Schizophrenia is a complex syndrome that has been recognized for many years. Schizophrenia is characterized by a broad spectrum of cognitive and emotional dysfunctions that include delusions and hallucinations, disorganized speech and behavior and in appropriate emotions Schizophrenia disrupts perception of the world, thought, speech, movement and almost every other aspect of daily functioning. Usually chronic with a high relapse rate, complete recovery from schizophrenia is rare. The Symptoms of schizophrenia can be divided into positive, negative and disorganized.
People with Schizophrenia do not all show the same kinds of symptoms. Symptoms vary from person to person and may be Cyclical. Common symptoms include:
- Unrealistic and bizarre beliefs not shared by others in the culture.
- Maybe delusions of grandeur [that you are really Mother Teresa or Napoleon] or delusions of persecution [the Cyclist who believed her competitors were sabotaging her by putting pebbles in the road].
- Sensory events that aren't based on any external event [hearing voices, seeing people who have died].
- Many have auditory hallucinations.
- Jumping from topic to topic.
- Talking illogically [not answering direct questions, going off on tangents].
- Speaking in unintelligible words and sentences.
- Pacing excitably, wild agitation.
- Catatonic immobility.
- Waxy flexibility [keeping body parts in the same position when they are moved by someone else].
- Inappropriate dress [coats in the summer, shorts in the winter].
- Inappropriate affect.
- Ignoring personal hygiene.
- Lack of Emotional response [Hat speech, little change in facial expressions].
- Apathy [little interest in day-to-day activities].
- Delayed and brief responses in conversation.
- Loss of enjoyment in pleasurable activities [eating, socializing, sex]
Schizophrenia triggered at
- Stressful, traumatic life event.
- High expressed emotion [family criticism hostility, and /or intrusion].
- Sometimes no obvious trigger.
- Inherited tendency [multiple genes] to develop disease.
- Prenatal / birth complications –viral infection during pregnancy/birth injury affect child's brain cells.
- Brain chemistry [abnormalities in the dopamine and glutamate systems].
- Brain structure [enlarged ventricles].
- Interaction Styles that are high in criticism, hostility and emotional over involvement can trigger a relapse.
- Positive Symptoms
- Active manifestations of abnormal behavior [delusions, hallucinations, disorganized speech, odd body movements or catatonia]
- Negative Symptoms
- Flat affect [lack of emotional expression].
- Avolition [ lack of initiative, apathy].
- Alogia [ relative absence in amount of content of speech].
Social / Cultural
- Environment [early family experiences] can trigger onset.
- Culture influences interpretation of disease / symptoms [hallucinations, delusions].
Individual, Group and family Therapy
- Can help patient and family understand the disease and symptom triggers.
- Teaches Families communication skills.
- Provides resources for dealing with emotional and practical challenges.
Social skills training
- Can occur in hospital or community settings.
- Teaches the person with schizophrenia social, self-care and vocational skills.
- Taking neuroleptic medications may help people with schizophrenia to:
- Clarify thinking and perceptions of reality
- Reduce hallucinations and delusions
- Drug treatment must be consistent to be effective. Inconsistent dosage may aggravate existing symptoms or create new ones.
David H. Barlow, BOSTON UNIVERSITY
V. Mark Durand, UNIVERSITY OF SOUTH FLORIDA- ST. PETERSBERG
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