Schizophrenia is a chronic, severe, and disabling brain disorder that has been recognized throughout recorded history. It affects about one percent of Americans.
People with schizophrenia may hear voices other people don't hear or they may believe that others are reading their minds, controlling their thoughts, or plotting to harm them. These experiences are terrifying and can cause fearfulness, withdrawal, or extreme agitation. People with schizophrenia may not make sense when they talk, may sit for hours without moving or talking much, or may seem perfectly fine until they talk about what they are really thinking. Because many people with schizophrenia have difficulty holding a job or caring for themselves, the burden on their families and society is significant as well.
Historically, schizophrenia in the West was classified into simple, catatonic, hebephrenic, and paranoid. The DSM now contains five sub-classifications of schizophrenia, the ICD-10 identifies 7:
(295.2/F20.2) catatonic type (where marked absences or peculiarities of movement are present)
(295.1/F20.1) disorganized type (where thought disorder and flat affect are present together)
(295.3/F20.0) paranoid type (where delusions and hallucinations are present but thought disorder, disorganized behavior, and affective flattening is absent)
(295.6/F20.5) residual type (where positive symptoms are present at a low intensity only) and
(295.9/F20.3) undifferentiated type (psychotic symptoms are present but the criteria for paranoid, disorganized, or catatonic types has not been met).
NB: Brackets indicate codes for DSM and ICD-10 diagnostic manuals, respectively. Some older classifications still use "Hebephrenic schizophrenia" instead of "Disorganized schizophrenia".
Currently, there is debate in the field about a new subtype known as the deficit syndrome. It is not currently included in the DSM-IV-TR, however it has been receiving a great deal of attention in the last 20 years. This subtype is more expansive than the other subtypes as a person can be diagnosed with both paranoid schizophrenia and the deficit syndrome. It is characterized by primary negative symptoms (which means that they cannot be caused by such things as the side-effects of medication or depression). People with the deficit syndrome tend to have extremely flat affect (do not appear to be very emotional), do not have good eye contact, do not enjoy normally pleasurable activities, and seem to be uninterested in social interaction. (There is, however, conflict in the research on this last point. While people who have been diagnosed with the deficit syndrome report being uninterested in social interaction, in the laboratory, they often report normal reactions to the situations.) Patients who have been diagnosed with the deficit syndrome tend to have a worse prognosis as these symptoms tend to be resistant to medication. This fact has brought much needed attention to negative symptoms (which have traditionally not been viewed as important as the positive symptoms).
The symptoms of schizophrenia fall into three broad categories:
Positive symptoms are unusual thoughts or perceptions, including hallucinations, delusions, thought disorder, and disorders of movement.
Negative symptoms represent a loss or a decrease in the ability to initiate plans, speak, express emotion, or find pleasure in everyday life. These symptoms are harder to recognize as part of the disorder and can be mistaken for laziness or depression.
Cognitive symptoms (or cognitive deficits) are problems with attention, certain types of memory, and the executive functions that allow us to plan and organize. Cognitive deficits can also be difficult to recognize as part of the disorder but are the most disabling in terms of leading a normal life.
POSITIVE SYMPTOMS
Positive symptoms are easy-to-spot behaviors not seen in healthy people and usually involve a loss of contact with reality. They include hallucinations, delusions, thought disorder, and disorders of movement. Positive symptoms can come and go. Sometimes they are severe and at other times hardly noticeable, depending on whether the individual is receiving treatment.
Hallucinations. A hallucination is something a person sees, hears, smells, or feels that no one else can see, hear, smell, or feel. "Voices" are the most common type of hallucination in schizophrenia. Many people with the disorder hear voices that may comment on their behavior, order them to do things, warn them of impending danger, or talk to each other (usually about the patient). They may hear these voices for a long time before family and friends notice that something is wrong. Other types of hallucinations include seeing people or objects that are not there, smelling odors that no one else detects (although this can also be a symptom of certain brain tumors), and feeling things like invisible fingers touching their bodies when no one is near.
Delusions. Delusions are false personal beliefs that are not part of the person's culture and do not change, even when other people present proof that the beliefs are not true or logical. People with schizophrenia can have delusions that are quite bizarre, such as believing that neighbors can control their behavior with magnetic waves, people on television are directing special messages to them, or radio stations are broadcasting their thoughts aloud to others. They may also have delusions of grandeur and think they are famous historical figures. People with paranoid schizophrenia can believe that others are deliberately cheating, harassing, poisoning, spying upon, or plotting against them or the people they care about. These beliefs are called delusions of persecution.
Thought Disorder. People with schizophrenia often have unusual thought processes. One dramatic form is disorganized thinking, in which the person has difficulty organizing his or her thoughts or connecting them logically. Speech may be garbled or hard to understand. Another form is "thought blocking," in which the person stops abruptly in the middle of a thought. When asked why, the person may say that it felt as if the thought had been taken out of his or her head. Finally, the individual might make up unintelligible words, or "neologisms."
Disorders of Movement. People with schizophrenia can be clumsy and uncoordinated. They may also exhibit involuntary movements and may grimace or exhibit unusual mannerisms. They may repeat certain motions over and over or, in extreme cases, may become catatonic. Catatonia is a state of immobility and unresponsiveness. It was more common when treatment for schizophrenia was not available; fortunately, it is now rare.
NEGATIVE SYMPTOMS
The term "negative symptoms" refers to reductions in normal emotional and behavioral states. These include the following:
flat affect (immobile facial expression, monotonous voice),
lack of pleasure in everyday life,
diminished ability to initiate and sustain planned activity, and
speaking infrequently, even when forced to interact.
People with schizophrenia often neglect basic hygiene and need help with everyday activities. Because it is not as obvious that negative symptoms are part of a psychiatric illness, people with schizophrenia are often perceived as lazy and unwilling to better their lives.
COGNITIVE SYMPTOMS
Cognitive symptoms are subtle and are often detected only when neuropsychological tests are performed. They include the following:
poor "executive functioning" (the ability to absorb and interpret information and make decisions based on that information),
inability to sustain attention, and
problems with "working memory" (the ability to keep recently learned information in mind and use it right away)
Cognitive impairments often interfere with the patient's ability to lead a normal life and earn a living. They can cause great emotional distress.
2006-10-20 02:51:19
·
answer #1
·
answered by Anonymous
·
1⤊
0⤋
Interestingly, I have by no means met any person who has advised me that she or he has been identified with schizophrenia. I have, nevertheless, met a few undiagnosed schizophrenics, they usually had been surprisingly fascinating, despite the fact that reasonably creepy while I notice the disorganization in their speech (quite often after a protracted interval in which the whole lot sounds natural). I get drawn in to the dialog, and there's a factor at which it turns into transparent that the man or woman does now not see truth the way in which I and such a lot others do. These humans have weird magical considering, ritual and in a single case, mentioned a talk with 2 nonexistent humans. When I discovered they were not truly however he handled them as truly, that is while matters obtained creepy. Also the lengthy stare is a bit off-hanging and contributes to the sensation of creepiness (now not relatively correct, many times subliminal in its have an effect on.) If I chanced to satisfy any one who used to be identified, it could be much more likely that she or he used to be already on therapy and in addition had capabilities of the pain and used to be taking steps to manage it. That could be a lot much less creepy than one that has no inspiration why his or her strategies are they means they're--the 2 I met concept they had been simply natural (one had a "finding out incapacity" however used to be great at chess, and the opposite used to be a drifter who occurred to be on the motel I stayed directly.) It is the "simply natural" humans who show those indicators which might be the creepy ones, in view that you get the inspiration that you just can not expect what they will do in line with you. The chain of good judgment and rationality is not there, there's no attention of the ailment (or reimbursement), and that's a bit bit scary. So that is my revel in with humans with schizophrenia.
2016-08-31 23:54:52
·
answer #2
·
answered by Anonymous
·
0⤊
0⤋