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Schizophrenia2

Schizophrenia2 Schizophrenia is a chronic, severe, and disabling brain disease. People with schizophrenia often suffer terrifying 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. Their symptoms can be grouped into three categories: positive symptoms, negative symptoms, psychomotor symptoms. Positive symptoms of schizophrenia include delusions, illusions, disorganized thinking and speech, heightened perceptions and hallucinations, and inappropriate affect. Delusions are ideas that they believe frequently but have no basis in fact. These patients may believe that they, or a member of the family or someone close to them, is the focus of this persecution. Sometimes the delusions experienced by people with schizophrenia are quite bizarre; for instance, believing that a neighbor is controlling their behavior with magnetic waves that people on television are directing special messages to them; or that their thoughts are being broadcast aloud to others. Hallucinations and illusions are disturbances of perceptions that are common in people suffering from schizophrenia. Although hallucinations can occur in any sensory form - sound, sight, touch, taste, smell - hearing voices is most common. Voices may describe the patient's activities, carry on a Page 2 Conversations, warn of dangers, or even give orders to the person. Illusions on the other hand occur when a sensory stimulus is present nut is incorrectly interpreted by the individual. Disorganized thinking and speech makes it incapable to have logical, rational thinking, and often-present very peculiar speech. They can cause great confusion and make communication with others extremely difficult. Inappropriate affect is the display of emotions that are unsuited to the situation. They may smile in appropriately when making a somber statement or on being told terrible news, or become upset in situations that should make them happy. They may also undergo inappropriate shifts in mood. Negative symptoms include poverty in speech; flat affect and blunted affect, loss of volition, and social withdraw. Flat affect and blunted affect is when they manifest less anger, sadness, joy than most people, or they will show no emotion at all. People with schizophrenia often display alogia, a decrease in speech or speech content. Some people with this negative kind of formal thought disorder think and say very little. Other persons with alogia may say quite a bit nut still mange to convey little meaning. Loss of volition is to struggle to succeed is a distorted world. They may experience avolition, or feeling drained of energy and interest in normal goals and unable to complete a task. They just may be unable to regulate a normal, healthily life. Some people may also experience ambivalence, or conflicted feelings about most things. Social withdraw is when people is when people withdraw emotionally and socially from their environment and become totally preoccupied with their own ideas and fantasies. The may distance themselves from other people and avoid talking to them. The next category is Psychomotor Symptoms. These symptoms include loss of movement and development of odd grimaces, gestures, and mannerisms. There is no known cause for schizophrenia. Many diseases such as: heart disease, result from an interplay of genetic, behavioral, and biological factors; and this may be the case for schizophrenia as well. Scientists do not yet understand all of the factors necessary to produce schizophrenia, but all the tools of modern biomedical research are being used to search for genes, critical moments in brain development, and other factors that may lead to the illness. It has been known by scientists and doctors that schizophrenia runs in families. The genetic view has been supported by studies of 1) relatives of people with schizophrenia who are adopted, 2) twins with this disorder, 3) people with schizophrenia that are adopted, and 4) chromosomal mapping. It appears likely that multiple genes are involved in creating a predisposition to develop the disorder. Studies of relatives show that scientists found repeatedly that schizophrenia is more common amount relative of people with the disorder. The more closely related that relatives are to the person with schizophrenia, the greater the likelihood of developing the disorder. Twin studies show that twins that are among the closet of relatives have received particular study by schizophrenia researchers. If genetic factors are t work schizophrenia, identical twins (who share identical genes) should have higher concordance rate for this disorder than fraternal twins should. If one fraternal twin has schizophrenia in contrast, the other twin has approximately a seventeen percent (17 %) chance of developing the disorder. Adoption studies look at adults who were adopted as infants and compare them with both their biological and their adoptive relatives. Because they were reared apart from their biological relatives, similar schizophrenia symptoms in those relatives would indicate genetic influences. Clearly the biological relatives of adoptees with schizophrenia were most likely to develop the disorder. More recent adoptions studies in other countries have convinced many researchers that the genetic factors of schizophrenia is at least as important as that found in other illnesses with a clear genetic component, such as diabetes, hypertension, and coronary artery disease. Researchers have conducted chromosomal mapping research to identify more precisely the possible genetic factors in schizophrenia. Although chromosomal research is promising, many problems remain and need to be solved. Varied findings indicate that some of the suspected gene sites do not contribute to schizophrenia after all. Alternatively, different kinds of schizophrenia may be traced to different genes. Research has pointed to two kinds of biochemical abnormalities that apparently contribute to schizophrenia and could conceivably be inherited - biochemical abnormalities and abnormal brain structure. Basic knowledge about brain chemistry and its link to schizophrenia is expanding rapidly. Neurotransmitters substances that allow communications between nerve cells have long been thought to be involved in the development of schizophrenia, although not yet certain, that the disorder is associated with some imbalance of the complex, interrelated chemical systems of the brain, perhaps involving the neurotransmitters dopamine and glutamate. There have been advances in neuroimaging technology that allow scientists to study brain structure and function involving individuals. Many studies of people with schizophrenia have found abnormalities in brain structure or functions. It should be emphasized that neither these abnormalities are subtle and are not characteristic of all people with schizophrenia nor do they occur only in individuals with this illness. Micrographic studies of brain tissue after death have also shown small changes in distribution or number of brain cells in people with schizophrenia. It appears that many of these changes are present before and individual becomes ill, and schizophrenia may be, in part, a disorder in the development of the brain. Since schizophrenia may not be a single condition and its caused are still unknown, current treatment methods are based on both clinical research and experience. These approaches are chosen on the basis of their ability to reduce the symptoms of schizophrenia and to lessen the chances that symptoms will return. Antipsychotic medications reduce the risk of future psychotic episode in-patients who have recovered from an acute episode. Even with continued drug treatment, some people who have recovered will suffer relapses. Far higher rates are seen when medication in discontinued. In most cases; it would not be accurate to say that continued drug treatment "prevents" relapses; rather it reduces their intensity and frequency. The treatment of severe psychotic symptom reappear on a lower dosage, a temporary increase in dosage may prevent a full-blown relapse. (http://nimh.nih.gov/publicat/schizoph.htm), National Institute of Mental Health The discovery of antipsychotic medication dates back to the 1940's when researchers developed the first antihistamine drugs. The French surgeon Henri Lavorit soon discovered that one group of antihistamines, phenothizines, were used to clam patients before surgery while allowing them to remain awake. Laborite suspected that these drugs might also have a calming effect on persons with severe psychological disorders. There are also different types of therapy that can help a person will schizophrenia. They are Psychotherapy, insight therapy, family therapy, and social therapy. Before the discovery of antipsychotic drugs, psychotherapy was not really a viable option as a treatment for schizophrenia. Most patients were simply too far removed from reality to profit from it. Only a handful of therapist, apparently blessed with extraordinary patience and skill, specialized in the treatment of this disorder and reported some success. These therapists believed that the primary task of therapy was to win the trust of patients of schizophrenia and build a close relationship with them. Psychotherapy is now successfully employed in many more cases of schizophrenia, thanks to the discovery and effective of antipsychotic drugs. By helping relieve thought and perceptual disturbances, the drugs enable people to learn about their disorder, and play an active role in the therapeutic process. (Abnormal Psychology, third edition), Ronald J. Comer Another type of therapy is called insight therapy. A variety of insight therapies are now applied to schizophrenia. Studies suggest that insight therapist who are more experienced with schizophrenia have greater success, often regardless of their particular orientation. According to one study, therapists whose treatment is successful tend to make a more active role than less successful therapists, setting limits, expressing opinions, challenging patient's statements, and providing guidance. At the same time, gaining patience's trust remains a major part of therapy. (Abnormal Psychology, third edition), Ronald J. Comer Family therapy is another type used with schizophrenic patients. Between 25 and 40 percent of community residents who are recovering from schizophrenia live with their parents, siblings, spouses, or children. Such unions create special pressures for both the patients and the family members. Patients who are recovering from schizophrenia are greatly affect by the behavior and reactions of family members, even if family dysfunction was not a factor in the onset of the patient's disorder. Indeed, it has been found that persons with schizophrenia who have positive perceptions of their relatives do better in treatment. Family members, for their part, are often greatly affected by the behavior of a relative with schizophrenia. To address such issues, clinicians now commonly include family therapy in their treatment of schizophrenia. Family therapy provides family members with guidance, training, practical advice, education about schizophrenia and emotional support and empathy. It helps family members become more realistic in their expectations, more tolerant, less guilt-ridden, and more willing to try new patterns of interaction and communication. Over the course of treatment, family therapists also try to help the individual with schizophrenia cope with the pressures of family life, make better use of family resources, and avoid problematic interactions. Family therapy often is successful communication and reducing tensions with the family. In turn, it helps relapse rates to go down, particularly when it is combined with drug therapy. (Abnormal Psychology, third edition), Ronald J. Comer The last type of therapy is social therapy. Many clinicians that treat people with schizophrenia try to address all aspects of a client's life and recovery. They make practical advice and make adjustments to find treatments, and also direct therapy towards issues as problem solving, decision making, developmental of social skills, and management of medication. In addition they may help their clients find work, financial assistance, and proper housing. This king of intervention, called social therapy or socitherapy, may be offered in-group formats as well as in individual sessions. Research supports the belief that this particle, active, and broad treatments helps keep patients with schizophrenia out of the hospital. (Abnormal Psychology, third edition) Ronald J. Comer Schizophrenic patients may also take the community approach to treatments. A community approach was developed when a policy of deinstutionaltions brought about a mass exodus of hundreds of thousands of patients with schizophrenia and other sever problems from state institutions in the community. The number of persons living in mental heals settings has decreased from nearly 600,000 on any given day in 1955 to 80,000 today. A. Effective community care: Among the key elements of effective community care programs are coordination of patient services by a community mental health center, short-term hospitalization (followed by aftercare), day centers, halfway houses, and occupational training. A. Inadequacies of community treatment: Unfortunately, the quality of and funding for community care for persons with schizophrenia has been grossly inadequate throughout the United States, often resulting in a "revolving door" syndrome. Two factors are primarily responsible for this state off affairs: poor coordination of services and shortage of services. One result of the inadequacy of community treatment is that many people with schizophrenia have become homeless. Approximately one-third of the homeless people in the United States suffers from a severe mental disorder, commonly schizophrenia. Still others live in nursing homes or rest homes, many live in boarding housed or single-room-occupancy hotels, and many thousands live in prisons because their disorder has led them to break the law. B. The promise of community treatment: The success and potential of proper community care for persons recovering from schizophrenia continue to capture the interest of both clinicians and government officials. One major development has been the formation of national interest groups that are successfully promoting community treatment for people with severe mental disorders. (Abnormal Psychology, third edition), Ronald J. Comer There are also concerns with money when dealing with a schizophrenic patient. Many people with schizophrenia have trouble handling money matters. This can present families with some awkward situations. Some of these may be beyond an immediate or a ready solution. Normally, where a patient is entitled, he or she will receive help at the hospital to complete arrangements for welfare benefits. In this situation, your relative will then receive a monthly income that is under his or her complete control. Most will need a good deal of help learning how to budget people to meet such various items such as rent or board food and transpiration. They need to know that their spending over and above regular monthly needs should not exceed what is left. For many this is difficult, and is just the beginning. When a substantial sum available (for example, on receipt of a welfare check), many tend to "blow" all or a large part on impulse spending, often foolishly, or to give their money away to friends - even strangers. Families find that they are then called upon to make up the amount needed to comfier neglected basic living expenses. Behavior of this sort, although not surprising for someone with few chances to enjoy life, is difficult for families and requires that they exercise a good deal of patience. People dealing with schizophrenia also have trouble with the law. Unfortunately, a significant number of people with this disorder find themselves in bad situations with the law. Offences may range from shoplifting, mischief, assault or ordering a mean at e a restaurant and refusing to pay for it too much more serious crimes such as aggravated assault, arson or murder. Even though it is extremely difficult to cope with having schizophrenia or having a relative with schizophrenia there are ways in which we can deal and cope with the disorder. Some of these include: � Speak with a slow-paced and low -toned voice. Use short, simple sentences to avoid confusion. If necessary, repeat statements and questions using the same words. � Explain clearly why you are doing, and why you are doing it. For example, " I am putting your clean clothes in your closet. You can choose which clothes you want you want to wear today." � Establish a structured and regular daily routine. Be predictable. Be consistent. Do not say you will do something then change your mind. � Offer praise continually. If your relative combs his or her hair after three days of not doing so, comment on how attractive he or she looks. � Avoid over-stimulation. Reduce stress and tension. For example, eating meals with the family may be too overwhelming at first. � Persuade, but never force, your relative to take his or her medications and to keep all medical appointments. With time, the person suffering with schizophrenia may shows signs of being able to handle more responsibility. Although it should always be kept in mind the above ideas for reducing stress, families have compiled other suggestions for the times after the initial period of adjustment. � Discuss with your relative how he or she feels about doing more things. � Begin with mastery of self-care tasks- personal hygiene, getting dressed, eating scheduled meals. � Assign household responsibilities that are within your relative's abilities. Watch to see if your relative prefers to work alone or with others. For example, he or she may like to wash dishes, but not be able to handle the "help" of someone else drying. � Encourage, but never push, people to be part of social gatherings if appreciate. One or two relatives or friends might come over for dinner may be manageable, whereas and all-day gathering of the family- for example, a wedding- may cause frustration. � Discuss plans with your relative for an outing once a week. A drive and a walk in the country may be fun, whereas as trip to the city may be too noisy and tension filled. If the person enjoys coffee and doughnuts, plan a break around going to the donut shop, rather than a restaurant where there may be more of a formal atmosphere. � Do not be too inquisitive. Do not always ask, "What are you thinking about? Why are you doing that?" Talk simply about outside events. " Did you hear about the new movie starring�" � Understand that although it may be very difficult for the person to have a conversation, he or she may enjoy company in other ways. Consider watching television, listening to music, or playing cards. Talk about childhood events. The person may appreciate being read to also. � Avoid constant, petty criticism. Identify the major behaviors and learn to deal with them in an honest, direct manner. For example, in many families, the lack of personal hygiene is a source of great irritation. But saying things like, "Whey can't you wash?" Or " You smell awful, " does not seem to have much affect of solving the problem. � Be forgetful. Say something like; "I forgot the milk. Can you get it please'?" � Encourage the person to take responsibility. � Teach the person how to deal with stress in a socially acceptable manner. � Remember that family members are often the only friends the person may have. So try to be a friend. (http://www.mentalhealth.com/book/p40-sc01.html), Schizophrenia: A Handbook For Families. With time, the person suffering will begin to feel more confident and secure about Being able to do things. Some health care professionals have noted that it is around the period that new problems can emerge, particularly if the family isn't prepared to grow with the person. The process of becoming independent in long but standing by the side of a person with schizophrenia and giving them love and support seems to be the only "true" cure. Bibliography:

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