Psychiatric Disorders (Schizophrenia) and its Causes

Mental Disorder, Schizophrenia

Schizophrenia is a chronic brain disease, severe, and disabling. About 1 percent of the population develops schizophrenia during their lifetime - more than 2 million Americans suffer from the disease in a given year. Although schizophrenia affects men and women with equal frequency, the disorder often appears earlier in men, usually in their late teens or early twenties, than in women, who are generally affected in the twenties or early thirties. People with schizophrenia often experience terrible symptoms such as hearing internal voices not heard by others, or believing that other people are reading their minds, controlling their thoughts, or plotting to harm them. These symptoms may make them fearful and withdrawn. Their speech and behavior can be so disorganized that they may understand. They are also often afraid of other people. Available treatments can relieve many symptoms, but most people with schizophrenia continue to suffer some symptoms throughout their lives. It is estimated that not more than one in five individuals recovers completely.

Research gradually lead to new treatments safer and uncover the causes of complex diseases. Scientists are using many approaches from molecular genetic studies for population studies of schizophrenia. Methods of imaging brain structure and function promises new insights into the disorder.

Schizophrenia as a disease

Schizophrenia is found all over the world. The severity and duration of symptoms is different. Chronic pattern of schizophrenia often cause a high degree of disability. Drugs and other treatments for schizophrenia, when used regularly and as prescribed, can help reduce and control the distressing symptoms that arise from this disease. However, some people are not greatly helped by available treatments or may prematurely discontinue treatment because of unpleasant side effects or other reasons. Even when treatment is effective, endure the consequences of the disease (lost opportunities, stigma, residual symptoms, and side effects of treatment) may be very disturbing.

The first signs of schizophrenia often confusing, or even shocking. Examples of behavior change. Treat symptoms of schizophrenia can be very difficult for family members who remember how active or agile someone before they become ill. Sudden onset of severe psychotic symptoms is referred to as the phase of "acute" of schizophrenia. "Psychosis," a common condition in schizophrenia, is a state of mental disorder characterized by hallucinations, impaired sensory perception, and / or false delusions. Personal beliefs that result from an inability to separate real and who is not. Less obvious symptoms, such as social isolation or withdrawal, or unusual speech, thinking, or behavior, may precede, be seen along with, or follow the psychotic symptoms.

Some people have only one psychotic episode. However, some others have many episodes during a lifetime despite relatively normal lives during the interim period. However, individuals with schizophrenia "chronic" or recurring pattern, often does not fully recover normal functioning and typically requires long-term treatment, generally including medication, to control the symptoms.

Creating Diagnosis

It is important to rule out other diseases. Sometimes people suffer severe mental symptoms or even psychosis due to undetected underlying medical conditions. For this reason, a medical history must be taken and a physical examination and laboratory tests should be performed to rule out other possible causes of symptoms before concluding that a person has schizophrenia. In addition, because the commonly abused drugs may cause symptoms resembling schizophrenia. Blood or urine samples from the person can be tested in a hospital or doctor's office for treatment purposes.

Basically, it is difficult to distinguish one from the other mental disorders. For example, some people with schizophrenia symptoms showed prolonged extremes of elated mood or depression, and it is important to determine whether the patient has schizophrenia or actually has a manic-depressive (or bipolar) disorder or major depressive disorder. People whose symptoms can not be clearly categorized are sometimes diagnosed as having a "schizoaffective disorder."

Can Children Suffering from Schizophrenia?

Children over the age of five can suffer from schizophrenia, but it is very rare before adolescence. Although some people who later contracted schizophrenia may seem different from other children at an early age, psychotic symptoms of schizophrenia - hallucinations and delusions - are very rare before adolescence.

 

World of People with Schizophrenia

Distorted perception of reality

People with schizophrenia may have perceptions of reality that is very different from the reality seen by others around them. Living in a world distorted by hallucinations and delusions, individuals with schizophrenia may feel frightened, anxious, and confused.

Partly because of the unusual realities they experience, people with schizophrenia may behave very differently at various times. Sometimes they may seem distant, detached, or preoccupied and may even sit as still as a stone, not moving for hours or a sound. Other times they may move continuously, always awake, alert, and vigilant.

Hallucinations and Illusions

Hallucinations and illusions are disturbances of perception that is common in people suffering from schizophrenia. Hallucinations are perceptions that occur without connection to the appropriate source. Although hallucinations can occur in any form of sensory - auditory (sound), visual (sight), tactile (touch), taste (taste), and olfactory (smell) - hearing voices that other people do not hear is the most common type of hallucination in schizophrenia. Sound can describe the patient's activities, carry on a conversation, warn of impending danger, or even issue orders to the individual. Illusion, on the other hand, occur when a sensory stimulus is present but not interpreted by individuals properly.

Delusions

Delusions are false personal beliefs that are not subject to reason or contradictory evidence and are not explained by the usual concepts. Delusions may take on different themes. For example, patients suffering from paranoid types of symptoms - about one-third of people with schizophrenia - often have delusions of persecution, or false and irrational beliefs that they are being cheated, harassed, poisoned, or find a group of people conspired to harm him. These patients may believe that they, or a family member or someone close to them, are the focus of this persecution. In addition, delusions of grandeur, in which a person may believe he or she is a famous or important figure, may occur in schizophrenia. Sometimes the delusions experienced by people with schizophrenia are quite bizarre, for example, believing that neighbors can control their behavior with magnetic waves, that people on television are directing special messages to them, or that their thoughts are being broadcast aloud to people another.

Substance Abuse

Substance abuse is a common concern of the family and friends of people with schizophrenia. Some people with drug abuse may exhibit symptoms similar to schizophrenia. Researchers increasingly suggests that some street drugs (such as marijuana / cannabis) can significantly increase the risk of schizophrenia. People who have schizophrenia often abuse alcohol and / or drugs, and may have had very bad reactions to certain drugs. Substance abuse can reduce the effectiveness of treatment for schizophrenia .. stimulants (such as amphetamines, cocaine, PCP, or cannabis) can cause major problems for patients with schizophrenia. In fact, some people experience a worsening of their schizophrenic symptoms when they take the drug. Substance abuse also reduces the likelihood that patients will follow the treatment plan recommended by their physician.

Schizophrenia and Nicotine

The most common form of drug use disorders in people with schizophrenia is nicotine dependence due to smoking. While the prevalence of smoking in the US population is about 25 to 30 percent, prevalence among people with schizophrenia is approximately three times higher. Research has shown that the relationship between smoking and schizophrenia is complex. Although people with schizophrenia who smoke can treat their symptoms, smoking will interfere with the response to antipsychotic drugs. Several studies have found that schizophrenia patients who smoke need higher doses of antipsychotic drugs. Quitting smoking may be very difficult for people with schizophrenia since nicotine withdrawal symptoms may temporarily worsen the symptoms of schizophrenia. However, smoking cessation strategies that include nicotine replacement methods may be effective. Doctors should carefully monitor medication dosage and response when patients with schizophrenia begin goodness or quit smoking.

Disorganized thinking

Schizophrenia often affects a person's ability to "think straight." A person may not be able to concentrate on one thought for a very long time and can be easily distracted, unable to concentrate.

People with schizophrenia may not be able to sort out what is relevant and what is not relevant to the situation. People may be unable to connect thoughts into logical sequences, with thoughts becoming disorganized and fragmented. Lack of logical continuity of thought, termed "thought disorder," can make conversation very difficult and may contribute to social isolation. If people can not understand what someone is saying, they tend to become uncomfortable and tend to leave that person alone.

Emotional expression

People with schizophrenia often show a sense of "blunted" or "flat". This refers to a severe reduction in emotional expression. People with schizophrenia may not show signs of normal emotion, perhaps may speak in a monotone voice, have diminished facial expressions, and appear extremely apathetic. The person may withdraw socially, avoiding contact with other people, and when forced to interact, he or she may have nothing to say, reflecting "impoverished thought." Motivation can be greatly decreased, as there is no interest in or enjoyment of life. In some severe cases, a person can spend the whole day without doing anything at all, even neglecting basic hygiene. These problems with emotional expression and motivation, which may be very disturbing family members and friends, are symptoms of schizophrenia - not a character flaw or personal weakness.

Normal Versus Abnormal

At any given time, normal individuals may feel, think, or act in a way that resembles schizophrenia. Sometimes a person may become very anxious, for example, when speaking in front of groups and may feel confused, unable to pull their thoughts together, and forget how to "think straight.". This is not schizophrenia. At the same time, people with schizophrenia do not always act normal. Indeed, some people with this illness can appear completely normal and perfectly responsible, even while they experience hallucinations or delusions. Individual behavior may change from time to time, be strange if the medication is stopped and returning closer to normal when receiving appropriate treatment.

Schizophrenia is not "Split Personality"

There is a common notion that schizophrenia is the same with "multiple personalities" -Dr Jekyll-Mr Hyde switch in character. This is not true.

Are People With Schizophrenia Maybe To Perform Violence?

News and entertainment media tend to link mental illness and criminal violence. However, research shows that except for people with a criminal record of violence before becoming ill, and those with substance abuse or alcohol problems, people with schizophrenia are not very vulnerable to violence. Most individuals with schizophrenia are not hard; usually, they actually withdrawn and prefer to be left alone. Most violent crimes are not committed by people with schizophrenia, and most people with schizophrenia do not commit violent crimes. Substance abuse significantly increases the level of violence in people with schizophrenia, but also in people who do not have mental illness. People with paranoid and psychotic symptoms, which can become worse if the drug is discontinued, may also have a high risk for violent behavior. When violence occurs, it is most often targeted at family members and friends, and are more common in the home.

About Suicide?

Suicide is a serious danger in people who have schizophrenia. If someone tries to commit suicide or threatens to do so, professional help should be sought immediately. People with schizophrenia have a higher suicide rate than the general population. About 10 percent of people with schizophrenia (young adult males in particular) to commit suicide. Unfortunately, the prediction of suicide in people with schizophrenia can be very difficult.

What Causes Schizophrenia?

There is no known single cause of schizophrenia. Many diseases, such as heart disease, result from the interaction of genetic, behavioral factors, and others, and this may be the case for schizophrenia as well. Scientists do not yet understand all the factors necessary to produce schizophrenia, but all the tools of modern biomedical research are used to look for genes, critical moments in brain development, and other factors which may cause illness.

Does Schizophrenia Inherited?

It has long been known that schizophrenia runs in families. People who have a close relative with schizophrenia are more likely to develop the disorder than people who do not have relatives with the disease. For example, (identical) monozygotic twin of a person with schizophrenia has the highest risk - 40 to 50 percent - to develop the disease. A child whose parents schizophrenia has about a 10 percent chance. By comparison, the risk of schizophrenia in the general population is about 1 percent.

Scientists are studying genetic factors in schizophrenia. It seems likely that multiple genes are involved in creating a predisposition to develop the disorder. In addition, factors such as intrauterine pregnancy difficulties such as starvation or viral infections, perinatal complications, and various specific stressor seem to influence the development of schizophrenia. However, it is not yet understood how the genetic predisposition is transmitted, and can not be accurately predicted whether the person who has a schizophrenic genes will or will not develop the disorder.

Some areas of the human genome are being investigated to identify genes that may provide susceptibility to schizophrenia. The strongest evidence to date is chromosomes 13 and 6 but remains unconfirmed. Identification of specific genes involved in the development of schizophrenia will provide important clues into what goes wrong in the brain to guide the development of new and better treatments.

Is Schizophrenia Associated With A Chemical Defect In The Brain?

Basic knowledge about brain chemistry and link to schizophrenia is expanding rapidly. Neurotransmitters, substances that allow communication between nerve cells, have long been thought to be involved in the development of schizophrenia. Chances are, though not certain, that the disorder is associated with some imbalance of the complex chemical systems of interrelated of the brain, perhaps involving the neurotransmitters dopamine and glutamate. The study area is promising.

Is Schizophrenia Caused By Physical Abnormalities In A Brain?

There is a dramatic advances in neuroimaging technology that allows scientists to study brain structure and function in living individuals. Many studies of people with schizophrenia have found abnormalities in brain structure (eg, enlargement of the fluid-filled cavities, called the ventricles, in the interior of the brain, and decreased size of certain brain regions) or function (eg, decreased metabolic activity in certain brain regions). It should be emphasized that this disorder is quite smooth and not characteristic of all people with schizophrenia, nor do they occur only in individuals with this disease. Microscopic studies of brain tissue after death have also shown small changes in distribution or number of brain cells in people with schizophrenia. It seems that many (but probably not all) of these changes are present before an individual becomes ill, and schizophrenia may be, in part, a disorder in brain development.

Neurobiological development was funded by the National Institute of Mental Health (NIMH) found that schizophrenia may be a developmental disorder resulting when neurons form a relationship that is not perfect during fetal development. This fault may lay dormant until puberty, when changes in the brain that occur normally during this critical stage of maturation interact adversely with the faulty connections. This research has prompted efforts to identify prenatal factors that may have some bearing on developmental abnormalities.

In other studies using brain imaging techniques, researchers have found evidence of early biochemical changes that may precede the onset of symptoms of the disease, encouraging examination of neural circuits that are most likely involved in producing the symptoms. Meanwhile, scientists working at the molecular level to explore the genetic basis for abnormalities in brain development and in the neurotransmitter systems that regulate brain function.

How is Schizophrenia Treated?

Because schizophrenia is probably not a single condition and its cause is unknown, current treatment methods based on both clinical research and experience. This approach was chosen based on their ability to reduce the symptoms of schizophrenia and to reduce the possibility that the symptoms will return.

About Medication?

Antipsychotic medications have been available since the mid-1950s. They have greatly improved the outlook for each patient. These medications reduce the psychotic symptoms of schizophrenia and usually allow the patient to function more effectively and appropriately. Antipsychotic drugs are the best treatment now available, but they do not "cure" schizophrenia or ensure that there will be no further psychotic episodes. The choice and dosage of the drug can be made only by a qualified physician trained in the medical treatment of mental disorders. Drug dosage is individualized for each patient, because people can vary a lot in the amount of medication needed to reduce symptoms without producing troublesome side effects.

Most people with schizophrenia show substantial improvement when treated with antipsychotic drugs. Some patients, however, are not helped very much with drugs and some do not seem to require. It is difficult to predict whether a patient will benefit from treatment with antipsychotic medications or not.

A number of new antipsychotic drugs (the so-called "atypical antipsychotics") have been introduced since 1990. The first, clozapine (Clozaril ®), has been shown to be more effective than other antipsychotics, although the possibility of serious side effects - in particular, a condition called agranulocytosis (loss white blood cells that fight infection) - requires that patients be monitored with blood tests every one or two weeks. Even the new antipsychotic drugs, such as risperidone (Risperdal ®) and olanzapine (Zyprexa ®), are safer than the older drugs or clozapine, and they also may be better tolerated. Several additional antipsychotics are currently under development.

Antipsychotic drugs are often very effective in treating certain symptoms of schizophrenia, particularly hallucinations and delusions, unfortunately, the drugs may not help with other symptoms, such as reduced motivation and emotional expressiveness. Indeed, the older antipsychotics (which also goes by the name of "neuroleptics"), drugs such as haloperidol (Haldol ®) or chlorpromazine (Thorazine ®), can even produce side effects that resemble the more difficult to treat symptoms. Often, lowering the dose or switching to a different medication can reduce side effects; new drugs, including olanzapine (Zyprexa ®), quetiapine (Seroquel ®) and risperidone (Risperdal ®), seems less likely to have this problem. Sometimes when people with schizophrenia become depressed, other symptoms can appear to worsen. The symptoms can be improved with the addition of an antidepressant.

Patients and families sometimes become worried about the antipsychotic drugs used to treat schizophrenia. In addition to concerns about side effects, they may worry that the drug can lead to addiction. However, antipsychotic medications do not produce the behavior of the "high" (euphoria) or addictive patients.

Another misconception about antipsychotic drugs is that they act as a kind of mind control. While these medications can soothe, and while this effect can be useful when starting treatment, especially if an individual is very restless, not because the utility sedative drugs but for their ability to reduce hallucinations, agitation, confusion, and delusions of a psychotic episode. Thus, antipsychotic medications should eventually help an individual with schizophrenia to deal with a more rational world.

How Long People With Schizophrenia Treated with Antipsychotic?

Antipsychotic drugs reduce the risk of future psychotic episodes in patients who have recovered from an acute episode. Even with continued drug treatment, some people who have been healed will recur. Relapse rate is much higher when the drug is stopped. In most cases, advanced drug therapies will "prevent" recurrence accurately, but reduce the intensity and frequency. Treatment of severe psychotic symptoms generally requires higher doses than those used for maintenance treatment. If symptoms reappear on a lower dosage, a temporary increase in dosage may prevent recurrence great.

Because relapse is more likely when antipsychotic medications are discontinued or irregular consumption, it is important that people with schizophrenia, their doctors, and family members adhere to their treatment plan. Adherence to treatment refers to the extent to which patients follow the treatment plans recommended by their doctors. Good adherence involves taking prescribed medication at the right dose and the right time every day, attending clinic appointments, and / or carefully follow the other treatment procedures. Treatment compliance is often difficult for people with schizophrenia, but it can be made easier with the help of several strategies and can lead to improved quality of life.

There are various reasons why people with schizophrenia may not adhere to treatment. Patients may not believe they are ill and may deny the need for medication, or they may have thought disorganized that they can not remember to take their daily dose. Family members or friends may not understand schizophrenia. No right to suggest people with schizophrenia to stop treatment when he feels better. Physicians, who play an important role in helping their patients adhere to treatment, may neglect to ask patients how often they take their medication, or may be unwilling to accommodate a patient's request to change the dosage or try a new treatment. Some patients report that the side effects of the drug seems to be worse than the disease itself. Further, substance abuse can interfere with the effectiveness of treatment, causing patients to stop treatment. When a complicated treatment plan is added to these factors, good adherence can be more challenging.

Fortunately, there are many strategies that patients, doctors, and families can use to improve adherence and prevent worsening of the disease. Some antipsychotic drugs, including haloperidol (Haldol ®), fluphenazine (Prolixin ®), perphenazine (Trilafon ®) and others, are available in long-acting injectable forms that eliminate the need to take a pill every day. The main objective of the current research on treatments for schizophrenia is to develop more types of long-acting antipsychotics, especially the newer agents with mild side effects, which can be delivered by injection. Calendar drug or pill boxes labeled with the days of the week can help patients and caregivers know when medications have or have not been taken. Using electronic timers that beep when medications should be taken, or a pair of drug taking with routine daily events like meals, can help patients remember and adhere to the schedule of administration. Involving family members in observing oral medication patients can help ensure compliance. In addition, through various other methods of monitoring compliance, doctors can identify when taking pills is a problem for their patients and can work with them to make compliance easier. It is important to help motivate patients to continue taking their medication properly.

In addition to adherence strategies, patient and family education about schizophrenia, symptoms, and medications prescribed to treat a disease is an important part of the treatment process and helps support the rationale for good adherence.

About Side Effects?

Antipsychotic drugs, like virtually all medications, have unwanted effects along with their beneficial effects. During the initial phase of treatment, patients may be troubled by side effects such as drowsiness, restlessness, muscle spasms, tremors, dry mouth, or obscure vision. Most can be corrected by lowering the dosage or can be controlled by other drugs. Different patients have different treatment responses and side effects to various antipsychotic drugs. A patient may do better with one drug than another.

Long-term side effects of antipsychotic drugs can cause much more serious problems. Tardive dyskinesia (TD) is a disorder characterized by involuntary movements most often affecting the mouth, lips, and tongue, and sometimes the trunk or other parts of the body such as arms and legs. It occurs in about 15 to 20 percent of patients who had received antipsychotic drugs for years, but TD can also develop in patients who have been treated with drugs for a longer period of time. In most cases, the symptoms of TD are mild, and the patient may not be aware of the movement.

Antipsychotic drugs developed in the last few years all seem to have a much lower risk than older antipsychotics and traditional. The risk is not zero, however, and they can produce side effects such as weight changes. Additionally, if given at a dose is too high, a new drug can cause problems such as social withdrawal and symptoms resembling Parkinson's disease, a disorder that affects movement. Nonetheless, the new antipsychotics are a significant advance in the treatment, and their optimal use in people with schizophrenia is the subject of much research done at this time.

Psychosocial Treatments?

Antipsychotic drugs have proven to be important in relieving psychotic symptoms of schizophrenia - hallucinations, delusions, and incoherence - but not consistent in relieving the symptoms of conduct disorder. Even when patients with schizophrenia are relatively free of psychotic symptoms, many still experiencing tremendous difficulties with communication (self-awareness, motivation in building and maintaining relationships with other people). In addition, because patients with schizophrenia frequently become ill during the critical career-forming years of life (eg, ages 18 to 35), they are less likely to complete the training required for skilled work. As a result, many people with schizophrenia do not only have difficulty in thinking and emotional, but also lacking social skills, work, and also experience.
While psychosocial approaches have limited value for acutely psychotic patients (those who are out of touch with reality or have prominent hallucinations or delusions), they may be useful for patients with less severe symptoms or for patients with psychotic symptoms controlled. Various forms of psychosocial therapy are available for people with schizophrenia, this therapy focuses on improving social functioning of patients - whether in a hospital or community, at home, or at work. Unfortunately, the availability of different forms of treatment varies greatly between one place and another place.

Rehabilitation

Broadly defined, rehabilitation includes a wide array of non-medical interventions for those with schizophrenia. Social rehabilitation program emphasizes vocational training to help patients and former patients overcome difficulties in these areas. Programs may include vocational counseling, job training, problem-solving and money management skills, use of public transportation, and social skills training. This approach is essential to the success of treatment as well as the skills necessary to lead productive lives outside the confines of a mental hospital sheltered.

Individual Psychotherapy

Individual psychotherapy involves regularly scheduled talks between the patient and a mental health professional such as a psychiatrist, psychologist, psychiatric social worker, or nurse. Sessions can be focused on the problem of current or past experiences, thoughts, feelings, or relationships.