Mar 05, 2018
Schizophrenia is a serious chronic mental illness, a set of mental and behavioral phenomena, a clinical syndrome characterized by abnormal perception of the outside world, for example, hallucinations and mania, which are called psychotic symptoms. Other symptoms include slurred speech, difficulty in reasoning, and inability to work in society. The term "schizophrenia " means the split personality and refers to the loss of a sense of reality that sometimes occurs. The onset of schizophrenia can be sudden( within days, weeks or months), but usually it develops slowly over several years. On average, about 1 percent of the population has schizophrenia;the greatest number of cases of development of the disease is observed in men aged 15 to 25 years and in women aged 25 to 35 years. Schizophrenia can be divided into five subtypes: catatonic schizophrenia, gebefrenia, paranoid, undifferentiated and residual schizophrenia. Each type has its own set of symptoms in addition to the common signs of schizophrenia.
Its manifestations may include abnormal perception in the form of hallucinations;deviant conclusions and judgments, leading to extraordinary beliefs and delusional interpretations;distortion of thought processes, which are revealed in the form of verbal disturbances;unusual, often limited emotions, reduced motivational and volitional activity;expressed cognitive problems, especially concerning memory and performing functions;seeming strange behavior, explainable only in the context of these unusual experiences, and violations of control systems. In the end, it becomes more obvious, just as it seemed a century ago, that it is a question of both motor and development-reflecting aspects. It is, indeed, a manifold in which there are never two completely identical cases.
As with other complex diseases, we in some sense know a lot about schizophrenia, but still remain unknown. So, about 1% of people in this or that period of life experience this syndrome, and 24 out of 100,000 annually face it for the first time. Schizophrenic syndrome is in fact very rare until pubertal age and is most often manifested in the first half of adulthood. This should explain a lot about the mechanisms underlying the disease that occur in the brain and in mental activity, their interconnection, which requires the generalization of characteristic features.
Appropriate treatment and support allows 50-75 percent of patients to lead a normal life. Approximately 25 percent of schizophrenic patients, however, have a poor prognosis of the disease. They are not able to work or live independently. Suicide attempts and episodes of depression are common in this disease.
• Common symptoms: confusion( eg, confidence that the speaker speaks directly to him from the TV screen);hallucinations( for example, when a person hears the voices of people who are not around);fuzzy or meaningless speech;highly disorganized behavior;inadequate emotional reactions or emotional detachment;taciturnity;lack of conscious movements.
• Catatonic schizophrenia: minimal or obstructed motion or stupor;excessive and erratic movements;negative reaction( refusal to go or resistance, when the patient physically move);dumbness;unusual movements, facial expressions or postures;meaningless and repetitive speech( words or phrases) or movements.
• Disorganized type;meaningless speech, which can be accompanied by stupidity and laughter;lack of organization in the performance of basic daily activities, such as washing, preparing food and cleaning teeth.
• Paranoid type: frequent hallucinations or persecution mania.
• Undifferentiated type: general symptoms of schizophrenia , but no symptom characteristic of catatonic, disorganized or paranoid type.
• Residual type: long-lasting signs of the disease, but no noticeable or acute symptoms.
Two( or more) of the following symptoms, each of which is present for a significant part of the time for 1 month( or less with successful therapy):
Note: Only one symptom of criterion A is required if delusions are fanciful or hallucinations represented by a voice thatcomments on the patient's behavior and thoughts, or by two or more voices talking to each other
Much of the time since the onset of violations, one or more of the main areas of functioning, such as work, interpersonal communications or self-care, remain substantially below the level reached before the onset of the illness( or, at the onset of childhood and adolescence, failure to achieve the expectedlevel of interpersonal, scientific and professional successes).
No single sign by itself is sufficient or necessary to make a diagnosis;but the association of many clinical cases with schizophrenia becomes apparent due to the presence of a variety of characteristic symptoms. It should be noted that we are not sure where the border lies: there may be a partial cross-over with other mental disorders, such as affective or obsessive-compulsive disorders, or there may be a spectrum of clinical abnormality that merges with the marginal cases in the general population.
Continuous signs of impairment continue for at least 6 months.
This 6-month period should include at least 1 month.the presence of symptoms( or less in successful treatment) that meet the criteria of A( ie symptoms of the active phase) and may include periods of prodromal or residual symptoms. During these prodromal and residual periods, the symptoms of the disorder can be manifested only by negative symptoms or by two or more symptoms presented in a weakened form( for example, strange beliefs, deceptions)
I. At least one of the syndromes, symptoms or signs listed below(1), or at least two of the symptoms and signs listed below( 2) should be present at the greater length of the episode of a mental illness lasting at least 1 month( or sometimes duringMost of the days)
1 At least one of the following should be present:
2 At least two of the following:
Diagnostic criteria indicate that the schizophrenic syndrome can have a variety of manifestations and flow variants. Such uncertainty about outcomes usually leads to difficulties in explaining what will happen to people suffering from this syndrome and those who care for them. These problems limit the use of the diagnosis of schizophrenia and underlie the widespread habit of referring to compromise terms "psychosis" or "ineffective psychosis" to show that depression or mania is either not present or is not the best explanation for the disease. The term "psychosis" seems less pejorative, and people can be less stigmatized and are more supportive of such a diagnosis. He has his original sources in a very broad view of mental disorders, but is now used in relation to specific symptoms and signs. Those who use the term "psychosis" should be more precise in that they understand it, in terms of positive symptoms, negative manifestations, social functioning, etc. They also need to understand the differences between classification, diagnosis and the full clinical definition and construction of a health care plan. People with this disorder are especially interested in the last questions and want to know what will happen after a long time;The classification is much less interesting for them.
Schizophrenia leads to abnormalities in many areas, often beyond the scope of positive psychotic manifestations. Thus, it is possible to describe the loss of a multitude of abilities in persons affected by this disorder.
The damage accrues as a result of primary and, to some extent, secondary violations. It extends to professional functioning, social connections and the level of everyday concern for someone. These manifestations of damage vary in different phases of the disease and are not always associated with positive symptoms. Negative symptoms and cognitive problems are the main determinants, especially when positive manifestations are less pronounced due to medication and psychotherapeutic interventions, even if they themselves continue to be present.
Of course, they are more influential than a situation such as the attitude of society towards the mentally ill.
Some patients need supervision so that they are confident in their adequate nutrition and hygiene standards and to protect them from the consequences of impulsivity, uncriticality, cognitive impairment, or acts committed under the influence of delirium and imperative hallucinations. In the intervals between episodes of illness, the severity of the remaining insolvency can range from zero to a significant level.
Violence from schizophrenic patients attracts the attention of the media and the public and can directly affect health policy. While the frequency of such actions is insignificantly higher than in the general population, it will be the same in many comparison groups, and absolute indices remain very low.
The level of violence in the population( especially among men) associated with the abuse of alcohol and drugs is significantly higher than that due to any mental illness. The presence of positive symptoms, alcohol abuse, loss of contact with services and therapy are nevertheless a combination of factors that increase the risk of violence in schizophrenia that is amenable to correction and which psychiatric services should seek to reduce.
The life expectancy of schizophrenic patients is shorter than in the population. An important reason for this is suicide, as approximately 10% of patients die in this way. Prevention of suicide is another important aspect of any relief plan. The increased mortality for many other reasons makes the care of the patient's physical condition and maintenance of his health( including sexual health and medicinal recommendations) vital from the very beginning.
• There is no known way to prevent schizophrenia. But repeated attacks can be prevented with the help of antipsychotic medications.