| Schizophrenia Essay, Research Paper
Schizophrenia
Schizophrenia, an often misunderstood disease, is usually interpreted by those not familiar with it as Multiple Personality Disorder, but this is not so. While a person afflicted with schizophrenia may also suffer from multiple personality disorder, it is not the rule of thumb. Unfortunately, due to lack of support from family or friends, many schizophrenics go without proper treatment, and may wind up homeless. This paper will discuss procedures doctors follow when diagnosing the disease, treatment and control of the disease, and finally some of the legal and ethical concerns surrounding those who suffer from schizophrenia.
To start with since there is nothing that can be measured to diagnose schizophrenia, and many of its symptoms are shared by other diseases, what schizophrenia is or is not can not be decided on. However, German psychiatrist, Kurt Schneider developed a list of symptoms, which occur very rarely in diseases other than schizophrenia. These symptoms include auditory hallucinations in which voices speak the schizophrenic s thoughts aloud. There are also two other forms of auditory hallucinations, in one the victim will hear two voices arguing, in the other a voice will be heard commenting the actions of the person. Schizophrenics may also suffer from the feeling that their actions are being controlled by an external force, or the delusion that certain commonplace remarks have a secret meaning for themselves (Torrey, 1983).
From these symptoms, schizophrenia is divided into four sub-types determined by which symptoms are most prevalent (Strauss, 1987). The four sub-types are paranoid, hebephrenic, catatonic, and finally simple. Paranoid schizophrenics often suffer from either delusions, hallucinations, or both, of a persecutory content. Hebephrenic schizophrenia is characterized by inappropriate emotions, disorganized thinking, and extreme social impairment. Catatonic schizophrenics often suffer from rigidity, stupor, and often mutism. The final form of schizophrenia, simple schizophrenia, lacks developed hallucinations or delusion. It is however accompanied by an overwhelming loss of interest and initiative. The sufferer of simple schizophrenia will also usually suffer from withdrawal and will blunt their emotions (Torrey, 1983).
The part of the brain thought to be affected by schizophrenia is the limbic system. It was realized that the limbic system might be the source of the malfunction when it was discovered that all information and incoming stimuli must pass through the limbic system before being sorted out. Previously the limbic system was disregarded, and considered simply a remnant of our primitive pass. At that time the outer areas, the gray matter of the brain, was studied (Torrey, 1983).
It is understood that occasionally schizophrenia runs in family, although it s not well understood how. It is known that the close relatives (parents, siblings) of those with schizophrenia, have a 10% chance of developing symptoms, compared to the 1% chance of the general population (Torrey, 1983). As well, an identical twin of a schizophrenic is 50 times more likely to be a schizophrenic than someone in the general population (Marquis, 1996). There are some theories that debate whether or not schizophrenia can begin while in utero, even though symptoms may not be present until late teens or early adulthood. These theories include the study that states that anywhere in the Northern Hemisphere, there are a disproportionate number of babies born with schizophrenia in the winter months. Another theory is that something is disturbing the baby in the uterus, causing schizophrenia. Another factor indicating a disturbance is the fact that schizophrenics usually have unusual fingerprints. (Torrey, 1983).
As previously mentioned, not much is known about exactly what causes schizophrenia, or which exact parts of the brain are affected. One guess as to the cause of schizophrenia is that the neurotransmitter dopamine is involved. Some of the supporting evidence behind this theory is the fact that amphetamines, when given in large doses, cause the brain s dopamine levels to rise, this can cause the subject to show schizophrenia like symptoms (Torrey, 1983).
There are three different fields of thought as to how something is affecting the dopamine and causing schizophrenia. One is that there is an excess of the neurotransmitter in the brain. In contrast, another school of thought is that there is a deficit of dopamine in the brain. The final thought is that the dopamine is somehow being turned into a poison (Torrey, 1983).
A chemical imbalance of dopamine could very well be the cause of schizophrenia. If the levels are too high, there could be excess dopamine left in the synaptic gap. If the levels were to low, signals needing dopamine to be transferred would not be received.
Even though the causes of schizophrenia, are not confirmed, it is important to properly diagnose it so proper medical treatment may be sought. When diagnosing schizophrenia doctors first rely on symptoms such as hallucinations and delusions. Because these symptoms may be generated by another disease, doctors are often reluctant to diagnose a patient with schizophrenia unless the symptoms have been present for at least six months (Torrey, 1983).
However, with MRI it may be possible to get a clue as to if the person might be suffering schizophrenia. This might be feasible because research has shown that some specific brain structures, the hippocampal region especially, have been diminished. Also it has been found that there are some functional anomalies between a normal brain and that of a schizophrenic. One such abnormality is a reduced blood flow to the frontal cerebrum. It has also been found through postmortem studies of schizophrenics, that they have an abnormal number of brain cells, as well as unusual neural organization, especially in the temporal lobe (Gershon and Rieder, 1992). Other evidence that supports this is that when solving problems such as categorizing a card by color based on recent instructions, the frontal lobes of schizophrenics do not become as active as that of a normal person. These differences in brain activity can be picked up on MRI devices. (Marquis, 1996).
Once schizophrenia has been diagnosed, it important to seek the proper treatment. It may be necessary to have the schizophrenic hospitalized for a period of time, or they may be able to go through treatment at home. But treatment is all that can be given, as there is no cure for schizophrenia.
The most commonly used, and most effective, treatment is through the use of anti-psychotic drugs. Anti-psychotics, or neuroleptics, as they are sometimes called, reduce delusions, hallucinations, and act to diminish aggressive or odd behavior. Antiphycotics are most commonly given in liquid or tablet form (Torrey, 1983). They work by blocking the neurons dopamine receptors (Gershon and Rieder, 1992).
Unfortunately, as with most drugs, there are certain side effects. These side effects range in severity and occurrence. Common side effects are dry mouth, stiffness, restlessness, or slight slurring of the speech. Some uncommon side effects are loss of appetite, menstrual changes in woman, and on the more serious side, liver damage, damage to blood forming organs, convulsions, abnormal heart functions, or unexplained fever could occur (Torrey, 1983).
The most feared side effect is a disease called tardive dyskinesia. Tardive dyskinesia occurs mostly with patients who have been taking anti-psychotics for a prolonged period of time over many years. Its symptoms include involuntary movements of the tongue and mouth. Purposeless movements of the arms or legs may also occur. As of yet there hasn t been an effective treatment found for tardive dyskinesia
(Torrey, 1983).
Even with these side effects taken into consideration, drugs remain the safest, and most effective, way to control schizophrenia. The only other real alternative to drugs, which isn t used often, is shock therapy. The reason it hasn t been used is because more harm often comes to the patient than good. This is because the shock therapy may lead to damage of the neurons.(Torrey, 1983).
There are many legal and ethical concerns surrounding those with schizophrenia and their families. One of these is involuntary hospitalization. Should a person with schizophrenia be put in the hospital against their will? or on the other hand, be refused treatment if they pose no threat to themselves or others. The following is a good example of the dilemma faced by involuntary hospitalization:
A young woman is observed to be living in a train station for several days.
She asks passers-by for money but otherwise does not bother them. She is often seen talking to herself or to imaginary people. A newspaper reporter talks with her and discovers that she is a college graduate who has been recently released from a psychiatric hospital. The woman s conversation does not make sense. A policeman takes her to the local psychiatric hospital, but the psychiatrists there refuse to admit her because they say she has done nothing to suggest she is a danger to herself or others. She also indicates unwillingness to go back into the hospital voluntarily. She returns to the train station. A few days later she is found raped and murdered nearby (Torrey, 1983, pp. 182-183).
The most disturbing ethical problem concerns experimentation and research on those confined to mental hospitals. There are three types of experimentation and research, which could be applied to them. One is the use of procedures or drugs, which have little, or no bearing on the illness. For example, testing a hepatitis vaccine on schizophrenics. Another form is the use of procedures or drugs, which may be directly beneficial, such as a drug to control the symptoms of schizophrenia. The final type of research is that which is trying to find a better treatment, or the cause of the disease, but most likely won t be a benefit to the patient. An example of this would be performing tests on a schizophrenic to help develop a cure for schizophrenia. That would not benefit them because most likely by the time the drug is ready to be prescribed they would most likely be dead. (Torrey, 1983).
In conclusion, schizophrenia is a disease that is still not well understood. As more is learned about the disease and how it affects the brain of those who suffer from it better treatments will be discovered. Even with the best treatment, support from family and friends is crucial in maintaining normality to the life of those with schizophrenia
|