Schizophrenia
Part I
Definition of the Case Study
Schizophrenia is a
mental disorder characterized by many symptoms that are different combinations
involving feelings thoughts, actions, and relations with the surrounding world.
As a consequence of these symptoms, the schizophrenic adopts a way of living
that differs from prevailing in the society of which he is a part. The patient
often confuses fantasy with reality to live in a private world.
Nature of Disease
The schizophrenic often
entertains false beliefs or delusions. The patient may think that he is the
victim of persecutors. He may also have perpetual experiences without
appropriate external stimulations. For instance, he has hallucinations of
hearing voices although nobody is talking to him, or he perceives apparitions
without a corresponding external object. Although etiologically, the term
schizophrenia means a division or splitting between the different parts of the
psyche, the term as used by psychiatrist is not mean split personality.
Population Commonly
Affected
Schizophrenia is the
most common in mental illnesses. The disorder affects approximately 1% of the
population. Schizophrenia occurs in both men and women equally, it tends to
affect men earlier, usually by late puberty to the early 20s. Women are more
often affected in the late 20s to early 30s. Childhood schizophrenia is
uncommon and rare. Albeit, some people who later develop schizophrenia may have
appeared different from other children, the schizophrenia symptoms are in
common.
Part II
Signs and Symptoms
Signs of schizophrenia
generally divided into three categories: positive, disorganized and negative
symptoms. Delusions and hallucinations or positive symptoms. Hallucinations are
altered perceptions. They can occur without any outside factors. There are
numerous methods to experience a hallucinations; however, the most common are
auditory: the ailment of hearing voices that no one else can hear. Delusions
are a false state of reality. These delusions may take on different forms. A
common theme amongst patients is paranoia. Patients may believe that they are
being persecuted, harassed, and or conspired against. Another instance could be
a false sense of self, or delusions of grandeur. They may truly believe that
they are of high stature and is an important figure in society. These delusions
may be quite eccentric. The patient may actually believe that they are being
spied upon and that they are being controlled by magnetic waves.
Disorganized symptoms
include impoverished thought, disorganized speech, incoherence, and speaking an
abstract. The inability of piecing thoughts into logical sentences also
contributes to the social isolation of the patient. Disorganized symptoms also
include disorganized behavior such as dressing inappropriately, pacing, or
crying.
The negative symptoms of
schizophrenia or catatonic behavior, lack of emotional response, decline in
speech, and also avolition. The catatonic type is characterized by unusual
motor behavior. The patient may be in a state of immobility and assume
statuesque positions. Occasionally, states of immobility are interrupted by
unpredictable periods of excitement.
Disease Progression
Prodromal, active, and
residual are the three stages of schizophrenia. During the prodromal stage,
negative symptoms such as catatonic behavior, lack of emotion and disorganized
symptoms of impoverished thought and incoherence manifest. The prodromal period
varies from days to months before the onset of the illness begins.
Delusions and
hallucinations are the positive symptoms exhibited during the acute phase. At
this point, the symptoms may progress slowly over a period of time or may occur
suddenly. The negative symptoms of the prodromal stage may or may not still be
present. The symptoms may develop from severe positive symptoms to stages of
remission in which the disease may be dormant. It is during the first 5 to 10
years, of the active phase, that the unique pattern of illness develops.
The residual phase is
the period in which the positive symptoms may be less ardent; however, at this
point the negative symptoms may worsen. It is possible to regain social
employment skills; however, being able to fully function in society
independently may still be a challenge. It is at this stage in which medication
is implemented to manage any relapse or outburst of the disease.
Part III
Nursing Care
There are numerous
benefits of schizophrenic patients who receive care in a nursing facility. The
responsibility in nursing care while dealing with the schizophrenic patient
requires dedication and empathy. The objective is treating each patient as an
individual. The patient is treated to develop self-respect by providing some
level responsibility and to provide self motivation for behavioral improvement.
For those who suffer from the acute stage of the disease, if left untreated and
unmanaged, many patients often will inflict self harm, which is why a high
percentage commits suicide. Being in a safe environment with a consistent
regiment will enable the patient to diminish irrational thinking and feel
comfortable and inviolable.
Medical Treatment
Available
While there is no cure
for schizophrenia, it is a highly treatable disorder. Medication appears to
improve a long-term prognosis for many people with schizophrenia. Studies show
that after 10 years of treatment, 1/4 have improved considerably, and 1/4 have
improved modestly. 15% have not improved and 10% or dead. Antipsychotic drugs
are using a treatment of schizophrenia. These treatments help relieve the
delusions and hallucinations, and thinking problems associated with this
devastating disorder. Scientists believe the drugs work by correcting
imbalances in the chemicals that help brain cells communicate with one another.
As with drug treatments for other physical illnesses, many patients with severe
mental illnesses may try several different antipsychotic medications before
they find the one, or combination of medications, that works best for them.
Rehabilitation and
Restorative Care
Rehabilitation includes
a variety of non-medical interventions for those of schizophrenia.
Rehabilitation programs emphasize social and vocational training to help
patients and former patients overcome difficulties in these areas. Programs may
include counseling, job training, problem-solving and money management skills,
and social skills training. These approaches are important for the success of
the community centered treatment of schizophrenia because they provide
discharge patience with skills needed to lead productive lives outside the
sheltered confines of a mental hospital.
Part IV
Conclusion
In summary, a specific
cause is not implicated, and multiple genetic and environmental factors may be
relevant to the cause of schizophrenia. These causal factors interact, in an
unknown way, to produce abnormal fetal development and or chemical imbalances.
It is not certain whether this early developmental deviation is necessary and
or sufficient to be the cause of schizophrenia; however, it may leave an
individual susceptible to the disorder. To understand schizophrenia, future
research needs to concentrate on furthering the understanding of brain
development in maturation. Hopefully, this knowledge will enable the mechanisms
involved in subnormal neurodevelopment to be understood. Studies are needed to
define the trigger which causes the development of psychotic symptoms and explain
how and why the disease remains latent for 20 to 30 years. Another area
warranting further study is the interactions between the genes and
environmental factors associated with development of schizophrenia.
Part V
Bibliography
References
Anthony, William A.
Recovery from mental illness: The guiding vision of the mental health service
system in the 1990s. Psychosocial Rehabilitation Journal, Volume. 16, No 4, p.
11-23 (1993).
Schizophrenia Center:
Types, Symptoms, Medications, Causes, and Tests. (n.d.). Retrieved November 21,
2020, from https://www.webmd.com/schizophrenia/default.htm
Nutt, A. (2019, April
29). Scientists open the 'black box' of schizophrenia with dramatic genetic
discovery. Retrieved November 21, 2020, from
https://www.washingtonpost.com/news/speaking-of-science/wp/2016/01/27/scientists-open-the-black-box-of-schizophrenia-with-dramatic-genetic-finding/
Photo by: Matt Flores
https://unsplash.com/@matdflo/portfolio
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