Schizophrenia

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Schizophrenia is a psychosis-based mental disorder, being most common of the psychotic disorders.^[3][4][5] It is often characterized by abnormal social behavior, cognitive dysfunction, and failure to recognize what is real. Common symptoms include false beliefs, convincing auditory hallucinations (visual hallucinations are possible and common but not characteristic), confused or unclear thinking, inactivity, and reduced social engagement and emotional expression.^[6][7]

Being diagnosed with schizophrenia does not usually mean that a person will be in a psychotic state for the rest of their life, but schizophrenia has several disease courses. Some patients have only one episode of psychosis that has led to a diagnosis of the illness, some have alternating asymptomatic and psychotic episodes, and some have continuous psychosis.^[8][6]

People often mistakenly associate schizophrenia with “split personality”; which actually refers to another condition known as dissociative identity disorder.^[9][10] Also, violent behavior is not a symptom of Schizophrenia, or any other psychosis-based mental disorder.^[3]

Symptoms[edit]

Schizophrenia is a type of psychosis.^[11] According to the definition of Yrjö O. Alanen, late Professor of Psychiatry at the University of Turku, Schizophrenia is; "a mental illness that usually begins in adolescence or young adulthood, characterized by a partial disruption of the integrity of personality functions, developmental regression, and a tendency to withdraw from relationships with other people and into a subjective inner world of thoughts that is more or less colored by hallucinations or delusions."^[12] There is a considerable degree of heterogeneity in symptoms of schizophrenia; the presence and degree of symptoms vary wildly from patient to patient. However, common symptoms are categorised in three distinct areas:

Positive[edit]

Positive symptoms refer to phenomena normal people do not experience, but are experienced by schizophrenic patients. Individuals with schizophrenia may experience hallucinations (most reported are hearing voices), delusions (often bizarre or persecutory in nature, hence the term "paranoid schizophrenic")^[13], and disorganized thinking and speech. The last may range from loss of train of thought (something called thought blocking), to sentences only loosely connected in meaning (tangentiality), to speech that is not understandable, known as word salad in severe cases. In some cases patients can become catatonic, a trance-like state of abnormal motor activity in which the patient may stay frozen in the same position (often quite awkward and uncomfortable) for hours without moving or speaking, allow themselves to be posed by others (something called waxy flexibility), or in some cases enter an agitated motor frenzy. They are relatively easy to manage with antipsychotic medication. When talking about delusions, sometimes a delusional belief can vary in its degree of rationality, some delusions can be blatantly irrational (alien abduction fantasies, visits from angels, speaking with dead people). Paranoid delusions also include entirely plausible things, such as the idea that your partner is cheating on you, or you are being stalked, these at least can happen and are much more likely. The important part is incorrigible belief, and lack of evidence. It is also important to note that even though some delusions can be later proven to be true, they are still delusional.^[14]

Negative[edit]

Negative symptoms refer to various social and emotional deficits present in individuals with schizophrenia. Social withdrawal, sloppiness of dress and hygiene, and loss of motivation and judgment are all common in schizophrenia.^[15] People with schizophrenia often find facial emotion perception to be difficult.^[16] Poorness of speech (alogia), little to no emotion (blunted affect) and inability to experience joy or pleasure (anhedonia) are also very common. Despite what one might think at first, negative symptoms contribute more to poor quality of life than the positive symptoms do. On top of that, negative symptoms are not very responsive to medication.

Cognitive[edit]

Cognitive dysfunctions are a central feature of schizophrenia. The extent of the cognitive dysfunction experienced by the patient is quite often an accurate predictor of functionality and treatment compliance; they're also known to determine quality of life to an even larger extent than the negative symptoms. The cognitive dysfunctions affect a wide range of activity; attention, working memory, short and long-term memory, learning and verbal processing, among others, are all affected by schizophrenia.

Prognosis and social stigma[edit]

Schizophrenia is a major cause of disability, with active psychosis ranked as the third-most-disabling condition after quadriplegia and dementia and ahead of paraplegia and blindness.^[17] In a large, representative sample from a 1999 study, 12.8% of Americans believed that individuals with schizophrenia were "very likely" to do something violent against others, and 48.1% said that they were "somewhat likely" to. Over 74% said that people with schizophrenia were either "not very able" or "not able at all" to make decisions concerning their treatment, and 70.2% said the same of money management decisions.^[18]

Self-medication and alternative medicine[edit]

A significant proportion of people with schizophrenia use cannabis^[19] and/or nicotine.^[20] It has been widely thought that cannabis and/or tobacco use is a form of self-medication, but there is some evidence that usage is actually causative of psychosis.^[21][22]

According to Paul Ekman, learning to detect micro-expression can help develop social skills for schizophrenic people.^[23]Other scientists believe MDMA may be useful.^[24]

Religion, depending on how a patient views it, can be paralyzing and quite harmful, in that a patient may refuse treatment based on religious beliefs; in certain instances, one might believe that their delusions and hallucinations are actually a divine experience, and therefore deny any need for treatment. On the other hand, religion can also be a very valuable tool in coping with the disorder, especially for those who are active in a religious community.^[25] Why this might be the case is unclear, but it may allow the schizophrenic to become better able to define their relationship with the perceived source of the hallucinations, ideally into something that is positive or at least benign in nature.

It has been shown that those with schizophrenia who suffer from religious delusions are more religious than those who do not suffer from these delusions.^[26]

In a 2014 cross-cultural study, researchers found that schizophrenics from different countries tended to have different types of hallucinations. In the United States, schizophrenics tended to hallucinate of "disembodied voices that hurl insults and make violent commands", whereas in India and Ghana, schizophrenics often reported "positive relationships with hallucinated voices that they recognize as those of family members or God."^[27][28]

Political abuse of diagnosis[edit]

Sluggish schizophrenia was coined by Andrei Snezhnevsky, who as one of the chief architects of Soviet psychiatry broadened the symptoms of schizophrenia to include any pesky political dissidents and even those indirectly affected by alcoholism.^[29]

Famous people who have suffered from schizophrenia[edit]

• John Forbes Nash Jr. Nobel prize winning economist and mathematician who made contributions to game theory, differential geometry, and the study of partial differential equations
• Vashishtha Narayan Singh Indian mathematician
• Valerie Solanas American radical feminist who attempted to murder artist Andy Warhol (see Valerie Solanas)
• Larry "Wild Man" Fischer, a outsider musician who was promoted by Frank Zappa
• Wesley Willis, another outsider musician, promoted by Jello Biafra
• Syd Barrett of Pink Floyd
• Science fiction writer Philip K. Dick, though diagnosis has been contested
• Roky Erickson of The 13th Floor Elevators
• John Hinckley, Jr., would-be assassin of Ronald Reagan
• Brian Wilson of the Beach Boys was diagnosed with schizophrenia, but the diagnosis was later retracted. He has stated that he suffers from schizoaffective disorder, a somewhat similar condition.
• Gene Ray, of Time Cube fame
• Terry A. Davis, creator of TempleOS

References[edit]