2/07/2009

Schizophrenia development

The term "schizophrenia" comes from the Greek word which can be roughly translated as "shattered mind”. Schizophrenia is not with the same as multiple personality disorder but in popular culture the two are often confused. Schizophrenia is a psychiatric disorder characterized by mental impairm...
The term %26quot;schizophrenia%26quot; comes from the Greek word which can be roughly translated as %26quot;shattered mind%26rdquo;. Schizophrenia is not with the same as multiple personality disorder but in popular culture the two are often confused. Schizophrenia is a psychiatric disorder characterized by mental impairments in the perception or expression of reality and by a significant social or occupational dysfunction. The most common symptoms that person with schizophrenia is experiencing are disorganized thinking, and delusions or auditory hallucinations. Although the disorder is primarily affecting cognition, it can also contribute to chronic problems with behavior and emotion.



Possible causes of schizophrenia development




There are many studies which tried to find the exact cause of this disorder and most of them came to the conclusion that there are many possible causes which usually act simultaneously. The possible causes of schizophrenia include:

1. Genetic causes

Since schizophrenia tends to run in families, experts have been trying to find the specific genes which increase a person's chance of developing this illness. Most studies, especially those performed on twins, have found that heredity plays an important role in the development of schizophrenia. If one of the identical twins who have been raised separately develops schizophrenia, the chance that the other twin will also develop it is 50%.
Some studies have proposed that an imbalanced level of a specific neurotransmitter such as dopamine and serotonin could be the cause of shizophrenia and this theory ius known as Neurotransmitter theory.

2. Abnormal brain development

Many studies of people with schizophrenia have found abnormalities in their brain structure.

The most common abnormalities are:

%26bull; enlargement of the ventricles, fluid-filled cavities, in the interior of the brain,
%26bull; decreased size of certain brain regions
%26bull; decreased metabolic activity in certain brain regions

Experts are also saying that schizophrenia may be a developmental disorder resulting from the inappropriate connecting of the neurons during fetal development.







3. Infection

There are several studies which have shown that viral infections may play a role in the development of schizophrenia. Viruses that could be responsible for the development of schizophrenia are poliovirus, the flu virus and a virus called encephalitis lethargica.

4. Birth complications

Complications during pregnancy, abnormal fetal growth and complications during delivery are significant risk factors in the development of schizophrenia. Those that play a significant role in the development of schizophrenia include:

%26bull; complications in pregnancy including bleeding and diabetes
%26bull; abnormal fetal growth and development including conditions such as low birth weight
%26bull; complications of delivery including asphyxia and emergency Caesarean section

5. Head injury

Traumatic head injuries can cause symptoms of psychosis but it is still unknow how exsactly they induce schizophrenia.

6. Psychological causes

The main psychological trigger that can lead to the onset of symptoms of schizophrenia is a stressful life event. Social isolation is thought to pay an important role in such stresful sitiations.

7. Drug use

It is a common incorrect belief that drug use causes schizophrenia. The fact is that drugs do not directly cause schizophrenia. The fact is, however, that certain drugs may cause a disturbance in the brain.



Symptoms of schizophrenia



Schizophrenia is characterized by disruption in cognition and emotion, affecting the most fundamental human attributes:

%26bull; language,
%26bull; thought,
%26bull; perception,
%26bull; affect,
%26bull; sense of self

No single symptom is definitive for diagnosis.

Symptoms are typically divided into positive and negative symptoms because of their impact on diagnosis and treatment.

Positive symptoms

These symptoms appear to reflect an excess or distortion of normal functions. The most common positive symptoms are:

%26bull; Delusions
Delusions are firmly held erroneous beliefs caused by exaggerations of reasoning and misinterpretations of perceptions or experiences.
%26bull; Hallucinations
Hallucinations are distortions or exaggerations of perception in any of the senses, although auditory hallucinations are the most common.
%26bull; Disorganized speech/thinking
Disorganized speech or thinking is a key aspect of schizophrenia.
%26bull; Disorganized behavior
Grossly disorganized behavior includes difficulty in goal-directed behavior, unpredictable agitation or silliness, social problems, or behaviors that are bizarre.
%26bull; Catatonic behaviors
These are characterized by a decrease in reaction to the immediate surrounding environment.

Negative symptoms

These symptoms appear to reflect a loss of normal functions. The most common negative symptoms are:

%26bull; Affective flattening
This is the reduction in the range and intensity of emotional expression, including facial expression, voice tone, eye contact, and body language.
%26bull; Alogia
Alogia means lessening of speech fluency and productivity, thought to reflect slowing or blocked thoughts, and often manifested as short, empty replies to questions.
%26bull; Avolition
This is the reduction, difficulty, or inability to initiate and persist in goal-directed behavior; it is often mistaken for apparent disinterest.



Types of schizophrenia




%26bull; Paranoid schizophrenia
People with this disorder are very suspicious of others and often have grand ideas of persecution at the root of their behavior. Hallucinations, and more frequently delusions, are a prominent and common part of the illness. All this is accompanied with anxiety, anger, violence and argumentativeness.
%26bull; Hebephrenic Schizophrenia
Person suffering from this type of shizophrenia is verbally incoherent and may have moods and emotions that are not appropriate to the situation.
%26bull; Catatonic schizophrenia
In this case, the person is extremely withdrawn, negative and isolated, and has marked psychomotor disturbances. It is accompanied with motor disturbances, stupor, negativism, rigidity and agitation, inability to take care of personal needs and decreased sensitivity to painful stimulus.
%26bull; Residual schizophrenia
In this case the person is not currently suffering from delusions, hallucinations, or disorganized speech and behavior, but lacks motivation and interest in day-to-day living.
%26bull; Schizoaffective disorder
These people have symptoms of schizophrenia as well as mood disorder such as major depression, bipolar mania, or mixed mania.
%26bull; Disorganized type
Common symptoms of this type are incoherence, regressive behavior, flat affect, delusions, hallucinations, inappropriate laughter, repetitive mannerisms and social withdrawal.



How is schizophrenia treated?




Since the causes of schizophrenia are still unknown, current treatments focus on eliminating the symptoms of the disease.

%26bull; Antipsychotic medications

These medications can effectively alleviate the positive symptoms of schizophrenia. While these drugs have greatly improved the lives of many patients, they do not cure schizophrenia.

The older antipsychotic medications include:

o chlorpromazine (Thorazine%26reg;), haloperidol (Haldol%26reg;),
o perphenazine (Etrafon%26reg;, Trilafon%26reg;), and
o fluphenzine (Prolixin%26reg;).

The problem is that these older medications can cause extra pyramidal side effects, such as rigidity, persistent muscle spasms, tremors, and restlessness.

Newer drugs called atypical antipsychotics, rarely produced these side effects. Some of the drugs that were developed after clozapine was introduced are

o risperidone (Risperdal%26reg;),
o olanzapine (Zyprexa%26reg;),
o quietiapine (Seroquel%26reg;),
o sertindole (Serdolect%26reg;),
o ziprasidone (Geodon%26reg;)



Psychosocial treatment



Numerous studies have found that psychosocial treatments can help patients deal with certain aspects of schizophrenia, such as:

%26bull; difficulty with communication,
%26bull; motivation,
%26bull; self-care,
%26bull; work,
%26bull; establishing and maintaining relationships with others

It is based on learning and using various mechanisms to address these problems and it allows people with schizophrenia to attend school, work, and socialize. Patients who receive regular psychosocial treatment also adhere better to their medication schedule and have fewer relapses and hospitalizations.




Prognosis




There are many different potential outcomes of schizophrenia. The good thing is that most people with schizophrenia find that their symptoms improve with medication, and some achieve substantial control of the symptoms over time. However, unfortunately others experience functional disability and are at risk for repeated acute episodes, particularly during the early stages of the illness.