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Thursday, May 9, 2013


Mental Disorders - Behavioral and Emotional Problems 

Schizophrenia is a general name for a group of emotional disorders that are all forms of psychosis, in which the person has problems telling fact from fantasy and therefore behaves irrationally. Schizophrenia alters a person's thought patterns, reactions to others, and behavior so severely that he or she undergoes a change in personality.

For a diagnosis of schizophrenia to be confirmed, the person must show signs of fragmentation (disorganization) of the personality for at least six months. Also, the six-month period must include at least one episode of delusions i.e. false ideas, hallucinations (sensory experiences that originate in the mind), or significant thought disorders. Schizophrenia should not be confused with multiple personality disorder.

Some mental health professionals and specialists think that schizophrenia is an inherited disorder, others believe that it is the result of a profound disturbance in early mother-child relationships. The symptoms usually appear in late adolescence or early adulthood. The disorder may be lifelong, but acute episodes tend to occur at times of emotional stress or personal loss.

What are the symptoms?

  • For most people with schizophrenia, an episode begins with a gradual, or occasionally sudden, withdrawal from day to day activities. The content of the person's speech may become increasingly vague, and her or she may seem unable to follow a simple conversation. An acute bout can happen unexpectedly. Often the onset is so gradual that it is difficult to know when psychotic symptoms appear. Among such symptoms are seemingly disconnected remarks, along with blank looks. 
  • Schizophrenics often believe that others "hear" and "steal" their thoughts. Those with schizophrenia may have delusions, ranging from a single idea such as a conviction they are George Washington to complex symptoms of related beliefs. Sometimes they fear they have lost control of bodily movement as well as thought, as if they were puppets. They frequently believe they hear voices, often hostile ones. Less commonly, they have hallucinations of odd physical sensations, fearing that they have been poisoned or otherwise attacked by others. In time many people with schizophrenia build up a set of beliefs in a fantasy world. In this way they flee from reality and withdraw from what they perceive to be an overwhelmingly threatened world. They may express exaggerated feelings of happiness, bewilderment, or despair. They may laugh at a sad moment or cry without cause.
  • In an early phase of schizophrenia the person may have symptoms similar to those of manic-depressive illness. A schizophrenia deepens, however, the person may become very detached toward others. The detached person is then more likely to behave strangely and to neglect his or her personal appearance. Their are several types of schizophrenia with similar symptoms, but the only practical distinction that most mental health professionals now make is between paranoid schizophrenia and other types. The main symptoms of a person with paranoid schizophrenia are constant suspicion and resentment, accompanied by an irrational fear that people are hostile or even plotting to destroy him or her.

What are the risks?

  • Schizophrenia is most common type of psychosis, usually begins between ages 15 to 30. Males and females are about equally affected by the disorder.
  • For unknown reasons schizophrenia is more common in certain geographic areas such as inner cities of the United States. Throughout the world schizophrenia has and average lifetime prevalence of almost one-percent. It tends to run in families, chemical changes in the brain may also play a role.
  • People who have bouts of schizophrenia in its most severe forms may physically harm themselves or others, or may try to commit suicide.

What is the treatment?

  • Severe cases are treated in a hospital setting. Treatment usually involves the use of medication, psychotherapy, and rehabilitation.
  • The most effective medication are regular doses of anti-psychotic drugs designed to reduce symptoms so that the person can benefit from psychotherapy. As symptoms gradually disappear, doses are reduced. Some people however, need long-term medication. They may either take oral medication regularly or be given an injection every 2 to 4 weeks to ensure compliance.
  • As soon as the person's symptoms are controlled by medication, he or she is ready to be helped by psychotherapy. Techniques of psychotherapy very, but the goal is the same: to help the person understand the emotional factors underlying the disorder and how they contributed to the current episode. Medication and psychotherapy play major roles in helping the person get back in touch with reality. For treatment to be effective, the family needs to be closely involved. 
  • The final stage of treatment is rehabilitation, which helps people who are recovering from a bout of schizophrenia to regain normal skills and behavioral patterns. In the early stages of hospital treatment, people with schizophrenia are generally given increasingly complex tasks and pressures, which eventually approximate the tasks and pressures of the real world. Those with schizophrenia need assistance from day centers or other community care once they are released from the hospital, but these resources are not always available.

What are the long-term prospects?

Many people recover from an episode of schizophrenia well enough to return to varying degrees of independence. But they may have further episodes, especially if they do not take their medication as prescribed. In some people the condition becomes chronic. About 10% remains impaired for life. The outlook improves if you follow your physician's advice about medication, and if the family is involved in your treatment.

What should be done?
  • If you suspect that someone in your family is schizophrenic, try to get the person to see a physician. It probably will not be easy. People who are becoming mentally ill often refuse to admit it. But medical care is crucial. Do not leave a person alone who at that time seems extremely disturbed. The presence of a relative or friend will reassure that person. Keeping him or her from self destructive behavior until help arrives may be essential. However, if you feel threatened, leave the person and wait for help. People with symptoms similar to those of schizophrenia may be admitted to a hospital for a preliminary period of observation.