Schizophrenia has a broad range of indicators or symptoms. This is the explanation that can be given for the enormous size of the diagnostic material that is available. Excited catatonia or paranoid schizophrenia may be misconstrued to be the reasons for a panic attack that appears in both these cases as well as schizophrenia itself. Another possible problem with which it can be confused is hebephrenia (Szasz 1976, p.34). This however takes a different direction for the better if the person under investigation has a clear history. The process of diagnosis is quite easy.
According to the American Psychiatric Association (DSM-IV-TR), schizophrenia, which is a chronic illness, psychotic symptoms almost always precede the excitation; in mania, which occurs as an episodic illness (2000). However, affective symptoms appear first; and psychotic ones only appear as the patient progresses into the acute stage of mania and on up to the height of a manic episode, delirious mania. When history is lacking, certain symptomatic differences may allow for a differential diagnosis. The mood and affect of a patient with mania are typically “infectious” and well developed. By contrast, the mood of an excited hebephrenic is one of silly, shallow hilarity, which, rather than provoking laughter, might leave the interviewer with a sense of puzzlement.
Diagnostic Criteria for Schizophrenia
- Characteristic symptoms: The patient is diagnosed with schizophrenia if he/she has two or more of the following symptoms in a month:
- Hallucinations or delusions;
- Disorganized speech (for instance, incoherence);
- Disorganized behavior (as well as occasional stupor);
- Avolition or alogia (DSM-IV-TR, 2000).
- Note: A patient may be diagnosed with schizophrenia based on one symptom only if his/her delusions include auditory hallucinations (the most dangerous are those in which more the one voice is present) (DSM-IV-TR, 2000).
- Social/occupational dysfunction: After the onset of the disease, such areas as interpersonal relations, work, and self-care are strongly affected. In case the onset falls to adolescence or childhood, a proper level of academic and interpersonal achievement might not be achieved (DSM-IV-TR, 2000).
- Duration: Signs of disturbance may be observed during 6 months, of which 1 month is taken by the symptoms. If this is the case of active-phase symptoms meeting Criterion A, prodromal or residual symptoms may be observed as well (DSM-IV-TR, 2000).
- Medical condition/substance use: This disturbance does not occur because of a general medical condition or substance abuse.
- Relationship to a Pervasive Developmental Disorder: If there were cases of Autistic Disorder or another Pervasive Developmental Disorder in the patient’s history, he/she may be diagnosed with schizophrenia if he/she experienced hallucinations or delusions during at least a month (or less if the symptoms have been treated) (DSM-IV-TR, 2000).
Subtypes
Paranoid Type
The patient is diagnosed with this type of disease under the following conditions
- The patient experiences auditory hallucinations or frequent delusions;
- The patient does not exhibit disorganized behavior or flat affect, as well as disorganized speech (DSM-IV-TR, 2000).
Catatonic Type
At least two of the following symptoms are required to diagnose the patient with this type of disease:
- motoric immobility (possibly, catalepsy or stupor);
- excessive motor activity that might not be affected by external stimuli);
- mutism or extreme negativism;
- different kinds of voluntary movement (for example, stereotyped movements, echolalia, or echopraxia) (DSM-IV-TR, 2000).
Disorganized Type
This type requires meeting the following criteria:
- The patients’ state may be characterized by disorganized speech and behavior, as well as flat or inappropriate effects (DSM-IV-TR, 2000).
- The patient is also diagnosed with this type of disorder if his/her symptoms do not meet the criteria for Catatonic Type.
Undifferentiated Type
The patient is diagnosed with an undifferentiated type of schizophrenia if he/she has Criterion A symptoms, but his/her symptoms meet none of the abovementioned types of the disease (DSM-IV-TR, 2000).
Residual Type
Diagnosing the patient with a type of schizophrenia requires his meeting the following set of criteria:
- The patient does not experience delusion or hallucinations, as well as does not have disorganized behavior and speech;
- The disturbance has been observed for quite a long period; at this, the patient showed negative symptoms or an attenuated form of the symptoms (two or more) listed in Criterion A (DSM-IV-TR, 2000).
- The patient exhibits any kind of unusual behavior (is sexually deviant, for instance, hypoactive, depressed, euphoric, fearful, etc) or other unusual states (sexual dysfunction, antisocial personality, eccentric personality (DSM-IV-TR, 2000).
Description of the Disorder: Schizophrenia
As a mental disorder, schizophrenia affects the general behavior of the individual. The coverage is given above as cited from the diagnostic statistical manual shows how far-reaching the disorder can be. Nearly every aspect of behavior is affected; a scenario that makes it difficult for the person to function in society. For instance, speech is usually impaired and the behavior of the person becomes weird with unpredictable displays of excitement and agitation. The fellow can see golden scenes that do not exist and can also feel inexistent power.
The condition does not affect the individual only. The family members normally get strained due to the care that is given to the member suffering from schizophrenia. It is always advised that family members seek counseling as a way of putting up with the pressure that comes with taking care of a loved one with schizophrenia. The other source of stress for the family is the economic impact experienced as a result of trying to meet the medical expenses of the patient (Fleck, Lidz & Cornelison 1985, p.23). Medical care given to schizophrenic individuals is expensive and can dry up the resources of the family. In cases where the individual with the disorder is the breadwinner, the family suffers from a lack of resources as the individual can not earn for the family anymore.
Age-Related Information of Schizophrenia
Schizophrenia can be described as a young people’s disorder. It is known to be very common among young people between sixteen years and twenty-five years. It is very rare to find people who get the disorder at the age of thirty or forty years. This has made members of the medical profession develop the reasoning that once someone has gone past thirty years, that person has successfully gone beyond the age of getting affected by this mental disorder.
The possible explanation as to why this is the most common age at which this disorder is set is that most drug addicts lie at this age, and given that drug abuse is a possible cause of schizophrenia, it is safe to assume that the disorder sets in at this age range. The genetic factors that are the other possible causative agents are also known to manifest their effects a bit early in human development (Keen 1999, P.413).
This, therefore, means that the age of sixteen and twenty-five seems to be the most ideal for the manifestation of the disorder. It is not possible that it can appear at a later age because the maturity of the individual is meant to bring to maturation all the genetic conditions that the person may have inherited. It is also important to note that old people beyond the age of twenty-five up to seventy years are not highly affected by this disease (Laing(1990,p.97). Also, the number of females who suffer from the disorder is far much less compared to the number of males.
Medication
The medical attention that is possible for people suffering from schizophrenia is mainly meant to deal with the symptoms. In most cases, dealing with the most serious symptoms that make the patient restless is of prime importance since it sets the stage for the other remedial steps that can only take place when the patient is controlled. The training of the patient in social behavior follows the period after the control of the serious manifestations.
As part of the treatment, psychological help is very necessary. The patient should be exposed to reliable counseling services as a way of ensuring that he or she can have a clear understanding of what is affecting their health and that all that is being done is meant to help them or achieve health. This is an alien concept to most if not all schizophrenic individuals and it makes it difficult for their caretakers to give them both medication as well as other aspects related to their care. It is also appropriate because the counseling services will assist them to understand their behavior and therefore play a vital role in their recovery.
It is never in the knowledge of schizophrenic individuals that they are not in mental health when the disorder is at its worst. This is why any attempt to control the patients’ behavior is always met with stiff opposition. Early detection is helpful and the presence of care at all times is also important as it will help avoid self-inflicted injuries on the part of the patients. Stigmatization has also to be avoided at all costs as it can worsen the negative effects (Mario &Sartorius, 1999, p. 292).
Growth in Each age Group-Normal Growth (Covered in lists instead of tables)
25-45 years
- Active
- Focused
- Both men and women get married and start families in most cases (Erikson 1968, p.87).
- They are capable of administration functions and can make sound choices
- Mental problems: Isolation is a major issue according to Erikson, Freud, and Piaget.
45-65 years
- Active
- Settled in most cases
- Capable of sound choices
- Age related problems begin to set in at the early sixties
- Activity goes down.
- Mental disorders at this stage: There is the stagnation that sets in. Though known by different names, Gilligan, Freud, Erikson, Kohllberg, and Piaget agree on this disorder (Erikson 1968, p.78).
65 year and above
- Activity goes down to a higher degree
- Settled
- Age related problems begin to set in
- Mental disorder in this stage:
- Despair. This is due to old age. This is also agreed upon by Erikson, Piaget, Kohlberg, Gilligan and Freud.
References
American Psychiatric Association. (2000). Diagnostic And Statistical Manual Of Mental Disorders (Revised 4th ed.). Washington, DC: Author.
Erikson, E.H. (1968). Identity: Youth and Crisis. New York: Norton.
Fleck, S., Lidz, T & Cornelison, A. (1985). Schizophrenia and the Family. New York: International Universities Press.
Keen T.M. (1999). “Schizophrenia: Orthodoxy and Heresies. A Review of Alternative Possibilities”. Journal of Psychiatric and Mental Health Nursing 6 (6): 415–424.
Laing, R.D. (1990). The Divided Self: An Existential Study in Sanity and Madness. New York: Penguin Books.
Mario, M & Sartorius, N. (1999). Schizophrenia. Chichester: Wiley.
Szasz, T. (1976). Schizophrenia: The Sacred Symbol of Psychiatry. New York: Basic Books.