Schizophrenia Demystified




Psychiatry_Psychology2.jpgAffecting nearly 1% of the population, schizophrenia is marked by chronic or reoccurring psychosis and behavioral-cognitive deficits. Dr. Kristin Cadenhead and Dr. David Granet of the UCSD School of Medicine discuss schizophrenia and delve into the nature of psychosis, early detection, and possible prevention.

Clinical symptoms of schizophrenia usually begin in late adolescence or early adulthood. They are generally grouped into three broad categories: “positive” or “negative” based on the pathological effects of normal functions, and “cognitive impairments.” Over time, positive and negative symptoms tend to be episodic and vary in intensity.

Positive symptoms include indications that are considered exaggerations or distortions of normal functions: psychosis, false beliefs (delusions; 90% incidence of all subjects), perception of something when indeed nothing exists in the perceptual field (hallucinations; 50% incidence), and bizarre behaviors (Hirsch & Weinburger, 2003).

Negative symptoms are deficit states in which fundamental emotions are either weakened or entirely deficient, including blunted affect, anhedonia (inability to experience pleasure from normal activities), apathy (loss of interest and motivation), social withdrawal, and alogia (diminished speech content). They have an earlier and more subtle onset, and are less episodic than psychotic symptoms.

Schizophrenia may encompass disturbances in cognition, usually related to attention and concentration, learning and memory, psychomotor speed (e.g. prolonged reaction time), and executive processing (e.g. formulating and initiating plans, abstract thinking, and problem-solving).

Schizophrenia is a devastating psychotic disorder for it destroys the social functioning and employability of patients, and the psychiatric community is increasingly recognizing such symptoms as the part of diagnosis and treatment. Generally, negative symptoms and cognitive impairment are the disabling mechanisms of schizophrenia. Patient may no longer have the ability to concentrate on and take pleasure in work, studies, and entertainment. Relatives and other observers may mistakenly identify the patient’s lack of will (avolition) and develop antagonistic thoughts towards the schizophrenic patient (e.g. thinking one is lazy or deliberately preventing an improved life) (Mueser & McGurk, 2004). Moreover, the patient’s lack of medical insight further hinders their ability to take advantage of effective coping strategies which may further agitate social withdrawal, depression, and risk of suicide.

References

Hirsch, S. R., & Weinburger, D. R. (2003). Schizophrenia (2nd ed.). Malden, MA: Blackwell Science.

Mueser, K. T., & McGurk, S. R. (2004). Schizophrenia. Lancet, 363(9426), 2063-207

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  • Gabby

    This is a great article. Do you believe that schizophrenia or schizoaffective is a disability that warrants significant government outreach? I was a straight A student, and when my symptoms set in the first to go was my math ability and then my writing became completely scattered. Over the course of about 8 years of treatment I’ve gained back a lot. But I still struggle from lost time, dropping out of HS etc. I kept trying to finish college and still have one or more years left. I can’t afford tuition and I receive no government aid, and am now forced to pay back two scholarships. I’m faulted for trying to complete school, and then getting overwhelmed and withdrawing mid-semester which I’ve done about 4 times. Colleges don’t know what to think or how to help a person with schizophrenia. For me, all I would need is a private tutor who could have helped me stay on track. People have thought I receive disability—all because I told people about my diagnosis.

    I think there should be an extra type of benefit for someone with a severe disorder, like not disability because not all of us are disabled, but some kind of government or social outreach/grant so that we can all fulfill our goals. Also, while symptoms of schizophrenia may appear similar everyone is unique and not all symptoms affect people the same. The earlier you seek treatment, the better off you are, and the less you hide it the more likely you are to be a member of the community.

    What do you think?

Shaheen E Lakhan, MD, PhD, MEd, MS

Shaheen E Lakhan, MD, PhD, MEd, MS, is executive director of the Global Neuroscience Initiative Foundation (GNIF). He is a published scholar in protein biomarkers, bioethics, biotechnology, education technology, and neurology. He serves on the editorial board of several scholarly publications and has been honored by the U.S. President and Congress.
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