Table of Contents
Scholars define schizophrenia as a brain disease, which influences the manner in which an individual perceives the world, thinks as well as acts (Breeding, 2008). Individuals with the disorder significantly lose their contact with the reality, because their perception is altered. These individuals may hear or see inexistence things, talk in confusing and weird ways, feel like they are constantly monitored, and believe that other individuals are attempting to hurt them. The disorder makes it hard, as well as frightening, because individuals have a blurred line amid the imaginary and the real. Therefore, it is hard to negotiate the daily life activities with such individuals. In reaction, these individuals may withdraw from the masses or act in terror or in confusion.
Most schizophrenia cases occur in early adulthood or in the late teens. Nonetheless, the disorder can occur initially in the middle age or afterwards. Rarely, the disorder can affect adolescents and young children, but the signs are somewhat dissimilar. Generally, schizophrenia is more severe, if it develops earlier. The disease is more severe in men than in women. Despite being a chronic illness, assistance is available. Many patients can survive independently, as well as live fulfilling lives with medication, therapy and support. Nevertheless, the situation is preferable, if the disorder is diagnosed and cured immediately. Individuals should report any symptoms of schizophrenia without delays, in order to use the available treatments, and thereby, increase the recovery chances (Shean, 2008).
With regards to schizophrenia, this paper concerns reviewing the empirical literature on the disorder to uncover the matters pertaining to the disorder, such as symptoms, Relapses, current treatments and future implications. This is through summarizing the empirical resources on the disorder. Among the researchers to be reviewed include, Stephane et al. (2007), Schultze-Lutter (2009), Schultze-Lutter et al. (2007), Klosterkötter et al. (2008), Schultze-Lutter et al. (2007), Turkington, Kingdon & Weiden, P. (2008), Tai & Turkington (2009), Mojtabai et al. (2009), Breeding (2008), Chadwick (2006), McWilliams (2008), (Aguglia et al., 2007), and Kazadi, Moosa, and Jeena (2008).
Symptoms of Schizophrenia
According to Stephane et al. (2007) research on the speech content and verbal hallucination on schizophrenia patients, the disorder exhibits distortion in the identification of erroneous linguistic stimuli during the sublexical stage of language processing. After examining the 22 schizophrenia clients, as well as 11 fit control subjects, they found that the patients’ recognition of nonlinguistic stimuli were not impaired. These symptoms were revealed by procedures formulated to assess the lexical, syntactic and sublexial among other language processes. The differential impairment particular to the language could clarify the abnormalities of the speech in schizophrenia. Patients could be prevented from rectifying the distorted speech they may constantly produce through non recognition of wrong linguistic information.
According to Schultze-Lutter (2009), some symptoms are basic, and thus, subtle. These are experienced subclinical distractions in stress tolerance, speech, perception, central vegetative functions, thinking, affect, motor action and drive. These symptoms can occur and have previously been recorded in every level of the disorder, that is, starting from prodome to the initial psychotic incident, in prodromes to reversion, in remaining states, as well as when psychotic incidents are occurring.
Basic symptoms are dissimilar to what is regarded to as a person’s mental self. They are subjective, and thus, remain predominately private, as well as show only in the patient. It is hard to observe the basic symptoms in others, but the personal-initiated survival strategies of the patient in reaction to the basic symptoms may be identifiable to others. Such coping strategies include social withdrawal, as well as avoidance strategies. Basic symptoms are self-experiences that are dissimilar to the negative symptoms according to current understanding, that is as functional deficits that others can observe. These symptoms are also unique from the candid psychotic signs, which are passed through by the patient as feeling, thinking and real. Contrarily, the patient impulsively and directly identifies basic signs, as distractions of her or his mental processes. There are insights that something is improper with a person’s thinking although certain experiences may be very novel and extraordinary, so they are left almost inexplicable. The unusual, extremely reflective individual can express what is occurring, although any thorough explanation of the experiences commonly demand assistance in terms of guided questioning (Schultze-Lutter et al., 2007). The capacity to go through the basic symptoms with insight, as well as to survive them usually attenuate with continuous disease and rising psychotic signs, although is regained after the remission. Therefore, prominent and acute psychotic signs usually limit an assessment of basic symptoms.
Detection and Treatment
Many interventions have been discovered to treat schizophrenia, and many more are being researched on. To begin with, it is the cognitive behavior therapy (CBT), which is the main intervention approach, employed to treat schizophrenia (Tai & Turkington, 2009). CBT for schizophrenia has been developed, since the last 30 years of discovery, and thus, appropriate for treating the disorder. Previous interventions for the disorder depended chiefly on behavioral techniques to influence change, followed by a focus on the cognitive elements. Initially, these strategies aimed at promoting coping, creating autonomous living and social skills, as well as raising compliance with behavioral techniques, such as connecting tablet taking to a different action. Additionally, harmful signs were addressed through the provision of scored activity programs. The strategies have progressively been employed, in cases of the deficit schizophrenia symptoms and enhancing results are the major concerns of the intervention (Tai & Turkington, 2009).
For quite some time, assumptions have it that the encouraging signs related to schizophrenia rest beyond the sphere of average psychological performance. Therefore, the conversion to combining more cognitive theory and methods into performance emerged much afterwards, contrary to the CBT for nonpsychotic illnesses. Cognitive models rule out the way delusions and hallucinations may happen, when inconsistent experiences, which are common to most people, are attributed wrongly in a manner with intense and intimidating individual implications. The models spell out the function of faulty beliefs, raised concentration to risk-associated stimuli, prejudiced data processing of assenting proof, as well as safety conducts in the positive symptoms experience. Most stress is put on anguish, originating not essentially from hard experiences, although on the implication on the same experiences. For instance, a person who is passing through bodily sensations of tickly, and connects this to the workplace pressure is probably to experience the strikingly dissimilar result to individuals, believing that working individuals are bullying them and have deposited sharp objects beneath their skin. The theory is founded on the concept that the cognitive developments associated with mood, as well as nervousness illnesses happen trans-analytically. Studies’ outcomes back the concept that psychotic signs may be abstracted with orientation to ordinary psychological developments, in which case the composition of signs is comprehensible and agreeable to CBT. For instance, Tai and Turkington (2009) claim it is possible to conceptualize voices as intrusive thoughts.
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Arguably, CBT for other illnesses, such as depression and anxiety, could be employed to treat schizophrenia. However, key amendments are necessary to ensure the method’s compatibility. Stigma is an appropriate method identified for the negative beliefs, as well as assumptions individuals held concerning the prognosis and diagnosis of schizophrenia. Next is to find the proof that some of these experiences are usual in the society. Additionally, the role of stress showed the optimism and hope of these perspectives. These perspectives required less time, and were more flexible than CBT, thereby simplifying the further study. Disturbed sleep, safety conduct, and affect yielded mini-formulations for maintaining positive signs (Malik, Kingdon, Pelton, Mehta & Turkington, 2009). The center of treatment in CBT is the person’s own meaning, comprehension and coping with signs. For instance, people are facilitated in testing out the hallucination locations, cautiously assessing the manifestation and conduct of supposed tormenters, as well as trying homework, which is crucial to their outlined goals (Tai & Turkington, 2009).
Psychoanalytic techniques have been used to treat schizophrenia and have not changed much since the Freud. Other treatment methods are biomedical, but according to Chadwik (2006), biomedical approaches to schizophrenia are wanted because the patient feels that the provider is not listening to their issues, and causes loss of faith in psychiatrists responsible for aiding their recuperation. According to Shean (2008), an inclusive, well-incorporated range of rehabilitative and psychosocial services together with psychotropic drugs, progressive prescription adherence, and availability of inclusive pharmacological management services may enhance the efficiency of healing. On the other hand, Mojtabai et al. (2009) adds that healing in schizophrenia patients cannot be completely achieved, until availability of services, as well as improvement of prevailing services is attained. MacWilliams (2008) adds that optimism exists for the progressive practice of psychoanalysis as well as for the theory and method to endure; reinvention in an alternate form may be required.
The basic symptoms are employed during early detection, as well as prevention intrusion of psychosis (Klosterkötter et al., 2008; Schultze-Lutter et al., 2007). The most vital characteristic of basic symptoms in clinical practice is that they are experienced and recorded as unusual and onerous by patients themselves. Therefore, it is of paramount importance to create the awareness and campaign, in order to ensure the early detection, as well as prevention. These symptoms should be explained to patients in diminution form psychosis, as displaying untimely indication of relapse threat. These symptoms are also good indicators of the requirement for rehabilitation in enduring, post psychotic circumstances. They back a more absolute account of the remission degree outside the positive, as well as the negative signs. Here, they can be employed for making enough mixtures of rehabilitative, psychological, as well as pharmacological interventions. A patient’s inspirations for treatment encounter could be promoted by associating the therapeutic mechanisms to phenomena, which are vividly identified as subjectively burdensome signs. The concept of basic symptoms could educate the patients together with family, concerning the psychosis expressions, and help them to acquire a rooted comprehension of the anticipated vicissitudes of their disorder.
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According to Kazadi, Moosa, and Jeena (2008), schizophrenia relapses are the reemergence or the deterioration of psychotic symptoms. Some criteria are employed to define the relapses, and include provocation of negative and positive symptoms, hospital admission in the last six months, as well as increased intensive reports management and medications change. A relapse may result in the resistance of treatment, impairment of the cognitive because of the continuous damage of brain structure, personal agony, intrusion with efforts to rehabilitate and incarceration. Relapses increase the health care economic budget because of its related morbidity, as well as hospital re-admission. Therefore, prevention of the relapses could improve the socio-economic and therapeutic condition significantly. Globally, the factors normally related to relapse are stressful life activities, noncompliance with treatment, co-morbid disorders, substance abuse, surgical complications and the setting of the treatment.
According to Kazadi, Moosa, and Jeena (2008), the rate of compliance to medication for non-psychiatric disorders is 76%, whereas that for psychiatric diseases is 58%. More particularly, around half of schizophrenia patients do not adhere to treatment, which may cause a relapse of the same. The noncompliance could be because of the factors, which are related to the patient, such as nervousness, absentmindedness, lack of insight, insufficient knowledge, and lack of inspiration. Those related with care include poor relationship between the provider and patient, inadequate services and inaccessibility to services, and poor staff training. On the other hand, social economic factors include illiteracy and low education level, whereas those related to treatment are complicated treatment schedules and poly-pharmacology.
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Schizophrenia patients are commonly known to be substance abusers, which can cause a relapse independent of its influence on adherence of treatment. The lifetime frequency is approximated to 47% with about 33% patients having an alcohol dependence illness. Some of the substances commonly abused are cocaine, alcohol, and cannabis. The South African research on cannabis use and alcohol abuse revealed that the two are major factors, which contribute to the relapse of mental illnesses including schizophrenia (Kazadi, Moosa & Jeena, 2008). Stress is also associated with the start of psychotic relapse often in the three weeks before the relapse. Life stressors may be either internal or external, and both may work together. Schizophrenia patients are more receptive, as well as susceptible to the negative influences of yet minor stressors. The study reported that joblessness and loss of a loved one are major causes of schizophrenia relapses in South Africa.
Another study conducted in Italy to assess schizophrenia relapses (Aguglia et al., 2007). The findings of the experiment showed a considerable improvement in almost all the treatment approaches used. The most significant was the reduced number of relapses involving hospitalization, clinical parameters and hospital days. The study confirmed the effectiveness of the treatment therapies in reducing relapses; there was an improvement in value of life, clinical parameters and the relationship with the providers.
Despite several advances have been made towards the understanding of schizophrenia, there is a gap in immense study, which is required to improve the patients’ lives. The emergence of the second-generation antipsychotics has offered the novel treatment choices with various merits; however, these medications have their own difficult set of adverse influences, which have decreased the certain initial enthusiasm. Progressive research efforts are required to enhance treatments for schizophrenia. These study efforts will persist to demand the voluntary participation, as well as informed consent of individuals with schizophrenia. Although, study concerning individuals with schizophrenia or other related mental disorders is not subject to further safeguards under the Common Rule, these people are nonetheless regarded to be potentially at risk in the research context. Theoretically, schizophrenia symptoms, such as negative and positive signs together with cognitive deficits may have deleterious influences on the ability of making research decisions. Nonetheless, to establish whether, under what situations and to what extent schizophrenia patients are vulnerable in study, research particularly scrutinizing abilities to make decisions in schizophrenia are required instead of making assumptions concerning the decisional ability founded on diagnosis.
Schizophrenia is a brain disorder in which the patient suffers from perception and other related distortions. The symptoms of the disease include both positive and negative ones. They are majorly described as basic symptoms, which are observed at different levels of the disease. Numerous interventions can be employed to treat this disorder and among the most used is CBT. In reviewing the literature above, there appears to be contradictory reports of the efficiency of employing psychoanalytic theories for schizophrenia management. However, it is evident that regardless of whether the psychoanalytic or CBT approach is used, the talk therapy is advantageous. Patients can recover from schizophrenia, and it should be the aim of every patient. Patients ought to have faith in the clinician, whereas the clinician should give enough reason for the same. Basic symptoms have also been used as a base to diagnose and treat schizophrenia. Generally, all the treatment interventions should work together for the sole purpose of recovery.
Concerning the relapses, despite the current therapeutic progress, schizophrenia relapse is widespread and a major problem. The relapse is mostly increased by noncompliance, co-morbid depressed mood, and medical side effects. Therefore, the responsible psychiatrist should identify and cure mood characteristics together with devising means to improve insight, as well as compliance. In case atypical antipsychotic techniques can enhance the rates of adherence, considerable reductions in service costs and rates of relapse could result.
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