Schizophrenia is a serious medical illness that represents a collection of mental and behavioral phenomena that affect a person’s life in a debilitating way. The following features are singled out most often in the observation of schizophrenic patients: abnormal perceptions, extraordinary beliefs and delusions, hallucinations, malfunctioning of thought construction which as a result leads to language disorder, impairment in cognitive process, aberrant control systems, and other features. Approximately 1% of people fall victims to the disease at certain point of their lives. Schizophrenia is a rare illness to occur before puberty; most commonly it has its onset during the first half of adult life of a person.
Criteria for Diagnosing Schizophrenia
Experts at diagnosis of the disease state that schizophrenic syndrome can demonstrate a number of presentations and run a variable course. In the process of diagnosis one should take into account that anyone can get this debilitating syndrome. It is considered that the illness is more common in men, provided that it is defined in terms of excluding affective symptoms in the course of disease. Despite the fact that schizophrenia is thought to occur in early adult life, the true onset of the disease is difficult to date. This fact is largely based on the assumption that schizophrenia is a longitudinal phenomenon, rather than a cross-sectional one. Therefore, the syndrome develops overtime, and the treatment can start sooner rather than later.
There exists a number of Assessment Instruments for the diagnosis of schizophrenia. They represent traditional psychological tests that are applied in a psychiatric environment in order to evaluate patients with a potential schizophrenic diagnosis. The most frequently used tests are Minnesota Multiphasic Personality Inventory, Rorschach test, and Thematic Apperception Test (TAT). The structured instruments also include the Diagnostic Interview schedule or DIS, and the Composite International Diagnostic Interview or CIDI. Both are fully structured diagnostic interviews that contain relevant questions in order to assess the absence or presence of each criterion for diagnosis of schizophrenia in DSM-IV.
The above-mentioned longitudinal view of the development of schizophrenia includes pre-morbid differences and abnormalities, prodromal change, and episodes of schizophrenic illness. The criteria of the DSM-IV belong to the active phrase of psychotic symptoms. In DSM-IV, the diagnosis of schizophrenia depends upon the presence or absence of characteristic symptoms, the occurrence of social or occupational dysfunction, general medical conditions, and other features. According to DSM-IV, there exist no strictly pathognomonic schizophrenic symptoms. Instead, characteristic symptoms can be subsumed under two broad categories: negative and positive. Positive symptoms include delusions, hallucinations, catatonic behavior, and disorganized speech. Negative symptoms are affective flattening, avolition, and alogia.
The so-called prodromal phase, or the six-months period when only negative or slightly less severe symptoms of disturbance are present, embraces criteria which can mostly be obvious only in retrospect, however do not appear to be effective in terms of a diagnostic test. Prodromal phase includes the following features: impairment in general functioning and behavior of a person, withdrawal from the set social roles, alternation of emotions, neglect in keeping personal hygiene, communication difficulties, restricted energy level, interest and imitativeness, unusual ideas and strange perceptual experiences. The criteria during the prodromal stage are considered to be insidious, and therefore may not be helpful in identifying the true change and schizophrenic nature.
In general, when it comes to diagnosis of the disease, one should bear in mind that there exists only a limited amount of information on schizotypal disorder, and many additional studies are needed in order to set a clear distinction between schizophrenia, schizotypal disorder and other personality disorders on a schizophrenia spectrum.
The Effect of Schizophrenia on a Person’s Life
The disease presupposes impairments in many spheres of human life caused by the disabilities incited by the illness. Primary disabilities include positive and negative features, depression and other psychopathology. Tertiary disabilities are present as well. They include occupational functioning, social relations and communication, self-catering on a daily basis. In general, schizophrenic patients demonstrate a lack of increase in IQ (which is most probably due to environmental factors related to the disease). Another negative outcome is the aberrant salience demonstrated by the patients is thought to relate to presence of delusions and linked with negative symptoms. Such fact proves the presence of impaired leaning of stimulus-reinforcement associations in medicated patients.
Patients also have difficulties in classifying emotions. All these impairments contribute to the fact that social and professional dysfunctioning, as well as social skill deficits are quite extreme among schizophrenic patients. A number of people diagnosed with schizophrenia or related disorders might require daily supervision to help them acquire adequate nutrition, hygiene standards, as well as to protect these people from the outbursts and consequences of impaired judgment, impulsivity, cognitive malfunctioning, hallucinations and delusions. Moreover, schizophrenic patients may also be violent.
Possible Medications for Treating Schizophrenia and its Cure
One of the main ideas behind medication treatment plans is observe whether a complex medication regimen produces good results. Moreover, a key part of medication treatment for schizophrenic patients is a constant review of the entire regimen in order to know the right moment to discontinue medications that are no longer necessary to be taken. These measures enhance adherence and lowers the likelihood of side effects.
There exists a general agreement that antipsychotics are main types of medication in the treatment of chronic schizophrenia; however, most patients with schizophrenia have coexisting conditions and a series of symptoms that presuppose treatment with a number of medication types, such as antidepressants, sedative-hypnotics, antianxiety agents, etc. Medications used to treat schizophrenia are classified into many different subcategories. The two primary classes are referred to as typical and atypical antipsychotics. The former includes phenothiazine, butyrophenone, thioxanthenes, dihydroindolines, and dibenzoxazepines.
The latter includes clozapine, risperidone, olanzapine, quetiapine, ziprasidone, and arippiprazole. However, studies still continue to take place. Recent results suggest that nonapeptide oxytocin can improve emotion recognition in patients with schizophrenia. Even though interest in oxytocin in schizophrenic treatment is just beginning to emerge, recent studies were able to demonstrate improvements in clinical symptoms, including positive and negative symptoms, with oxytocin administration. Oxytocin might have beneficial effects not only on emotion recognition and social functioning, but on symptoms in the longer term.
Schizophrenia is a debilitating and serious disease that affects human life through impairing one’s social and communicative function, speech and cognition, volition, and judgment. The long-term results of treatment are idiosyncratic for each patient, depending on the acuteness of symptoms and stages of disease evolution. The outcomes range from patients remaining symptom-free over the five years following firs admissions, developing discrete episodes and being free of symptoms between episodes, showing persistent florid symptoms. The best-case scenario is improving the separate symptoms and providing a patient with around-the-clock care to avoid negative consequences.