“I would hear him talking to himself at night when I was laying in my bed” my mom said when I asked her about her brother, whom I have never met and only have seen one picture of. He became a ward of the state of Oklahoma when he was younger, diagnosed with Schizophrenia sometime in the 70’s, and has been living in a home ever since. Schizophrenia is a serious diagnosis that negatively affects the day to day lives of those who have been diagnosed. Seeing how I have some sort of connection with Schizophrenia, I thought I would take the opportunity and do a little bit of research on the topic and explain what it is, what may be some causes for the disorder, and some symptoms and treatments that come along with the diagnosis.
What is schizophrenia? The National Institute of Mental Health defines schizophrenia as “a chronic and severe mental disorder that affects how a person thinks, feels and behaves, although it is not as common as other mental disorders, the symptoms can be very disabling.” Schizophrenia symptoms usually begin between the ages of 16 and 30 but there are rare cases where children have schizophrenia. (The National Institute of Mental Health, 'Schizophrenia').
The NIMH says that there are several factors the contribute to the risk of developing schizophrenia. One is genes and environment; schizophrenia can sometimes run in families; this is something scientists have long known. There are people with the disorder who don’t have any family members with it and then there are some who have multiple people with the disorder who never develop schizophrenia. Scientists believe that there is no one single gene that causes schizophrenia but that many genes may increase the risk. Interactions between genes and some parts of the individual’s environment are necessary for the disorder to develop is another way they think the disorder develops. Some of these factors include, exposure to viruses, malnutrition before birth, problems during birth, and psychosocial factors. Scientists also think different brain chemistry and structure play a role. They think an imbalance in the chemical reactions between the neurotransmitters, dopamine and glutamate, and maybe other that play a role in the development of the disorder. Some think problems during the development of the brain while in utero may lead to faulty connections or the changes that occur in the brain during puberty could set off the psychotic symptoms in those who are susceptible due to their genetics or brain differences (The National Institute of Mental Health, 'Schizophrenia').
Schizophrenia symptoms fall into three categories: positive, negative and cognitive. The NIMH explains that positive symptoms are psychotic behaviors and the people that display them may seem to “lose touch” with some parts of reality. These are not usually seen in healthy people. The positive symptoms include hallucinations, delusions, thought disorders and movement disorders. Negative symptoms are associated with disruptions to normal emotions and behaviors. These symptoms include a “flat affect, reduced expression of emotions via facial expressions or voice tone, reduced feelings of pleasure in everyday life, difficulty beginning and sustaining activities, and reduced speaking.” Cognitive symptoms are subtle for some but for others they are severe. Some patients may notice changes in their memory or other aspects of thinking. Some of these symptoms include “poor executive functioning (the ability to understand information and use to make decisions), trouble focusing or paying attention and problems with “working memory” or the ability to use information immediately after learning it” (The National Institute of Mental Health, 'Schizophrenia').
There are currently 20 marketed antipsychotic drugs available. Chlorpromazine was the first, introduced in the U.S. in 1954. There have been numerous studies that demonstrate the dramatic efficacy of antipsychotic drugs in suppressing psychotic symptoms and preventng their recurrence. The studies also showed their inability to alleviate the negative and cognitive symptoms. The effectiveness of the newer second-generation antipsychotic drugs is not significantly any better than the older first generation, with clozapine being an exception (Lieberman, 'Treatment of Schizophrenia: Current Capability, Future Promise', 2012). In a 2010 randomized, controlled trial of risperidone, was done to determine the duration of maintenance treatments that are needed with the initial therapeutic dose, in contrast to a reduced dose. Preventing a relapse in schizophrenic patients is the crucial task in maintenance treatments. The method for the controlled study was patients with schizophrenia who were clinically stabilized following as acute episode, were assigned to a no-dose-reduction group, randomly. A 4-week group, the initial optimal therapeutic dose continued for 4 weeks, then a 50% dose reduction was maintained until the study ended. This was the same with the 26-week group, the optimal dose was continued for 26 weeks then a 50% dose reduction until the study ended. The patients all continued the study until the last patient that was recruited finished the 1 year follow up. For this study only 374 out of the 404 recruited completed it. The results showed that the mean time from entry to relapse was 571 days (30.5%) in the 4-week group, 615 days (19.5%) in the 26-week group and 683 days (9.4%) in the no-dose reduction groups. The no dose reduction patients experienced greater reduction in the severity of psychotic symptoms (Wang, et al., 'Risperidone Maintenance Treatment in Schizophrenia: A Randomized, Controlled Trial', 2010).
After reading about the disorder and talking with my mom about her experience in knowing her brother, it does seem that schizophrenia is a serious diagnosis that effects the person’s everyday life. You never know why or what caused the person to have it or what symptoms they are going to display. Or even if medication will help the person. Schizophrenia not only affects the person diagnosed but their family as well.
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