Schizophrenia.

The schizophrenia is a chronic ,severe form of mental disorder, It affects persons thoughts, emotions and behavior .It will take long time for cure , sometimes it may life long.about 1 person in 100 may experience schizophrenia at some time in their life period.1% of worlds population suffer from this disorder .Men and women have equal chances to get affect from schizophrenia in their life.Most commonly it start in between the age of 16 to 30.It start earlier in men than women.Schizophrenia is an complex disorder ,it has not a single cause but the number of factors that increase the risk of this disorder.In initial stage schizophrenia puzzling to the patient ,person didn’t understand this disorder for long time because it develop slowly.Socail and economic impact of schizophrenia is very bad on patient and their family, because patient doesn’t have good career , sometimes they socially isolated themselves, they may facing trouble in speech in front of others hard to convey their feelings.Schizophreic person fail to distinguish between imagination and reality, sometimes person started speaking in non existing language so others didn’t get its meaning easily .Probability of suicide act increased in this disorder.Comsumption of cannabis may increase the risk of Schizophrenia disorder.

Symptoms:

People with schizophrenia do not have same symptoms.Many patients in this disorder also having other psycho disease mostly probability is OCD , Anxiety .Mainly three types of symptom showing in Schizophrenic person namely positive , negative and congnetive.

Positive Symptoms: In this case positive doesnt means healthy but positive means addition , additionally presensence .Ex.Delusion , hallucinations.In healthy people this symptoms are absent.

Delusion :

False belief that doesn’t relate to the reality.some example of delusion mention below.

Reference The behavior of others, objects, orbroadcasts on the television and radio have aspecial meaning or refer directly to the person, e.g. “A parcel came from Sun Alliance and the radio said that ‘the son of man is here’, on a Sunday, so I am the son of God”.

Infatuation A particular person is in love with the patient (also known as erotomania or de Clerambault’s syndrome).

Control The sensation of being the passive recipient of some controlling or interfering agent that is alien and external. This agent can control thoughts, feeling and actions (passivity experiences), e.g. “I feel as if my face is being pulled upwards and something is making me
laugh when I’m sad”.

Somatic Delusional belief pertaining to part of the person’s body, e.g. “My arms look like they’ve been melted and squashed into a mess”.

Persecution An outside person or force is in some way interfering with the sufferer’s life or wishes them harm, e.g. “The people upstairs are watching me by using satellites and have poisoned my food”.

Grandeur Exaggerated belief of one’s own power or importance, e.g. “I can lift mountains by moving my hands, I could destroy you!”.Doubles A person known to the patient, most frequently their spouse, has been replaced by another (also known as Capgras’ syndrome or, confusingly, ‘illusion’ of doubles).

Nihilism Others, oneself, or the world does not exist or is about to cease to exist (often called Cotard’s syndrome), e.g. “The inside of my tummy has rotted away. I have no bowels”.

Infidelity One’s partner is being unfaithful (also known as delusional jealousy or the Othello syndrome).

Hallucinations:

Schizophrenic people hearing voices, 60-70% People with schizophrenia occurs with this symptoms.Though no one around person hearing noisy voices like hundreds of people speaking each other.Sometimes person feel like bug,insect crawling on skin.Sometimes person seeing shadows of people walking around them , this visual hallucinations is deadly symptom for person .

Disorganized speech :

Person with schizophrenia hard to manage thoughts and failed to good communication.Its hard to manage words while speaking or conveying in front of others.Sometimes person speaking in nonexisted language it’s hard to understand for others.Its seem scary .

Abnormal behavior.

  • Automatic imitation of another person’s movements even when asked not to.
  • Repeated fixed moments again and again .
  • Inappropriate or bizarre bodily posture continuously for a substantial period of time.

Negative symtomps :

This symptoms are hard to manage than positive,less responsive to the medication.Victim losses their interest in daily activities trying to procrastinate.

  • Poverty of speech Restriction in the amount of spontaneous speech and in the information contained in speech (alogia).
  • Flattening of affect Restriction in the experience and expression of emotion.
  • Anhedonia–asociality Inability to experience pleasure, few social contacts and social withdrawal.
  • Avolition-apathy Reduced drive, energyand interest.
  • Lack of self-care/self-hygiene: Losing interest in everyday activities like bathing, grooming, or getting dressed. This may make them seem lazy or unwilling to help themselves, but the problems are symptoms caused by the schizophrenia.
  • Attentional impairment Inattentiveness at work and interview.

Cognitive symptoms:

  • Patient give less important to this symptoms but others are easily observe the change .
  • Hard to understand information about something.
  • Trouble in concentrate .
  • Problem in memorizing and learning new things.

Causes and risk factors.

It’s oftenly said Schizophrenia is a diseases with unknown cause but this is no longer true.Schizophrenia is like other complex disorder like Coronary artery disease where no single cause but different types of cause and factors increase the risk of disorder .

Genetics :

Genetics is main leading cause of schizophrenia.Affceted relatives may increase the risk of schizophrenia. Adoption studies have demonstrated conclusively that liability to schizophrenia is transmitted through genes and not through some intrafamilial environmental effect.

Relationship Percentage Schizophrenia
Parent5.6
Sibling10.1
Sibling &one parent affected16.7
Children of one affected parent12.8
Children of two affected parents46.3
Uncles/aunts/nephews/nieces2.8
Grandchildren3.7
Unrelated0.86
Relationship and percentage of Schizophrenia

Brain development

Studies of people with schizophrenia have shown there are subtle differences in the structure of their brains.

These changes aren’t seen in everyone with schizophrenia and can occur in people who don’t have a mental illness. But they suggest schizophrenia may partly be a disorder of the brain.

Neurotransmitters

Neurotransmitters are chemicals that carry messages between brain cells. There’s a connection between neurotransmitters and schizophrenia because drugs that alter the levels of neurotransmitters in the brain are known to relieve some of the symptoms of schizophrenia.
Research suggests schizophrenia may be caused by a change in the level of two neurotransmitters: dopamine and serotonin.

Some studies indicate an imbalance between the two may be the basis of the problem. Others have found a change in the body’s sensitivity to the neurotransmitters is part of the cause of schizophrenia.

Pregnancy and birth complications:

Research has shown people who develop schizophrenia are more likely to have experienced complications before and during their birth, such as:

  • a low birth weight
  • premature labour
  • a lack of oxygen (asphyxia) during birth.

It may be that these things have a subtle effect on brain development.

Drug abuse

Drugs don’t directly cause schizophrenia, but studies have shown drug misuse increases the risk of developing schizophrenia or a similar illness.

Certain drugs, particularly cannabis, cocaine, LSD or amphetamines, may trigger symptoms of schizophrenia in people who are susceptible.

Using amphetamines or cocaine can lead to psychosis, and can cause a relapse in people recovering from an earlier episode.

Three major studies have shown teenagers under 15 who use cannabis regularly, especially “skunk” and other more potent forms of the drug, are up to four times more likely to develop schizophrenia by the age of 26.

Treatment :

Medication:
Despite schizophrenia complex hard to cure medication and psychotherapy helps to manage symptoms.First generation and second generation antipsychotic drugs are mostly used in medication to manage schizophrenia.medication helps to balance neurotransmitters level , specially dopamine.Antipsychotic drug manage the schizophrenic symptoms with lowest possible dose, for this psychiatrist use the combination of different antipsychotic drug.

Psychotherapy:
Therapeutic treatment implemented when patients symptoms stabilized by medication.Therapy helps to improvement in day to day activity, it helps to be a more social, attending work, self care , learning illnesses management.

  • Below mentioned therapies used in treatment.
  • Personal therapy
  • Cognitive behavior therapy.
  • Family therapy.
  • Social skill development.
  • Rehabilitation.

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