Schizophrenia: The Word's Meaning
The word schizophrenia originates from the Greek Language. The meaning of Schizophrenia can be understood by the split Greek terms schizo, meaning split, and phrene, meaning mind, representing a person's fragmented thinking. Schizophrenia is a chronic mental disorder that affects how a person thinks, acts, perceives reality, and relates to others.
It involves psychosis, a mental illness wherein a person can't tell what's real from what's imagined. The complexity of schizophrenia may help explain some misconceptions about the disease. For instance, some people think it causes a "split personality." In fact, schizophrenia and split personality, clinically known as dissociative identity disorder, are two different disorders.
A person with the disorder can show a sudden change in behavior due to the lack of control during a psychotic episode. The illness is not the same for everyone. Some people have only one psychotic episode, while others have many episodes during a lifetime but lead relatively everyday lives in between. Still, others may have more trouble functioning over time, with slight improvement between full-blown psychotic episodes.
People with the condition are ordinarily not violent. More typically, they prefer withdrawal from social settings. When people take part in destructive behaviors, it is generally a result of their psychosis and the fear that they're being threatened in some way by their surroundings. Caregivers in such cases can give consent to supported admission for the treatment of their loved one at a hospital or clinic. This is applicable if and when a violent psychotic episode, causes them to be at risk of injuring themselves or the people around them.
Diagnosis of Schizophrenia
Researchers suggest that a combination of genetics, brain chemistry, and environmental factors contribute to the early onset of Schizophrenia.
Neuroimaging studies show differences in the brain structure and central nervous system of people with Schizophrenia. While researchers aren't sure about the significance of these changes, they indicate that this illness is specifically a brain disease.
The disorder can be identified within a person based on their various symptoms.
- Positive symptoms include; Delusions, Hallucinations, and Catatonia.
- Disorganized Symptoms include; repeated movements, slow speech, and brain fog.
- Cognitive Symptoms include; trouble paying attention and poor executive functioning
- Negative symptoms include; lack of motivation, poor hygiene, withdrawal
A diagnosis can be made through a Psychiatric Evaluation and Tests or the DSM criteria. Delusions, Hallucinations, and Catatonia can result from a substance that was abused or another underlying physical condition. Thus it is essential to diagnose Schizophrenia by determining how these symptoms are based on no other illness or disorder but due to Schizophrenia itself.
Types of Schizophrenia
The Disorder is no longer viewed based on its subtypes. It is diagnosed and treated as a whole. “Schizophrenia has several subtypes but is diagnosed and treated as a whole. Understanding the symptoms of these subtypes helps us deal with the condition better,” explains Dr. Priya, Consultant Psychiatrist, Cadabams Group.
Paranoid Schizophrenia is a chronic condition marked by the onset of paranoia that is not abrupt. It is a gradual change that a person might experience in their thoughts about themselves and the world. Paranoid symptoms usually involve hearing, seeing, and tasting things that others don't. These are positive symptoms of hallucinations that are auditory, visual, tactile, and olfactory.
People with the condition may start behaving strangely as they actively hold on to unusual beliefs. Many prefer distancing themselves from friends and family and cannot think clearly, pay attention, and function enough. Usually, their psychotic episode is accompanied by the delusion of persecution and hallucinations.
Undifferentiated Schizophrenia is diagnosed when an individual meets the criteria for diagnosis of Schizophrenia but cannot be classified into any of the five defined subtypes. People who are diagnosed with undifferentiated schizophrenia display traits of more than one type of Schizophrenia. The recent edition of DSM-5 no longer includes these subtypes as distinct conditions because they were gathered to have low validity and reliability in terms of diagnosis.
Disorganized Schizophrenia is characterized by disorderly behavior and speech. Hallucinations and delusions are less pronounced with disorganized Schizophrenia. This form of the disorder can cause people to have difficulty concentrating and maintaining a train of thought, which manifests in how they speak.
People with disorganized speech speak incoherently, respond to questions with unrelated answers, or shift topics frequently. A person who is disorganized may lose associations, expressed in made-up words that only have meaning to the speaker.
A person with disorganized Schizophrenia is also likely to have difficulty beginning a specific task or finishing it.
Residual Schizophrenia phrase used to describe a patient who is not presently experiencing prominent delusions, hallucinations, disorganized speech, or disorganized or catatonic behaviors. However, they are feeling at least two of those symptoms to a lesser extent, or they continue to experience the negative somatic symptoms of the illness(e.g., difficulty paying attention, social withdrawal, apathy, a reduction in speech). This subtype is distinguished from the "residual phase" of Schizophrenia.
Catatonic Schizophrenia is now deemed a rare subtype because it is believed to be primarily the result of leaving the disorder untreated. It occurs less frequently among people with Schizophrenia as early intervention and treatment have advanced. It is characterized by a significant reduction or improvement in movement.
A person with catatonia may be principally immobile, maintain a firm posture, and resist moving attempts. On the other hand, there may be excessive, seemingly purposeless movement. This can include repeating what other people say and mimicking other people's actions.
The antipsychotic medication for Schizophrenia is a widely used method of treatment. The goal of such a treatment is to manage signs and symptoms at the lowest possible. The drug can be administered orally in first and second-generation medicines or via intramuscular or subcutaneous injections.
While medication helps relieve symptoms, various psychosocial treatments can help with the behavioral, psychological, and social dysfunctions that go with the illness. These include Cognitive Behavioural Therapy, Electroconvulsive Therapy, Family Therapy, and Dignity Therapy. Optimism is essential during treatment and rehabilitation. Family members need to be mindful that many people with the disorder have an affirmative course of illness, that challenges can often be approached, and that patients have many personal strengths that must be identified and supported.