Schizophrenia in Adults: Causes, Diagnosis, and Management Research Paper

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Introduction

The aspect of schizophrenia addressed by the paper is to specifically study schizophrenia among adults who are 18 years and old. This will be achieved through analysis of its causes, management, and how it can be diagnosed and will constitute the main focus of the research paper. The focus is also based on the impact of the mental condition on the family members both financially and psychologically. Schizophrenia is a disease affecting the brain and researchers believe that about 1% of the world’s population live with the condition. Research indicates that the onset of the condition is common in the late teenage and early adulthood, where various symptoms include mixed-up thoughts that are accompanied by irrational beliefs; commonly known as delusions. The victim also suffers hallucinations where he/she perceives non-existent things. According to Tilton (1966), it becomes hard for such a victim to perform ordinary tasks, especially if abstract memory and much attention are required. However, symptoms of schizophrenia manifest in different forms among different adults; making a diagnosis of the condition to be difficult. This is especially due to the lack of laboratory tests of the condition. A medical practitioner is therefore required to have a follow-up of consistent symptoms for a period ranging between 1 to 6 months depending on the magnitude of the disorder. Sturmey (1998) argues that, in extreme cases, the victim suffers marked dysfunction as far as social, education, and occupational life is concerned. Among the usual characteristics of schizophrenia is low motivation; which consequently makes the victim withdraw from other members of the society. “Although studies have shown that, women are equally likely to develop the mental disorder as men, the condition manifest earlier in men. However, women are more likely to develop the mental condition compared to men especially after the age of 45” (Tilton, 1966 P. 56).

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Considerations to Make During Diagnosis for Schizophrenia

Sturmey (1998) argues that, during diagnosis for schizophrenia, there are conditions that may result in similar symptoms as those of schizophrenia, and chances of being mistaken are high. Before diagnosis for the brain disorder begins, it is, therefore, advisable for the doctors to rule out such conditions. Among such mistaking, conditions are drug abuses, where the individual may have used hallucinogens that comprise LSD drugs. This includes mescaline which is known to cause regular users to see non-existent things. Studies also indicate that, individuals who are epileptic, experience brain disorder as a result of unstable electric signals along with the brain; resulting in seizures. An epileptic will therefore experience involuntary movements, accompanied by seeing as well as hearing non-existent events and sounds. Mendel (2003) says that brain tumor which refers to growth in parts of the brain may also result in behavior change on the victim; similar to those of an individual suffering from schizophrenia. When there are inflammations in the brain, a condition commonly known as encephalitis with similar symptoms to schizophrenia are observed. Another characteristic is the existence of thyroid disorders caused by the gland being overactive; resulting in excessive thyroid hormone in the bloodstream.

According to Mendel (2003), experiences of lethargy and confusion may also be experienced if an individual has sugar below the normal level; a condition usually known as hypoglycemia. A person may also be having excessive copper in his/her red blood cells through hereditary genes and this alters the functions of the brain causing a condition called Wilson’s disease; with effects similar to those of schizophrenia. “Research has shown that most medication that people receive in life is accompanied by side effects mimicking symptoms experienced by victims of schizophrenia, such as delusion and high levels of confusion; especially at old age. Most psychiatric conditions have also been found to share similar symptoms” (Sturmey, 1998 pp 66).

Symptoms of Schizophrenia

The physical world appears to have changed for victims of schizophrenia, where they experience great alteration of familiar things such as color and sounds as well as food taste. Symptoms of Schizophrenia arise when the brain fails to interpret received information through the normal process; even when the senses have performed their tasks correctly. According to Scott (1999 pp 26-29), “The symptoms manifest in a variety of fashions, depending on the individual, and they can be gradual to some people while in others, they are sudden. Victims of schizophrenia are usually tense, and have a low concentration that makes them lack adequate sleep leading to poor school performance and unfriendly relationship with other people”. When the condition advances, the victims experience acute symptoms such as psychosis, which encompasses major psychiatry. The victims incorrectly interpret the accuracy of perceptions and mental processes resulting in an incorrect conclusion regarding reality. Various symptoms manifest in cycles such as hallucination and illusions. The victims experience delusions where the manner of thinking becomes disordered because of disruptions caused by poor emotional expressions; resulting in inappropriate reactions. (Sturmey, 1998).

Definitions

Delusions are false ideas experienced by a person in matters regarding his/her life. For example, the victim may believe he/she is famous in a particular region or country. A person may see objects or smell things that are not real and which do not exist. Illusion on the other hand results in false interpretations of sensory stimuli, especially those that are external. It takes the form of seeing or hearing and includes mirages in the desert or unusual voices from the wind. (Russo, 2000).

Hallucinations/Illusions

Perceptions in adults with schizophrenia become disturbed, and there exists no connection between sources of stimuli and the receptors. This affects the sensing of sound, smell, and taste. The individual suffers illusions in presence of a sensory stimulus that does not follow correct interpretation. An example is when a person believes there is noise from running water, even when he/she is far from any source of water. Spitzer (1987 pp 45-50). Research has indicated that, most victims of schizophrenia experience hallucinations in form of non-existent sounds giving commands, while others receive these voices in form of comments as well as warning of incoming danger.

According to Sturmey (1998), when a victim of schizophrenia has delusions, the mind generates false ideas that touch his/her life such as other people conspiring either against them or a feeling of extra-ordinary regard of importance by other people. The victims believe in such ideas with a lot of certainties; the ideas dominating the mind. “Most of these ideas are bizarre and include non-existent animals in the living room or a feeling by the person that, somebody is spying on him/her” (Vickers, 2001 pp 39).

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Disordered Way of Thinking

According to Viederman (1996), another way of diagnosing victims of schizophrenia is finding if the victims have difficulty in thinking in a clear manner. Studies have shown that victims of the brain disorder are not able to gradually shift from a particular topic to another, and will always have a sudden shift of topics during conversations; with very little sense in the topics. “The topics may even contain words of their own making that are accompanied by unnecessary sounds” Viederman (1996 pp203-207). The victim tends to give a speech that is not coherent because most of the things he/she says are disjointed as a result of poor processing of information. Most of the words in their speech are based on the similarity regarding non-existent sounds; as opposed to the meaning derived from such words.

Lack of Emotional Expression

A victim of schizophrenia may not be able to express himself/herself, depending on the situation surrounding him/her. The speech is monotonous as it lacks gestures, especially from the face. During speech and when talking to other people, the victim tends to have inappropriate reactions that do not match the prevailing circumstances. An example of such behavior would be the victim engaging in hysterical laughter after receiving sad news. (Darby, 1976).

Testing for Schizophrenia

Mendel (2003) argues that the condition cannot be diagnosed through a chemical test and doctors can only diagnose the condition through symptoms; holding several interviews with the suspected victim, to establish a follow-up and make substantiated conclusions. Doctors also use imaging techniques to find out if there is any part of the brain that could have been damaged. Imaging through magnetic resonance produces images which when analyzed, describes the structure of the brain. Another technique is known as single-photon emission computed tomography, where a scanner is used and revolved around the head of the victim. Several detectors installed in the scanner perform the task of reducing the time for imaging. “Positron emission tomography is also another technique that involves a radioactive substance being injected through the body of the victim, and then let to travel along the blood vessels before reaching the brain where it is picked by the device creating an image on a film” (Mendel, 2003 p 47).

How to Avoid Relapse of Schizophrenia After Diagnoses

Tilton (1966) argues that victims of schizophrenia are likely to experience relapses even when they have received continued treatment. However, chances of relapses are more likely to occur if the patient is either discontinued from the medication or if the medication is being administered irregularly. To avoid this problem from occurring, victims of schizophrenia are advised to have a continued medication to minimize the intensity of the condition. “In addition to this, the victims are advised to liaise with their doctors and members of their families, to enhance adherence to a proper treatment plan. This involves the victim being strict on the medication prescriptions such as being time conscious, as well as the right quantity of the drugs” (Spitzer, 1987 pp 47-48).

Causes of the Mental Condition

Various psychological hypotheses have existed, which have now been advanced to explain the condition. Through modern science, the condition has been recognized as a brain disease, though exact causes of the condition are not yet known. However, medical research has indicated that the malfunctioning of the brain could be caused by a problem with neurotransmitters, which eventually produces symptoms related to the illnesses (Tilton, 1966) Among the probable causes of schizophrenia are environmental and other genetic. Research has shown that genetic and environmental factors can interfere with brain development during gestation and at birth. Tilton (1966) argues that, immediate members of families with individuals nursing the mental condition have a higher probability by ten folds, to develop schizophrenia in comparison to the general population. Research has shown that, their children are 40% likely to develop the condition. Regarding environmental factors, inconclusive evidence indicates that trauma at prenatal care are major contributor of the condition. Research also indicates that, if an individual is severely socially disadvantaged early in life, he/she is more likely to develop the condition.

Managing Schizophrenia

It is important to give the victim of schizophrenia individual attention, as the condition develops differently in individuals manifesting varying symptoms. According to Szatmari (1989 78-83), “Although studies of the brain disorder indicate that, the condition is not treatable, it is easy to manage it effectively for most of the victims”. Treatment includes administration of antipsychotic drugs which research has shown to be having the capacity to improve the conditions. These drugs have been used for a long time with positive results being recorded. Symptoms are greatly reduced through such medications and the victim is more effective in his/her way of functioning. The drugs work through a mechanism that blocks receptors carrying chemical messages through the brain, which has a significant contribution towards brain disorder. The medication works effectively reducing hallucination and delusions. Some of the drugs include chlorpromazine and haloperidol.

Szatmari (1989) argues that, when the victim is under such treatments, he/she is likely to experience sleepiness and feeling of lethargy, which are known to decrease after some time. The mouth of the victim becomes dry and the eyes may develop some problems, in addition to allergic reactions and weight gain in most individuals. Research has shown that, in women, monthly periods may become irregular accompanied by sexual dysfunction, though this affects even men. When the victims are under the medications, they may experience spasm in their muscles resulting to movements that are not voluntary around the nerves; making it difficult for the victim to control coordination in the body. Doctors usually reduce the dosage in occurrence of such symptoms, as well as introducing an alternative medication for the victim. Some victims may develop a condition known as Tardive dyskinesia, which refers to uncontrolled movements around the mouth, especially if the victim has been receiving treatments for along time. However, the condition only affect about 20% of all those with this condition and only after taking the medication for a long time. (Tilton, 1966).

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Alternative Medication for Schizophrenia

For the last 18 years, there have been medicines known as “atypical drugs” to treat schizophrenia especially in the brain areas; usually not affected by antipsychotic drugs. Clozapine is one of such drugs that work effectively for victims aged less than 20 years. However, like any other drug, clozapine has side effects such as nasal congestion and inconsistent blood pressure; accompanied by headache and seizure as well as less white blood cells. It is therefore advisable for victims of schizophrenia under the medication to be tested regularly; preferably after every two weeks. Risperidon is also another drug that gives better result to majority of victims but also has associated side effects such as sleepiness and dizziness. “For patients with schizophrenia, depression is a common phenomenon and therefore, antidepressants are administered to avoid occurrence of relapses of the symptoms” Szatmari (1989, p 79).

Anti-anxiety drugs such as benzodiazepine are also effective alternatives in reducing anxiety in some individuals. Administration of lithium is recommended for victims of schizophrenia with no history of the mental condition in their family lineage. In ordinary circumstances, lithium is used for people suffering bipolar disorder. Other useful drugs include antiepileptic; usually used to control epilepsy especially when the patient is violent, and when administered with other drugs, he/she shows no positive response. When schizophrenia is diagnosed, electroconvulsive therapy which causes shock may also be administered as it has positive response. (Tilton, 1966).

The patient of schizophrenia is subjected to an electric current at low voltage and this causes seizure which produces the desired therapy. This method has been applied for several years and recent research indicates that, it works better and is safer in comparison to the conventional drug therapy. In addition to this therapy, psychotherapy can also be administered to a patient who has been diagnosed with schizophrenia. It refers to a variety of related techniques used to control mental as well as emotional disorders where physical means are avoided as much as possible. This is administered by psychiatrists and social workers as well as nurses. “When the methods are used to treat schizophrenia, it is administered along with other medication through an integrated program comprising of treatment that is both medical, as well as psychological. Szatmari” (1989, p 82).

Family support is also very important to help the victim undergo improvement on long-term basis before recovering from schizophrenia. Research has generally shown that, methods that are based on cognitive behavior are more effective. According to Scott (1999) they increase the victim’s capacity to think normally through mental exercises as well as through self-observation. This works through altering the behavior pattern of the victim of the mental disorder from being negative to positive. The victim can design techniques for problem solving as well as other strategies. “Treatment through psychotherapy is also recommended where both past and current mental disorders are focused and analyzed, to find out how they have been affecting the individual’s life experiences while relating with other people” (Russo, 2000 p 35).

When victims of schizophrenia share they experiences through therapy sessions, they gradually understand more issues regarding their metal disorder. The patients are also taught on how to make out real issues from the unreal. The conditions of schizophrenia are made worse if the victim is in a hostile family, where harsh emotional experiences may have reached a critical point. Most members of families with patients of schizophrenia experience painful moments, when they see one of their own have behaviors that are controlled through an internal mechanism, rather than a healthy response. Due to lack of right education, and support in most families, there is no particular program to help both the victim and the rest members of the family. Family support is effective in controlling the mental condition; especially when it is done through groups and therefore, families with such victims are always advised to adopt such supports. (Scott, 1999).

Rehabilitation

According Vickers (2001), several programs work effectively for patients of schizophrenia such as rehabilitation through social training. Such a program would enable the victim get exposed to skills to perform various tasks. Studies indicate that, victims of schizophrenia have poor masterly of skills and therefore perform related tasks dismally. When the victims of schizophrenia are rehabilitated, their confidence is enhanced and they are therefore able to look after themselves; making their life more productive. This should be implemented through community programs through professional teams, and a wide range of support on those victims of schizophrenia. The teams should make effort to have follow-up of the programs to the victim’s homes as this has more benefits, and also effective in terms of cost. Studies however show that, this has not been accessible to most communities where these victims come from. (Russo, 2000).

Impact of the Mental Condition

Patient with the mental condition usually experiences a difficult financial situation, and this extends to the rest of the family members as well as the concerned systems of health care. Schizophrenia has also been found to impact negatively on economic development because; a lot of money is budgeted to handle the situation on yearly basis. The cost comprises of healthcare and expenses incurred through administration and several assistance programs. The onset of the disease coincides with the age at which the victim is more productive and therefore, there is reduced productivity. Studies have shown that, approximately $2 billion is incurred in form of direct cost annually. On a global scale, research has shown that, about 3% of the overall burden that arises from human disease is caused by the conditions of schizophrenia. (Vickers, 2001).

Conclusion

The aspect of schizophrenia addressed by the paper is to specifically study about schizophrenia among adults who are 18 years and old. This was achieved through analysis of its causes, management and how it can be diagnosed and constituted the main focus of the research paper. The summary findings of the research indicated that, Schizophrenia is easily diagnosable because it manifests through mixed-up thoughts and false beliefs that are usually irrational, such as delusion as well as hallucinations. It makes the victims not to concentrate with their tasks. Regarding diagnosis of schizophrenia, no chemical tests are known and doctors only rely on the symptoms through interviewing the victims. However, it is recognized that, the mental illness is a very serious condition impacting significantly on the victim and the rest of the family members. Victims of schizophrenia are usually distressed and mentally impaired, and may not function normally especially when interacting with other people. Research has however reduced worries of the mental condition as it is treatable effectively through right medication along with proper education as well as primary care in health services; both at hospitals and community level. Although research had initially indicated that, more than 50% of individuals suffering the condition are aged between 25 and 44 years, recent studies have shown that, rates of hospitalization among general hospitals have been on the rise among young people. (Vickers, 2001).

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Annotated Bibliography

The following is the annotated bibliography of various research papers, with relevance to research on schizophrenia and the related symptoms that enable easy diagnosis of the mental condition. The papers contain several mental disorders such as hallucination and delusion which refers to mistaken perception of non-existent sounds, sight and taste that provide a basis for the diagnosis of the health condition.

Darby J. (1976): Neuropathology Aspects of Psychosis in Adults: Springer PP17-23.

The work of the author is highly credible because of the Specifications of formal brain disorder that were done through research, on symptoms of schizophrenia and how they were related to semantic as well as executive dysfunction. Quality was added to the studies in this article since the author tested semantic controls. He analyzes verbal frequency and how schizophrenic patients could comprehend when having thought disorder and when without the disorder as a control experiment. The results of the experiment indicated that, thought disorder among patients of schizophrenia could impair executive function; with some unknown effects regarding semantic function. (Darby, 1976).

Most of the research papers discuss an overview regarding issues of modern and traditional interpretation of various ways to diagnose schizophrenia, through various symptoms. Credibility of this online research has been significant as it was through scholarly reviewed work and therefore, is more updated than researches that were done several years ago; which means the quality is also very high.

Mendel W. (2003): Schizophrenia: The Experience and Its Treatment: – 1976: Bass Inc., US PP45-49.

The success of the author’s work was evident through the results of experiment which showed that, inner speech was accompanied by alteration of the fiber tract among patients of schizophrenia; who suffered frequent hallucination. This led to lack of normal co-activation in areas where the processing of external stimuli takes place. Relevance of information to meaning in relation to the condition of schizophrenia is examined where the structure depends on the processor for a common language; making the research work to have high quality. (Mendel, 2003).

Russo D. (2000): Hospital Stays and More Rapid Improvement Among Patients With Schizophrenia and Substance Disorders: Am Psychiatric Assoc PP 32-37.

Several researchers have commended the work of the author because in the work, the research involved analysis involving over more than one thousand studies in 1990-2003 focusing on the cognitive deficit among adults suffering from schizophrenia. Several examinations were carried out such as intelligent quotient, coherence in language use, memory and level of attention. The results of the studies were found to be highly reliable because the research involved one thousand studies; a number that was considered as high and therefore any error was well distributed and thus it is of high quality. This is opposed to researches that involve few studies as they result to localization of errors. (Russo, 2000)

Scott J. (1999): Co-occurring Severe Mental Illness and Substance Use Disorders: Am Psychiatric Assoc PP26-32.

Tests on cannabis were conducted on people who had been diagnosed with brain disorder and also on individuals who exhibited inclined liability to psychosis. The credibility of the source is brought by the fact that, the outcome of the experiment showed that, substance usage led to development as well as prognosis of mental disorders. The quality in which experiments were done through the studies makes the source even more credible because. This is because an attempt was also made to find out if an anti-depressant effect could be gained on administration of the drug; ketamine to the patients of schizophrenia who suffered acute condition. (Scott, 1999).

Spitzer A. (1987): Adult Schizophrenia: Amer Psychiatric Pub Inc pp 45-53.

Various aspects of mental disorder such as diagnosis and how it can easily be mistaken for other health condition since there is no chemical test for the schizophrenia are addressed. The source is considered as highly reliable because it is in agreement with previous results of other researchers that, there are no chemical tests to diagnose schizophrenia and that, differentiation of symptoms similar to schizophrenia have also been addressed. Other aspects such as the nature of schizophrenia and the related social and environmental as well as economic factors are also discussed. The results of the studies done by the author are of high quality since they also address the impact of the mental condition on other issues of life such as social, economic and environmental attributes to the disease. (Spitzer, 1987).

Sturmey P. (1998): Classification and Diagnosis of Psychiatric Disorders in Persons With Developmental Disabilities: Springer PP 65-69.

The authors work was unique and credible because theory about the possibility of the patients of schizophrenia mistaking their inner voice and taking it to be someone else was analyzed through vision studies among patients of schizophrenia. High quality was added to the work of the author through a correlation that was found by the regarding the level of delusions among patients of schizophrenia and their capacity to ignore self-induced induced information regarding motion of objects as well as perceptions of sound and tastes and smell. (Sturmey, 1998).

Szatmari P. (1989): A Follow-up Study of High-Functioning Autistic Children: Springer PP 78-83.

This author made use of the modern technology where Analysis was done on a computerized adult speech using software; a factor that eliminated human bias. The patients suffered depression and those who conducted the experiments wanted to find out whether depressed adults exhibit linguistic differences in comparison to speech from normal individuals. Unique qualities of the source is brought by analysis of effects of age on narrative speech where experimenters studied on age related changes in adult speech during story telling especially after watching pictures. (Szatmari, 1989)

Tilton R. (1966): Schizophrenia: Grune & Stratton PP 56-59.

This is a paper focusing on the basis of the brain disorder and its symptoms. Various aspects of the mental condition are analyzed that include nature of schizophrenia and the related environmental factors. This source has been found to be reliable because it has addressed the comparison between symptoms of schizophrenia and those of other mental conditions that are similar to schizophrenia and therefore helping medical practitioner to make diagnosis more efficiently. Several studies have been considered before the author arrives at the conclusion and therefore the source is of high quality. (Tilton, 1966)

Vickers R. (2001): Systematic Reviews of Complementary Therapies: Am Psychiatric Assoc pp 37-41.

The article is regarded as credible because of the incorporation of how cognitive task can be used to diagnose schizophrenia as well as the history regarding neuroimaging techniques including MRI as well as PET scanning. The evidence obtained from the use of both type of scanning makes the research work of the author to have more quality than that of most researchers. The author summaries research findings by indicating that, the differences in the cognitive aspects among patient of schizophrenia in comparison with healthy individuals provides significant means through which the brain of a healthy person can be distinguished from that of a victim of schizophrenia. (Vickers, 2001).

Viederman M. (1996): Psychiatric Issues in Capacity, Competency, and Informed Consent: Elsevier PP 203-207.

The quality of the source is high because the experiments provided identification of schizophrenia’s neuropsychological endophenotypes; meeting criteria of sensitivity as well as stability. The quality of the author’s work was added through a gabling task that was also performed on individuals suffering from schizophrenia, and those who were normal. The research was successful because the results indicated that, patients of schizophrenia have a tendency of experiencing decision making that are distinct from that of normal individuals and this has been confirmed through several other studies. (Viederman, 1996).

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