystone Program Team).

Other experts ascribe the disorder to genetic and perinatal causes (Frankenburg, 2009). The risk is higher among biological relatives of a sufferer at 10% among first-degree relatives. The risk reaches 40% if both parents are sufferers, 10% for dizygotic twins and 40-50% for monozygotic twins. The most suspected gene variants have, however, been found to account for only a few cases of schizophrenia and have not been replicated for confirmation as evidence. The catechol-O-methyltransferase gene codes, the RELN gene codes for the protein reelin and the NOSIAP gene codes have aroused interest among researchers (Frankerburg).

Certain perinatal conditions are also held suspect. Women who suffer from malnutrition or viral illnesses during pregnancy may increase of the child's vulnerability to schizophrenia in later life (Frankenburg, 2009). Children of malnourished Dutch mothers during World War II recorded high incidence of the mental disorder. The 1957 influenza A2 epidemics in Japan, England and Scandinavia raised the incidence of schizophrenia among the children of women who got ill of the flu during their second trimester of pregnancy. Studies also showed that women in California who were pregnant between 1959 and 1966 had increased risks of giving birth to children who later developed schizophrenia if these mothers were ill of flue during the first trimester of their pregnancy. Obstetric complications and childbirths in the winter months had higher risks of schizophrenia (Frankenburg).

Most experts conjecture that schizophrenia is the result of a combination of a genetic predisposition and environmental factors and/or stresses during pregnancy or childhood (Schizophrenia.com, 2009). These factors contribute to, or trigger, the disorder. The key genes include the DISC1, Dysbindin, Neuregulin, and G72 genes. But experts are agreed that up to a dozen or more genes are likely to be involved in creating a predisposition or increasing the risk for schizophrenia (Schizophrenia.com).

Symptoms

These include disturbances in thoughts or cognitions, mood, perceptions, and relationships (Frankenburg, 2009). The most discernible symptoms are auditory hallucinations and delusions of fixed and false beliefs. Distorted information processing is less frequent and vivid. Employment, marriage and independent living are more affected in people with schizophrenia than other people without the disorder (Frankenburg).

Psychotic symptoms suddenly appear in schizophrenia as among its most startling characteristics (Greystone Program Team, 2009). While individuals may have different symptoms, they share a lot in common. Among these are a distorted perception of reality, confused thinking, detailed and irrational thoughts and ideas, suspiciousness and/or paranoia, hallucinations, delusions, extreme moodiness, severe anxiety, flat affects, difficulty in performing school or work functions, exaggerated self-importance, social withdrawal, sudden agitation, immobility and other odd behaviors. These symptoms are either positive or negative. Positive symptoms include delusions, hallucinations and bizarre behavior. Negative symptoms include flat affect, withdrawal and emotional unresponsiveness. A person with schizophrenia may also exhibit disorganized or incomprehensible speech, disorganized or catatonic behavior. Catatonic behavior includes mood swings, sudden aggression or confusion, which is followed by similarly sudden motionlessness and staring. Afflicted children display similar symptoms. In 80% of cases, these are auditory hallucinations. They experience delusions and disorganized thought disorders when they reach adolescence or later (Greystone Program Team). Other experts cognitive and mood symptoms (Frankenburg, 2009). Cognitive or neurocognitive symptoms include deficits in working memory, attention and executive functions, such as thought organizing and abstract thinking. Mood symptoms include depression and alternating cheerfulness and sadness in an irrational way (Frankenburg).

Course and Personal Experiences

A gradual prodromal or pre-cursor stage precedes the full start of schizophrenia and this is characterized by anxiety, restlessness and hallucinations (Nemade and Dombeck, 2008). The loss of a sense of reality is often gradual. Some schizophrenia patients describe the start of their odd feelings, thoughts and perceptions months before they exhibit visible symptoms. This makes the prodromal or pre-cursor stage difficult to diagnose. At this stage, the person hears criticizing voices and delusion but his symptoms are not strong enough for his personality to break down. He is able to hide his symptoms for the first time. But as the process continues, his external actions begin to reveal his inner distortions and agitations. It is only during the so-called psychotic break or "first break" that his condition is perceived by a mental health professional (Nemade and Dombeck).

While the person goes through a terrifying internal experience, his family and other people around notice or are disturbed by the accompanying outward symptoms of the ailment (Nemade and Dombeck, 2008). These include changes in self-care, sleeping or eating patterns; weakness, lethargy, headaches, changes in school or work performance, strange feelings and sensations, and confused or strange thinking expressed in irrational or bizarre behavior. His break with reality can occur before people around him notice that something terribly wrong is happening to him. The period following the psychotic break is called the active phase. When schizophrenia sets in, it turns chronic and remains throughout life in different levels of intensity. If schizophrenia is mild and treatment is applied promptly and appropriately, the first break may be the last. The first break usually consists of periods of relative recovery and of new active-phase psychosis. These periods persist through the patient's live (Nemade & Dombeck). The 10% lifetime risk of suicide among those with schizophrenia is compounded by medical conditions occasioned by the disorder (Frankerburg, 2009). These are unhealthy lifestyles, side effects of medications, decreased self-care and other risks they expose themselves to (Frankenburg).

Diagnosis, Effects on Family and Treatments

Diagnosis

This covers blood tests, imaging studies and neurological tests conducted at the start of the disorder and periodically afterwards (Frankenburg, 2009). The patient is subjected to a complete blood count; liver, thyroid, and renal function tests; electrolyte, glucose, vitamin B12, folate and calcium level tests; HIV, RPR, ceruloplasmin, ANA, urine, pregnancy and syphilis tests. Brain imaging and chest x-rays are also performed to eliminate hematomas, vasculitis, abscesses and tumors, pulmonary or malignancy possibilities. Other examinations are neuropsychological testing, an electroencephalogram, dexamethasone suppression test and adresnocorticotropic hormone stimulation tests. The patient's family medical and psychiatric history is recorded. This includes mother's pregnancy and the patient's early childhood, travels, medications and substance use or abuse (Frankenburg).

The patient's childhood is usually unremarkable until a noticeable change in personality is noticed (Frankenburg, 2009). His academic, social and interpersonal functioning deteriorates during middle to late adolescence. His family often describes him as physically clumsy and emotionally aloof as a child. He is typically anxious and a loner, learns walking at a later… READ MORE

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