Identification of the disease
Schizophrenia is a chronic mental condition or disorder with a severe effect on the human mind, especially by affecting the patient’s thinking system (Barry, Gaughan & Hunter, 2012). In particular, the condition affects a person’s ability to distinguish between reality and unreality. Schizophrenic patients are unable to think properly and clearly, manage emotions, or function normally (Barry, Gaughan & Hunter, 2012). Moreover, the condition affects personal relations with others, often causing conflicts.
Symptoms of schizophrenia
The primary and obvious type of impairment caused by the condition involves the disruption of the human processes of thinking. Schizophrenic people lose a lot of their ability to evaluate their surroundings and relate with others in a rational manner (Picchioni & Murray, 2011). They tend to believe in things that are unreal or untrue and reject reality. Hallucinations and delusions are common symptoms in schizophrenic patients (Van Os & Kapur, 2012). Both symptoms are disturbing to the patient and their families because they seem bizarre to the normal people, including those who are consistent with the abnormal perceptions and beliefs associated with the condition (Picchioni & Murray, 2011). Noteworthy, hallucinations and delusions are reflections of the distortions of the human mind, which in turn causes distortions of the person’s perceptions and interpretations of reality (Barry, Gaughan & Hunter, 2012).
Individuals tend to develop a fear of anything, including the fear of unknown people, objects, or events. For example, a schizophrenic individual may purchase and use multiple locks due to the fear of theft or harmful individuals, yet the reality is that such fear is unfounded. However, to the patient, the actions are justified because hallucinations occur in the form of heard voices and bizarre and persecutory delusions (Barry, Gaughan & Hunter, 2012). As the condition persists, the individual develops disorganized thinking and speech, which includes loosely connected words that fail to make meaning. Eventually, the disease causes social withdrawal, loss of motivation, poor judgment, and untidiness (Picchioni & Murray, 2011). Some individuals also develop paranoia, inability to work, loss of long-term memory and attention, poor functioning, and slow speed of mental processing.
Conditions such as major depressions, anxiety disorders, and substance use disorders are normally associated with schizophrenia. More than 50% of the patients have are likely to have some of these conditions (Barry, Gaughan & Hunter, 2012).
Prevalence
Currently, about 24 million people in the world are schizophrenic, but only about 1% of the patients have disabilities due to the disease (Barry, Gaughan & Hunter, 2012). The disease causes more than 20,000 deaths per annum (Ayuso-Mateos, 2013). The occurrence is relatively uniform around the world, with Africa, Asia and Japan has about 340, 540, and 378 male patients per 1000,000 people respectively and 370 and 520 female sufferers per 100,000 people in Africa and Europe respectively (Barry, Gaughan & Hunter, 2012).
The peak period for the onset of the condition occurs around late adolescence and early adulthood, which explains why the brain functioning is damaged during its critical period of development. About 40% male and 25% female patients develop the disease before reaching the age of 19 (Kumra, Shaw, Merka, Nakayama & Augustin, 2001).
Moreover, between 0.3% and 0.9% of the total world population are affected by the condition during their lifetime (Barry, Gaughan & Hunter, 2012). Individuals affected by the condition have short life expectancies, often reducing by about 50% (Picchioni & Murray, 2011). The life expectancy of an individual who suffers the condition during childhood, adolescent or early adulthood is likely to be reduced by 10 to 25 years due to the associated physical health problems (Herson, 2011). In addition, it is worth noting that more than 50% of the patients are likely to attempt suicide (Herson, 2011).
Causes
Studies have revealed that schizophrenia occurs due to a combination of factors that affect individuals in any society. In particular, environmental and genetic factors play a significant role in the development of the condition because studies have shown that the condition may run through families (Picchioni & Murray, 2011).
The genetic conditions or factors that influence the condition have been a subject of biomedical studies in the recent past. However, the difficulty of separating the impacts of the environmental conditions and the genetic factors has made it difficult to elucidate the actual estimates of heritability of schizophrenia (Picchioni & Murray, 2011). Despite these difficulties, studies have shown that genetic factors are likely to be associated with the development of the disease because people with schizophrenic first-degree relatives and monozygotic twins have about 6% and 40% risks of developing the condition respectively (O’Donovan, Williams & Owen, 2012). In addition, individuals with one schizophrenic parent and both schizophrenic parents have about 14% and 50% risks of developing the condition respectively (O’Donovan, Williams & Owen, 2012).
With this knowledge, it has been able to carry out molecular studies to examine the actual genes that may be associated with the condition. In this case, a number of candidate genes have been identified or proposed. For example, the histone protein loci and the associated copy number variations and NOTCH4 gene have been proposed (O’Donovan, Williams & Owen, 2012). The Zinc finger protein 804A is an example of genome-wide associations that have been identified and linked with the development of schizophrenia (O’Donovan, Williams & Owen, 2012).
On the other hand, several environmental conditions have been identified and linked with the development of the disease. For instance, substance use is highly linked with schizophrenia. Excessive use of alcohol and hard drugs are the major environmental risks associated with the disease. For example, drugs like cocaine, amphetamine and binge drinking are likely to cause psychosis (Herson, 2011). Noteworthy, psychosis and schizophrenia have similar symptoms are may occur in individuals with the genes identified above.
Cannabis and nicotine have also been associated with the development of the condition. Individuals with the condition may resolve to use cannabis in order to cope with the symptoms (McLaren, Silins, Hutchinson, Mattick & Hall, 2010). In addition, some studies have shown that cannabis use cannot cause the disease but contributes to the development when other factors are present (McLaren, et al., 2010).
Apart from drugs and substance use, developmental and living conditions are associated with the disease. For instance, hypoxia, infections, malnutrition during fetal development and stress are associated with increased risks of developing schizophrenia in later life (McLaren, et al., 2010).
Diagnosis
The American Psychological Association has developed a comprehensive criteria for diagnosis of schizophrenia based on the APA 5th edition of Diagnosis and Statistical Manual of Mental Disorders (DSM 5). In addition, the world health organization recommends the use of the ICD-10 criteria (Picchioni & Murray, 2011). Both methods use the self-reported experiences of the affected individuals as well as reported cases of behavior change and behavior anomalies. A mental health profession is then involved in a clinical assessment to establish the presence of the condition. Before making a positive diagnosis, the observed symptoms must occur continuously within the population and reach a critical level of severity (Picchioni & Murray, 2011).
Management
Antipsychotic medications are the primary treatment methods for the condition. They are combined with social and psychological support methods to ensure effective interventions. It is expected that the psychotic medications will reduce the symptoms within one or two weeks. The most commonly use antipsychotic drugs include olanzapine, clozapine, risperidone and amisulpride. Nevertheless, they have some side effect such as agranulocytosis, extrapyramidal effects and risks of diabetes and metabolic syndrome (Picchioni & Murray, 2011).
References
Ayuso-Mateos, J. L. ( 2013). Global burden of schizophrenia. New York, NY: World Health Organization.
Barry, S. E., Gaughan, T. M., & Hunter, R. (2012). Schizophrenia. BMJ Clinical Evidence, 359(1278), 567-73.
Herson, M. (2011). Etiological considerations. Adult psychopathology and diagnosis. New York: John Wiley & Sons.
Kumra, S., Shaw, M., Merka, P., Nakayama, E., & Augustin, R. (2001). Childhood-onset schizophrenia: research update. Canadian Journal of Psychiatry 46(10), 923–30.
McLaren, J. A., Silins, E., Hutchinson, D., Mattick, R. P., & Hall, W, (2010). Assessing evidence for a causal link between cannabis and psychosis: a review of cohort studies. Int. J. Drug Policy 21(1), 10–9.
O’Donovan, M. C., Williams, N. M., & Owen, M. J. (2012). Recent advances in the genetics of schizophrenia. Hum. Mol. Genet. 12(2), R125–33.
Picchioni, M. M., & Murray, R. M. (2011). Schizophrenia. BMJ 335(7610), 91–5.
Van Os, J., & Kapur, S. (2012). Schizophrenia. Lancet 374(9690), 635–45.