SCHIZOFRENIA

Un nou mod de viata

ASISTENT SOCIAL
SABADUS IONUT SEBASTIAN

25.04.2009

CUPRINS
I.

DEFINITIE...............................................................................
..1
II. SIMPTOMATOLOGIE...........................................................
..2
III. CLASIFICARE......................................................................2
1. Schizofrenia dezorganizata ................................................2
2. Schizofrenia catatonica.......................................................3
3. Schizofrenia paranoida .......................................................3
4. Schizofrenia reziduala.........................................................4
5. Schizofrenia simpla ............................................................4
6. Schizofrenia nedeferentiata ................................................4
IV. TRATAMENT.......................................................................4
V. BOLNAVUL SCHIZOFRENIC PREZENTAT PRIN
OCHII
SOCIETATII ........................................................................5
VI. NORMALITATEA DEFINITIE ......................................6
VII. SCHIZOFRENIA PRIN OCHII UNEI PERSOANE
DAGNOSTICATE CU ACEASTA BOALA ......................7
VIII. PUNCTUL MEU DE VEDERE ...........................................9
IX. CONCLUZIA ........................................................................9
X. NOTA EXPLICATII .......................................................10

BIBLIOGRAFIE:
Asociatia psihiatrilor liberi din Romania, DSM IV Tr. 2000, Edit.
Asociatia Psihiatriilor Liberi din Romania, 2003
FLORIN TUDOSE Florin Tudose, PSIHOPATOLOGIE SI ORIENTARI
TERAPEUTICE IN PSIHIATRIE, Edit. Fundatiei Romania de maine, 2007
Martin Stefan, Mike Travis, Robin M. Murray, THE ENCYCLOPEDIA OF
VISUAL MEDICINE SERIES An Atlas of SCHIZOPHRENIA, Edit. The
Parthenon Publishing Group, 2002

Schizofrenia
Un nou mod de Viata

I Definiie
Din punct de vedere etimologic, cuvntul schizofrenie provine din skhizein = a
despica, a rupe + phren = suflet, spirit.
n manualul de diagnostic i statistic a tulburrilor mentale DSM IV,
schizofrenia este definit ca o: Tulburare mintal care dureaz cel puin ase
luni i presupune pentru cel puin o lun existena unei stri de boal (adic
existena a dou sau mai multe simptome dintre urmtoarele: idei delirante,
halucinaii, dezorganizarea vorbirii, comportament profund dezorganizat
sau catatonic, simptome negative).
Iniial denumit demena precoce pentru incapacitatea sever n
funcionalitatea zilnic pe care o produce (demen) i avnd n mod tipic un
debut n adolescen (precoce), schizofrenia este o boal a crei gravitate ar
putea fi pe scurt caracterizat prin urmtoarele trsturi:
Distruge coeziunea i unitatea contiinei i personalitii.
Bolnavul este un suflet frnt care reflect realitatea ca o oglind spart
(fiecare fragment altceva).
Bolnavul pierde contactul vital cu realul (Minkowski).
Are o frecven important 0.5-1% din populaie. Este o boal catastrofic
denumit i Cancerul bolilor mintale. Are o mare probabilitate s rmn
cronic.
Are o rat de suicid de 10%.
Schizofrenia este o boala psihica care apare in urma:
unui soc emotional puternic,
unui accident cu lovituri puternice in zona capului
unui stil de viata epuizant: agitatie continua urmat de frustrare acumulata pe
perioade foarte mari (cativa ani), loc de munca fara nici un fel de satisfactie
profesionala, finaciara sau emotionala, conditii minime de trai, sau pur si simplu
expunerea la un stres continuu fara momente de respiro, de relaxare
daca in cadrul familiei a existat o persoana bolnava de schizofrenie, individul
are sanse mari sa mosteneasca acesta boala; dar nu este obligatoriu, s-a dovedit

ca au existat persoane care au avut in cadrul familiei persoane bolnave de

aceasta boala psihica si ei nu au mostenit-o. Mediul familial conteaza foarte
mult, persoanele apropiate individului joaca un rol important, acestia fiind
factorul cheie in declansarea bolii.
Schizofrenia mai este numita si boala omului inteligent; asta datorita faptului ca
debutul bolii are loc undeva intre 16-25 ani, exceptie fac parte formele de
schizofrenie tardiva, varsta la care persoanele au acumulat si dezvoltat suficiente
abilitati si cunostinte pentru a avea parte de o viata independenta.
II Simptomatologia
Simptomele generale care se pot indentifica la o persoana bolnava de
schizofrenie sunt:
Halucinatii: vizuale, auditive, tactile, olfactive, chinestezice;
Existenta, aparitia unor idei delirante: de persecutie, de grandoare, mistice, de
gelozie, somatice;
Incoerenta de idei/salata de idei
Incoerenta verbala (fraze care nu au nici un fel de continuitate, fiecare fraza
fiind diferita fata de tema discutiei, intrerupte adesea de cuvinte care nu
reprezinta nici o logica ex: afara ploua, ma simt rau ca nu am fost astazi pe la
vecinu, parca ii prea multa lumina in camera asta si ma deranjeaza, tablou, dar
de ce nu vine cu cana sa imi dea cafeaua aia o data.)
Stare emotionala neadegvata situatie sau momentului in care se afla (ex: cineva
isi spune necazul si el rade si vorbeste fara nici o logica; ....sau..... povesteste
ceva ce are legatura cu trecutul lui, se plange ca nu are suficienti bani sa traiasca
si rade in timp ce povesteste);
Fobii legate de anumite lucruri sau locuri (frica accentuata si scapata de sub
motiunea de cenzura, legata de masini, tramvaie, trafic, televizor, societate, etc.)
Instabilitate emotionala si comportamentala.
III Clasificare
Din punct de vedere clinic Schizofrenia este de mai multe feluri:
III. 1. SCHIZOFRENIA DEZORGANIZAT
apare n adolescen/la oamenii foarte tineri;
pare a fi mai frecvent la brbai;
debutul n general brusc printr-o schimbare frapant a conduitei,cel n cauz
devenind dezorganizat n gnduri i comportament.
Dup cum sugereaz numele, aceast form clinic (denumit ntrecut
schizofrenie hebefrenic) se caracterizeaz printr-o dezorganizare ideativ i
comportamental masiv.
Dezorganizare ideativ se traduce prin incoeren masiv, sever.

Pacientul trece brusc de la o idee la alta aa nct nu se nelege ce vrea s spun.

Aceast incoeren nu este prezent doar la nivelul ideilor, ci i al cuvintelor
spuse la ntmplare, fr legtur.
Dezorganizare comportamental: pacientul este ntr-o continu deplasare, n
micare, parc ar fi ntr-un fel de investigare. Pacientul pare dispus, amuzat,
absolut detaat, de o bun dispoziie surprinztoare, prezenta unei stari de
euforie inexplicabile.
Sub aspectul coninutului comunicrii, el folosete cuvinte noi. Fondul su
lexical conine:
neologisme active cuvinte care aparin limbii respective/sau
neologisme pasive folosirea de cuvinte auzite, al cror coninut nu-l
stpnete, nu-i este cunoscut.
Dup mai multe sptmni sau cteva luni, pacientul devine n mod treptat mai
limitat n aberaiile lui verbale i comportamentale, tulburarea evolund treptat
spre remisiune. Rezumnd, putem spune c indivizii care sufer de acest subtip
de schizofrenie sunt frecvent incoereni, au o dispoziie neadecvat contextului
situaional sau detaare afectiv.
Prezint numeroase bizarerii de comportament. Vorbirea lor conine numeroase
neologisme, expresii bizare, idei delirante. Totui, nu au un set sistematizat de
idei delirante, neexistnd astfel o structur clar a patternului simptomatic.
III. 2. SCHIZOFRENIA CATATONIC
Este o form clinic caracterizat prin tulburri psihomotorii. n modelul clasic,
pacientul este catatonic i prezint flexibilitate ceroas ceea ce presupune c este
ca o statuie de cear, n general prezint mutism, iar atunci cnd este plasat ntro anumit poziie, va rmne n acea poziie pentru o lung perioad de timp.
Extremele tulburrilor psihomotorii sunt, pe de o parte, starea n care pacientul
este complet imobil, la cellalt pol situndu-se o forma maxim de agitaiepsihomotorie, o izbucnire a pacientului, care l face s fie extrem de periculos.
n aceast form de schizofrenie se descriu negativisme active i pasive.
Negativismul n schizofrenia catatonic este:
depete disponibilitatea voliional a persoanei; el nu poate da
curs invitaiei, ordinelor interlocutorului, nu se opune;
ca dovad c este n imposibilitatea de a da curs unei comenzi n plan verbal
sau motor, nici un mijloc de convingere/constrngere, nu poate da rezultate;
negativismul alimentar este o problem de intervenie psihofarmacologic de
urgen, viaa pacientului ajunge n pericol prin nealimentare.
Alte trsturi cuprind manierisme, stereotipii, supunere automat.Dei aceast
form se ntlnea frecvent n urm cu cteva decenii, azi este din ce n ce mai
rar datorit interveniei rapide i eficiente a medicaiei neuroleptice.
III. 3. SCHIZOFRENIA PARANOID
Simptomele dominante ale acestei forme sunt ideile delirante de persecuie sau
grandoare. Frecvent apar iluzii i halucinaii, cel mai adesea auditive, legate de
cele mai multe ori de coninutul temei delirante.

Sub influena ideilor delirante, pacienii pot scrie memorii, denunuri, pot
trece la msuri de aprare fa de presupusele ameninri, devenind astfel
periculoi. Debutul schizofreniei paranoide tinde s fie mai trziu n cursul vieii
dect la celelalte forme, iar trsturile distinctive mai stabile de-a lungul
timpului. Trsturile asociate ideilor delirante i halucinaiilor sunt: anxietatea,
furia, combativitate sau, dimpotriv, retragere social, ambivalena sau
inversiunea afectiv.
Aceti pacieni prezint rezultate puin modificate la testele neuropsihologice,
avnd cel mai bun prognostic dintre toate formele clinice de schizofrenie. De
asemenea, funcionalitatea ocupaional i capacitatea de a tri independent sunt
superioare celor ale bolnavilor cu alte tipuri de schizofrenie.
III. 4. SCHIZOFRENIA REZIDUAL
Aceast form presupune c a existat n trecut cel puin un episod acut de
schizofrenie, dar tabloul clinic actual nu prezint simptome psihotice pozitive
notabile (ex., idei delirante, halucinaii, dezorganizare a vorbirii). Apare o
retragere social marcat, aplatizarea afectului, abulie.
Pot fi prezente idei excentrice sau bizarerii de comportament, dar ele nu mai
sunt marcate. Halucinaiile i ideile delirante, atunci cnd apar, sunt puin
frecvente i vagi. Dei indivizii cu acest pattern simptomatic sunt identificai ca
avnd un subtip particular de schizofrenie, simptomatologia rezidual pe care o
prezint face, de fapt, parte din evoluia acestei boli.
III. 5. SCHIZOFRENIA SIMPL
Aceast form clinic de schizofrenie nu se distinge printr-un element clinic
semnificativ, caracteristic, ci printr-o gam larg de simptome negative:
o scdere a capacitii voliionale;
o scdere a capacitii de rezonan afectiv;
o scdere pn la anulare a funcionalitii profesionale i sociale;
o anumit detaare;
o nsingurare, izolare;
un comportament autist.
III. 6. SCHIZOFRENIA NEDIFERENIAT desemneaz n general o
categorie
care cuprinde indivizii ce nu pot fi plasai n niciuna din categoriile precedente
sau care ntrunesc criterii pentru mai mult dect o singur form clinic.ncercri
mai noi de clasificare a schizofreniilor pun accentul pe tipul tulburrilor i pe
aspectul cognitiv al acestora.
Aceasta este clasificarea facuta din punct de vedere clinic, o clasificare
facuta de catre medicii neuro-psihiatri.
O persoana bolnava de schizofrenie este foarte greu de incadrat in una din
aceste clasificari, deoarece de cele mai multe ori nu prezinta numai un anumit
tip de simptome; acest fapt se datoreaza si complezitatii fiintei umane, tipului de

personalitate pe care acesta il are si experientei negative sau pozitive acumulata

in urma anilor.
IV. Tratament
n ceea ce privete tratamentul psihosocial, sunt necesare strategii pentru
intervenia eficient:
Detecie i intervenie timpurie;
Facilitarea farmacoterapiei;
Tehnici de tratament n internare;
Managementul stresului ngrijitorului;
nvarea aptitudinilor traiului zilnic;
Managementul cazurilor sociale;
Tehnici educaionale i terapie familial;
Intervenii cognitiv-comportamentale.
Din pacate nici unul din tratamente nu vindeca aceasta boala. Acestea
ajuta bolnavul sa treaca peste momentele de criza, diminuarea acestora,
reducearea numarului de fobii si intensitatea acestora, acceptarea bolii si
adaptarea bolnavului la noul mod de viata.
V. Bolnavul schizofrenic prezentat prin ochii societatii.
Din punct de vedere social, sau mai bine zis punctul de vedere al societatii in
ceea ce priveste bolnavul psihic, aceste persoane sunt sunt vazute ca fiind
indivizi periculosi posibili sau viitori criminali, infractori. Aceste persoane sunt
marginalizate, excluse din societate, se incearca chiar negarea existentei lor,
stigmatizate. Societatea, oamenii nu vor sa aiba contact cu acesti oameni, nu vor
sa ii recunoasca ca fiind specimene umane, pur si simplu ii marginalizeaza, ii
ignora in cel mai fericit caz. Dar sa nu uitam ca cei mai mari filozofi ai omenirii
au fost diagnosticati cu diferite boli psihice, filozofi care au fondat conceptul de
societate, de civilizatie si ceea ce inseamna sa fi civilizat.
Societatea, oamenii din jurul bolnavilor de schizofrenie vad doar o mica parte
din comportamentul bolnavului, de obicei , cei din jurul lui vad doar partea urata
a acesteia, crizele care se manifesta diferit in functie de persoana, frustrarea
acumulata dealungul timpului, frustrare care se revasa din pacate pe cei din jur.
Ei vad o persoana care a avut candva ceva, dar care nu se stie din ce motive a
cedat, si-a pierdut mintile, care nu mai este printre ei, o persoana care nu mai
reprezinta nici un fel de interes, un accesoriu care s-a uzat si trebuie inlocuit.
O persoana spunea ...nebunii deschid calea iar inteleptii o urmeaza.
Bolnavii suferinzi de schizofrenie, in anumite situatii si sub supraveghere pot
dezvolta aptitudini extraordinare, talente ascunse in mintea lor, care odata
descoperite pot fi valorificate, indiferent de domeniul in care au fost descoperite.

Din pacate societatea uita ca acesti oameni au facut candva parte din anumite
grupuri sociale, ca ei au avut o viata perfect normala pana in momentul
debutului, ca acesta boala nu face diferente, ca oricine poate sa fie victima
acestei boli.
Cati dintre noi a vazut sau a avut contact vredata cu o persoana
bolnava, diagnosticata de schizofrenie?
Cati dintre noi cunosc astfel de persoane?
Putine sunt persoanele care au avut contact direct cu aceste pesoane, care
au interactionat cu ele, iar foarte putine sunt pesoanele care au incercat sa le
ajute. Din aceasta cauza, filmele care au fost regizate pana in acest moment
despre persoane diagnosticate cu schizofrenie, prezinta bolnavul psihic ca fiind
pericolul numarul 1 al societatii. Acele filme din anii 50 cu sau despre nebuni
sunt pur fantezie, fabulatii, chiciuri, nu au nici un fondament, dar... au contribuit
la interpretarea cuvantului bolnav psihic, acest cuvand primind conotatii
negative, acesta fiind folosit de catre populatie pentru a badjocori pe cineva, sau
pentru a scoate in evidenta factorul periculos agresiv al unei persoane.
Dar oare ce inseamna sa fii nebun? oare cum ii sa fii asa? Ce simti
in acele momente de criza?
Pentru a putea explica mai bine acest lucru, pentru a putea sparge acest
mit creat de Hollywood vreau sa incercati sa definiti normalitatea.
VI. Normalitatea - definite
Ce inseamna sa fii normal? Oare cum ar trebui sa fii sau ce
capacitati ar trebui sa ai ca sa fii normal?
La aceasta intrebare au raspuns medicii neuro-psihiatrii:
Normalitatea, adic sntatea, n cazul nostru cea mintal pare a fi o vast
sintez, o rezultant complex a unei mulimi de parametri ai vieii organice i
sociale aflai n echilibru dinamic, ce se proiecteaz pe modelul genetic al
existenei individuale, nealterat funcional i morfologic, n istoria sa vital.
Manifestarea acestei stri de sntate ar fi existena unei judeci i a unei
viziuni realist-logice asupra lumii, dublate de existena unei discipline
psihologice i sociale, pe fundalul bucuriei de a tri i al echilibrului introversieextroversie. (FlorinTtudose, Psihopatologie si Orientari Terapeutice in
Psihiatrie)

CRITERII DE NORMALITATE (dup Ellis i Diamond)

1. contiin clar a eului personal
2. capacitate de orientare n via
3. nivel nalt de toleran la frustrare
4. autoacceptare
5. flexibilitate n gndire i aciunea
6. realism i gndire antiutopic
7. asumarea responsabilitii pentru tulburrile sale emoionale
8. angajarea n activiti creatoare
9. angajarea moderat i prudent n activiti riscante
10. contiin clar a interesului social
11. gndire realist
12. acceptarea incertitudinii i capacitatea de ajustare a acesteia
13. mbinarea plcerilor imediate cu cele de perspectiv
Aceasta definitie si aceste criterii ale normalitatii la fel ca si
conceptul de anormal sau nebunie sunt pur fictiune. O persoana nu are cum
sa aiba toate aceste calitati in egala masura, asa ca , conceptul de nebunie este
desfiintat.
Acum ca am desfiintat acest concept si am lamurit termenul de normal
as vrea sa va prezint mici fragmente din viata unui bolnav psihic diagnosticat cu
schizofrenie.
Schizofrenia prin ochii unei persoane diagnosticate cu aceasta boala
S-a nascut in urma cu mai bine de 40 de ani, a fost un copil nascut sanatos, a
copilarit la tara cu bunicii, ca majoritatea copiilor de pe acea vreme. S-a
dezvoltat frumos, arminios, a terminat clasa a 8-a cu o medie foarte mare, peste
9.60, era copilul linistit al parintilor, un copil de incredere, cu o personalitate
puternica, crescut si educat intr-un mediu ideal, zicea el prea frumos ca sa fie
adevarat, a avut parte de unul dintre cele mai bune licee din orasul in care s-a
nascut. A avut parte de cei mai frumosi ani de liceu pe care ii poate avea un
adolescent. Nimic iesit din comun si nimic ce sa ii dea de gandit. A cunoscut o
fata, normal , era varsta la care mai toata lumea se indragosteste. Pana aici totul
pare in roz. Veni si vremea incorporarii, satisfacerea stagiului militar era
obligatoriu pe vremea aceea. Si precum se obisnuia pe atunci a fost dus in partea
opusa, cu cat mai departe de casa cu atat mai bine , cam asta era conceptia pe
atunci. A avut parte de un comandant nu tocmai implinit in viata si
satisfacut de progresul sau in viata, imi povestea pacientul cu un zambet ironic
pe fata. A avut parte de 2 ani foarte grei in armata. Ajunge si ziua liberarii,...
primeste o oferta din partea superiorilor, sa ramana in cadrul armatei, ca si
angajat al ministerului de aparare (M.A.P.N). A acceptat, s-a insurat, totul era

frumos. La servici era o persoana respectata, impunatoare, dar.... se pare ca ....

acel comandant de unitate neimplint si nesatisfacut a urcat in functie si ii
devine superior. De aici incep sa se clatine toate. Apar probleme, cineva ii baga
bete in roate, parca nimic nu ii bine, parca nimic din ceea ce face nu ii satisface
pe superiori. Parca indiferent ce ai face nu poti sa faci fata la locul de munca. O
tine asa mai bine de 8 ani din viata lui. Reuseste sa se transfere, scapa de acei
superiori neimpliniti, ...dar a sarit din lac in put. La noul loc de munca ii
mai rau. Mai mult stres, frustrare, furie acumulata. Acasa incep discutii, certuri,
parca s-a format un cerc vicios, parca problemele nu se mai termina. Ea parca nu
il mai suporta, sefii parca l-ar da afara, parca lumea se intoarce impotriva lui. Si
vine si momentul culminant, ... dupa o cearta destul de serioasa cu nevasta, ea se
hotareste sa se mute la mama ei. El,...a doua zi pleaca la servici, nimic iesit din
comun, aceleasi discutii la servici, .... dar primeste un telefon, .... primeste
veastea unui tragic accident, accident care s-a soldat cu victime, una dintre
victime este declarata decedata, acea victima era copilul lui.
Deocamdata nimik iesit din comun, de cate ori nu am vazut aceste lucruri
in filme sau am auzit de la prieteni ca ei au avut prieteni care au patit ceva
asemanator.
Dar .... se intampla ceva, parca totul se intuneca, parca toata lumea se
agita in jurul meu, cel de la telefon numa nu se mai opreste, parca rosteste
intruna ca copilul meu a murit, lumea se uita urat la mine, incep sa aud totul ca
un ecou care numa nu se mai termina, iar apoi dintr-o data o lovitura puternica
in piept, doua zvacniri parca venite din interior de undeva si o durere
inexplicabila ma rapune la podea. Pacientul, pune capul in pamant, .... trage o
gura de aer si spune cu parere de rau de aici a inceput totul, aici s-a terminat
totul. S-a trezit la spital dupa cateva zile de inconstienta. Cel putin asa zice el.
Revine la servici. Prima zi de lucru, dupa externarea din spital,(externare care
parca nu era la fel ca celelalte, era un spital pe care nu il mai vazuse, parca nu
stia unde este, ce zi este, parca lumea se uita din ce in ce mai urat la el), prima zi
din noul sa mod de viata. De la portarul de la intrare si pana la birou toti se uita
urat la mine, parca se feresc de mine, zici ca as avea lepra. Incerc sa salut pe
cineva pe coridor, dar mi se raspunde cu o privire urata, incruntata, parca i-as fi
facut ceva. Ajung la birou, ...secretarul se uita foarte speriat la mine, intru in
birou si..... ce sa vezi ... cineva statea pe scaunul meu ....la biroul meu.... cu
gradele mele.... la dosarele mele. Si cand sa zic ceva .... o persoana care nu o
mai vazusem pana atunci ... m-a prins de mana si mi-a spus sa ma duc in birou la
seful meu ..... trebuia sa fiu instiintat.
Din acest moment el a constiuentizat ca ceva nu este in regula cu el. A fost
trecut in rezerva, pe motiv de boala. Si-a pierdut locul de munca. Nu intelege
exact de ce, dar parca seful lui avea ceva personal cu el. Parca colegii il urmarea,
sau mai corect spus fostii colegi. Parca toti vroiau sa ii faca rau.
Merge la nevasta lui, un lucru perfect normal, dar de data asta ....era altfel.
Cand incearca sa vb cu ea in casa la socrii ei, ea se sperie de el, socrii lui il

amenintau ca or sa cheame politia daca nu pleaca din casa lor. Suparat dar si un
pic speriat merge la parintii lui. Acestia incep sa ii impuie capul cu fel si fel de
nume de psihologi si psihiatrii, de tot felul de medicamente si solutii pentru
boala lui.
Care boala? .... el nu stia ca era bolnav. Este dus la tot felul de medici,
urmeaza o serie de internari prin tot felul de spitale si sanatorii. Abia dupa
aproape 10 ani de suferinta de la declansarea bolii incepe sa realizeze ca in timp
ce el era la spital internat, in ziua in care a inceput totul, in ziua in care s-a trezit
la spital dupa cateva zile de inconstienta el practic era traz. Dar nu in lumea
noastra. El era intr-o lume imaginara. Practic facuse o criza de schizofrenie. Si
datorita acestui fapt, el isi pierduse totul, inclusiv prietenii. Acum isi ia
medicametele, si se simte mai bine. Dar acum, se simte singur. Nu mai are cu
cine vorbi. Nu il mai asculta nimeni. Toata lumea se fereste de el. Parintii lui au
murit, fosta nevasta si-a refacut viata si are copii cu actualul sot. El a ramas
singur intr-o casa mare si pustie. La varsta de 50 de ani a acceptat ideea ca este
bolnav, ca trebuie sa isi ia medicamentele, ca toate persoanele care vor sa ii faca
rau sunt doar niste halucinatii, ca totul se intampla in capul lui. Ca nimic ce a
trait si experimentat timp de 12 ani,(din momentul declansarii bolii pana in
momentul cand si-a dat seama ca ii bolnav si a facut diferenta intre lumea reala,
si lumea care era doar in imaginatia lui), nu era real.
Se zice ca persoanele diagnosticate de schizofrenie au 2 lumi lumea reala,
lumea in care ei sunt respinsi si stigmatizati, si, lumea lor imaginara, lume in
care el este sanatos si are tot ce isi doreste. Parerea mea este ca el are o singura
lume, o lume in care ii constient ca nu are nici un fel de viitor, ca lumea se
fereste de el si lumea aceasta datorita modificarilor neuronale, este distorsionata
si perceputa total diferit fata de noi. Dar asta nu il face criminal sau contagios.
Este o persoana cu probleme la fel ca ori care alta, doar ca vede diferit lumea
asta, reactioneaza diferit. Dar si el are sentimente si el are probleme si el ar vrea
un loc de munca. Doar ca el nu mai are nici o sansa in aceasta lume civilizata.
VIII. Punctul meu de vedere
Din punctul meu de vedere schizofrenia este rezultatul sau mai bine zis
produsul acestei societati civilizate avand ca fondament o malformare
genetica. Sunt persoane care au avut ghinion in viata. Care indiferent ca au
avut sau nu familia pe care si-au dorit-o, anumite circumstante create
intamplator, sau voit de anumite persoane au fost ajutate de fondul genetic
afectat intr-o oarecare masura de la nastere, a declansat aceasta boala.
Sa nu uitam ca si ei sunt oameni, ca si ei au nevoi la fel ca si noi. Sa nu
uitam ca este doar o boala, care daca este tratata cu medicatia corespunzatoare si
pacientul este ajutat de catre o echipa specializata din cadrul spitalelor si
institutiilor publice poate sa se adapteze la acest nou mod de viata. Pot fi

persoane care duc o viata normala, care au cercul lor de prieteni si persoane care
probabil odata in viata te vor ajuta sau te-au ajutat si tu nici macar nu stii.
X. Concluzia
Si sa nu uitam ce este mai importan: ori cine poate ajunge bolnav psihic.
Ori cine poate ajunge ca ei sau chiar mai rau. Bolile psihice nu fac diferente si
nu tin cont de starea ta sociala sau financiara. Important este ca noi sa avem
acele lagune, momente de respiro, momente in care ne deconectam de stresul
din viata de zi cu zi si ne relaxam. Ne linistim, ne destindem atat fizic cat si
psihic. Cea mai buna preventie pentru aceasta boala este un hobby, un lucru care
ne place foarte mult si care ne relaxeaza indiferent care este acela.

SCHIZOPHRENIA
A new way of life

Social worker
SABADUS Dj SEBASTIAN

25/04/2009
CONTENTS
I. Definition ............................................... .................................. 1
II. Symptoms ................................................. 2 ............
III. CLASSIFICATION ................................................. ..................... 2
1. Disorganized schizophrenia ................................................ 2
2. Catatonic schizophrenia ................................................ 3 .......
3. Paranoid schizophrenia ................................................ 3 .......
4. Residual schizophrenia ................................................ ......... 4
5. Simple schizophrenia ................................................ 4 ............
6. Schizophrenia nedeferentiata ................................................ 4
IV. Treatment ................................................. ...................... 4
V. ill schizophrenic presented through the eyes of
society .......................................... .............................. 5
VI. Normality - Definition ...................................... 6
VII. SCHIZOPHRENIA THROUGH THE EYES OF A PERSON WITH THIS DISEASE
DAGNOSTICATE ...................... 7
VIII. My point ........................................... 9
IX. CONCLUSION ................................................. ....................... 9
X. NOTE - EXPLANATION ............................................. 10 ..........
REFERENCES:
Free Psychiatric Association in Romania, "DSM IV" Tr 2000, Edit. Free Psychiatrists
Association in Romania, 2003

Florin Florin Tudose Tudose, "psychopathology and therapeutic orientation in

psychiatry" Edit. Tomorrow Foundation Romania, 2007
Martin Stefan, Mike Travis, Robin M. Murray, THE ENCYCLOPEDIA OF VISUAL
MEDICINE SERIES - "An Atlas of Schizophrenia" Edit. The Parthenon Publishing
Group, 2002

Schizophrenia
A New Way of Life

I Definition
Etymologically speaking, the word schizophrenia comes from skhizein = to split, to
break + phrenic = soul, spirit.
Diagnostic and statistical manual of mental disorders DSM IV, schizophrenia is
defined as a "mental disorder lasting at least six months and requires at least a
month there is a pathological condition (ie the existence of two or more of the
following symptoms : delusions, hallucinations, disorganization of speech,
disorganized or catatonic behavior profound, negative symptoms). "
Originally called "early dementia" for failing Severe daily functionality it produces
(dementia) and with onset typically in adolescence (early), schizophrenia is a disease
whose severity could be briefly characterized by the following features:
Destroy cohesion and unity consciousness and personality.
Patient is "... a broken soul that reflects the reality that a broken mirror" (each
fragment else).
The patient lost vital contact with reality (Minkowski).
Has a significant frequency - 0.5-1% of the population. It is a catastrophic disease
called "cancer mental illness." Is very likely to remain chronic.
It has a suicide rate of 10%.
Schizophrenia is a mental illness that occurs after:
a strong emotional shock,
an accident with blows to the head
an exhausting lifestyle: continuous agitation followed by frustration accumulated large
periods (several years), job satisfaction without any professional, financially or
emotionally, minimal living conditions, or simply exposure to constant stress without
moments of respite, relaxation
if in the family there was a person with schizophrenia, the individual is likely to inherit
this disease, but it is not mandatory, it turned out that there were people in the family
were sick of this mental illness and they have inherited o Family environment matters
a lot, people close to the individual plays an important role, they are a key factor in

causing disease.
Schizophrenia is called intelligent human disease, because this onset occurs
somewhere between 16-25 years are excellent forms of schizophrenia late, the age
at which people have acquired and developed sufficient skills and knowledge to get a
independent life.
II Symptoms
General symptoms that can identify a person sick with schizophrenia are:
Hallucinations: visual, auditory, tactile, olfactory, kinesthetic;
Existence, occurrence of delusions: the persecution, of grandeur, mystical, jealousy,
somatic
Incoherence of ideas / salad ideas
Verbal incoherence (phrases that have no continuity, each sentence is different from
your topic, often interrupted by words is not any logic eg raining, I feel bad that I was
now on the neighbor, if them too much light in this room and bothers me, painting,
why not come to give me that coffee cup at a time.)
Neadegvata situation or emotional state when they are in (eg someone says their
trouble, and he laughs and talks without any logic, .... or ..... something tells is about
his past complain that they have enough money to live and laughs as tells);
Phobias about certain things or places (pronounced fear and out of no-confidence
motion, connected cars, trams, traffic, TV, society, etc.).
Emotional and behavioral instability.
III Classification
Of clinically Schizophrenia is several ways:
III. 1. SCHIZOPHRENIA disorganized
- Appears in adolescence / the very young people;
- Seems to be more common in men;
- Usually start suddenly with a striking change of behavior, the person concerned
becomes disorganized in thought and behavior.
As the name suggests, this clinical form (called surpassed hebefrenic
schizophrenia) characterized by massive disruption ideation and behavior.
Disorganization suicidal translates into incoherence massive impairment.
Patient experiences sudden switches from one idea to another so that it is
understood what he meant. This inconsistency is present only at the level of ideas,
but the words spoken at random, unconnected.
Disorganization behavior: the patient is in constant movement, moving, as if
somehow investigation. The patient seems willing, amused, absolutely detached from
a good mood surprising presence of unexplained euphoria.
In terms of communication content, he uses new words. Its lexical Fund include:
- Active neologisms - words that belong to the respective language / or
- Neologisms liabilities - the use of words heard, the content of which is not mastered

it, is not known.

After several weeks or several months, the patient becomes progressively more
limited in aberrations of verbal and behavioral disorder, gradually evolving into
remission. Summarizing, we can say that individuals with this subtype of
schizophrenia are frequently inconsistent, have provided inadequate situational
context or emotional detachment.
Has many bizarre behavior. Their speech contains numerous neologisms, idioms
bizarre delusions. However, there are a set of systematized delusions and thus no
clear structure pattern of symptoms.
III. 2. SCHIZOPHRENIA Catatonia
Is a clinical form characterized by psychomotor disorders. In the classical model, and
the patient is catatonic waxy flexibility which means that it is like a wax statue
generally has mutism, and when placed in a certain position, will remain in that
position for a long time. Psychomotor disorders are extremes, on the one hand, the
state in which the patient is completely immobile, the other pole being placed top
shape, psychomotor agitation, an outbreak of the patient which makes him extremely
dangerous.
In this form of schizophrenia describe active and passive negativism. Negativity in
catatonic schizophrenia is:
exceeds the availability of individual volition and he can not give
invitation, party orders, prevent;
the evidence that is unable to respond to a verbal command or motor plan, no
means of persuasion / coercion, can not work;
Food negativity psychopharmacological intervention is a matter of emergency, lifethreatening reach the food.
Other features include mannerisms, stereotypes, submission automat.Dei this form
are common a few decades ago, today it is becoming increasingly rare due to rapid
and effective intervention neuroleptic medication.
III. 3. Paranoid schizophrenia
Dominant symptoms of this form are delusions of persecution or grandeur. Delusions
and hallucinations occur frequently, often auditory, mostly related content delusional
theme.
Under the influence of delusions, patients can write memoirs, denunciations, can
switch to defensive measures against alleged threats becoming dangerous. Paranoid
schizophrenia onset tends to be later in life than other forms, and distinctive features
stable over time. Delusions and hallucinations associated features are: anxiety,
anger, combativeness or, conversely, social withdrawal, affective ambivalence or
inversion.
These patients have slightly modified the results of neuropsychological tests, with the
best prognosis of all clinical forms of schizophrenia. Also, occupational functioning
and ability to live independently are superior to those of patients with other types of
schizophrenia.
III. 4. RESIDUAL SCHIZOPHRENIA
This form requires that existed in the past at least one acute episode of

schizophrenia, but current clinical psychotic symptoms not noticeable positive (eg,
delusions, hallucinations, disorganized speech). There is a marked social withdrawal,
affective flattening, Abul.
May be present eccentric or bizarre ideas of behavior, but they are not marked.
Hallucinations and delusions, when they occur, are infrequent and vague. Although
this pattern symptomatic individuals are identified as having a particular subtype of
schizophrenia, residual symptoms that you have done, in fact, part of the evolution of
this disease.
III. 5. SIMPLE SCHIZOPHRENIA
This clinical form of schizophrenia is characterized by a clinically significant element
characteristic, but by a range of negative symptoms:
a decrease in volitional capacity;
a decrease in the capacity of emotional resonance;
a decrease to professional and social canceling functionality;
a certain detachment;
a loneliness, isolation;
autistic behavior.
III. 6. SCHIZOPHRENIA undifferentiated generally means a category
comprising individuals who can not be placed in any of the preceding categories or
meet criteria for more than one form clinic.ncercri latest classification type
schizophrenia emphasize cognitive disorders and their appearance.
This classification is made in terms of clinical classification made by the neuropsychiatric physicians.
A person with schizophrenia is difficult to fit into one of these classifications, because
most cases do not have just one type of symptoms, and complezitatii this is due to
the human being, the type of personality that it has and experience positive or
negative accumulated from years.
IV. Treatment
Regarding psychosocial treatment are necessary strategies for effective intervention:
Early detection and intervention;
Facilitating pharmacotherapy;
inpatient treatment techniques;
Caregiver Stress Management;
learning daily living skills;
Case management social
educational techniques and family therapy;
Cognitive-behavioral interventions.
Unfortunately none of the treatments do not cure the disease. They help the patient
to overcome moments of crisis, reducing their intensity reducearea number of
phobias and their acceptance of the disease and the patient adapt to the new way of
life.

V. schizophrenic patient presented through the eyes of society.

From a social perspective, or rather the company's point of view regarding the
mentally ill, these people are dangerous individuals are seen as potential or future
criminals, criminals. These people are marginalized, excluded from society, they try
even denying their existence, stigmatized. Society, people do not want to have
contact with these people will not recognize them as human specimens simply
marginalize them, ignore them at best. But do not forget that the greatest
philosophers of mankind have been diagnosed with various mental illnesses,
philosophers who founded the concept of society, of civilization and what it means to
be civilized.
Society, people around the schizophrenia patients see only a small part of patient
behavior usually those around him see only bad part of it, crises behaves differently
depending on the person, frustration accumulated over time, frustration that Revas
unfortunately others.
They see someone who was once something but do not know for what reason gave
way, "lost his mind" is not among them, a person who is no longer any interest, "a
enhancement "that has worn and must be replaced.
One person said "... fools and wise one will open the way."
Patients suffering from schizophrenia in certain situations and under surveillance can
develop extraordinary skills, hidden talents in their mind that once discovered can be
recovered, no matter where they were discovered.
Unfortunately society forget that these people have done once part of certain social
groups, they had a perfectly normal life until the onset, it does not differentiate
disease that anyone can be a victim of this disease.
How many of us have seen or had contact with a sick person Vrede, diagnosed with
schizophrenia?
How many of us know these people?
Few are those who have had direct contact with the handful who have interacted
with them, and very few are the people who have tried to help them. Because of this,
movies were directed to date about people diagnosed with schizophrenia, shows
mentally ill as danger number 1 society. Those movies from the 50's with or about
"crazy" are pure fantasy, fables, frost, have no foundation, but ... contributed to the
interpretation of mentally ill word, this cuvand receiving negative connotations, which
is used by the population badjocori to someone, or to highlight the hazard aggressive
person.
But what it means to be "crazy"? Is how do you get it? What do you feel in those
moments of crisis?

To better explain this, in order to break this myth created by Hollywood I want to try to
define normality.
VI. Normality - defined
What it means to be "normal"? Does what it should be or what capacity you should
have to be "normal"?
Physicians responded to this question neuro-psychiatrists:
"Normality, ie health, in our case the mental seems to be a vast synthesis, a complex
resultant of a set of parameters of organic and social life are in dynamic equilibrium,
which is projected on the genetic model of individual existence, unadulterated
functionally and morphologically the vital history. Manifestation of this health condition
is the existence of a judgment and a realistic vision-logic of the world, coupled with
the existence of psychological and social disciplines, amid the joy of living and
introversion-extroversion balance. "(FlorinTtudose, Psychopathology and Therapeutic
Guidelines in Psychiatry)

Criteria of normality (after Ellis and Diamond)

1. personal self clear conscience
2. life guiding capacity
3. high level of tolerance to frustration
4. self acceptance
5. flexibility in thinking and action
6. realism and anti-Utopian thinking
7. taking responsibility for his emotional disorders
8. engaging in creative
9. moderate and cautious hiring risky activities
10. clear consciousness of social interest
11. realistic thinking
12. accepting uncertainty and the ability to adjust its
13. combining the immediate pleasures of perspective
This "definition" and the "criteria of normality" as well as the concept of abnormal or
"crazy" are pure fiction. One does not like to have all these qualities in equal
measure, so the concept of "madness" is abolished.
Now that we've cleared abolished the concept and term "normal" would like to
introduce small pieces of the life of a mental patient diagnosed with schizophrenia.
Schizophrenia through the eyes of people living with the disease

Was born after more than 40 years, was a child born healthy, grew up in the
countryside with his grandparents, like most children at that time. Developed nicely,
arminios, finished 8th grade with an average high of over 9.60 was quiet child of
parents, children trust, with a strong personality, raised and educated in an ideal
environment, he said " too good to be true, "had one of the best high schools in the
city where he was born. He enjoyed the best years of high school who may have a
teenager. Nothing out of the ordinary and nothing to give him food for thought. He
met a girl, of course, was the age when most people are in love. So far everything
seems rosy. Come and incorporation time, military service was compulsory at the
time. And as it used to when he was taken to the other side, the more away from
home the better, then that's what was conception. He had a commanding not just
"celebrated" life and "satisfactory" progress in life, telling me patient with an ironic
smile on his face. She had a very hard two years in the army. Reached and release
day ... receives an offer from superiors to remain in the military, as an employee of
the Ministry of Defence (Ministry of Defense). He accepted, was married, everything
was beautiful. At work was a person, imposing, but .... it looks like .... that unit
commander "neimplint" and "dissatisfied" went in function and becomes higher. From
here began to shake all. Problems, one "he put sticks in the wheels" do not like
anything good, like nothing you do not satisfy her superiors. Whatever you do if you
can not cope at work. Keep it up more than eight years of his life. Fails to transfer,
get rid of those superiors "unfulfilled" ... but "jumped out of the frying pan into the
fire". At her new job worse. More stress, frustration, anger accumulated. Home start
discussions, arguments, formed like a vicious circle, like the problems never end. It
seems no longer endure bosses would kick though, if the world turns against him.
And the climax comes, ... after a pretty serious argument with his wife, she decides to
move to her mother. He ... go to work the next day, nothing out of the ordinary, the
same discussion at work, .... but receives a phone .... veastea receives a tragic
accident, an accident that resulted in casualties, one of them is declared dead, the
victim was his child.
Nimik yet extraordinary, how many times have we seen this in movies or heard from
friends that they had friends who happened something.
But .... something happens, "if everything goes dark, though everybody shake around
me at the phone only never stops, as if uttering meet my child died, people looked
ugly to me, I begin to hear everything only echo no end, and then suddenly a strong
blow in the chest, two zvacniri like coming from somewhere inside unexplained pain
kills me on the floor. " Patient, put your head in the ground .... draw a deep breath
and said grudgingly "here it all started, here's all over." He woke up in the hospital
after several days of unconsciousness. At least so he says. Returns to work. First day
at work after hospital discharge (discharge that if it was not like the others, was a
hospital that no longer seen, though he did not know where it is, what day it is, if
people looked in increasingly hated it), the first day of his new way of life. "From the
doorman at the entrance to the office and everyone looked ugly to me, seems to
shun me, saying that I had leprosy. I try to greet someone in the hallway, but it
responds with a look ugly frown, as if I'd done something. Go to the office ...

secretary looked very scared of me, get into office and ..... What to see ... someone
sitting in my chair at my desk .... .... with my grades .... in my files. And when I say
something .... a person who no longer seen before ... grabbed my hand and told me
to go to the office my boss ..... I had to be notified. "
From the moment he constiuentizat that something is wrong with him. It was retired
on account of illness. He missed work. Do not understand exactly why, but if his boss
had something personal to him. If chased colleagues or former colleagues more
accurately. If everybody wanted to harm.
Go to his wife, a perfectly normal thing, but this time .... was different. When trying to
talk to her in-laws house, she's scared of him, his in-laws threatened him that they
would call the police if they leave the house. Angry but a little scared go to his
parents. They began to head shot with the kinds of names psychologists and
psychiatrists, all kinds of drugs and solutions for his disease.
Disease? .... he did not know he was sick. It led to all sorts of doctors, following a
series of admissions in all kinds of hospitals and nursing homes. Only after nearly 10
years of suffering from disease onset begins to realize that while he was admitted to
the hospital, the day it all began, the day he woke up in hospital after a few days of
"unconscious" he was practically "TRANSIT". But in our world. He was in a fantasy
world. Basically had done a bout of schizophrenia. And because of this, he had lost
everything, including friends. It takes antivirals, and feels better. But now feels lonely.
Has no one to talk to. You do not listen to anyone. Everyone watch it. His parents
died, former wife has restored life and have children with current husband. He was
alone in a big empty house. At the age of 50 years of accepted idea that is sick, you
have to take their medication, that all persons who want to harm them are just
hallucinations, everything happens in his head. As lived and experienced nothing for
12 years (since the onset of the disease until when she realized that her sick and
made the difference between the real world and the world was only in his
imagination), it was not real .
It is said that people diagnosed with schizophrenia have 2 worlds real world, the
world in which they are rejected and stigmatized, and their imaginary world, the world
in which he is healthy and has everything he wants. My guess is that he has only one
world, a world where he aware that he has no future as the world watch him and
neural changes the world because it is distorted and perceived totally different from
us. But that does not make criminal or contagious. It's a person with problems like the
other times, it just sees the world differently, react differently. But he feels he has
problems and he wants a job. Just as he has no chance in this world civilized.
VIII. My point of view
From my point of view, schizophrenia is the result or rather the product of such
"civilized society" having as one malformare genetic foundation. There are people
who have "bad luck" in life. That whatever they did or did not have family that wanted
certain circumstances created accidentally or deliberately by certain persons were

helped by the gene affected in some degree at birth, triggered the disease.
Do not forget that they are human, that they have needs just like us. Let's not forget
that it is only a condition that if treated with proper medication and the patient is
helped by a specialized team within hospitals and public institutions can adapt to this
"new life". May be people who live a normal life with their circle of friends and people
who probably once in a life will help you or helped you and you do not even know.
X. Conclusion
And do not forget what is most important: Whoever can get mentally ill. Whoever can
get them even worse. Mental illness do not take into account differences and not your
social or financial status. The important thing is that we have these "lagoons"
moments of respite, when we disconnect from the stress of everyday life and relax.
Calm down, we relax both physically and mentally. The best prevention for this
disease is a hobby, something that we really like and we relax no matter what it is.