Research Assessment #7

Date: October 31, 2017

Subject: Schizophrenia

MLA Citation:

Publishing, Harvard Health. “Schizophrenia.” ​Harvard Health​, Harvard Medical School , Oct.

2012, ​www.health.harvard.edu/mind-and-mood/schizophrenia-​.

Schizophrenia is easily mistaken for multiple psychiatric disorders. According to Harvard

Health, Schizophrenia is a chronic brain disorder in which victims “frequently have a hard time

recognizing reality, thinking logically and behaving naturally in social situations”. This is

believed to be caused by a combination of genetic and environmental factors. Harvard Medical

School educates readers of: what it is, symptoms, the diagnosis process, precautionary measures,

and treatment. Throughout all of this I have learned that this form of psychosis is incurable;

however, the intriguing diagnosis and treatment to make the illness less severe is very helpful.

This information is important to me, as I am currently studying the field of psychiatry. In

this program, I am required to learn about each aspect of medical mental assistance; therefore,

discovering mental illnesses is imperative to my learning. In this case, I am analyzing the

Schizophrenia disorder, to gain background information regarding an illness I will potentially be

required to treat. Throughout my ISM journey, it is vital that I begin to become specific with the

divisions of psychiatry I choose to research; on top of being aware of each element that comes

into play with the process as a whole. The more I learn about my topic, throughout Independent
Study and Mentorship, the stronger I will become in understanding what my career choice fully

does for a living.

This information can be classified as: what it is, symptoms, the diagnosis process, and

treatments. To summarize, this disorder is believed to be a genetic reaction causing impairment

in the brain. This impairment prohibits cognitive thinking, differentiating reality from

hallucinations, and natural behavior when encountering social situations. Those with

schizophrenia experience visions and hear things that are not there. Symptoms are often

categorized as either “positive” or “negative.” Positive symptoms would be delusions,

hallucinations, disoriented speech and/or behavior. Negative trademarks include a lack of

emotional expression, unresponsiveness, and trouble starting or continuing goal driven activities.

Difficulty with concentration and memory may also be present. The identification of

schizophrenia is difficult to make, requiring multiple visits to a psychiatrist in order for this to be

verified. Even if one is presented with psychiatric symptoms, that does not necessarily mean they

are a schizophrenic. Many computer tests cannot diagnose this disorder; however, they can rule

out causes of one’s symptoms. Multiple visits are needed, so psychiatrists can study the patients

behavior, regarding how the doctor will diagnose the client. This psychotic illness is inevitable,

but the earlier the treatment, the better chance there is to prevent the worst effects of the disorder.

Another way to prevent schizophrenia is genetic testing prior to having children. Educated

family members are often in a better position to provide assistance once understanding the

mental blockage. For the most part, antipsychotics are used to treat Schizophrenia. Generally

patients react better when having positive symptoms, although every person has a diverse
reaction to medication. Once prescribed medication, it is vital to continue indulging the

prescription; this will reduce the probability of psychosis returning.

With the data I have discovered, I will store this information in my portfolio of psychiatry

to refer to when needed. I will use this information to properly treat clients diagnosed with

schizophrenia. Currently, I do not have any prolonging questions regarding this subject; the

article was very clear on what the disorder is, symptoms, and how to treat those with it.

Reading these paragraphs was extraordinarily helpful, as this expanded my line of sight

regarding how schizophrenia is caused and ways to recognize it. Overall, this article clarified that

this disorder is thought to be a reaction to genetic factors, causing impairment in the brain

(hallucinations, voices). This is a chronic condition that I will one day handle and treat!
Schizophrenia
What Is It?
Published: October, 2012

Schizophrenia is a chronic (long-lasting) brain disorder that is easily misunderstood.

Although symptoms may vary widely, people with schizophrenia frequently have a hard

time recognizing reality, thinking logically and behaving naturally in social situations.

Schizophrenia is surprisingly common, affecting 1 in every 100 people worldwide.

Experts believe schizophrenia results from a combination of genetic and environmental

causes. The chance of having schizophrenia is 10% if an immediate family member (a

parent or sibling) has the illness. The risk is as high as 65% for those who have an

identical twin with schizophrenia.

Scientists have identified several genes that increase the risk of getting this illness. In

fact, so many problem genes have been investigated that schizophrenia can be seen as

several illnesses rather than one. These genes probably affect the way the brain

develops and how nerve cells communicate with one another. In a vulnerable person, a

stress (such as a toxin, an infection or a nutritional deficiency) may trigger the illness

during critical periods of brain development.

Schizophrenia may start as early as childhood and last throughout life. People with this

illness periodically have difficulty with their thoughts and their perceptions. They may

withdraw from social contacts. Without treatment, symptoms get worse.

Schizophrenia is one of several "psychotic" disorders. Psychosis can be defined as the

inability to recognize reality. It may include such symptoms as delusions (false beliefs),

hallucinations (false perceptions), and disorganized speech or behavior. Psychosis is a

symptom of many mental disorders. In other words, having a psychotic symptom does

not necessarily​ mean a person has schizophrenia.

Symptoms in schizophrenia are described as either "positive" or "negative." Positive

symptoms are psychotic symptoms such as delusions, hallucinations and disorganized

behavior. Negative symptoms are the tendency toward restricted emotions, flat affect

(diminished emotional expressiveness), and the inability to start or continue productive

activity.

In addition to positive and negative symptoms, many people with schizophrenia also

have cognitive symptoms (problems with their intellectual functioning). They may have

trouble with "working memory." That is, they have trouble keeping information in mind in

order to use it, for example, remembering a phone number that they have just heard.

These problems can be very subtle, but in many cases may account for why a person

with schizophrenia has such a hard time managing day-to-day life.

Schizophrenia can be marked by a steady deterioration of logical thinking, social skills

and behavior. These problems can interfere with personal relationships or functioning at

work. Self-care can also suffer.

As people with schizophrenia realize what it means to have the disease, they may

become depressed. People with schizophrenia are therefore at greater than average
risk of committing suicide. Family members and health care professionals need to stay

alert to this possibility.

People with schizophrenia are also at more risk for developing substance abuse

problems. People who drink and use substances have a harder time adhering to

treatment. People with schizophrenia smoke more than people in the general

population. The smoking leads to more health problems.

Anyone with serious and chronic mental illness is at greater risk for developing

metabolic syndrome. Metabolic syndrome is a group of risk factors that increase risk for

cardiovascular disease and diabetes. The risk factors include obesity, high blood

pressure and abnormal lipid levels in the bloodstream.

Schizophrenia has historically been divided into several subtypes, but researchers in

the last several years have determined that these divisions are probably not clinically

useful.

Symptoms
The symptoms of schizophrenia are often defined as either "positive" or "negative."

Positive symptoms

● Delusions (distorted thoughts, false beliefs)

● Hallucinations (disordered perceptions) that may involve any of the five senses,

including sight, hearing, touch, smell and taste

 ● Disorganized speech

● Unusual motor activity or disorganized behavior

Negative symptoms

● Restricted emotional range ("flat affect")

● Limited, unresponsive speech with little expression

● Trouble starting or continuing goal-directed activity

Diagnosis
The diagnosis of schizophrenia is often not easy to make. It is not possible to make the

diagnosis in one meeting. Even if the person has psychotic symptoms, that does not

mean he or she has schizophrenia. It may take months or even years to see if the

pattern of illness fits the description of schizophrenia.

Just as there are many causes of fever, there are many causes of psychosis. The

clinician doing the evaluation will look for some of these other causes, for example, a

mood disorder, a medical problem or a toxic substance. Experts know that brain

function is impaired in schizophrenia, but tests that examine the brain directly cannot yet

be used to make a diagnosis. A clinician may do tests such as computed tomography

(CT), magnetic resonance imaging (MRI) or an electroencephalogram (EEG). These are

not diagnostic tests for schizophrenia, but they can help to rule out causes of the

symptoms other than schizophrenia, such as a tumor or a seizure disorder.

Prevention
There is no way to prevent schizophrenia, but the earlier the illness is detected, the

better chance there is to prevent the worst effects of the illness.

Schizophrenia is never the parents' fault. But in families where the illness is prevalent, it

may make sense to pursue genetic counseling before starting a family. Educated family

members are often in a better position to understand the illness and provide assistance.

Treatment
Schizophrenia requires a combination of treatments, including medication,

psychological counseling and social support.

Medication

The major medications used to treat schizophrenia are called antipsychotics. They are

generally effective for treating the positive symptoms of schizophrenia. Every person

reacts a little differently to antipsychotic drugs, so a patient may need to try several

before finding the one that works best.

If a medication does help, it is important to continue it even after symptoms get better.

Without medication, there is a high likelihood that psychosis will return, and each

returning episode may be worse.

Psychosocial Treatments
There is growing evidence that psychosocial treatments are essential to the treatment of

schizophrenia. ​These treatments are not given instead of medications; they are given in

addition to medications.

In other words, the combination of medication and psychosocial treatment is most

helpful.

Several approaches are useful:

● Psychotherapy. Cognitive behavior therapy (CBT) can reduce symptoms in

schizophrenia. CBT in schizophrenia is conducted differently from CBT for

depression. When treating schizophrenia, the therapist puts a heavy emphasis

on understanding the person's experience, developing a relationship, and

explaining psychotic symptoms in realistic terms to defuse their distressing effect.

● Assertive Community Treatment. A community-based team with a variety of

caregivers (for example, a psychiatrist, psychologist, nurse, social worker, and/or

case manager) makes frequent contact with patients, monitors treatment

adherence, and assesses psychosocial and health needs. The team may also

provide emotional support to families. Some patients do well living in housing

where staff can monitor progress and provide practical assistance.

● Supported Employment. Such programs rely upon rapid job placement rather

than an extensive training period before employment. Programs work hard to

honor the person's preferences regarding work. They integrate on-the-job

 support and mental health services into the program. Most careful studies have

found such an approach to be more effective than traditional vocational services.

● Family Education. Schizophrenia profoundly affects families. Education about the

illness and practical advice can reduce relapse rates of patients as well as

reduce family distress and help family members support the person suffering with

the illness.

● Substance Abuse Treatment. Substance abuse, which is a common problem in

schizophrenia, can make the illness worse. Such treatment is essential when

substance problems emerge.

● General Health. Patients with schizophrenia have a higher incidence of smoking

and overweight. Thus, a comprehensive program may include a way to help

patients with these problems. Examples are smoke-ending advice, weight-loss

programs or nutritional counseling.

The overall goal of psychosocial treatment is to provide ongoing emotional and practical

support, education about the illness, perspective on the symptoms of the illness, advice

about managing relationships and health, skills for improved functioning and orientation

to reality. There may be an emphasis on sustaining motivation and solving problems. All

of these efforts can help a patient stick with treatment. The longer and more trusting the

relationships (with a therapist or case manager), the more useful it will be for the person

affected by this illness.