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Report On Schizophrenia: Symptoms, Factors, And Therapy

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Mental disorders with psychotic symptoms are commonly associated with crime. Psychiatric disorders are blamed by the media for the cause of tragic acts of evil done by school shooters and terrorists. One of the most commonly feared mental disorders is schizophrenia. Schizophrenia is a mental disorder characterized by psychotic episodes and scattered mental processing. It has many biological and environmental risk factors. The disorder is most commonly treated with antipsychotics but researchers are constantly studying new possible treatment plans.

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According to the DSM-58, schizophrenia is characterized by two or more of the following symptoms which include delusions, hallucinations disorganized speech, grossly disorganized or catetonic behavior, and negative emotional symptoms. The onset of disturbances must be present during high levels of stress such as work or school. Symptoms must be present for more than nine months. It is most commonly diagnosed between the ages of 5 and mid thirties. Symptoms usually lessen over a lifetime, with a twenty percent full recovery rate. Recovery is slower in those with more severe symptoms. Higher functioning patients find it easier quicker to recover. The Indian Journal of health and wellbeing explains that there are two types of recovery; clinical recovery and personal recovery.

Clinical recovery is based on objective testing while personal recovery a subjective view of how the client sees their own recovery. The goal of recovery has slowly evolved from symptom remission to an overall personal healthy lifestyle. Unfortunately, not all recovery attempts are successful. Approximately 6% of those with schizophrenia die by suicde. Schizophrenia is comorbid with substance abuse, anxiety disorders, obsessive compulsive disorders, and panic disorders.

Schizophrenia was first discussed as a disorder in the early nineteenth century. It was typically thought of as a strange disorder affecting the young that chronically deteriorates the mind. It was called many names across Europe. The French called it démence précoce. It was called adolescent insanity in scotland because it was discovered in children. Other names included catatonic syndrome, hebephrenia, and dementia praecox. In Jablensky’s article ‘The diagnostic concept of schizophrenia: its history, evolution, and future prospects’9, he writes of two European psychologists in the late 19th and early 20th centuries contributed to the early understanding of the manifestation of this disorder. Emil Kraepelin categorized different types of psychosis into “clinical forms” based on which part of the personality was affected and the progression of the disease.

At the turn of the 20th century, Eugen Bleuler expanded on Kraepelin’s system by coining the term schizophrenia and suggesting that the clinical forms did not always progress but rather manifested in different ways. He differentiated between basic symptoms and accessory symptoms. Basic symptoms include disorganized thought and speech patterns, withdrawal from reality, and contradictory ideas. Secondary symptoms include delusions and hallucinations. Bleuler also emphasized the importance of the study of heredity.

There is a strong correlation between schizophrenia and many hereditary factors. These factors include mitochondrial dysfunction, gut bacterial dysbiosis, overproduction of oxytocin, lower IQ scores, and neurological and cognitive deficits. There is a significant link between schizophrenia and mitochondria dysfunction known as Congenital Asidosic Enzyme-Metabolic Histangiopathy. According to Marchionni, Caramel, and Stagnaro1, this condition is passed on through mitochondrial DNA which is only inherited from the mother. EEGs found that patients with schizophrenia had decreased complexity in brain function and had difficulty sleeping. These factors suggest disorganization syndrome. Both mitochondrial dysfunction and disorganization syndrome are a crucial part in the investigation of quantum biophysical semeiotics. The biologists hope to one day use quantum biophysical semiotics to evaluate the inherited real risk factors of developing schizophrenia. Another possible biological risk factor may be the link between schizophrenia and gut bacterial dysbiosis.

Wang explains in his article2 that the insufficient lining of gut bacteria can leach neurotoxins into the body and overtime may cause neural impairment, apoptosis, and possibly schizophrenia. The disorder has also been linked to hormonal imbalances. Speck discovered in his study3 that there is a strong correlation between schizophrenia and an overproduction of oxytocin both before and after pleasurable emotional stimuli. This overproduction throws off the body’s regulation of its constant battle fighting for homeostasis. Another risk factor with biological roots include social and occupational impairments. These problems in those with schizophrenia is strongly correlated to neurocognitive deficits like sensorineural processing and lower IQ scores. The IQ test assesses processing speed, verbal and visual memory, social perception, theory of mind, reasoning, problem solving, social schemes, trains working memory and semantics. Those with schizophrenia were shown to have lower scores in these areas than the general population. These biological factors are highly correlated with the development of psychiatric disorders, especially when combined with environmental risk factors.

Environmental factors such as childhood trauma and attachment disorders can magnify the predisposition to already existing factors that contribute to the development of schizophrenia. Mitochondrial dysfunction and disorganization syndrome as well as genetic mutations may be a predisposition to schizophrenia triggered by traumatic events in early childhood. Trauma is a psychological wound. People heal from psychological wounds by reverting to their attachments. Early childhood experiences greatly influence one’s coping strategies for present difficulties. In Moskowitz’s Heritage to Giovani Liotti4, he theorizes that attachment influences memories, both conscious and subconscious. The link between dissociation and disorganized or avoidant attachment could cause psychotic symptoms. This is caused by the individual’s need to deviate its attachment. Thus this dissociation of attachment could cause auditory delusions that attempt to satisfy their attachment needs. Psychological wounds from attachment disorders and childhood trauma as well as biological risk factors are interrelated and greatly magnify the chances of the development of a psychiatric disorder. Psychiatric disorders are shown to improve with the treatment of addressing these risk factors.

There are many options in treating both the biological and environmental aspects of schizophrenia. These options include a type of hormone replacement therapy, psychiatric drugs, and neurocognitive therapy. There is a high correlation of an oxytocin imbalance in those with schizophrenia. Spec3 suggests Oxytocin Replacement Therapy as an option to treat the symptoms. It restores a balance within the body. Schizophrenia is a major mental disorder associated with neurological and cognitive deficits. Deficits manifest in high level cognitive functioning such as working memory, and executive processing as well as neurophysical responses when exposed to auditory and visual stimuli.

A new drug, which is being developed by Javitt6, has a goal of reversing some of these deficits. It is still in its testing phase. However, there is a difficulty in finding rodents with schizophrenia like symptoms. So it may be a while yet before they are able to ethically test this drug. Another treatment option is neurocognitive therapy which addresses the effects of environmental factors. Studies by De Mare, Cantrella, and Giovanni5 have shown that cognitive remediation interventions have improved cognitive performance and social functioning. Approaching multiple cognitive domains as a therapeutic strategy is shown to be beneficial in patients with schizophrenia. Integrated Neurocognitive Therapy combines both Neurocognitive therapy and social cognitive therapy. INT treats processing speed, verbal and visual memory, social perception, theory of mind, reasoning, problem solving, social schemes, trains working memory and semantics. These innovative treatment plans give hope to many who suffer from the disorder and improve their lives in all aspects.

The goals of the treatment programs are not to reduce the crime rate. Schizophrenia is not characterized or classified according to the crimes they commit, but by the internal turmoil and disorganized behavior. The lives of those with schizophrenia are immensely complicated by their genetic make-up, and life situations which magnify their symptoms. However, they yearn for the same things that all others do; happiness, wellbeing, and the love of life.

10 October 2020

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