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Vance Cope
Barbara Kennedy
PSY-2012-01Z
March 30, 20140
Understanding Schizophrenia
Schizophrenia is defined by the Encyclopedia Britannica as “any group of severe mental
disorders that have common such symptoms as hallucinations, delusions, blunted emotions,
disordered thinking, and a withdrawal from reality,” but what does that really mean
(“Schizophrenia”). This paper will discuss some of the early history of this mental disorder,
what schizophrenia is, some of the most common types, the effects it has on those that suffer
from it, and the symptoms physicians use to identify the disorder. It will also investigate
possible causes of schizophrenia, the various forms of treatment, new advances in research and
the future of medicine to help individuals with this disorder.
The history of the mental disorder we now call schizophrenia can actually be traced back
as far as ancient Egypt where descriptions of the common symptoms can be found in the ancient
text called the Book of Hearts. Coming from the Greek roots schizo and phrene, meaning split
mind, the word schizophrenia is only about 100 years old, first used by Swiss psychiatrist Eugen
Bleuler in 1911. However, it was many years before this in 1887 when the German physician
Dr. Emile Kraepelin identified this distinct mental disorder, which he originally called “dementia
praecox” or precocious madness. Bleuler changed the term to schizophrenia as it better
described what was happening in the brain of the individuals since dementia is more of a
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deterioration of the mind, like Alzheimer’s. Kraepelin and Bleuler differentiated schizophrenia
from other psychotic disorders by dividing it into categories based on the “positive” and
“negative” symptoms that were presented (“History of Schizophrenia”).
So what exactly is schizophrenia and how is it identified? The National Institute of
Mental Health (NIMH) identifies it as “a chronic, severe, and disabling brain disorder” where by
those affected by the disorder may hear voices, not make sense when they speak or speak to
those that aren’t there, have the constant feeling of paranoia. People with this mental illness,
approximately 1% of the adult population of America, often have a hard time fitting in social
situations like school, work, or even relationships (“Schizophrenia”). While many people think
those with schizophrenia suffer from split or multiple personality disorder, this is a false
assumption. It is actually a psychotic disorder that causes psychotic episodes causing those that
suffer with the disease to become confused and overwhelmed. The affects of schizophrenia
varies greatly between people, causing some to suffer a lifelong debilitating sickness, while
others may only have a few psychotic episodes letting them lead a somewhat normal life. The
frequencies of these episodes normally run in a cycles known as “relapses” and “remissions.”
There are no cures for schizophrenia, but there are a wide variety of drugs, therapies, and natural
remedies that help control the disorder (“Schizophrenia Guide”).
Schizophrenia is not actually just one disorder, rather it is more of a blanket term that
covers a group of mental disorders that have similar symptoms and behaviors. We will
investigate some of the most common types as listed by the The Mayo Clinic. These include
paranoid schizophrenia, disorganized schizophrenia, schizoid personality disorder, schizotypal
personality disorder, schizoaffective disorder, and childhood schizophrenia. (Mayo Clinic)
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Paranoid schizophrenia is the form of the mental illness most people think of when they
hear the word schizophrenia, and the most misunderstood. This form of the disease causes one
to lose touch with reality often becoming delusional, seeing things that aren’t there, and possibly
causing the sufferer to become suicidal in some cases when symptoms are not managed properly.
Often the patient will hear things that don’t actually exist during a psychotic episode, or may feel
that others are following them, perhaps out to get them in some way. Generally those suffering
from this disorder are not violent people and it does not interfere with one’s memory or daily
functions allowing them lead “normal” lives between relapses (Mayo Clinic).
Disorganized schizophrenia, also known as hebephrenic schizophrenia, is generally
associated by “illogical and incoherent thoughts and behaviors”. People suffering from
disorganized schizophrenia are considered to have a much harder time living a normal life since
they are unable to function in what most people consider a normal way. Things that most people
would consider routine (personal hygiene, eating) are extremely difficult because they may seem
illogical to the sufferer. Also, because they are not able to think in a clear manner,
communication with others can be frustrating since they cannot clearly express themselves
(Mayo Clinic).
Schizoid personality disorder affects the way someone interacts with others in society.
Those suffering from this condition often have trouble developing relationships on a personal
level, and tend to avoid interacting with others in social situations. People that aren’t familiar
with the disease may think the person suffering from schizoid personality disorder is simply a
boring person or just not sociable, often ignoring them. Sadly this is the opposite of what a
person like this desires as they usually have a need for emotional connections, but are confused
on how to meet these desires (Mayo Clinic).
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Similar to schizoid personality disorder, people who suffer from schizotypal personality
disorder have a hard time functioning in normal society because of the way the way they interact
with the public. Usually described as “odd or eccentric” by those around them because of their
odd interactions with other, they suffer from severe anxiety and become withdrawn when put in
unknown or awkward social situations (Mayo Clinic).
Schizoaffective disorder is when a person expresses symptoms of multiple types of
schizophrenia as discussed above combined with a mood disorder like depression. As with the
previous disorders, those with schizoaffective disorders often live outside normal society, facing
many difficulties when it comes to forming relationships or regularly attending work or school,
often depending on support groups to help them. The actual condition of schizoaffective
disorder is still being debated by physicians and psychiatrists on whether or not it is its own
disorder or should be treated as two distinct problems, schizophrenia and mood disorders (Mayo
Clinic).
Most people do not develop the symptoms of schizophrenia until their late teens and into
adulthood, which is why it is often called adult-onset schizophrenia. However, there is a small
population of children, fewer than 1 in 30,000, that are diagnosed each year in America with
child-onset schizophrenia. Much like adult-onset schizophrenia, children suffer from many of
the symptoms including seeing and hearing things that aren’t there, emotional struggles when it
comes to forming relationships, and odd outward behavior in social situations. While it is
completely normal for children to have and play with imaginary friends, children suffering from
schizophrenia will “often experience violent, scary and threatening delusions.” These delusions
often have a negative impact on the development of a child, often causing them to perform
poorly in school and prevent them from developing basic hygiene practices. Schizophrenia in
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children develops differently than in adults since it is more of a progressive disease instead of
sudden psychotic episodes like in adults. Often times the disease is overlooked simply as
behavioral problems or shyness in the child so treatment is delayed until the child totally loses
touch with reality (Drummond).
Since we now know the various forms of schizophrenia can take and some of the effects
we can concentrate on how doctors diagnose those that are affected. In general, men begin
showing possible signs of schizophrenia in the late teens to early twenties while women begin in
the mid-twenties to early thirties. When identifying the symptoms of schizophrenia, they are
usually put into three basic categories: positive, negative, and cognitive (“Schizophrenic
Guide”).
Positive symptoms are those that interfere with one’s normal outward functions, often
causing them to appear abnormal to those around them. These would include things such as
delusions (“beliefs not based in reality and usually involve misinterpretation of perception or
experience”), hallucinations (seeing and/or hearing things that aren’t real such as voices in your
head), and thought disorder (having a hard time speaking in a coherent manner or organizing
internal thoughts) (Mayo Clinic).
Negative symptoms, which often manifest themselves before positive symptoms, are
those that affect one's personal functions. Often these symptoms include the lack of personal
hygiene, loss of interest in social and everyday activities, and a lack of motivation. These
symptoms may be initially be diagnosed as a mood disorder like depression if it is described to
someone without additional information about the medical history of the patient (Mayo Clinic).
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Cognitive symptoms are those that disrupt normal thought processes and the performance
of normal, daily tasks. These include things such as memory problems and the inability to pay
attention and process information that is presented to the patients (Mayo Clinic).
Now that we know some of the most common types of schizophrenia and the effects that
it has on those who suffer from it, we will now investigate some of the possible causes of this
mental disease. Most doctors agree that schizophrenia is caused by a variety of factors, but that
human genes, brain structure and chemistry, and environmental factors are the biggest
contributors to the disease.
The most common theory behind the cause of schizophrenia is related to human genes
since it seems to be an inherited disease. NIMH gives the statistics that even though only 1% of
the American population has a form of the disorder, those who have a direct relationship to
someone (parent or siblings) with schizophrenia the rate is closer to 10%. Those who have an
indirect relationship with someone (aunts, uncles, grandparents) are also prone to developing the,
and twins have a 40 to 65 percent chance if their sibling has been diagnosed with schizophrenia.
Scientists have not been able to isolate any one particular gene that causes the mental illness;
rather it appears to be a combination of several rare genetic mutations that lead to the disruption
of brain development. It is this disruption that prevent crucial brain chemicals from functioning
properly, hindering the development of higher brain skills. Since there are so many possibilities
that may cause this genetic mutation since we inherit genes from both parents, scientists are still
not able to predict which individuals will develop schizophrenia or other mental illnesses
(“Schizophrenia”).
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The National Alliance for Research on Schizophrenia and Depression (NARSAD) cites
the theory that the development of schizophrenia is an imbalance of the brain chemicals
serotonin and dopamine and the actual structure of the brain. These two chemicals are referred
to as neurotransmitters, meaning they carry vital information between nerve cells and control the
way the brain reacts to stimuli from our bodily senses of sight, hearing, taste, and smell.
Because of this imbalance in neurotransmitters those with schizophrenia have a difficult time
processing sensory information received from the environment. Serotonin and dopamine are not
the only neurotransmitters in the brain though, and recently researchers have been examining
how the levels of the chemicals glutamate and gamma-amniobutyric acid (GABA) affect the
development of schizophrenia. Technology has also given researchers a new way to image the
brain so they can find any imperfections that may lead to the development of schizophrenia. One
of these imperfections that scientists have taken note of is the reduced number of synapses in the
brain of those who suffer from the disease. This reduced number of nerve cell connections,
while not responsible for schizophrenia, does contribute to the problem when there is an
imbalance of the chemical neurotransmitters (“Schizophrenia”).
Researchers are also interested in the effects that the “environment” has in the
development of schizophrenia. The environment in this case represents any outside factors that
someone is exposed to, and not any natural occurring body functions. For example, studies have
shown that those born during the winter months of the northern hemisphere may have a higher
likelihood of developing schizophrenia. Another factor that can influence one’s development of
a mental disorder is where they are raised. There is some recent evidence that someone raised in
an urban environment has a larger chance of developing schizophrenia as opposed to people who
are brought up in a more rural area (Leask).
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Substance abuse is one of these environmental factors that is of great interest to doctors.
Alcoholism is more prevalent in those that have schizophrenia, as is nicotine and marijuana
misuse, though the question is whether these substances aggravate the symptoms that are already
present and simply bring them to the surface, or if it is because of the disease that people misuse
these substances. It is difficult to answer this question since drugs themselves can cause
temporary psychotic episodes causing hallucinations that may worsen the delusions that a
schizophrenic may already have (Leask).
A second environmental situation that is of interest to physicians is the uterus, and the
environment the mother is in during pregnancy. One of the most interesting theories is that the
child of a woman who had influenza during the second trimester of pregnancy is more likely to
develop schizophrenia, according to Dr. Machon Mednick in 1988. Besides influenza, there is
also a belief that a range of viruses can also contribute to the development of different mental
disorders. The questions doctors face when trying to link these two components together is
whether it is the virus itself that causes the mental illness, or perhaps it’s the interaction of
prescription drugs, or even the mother’s own immune system, that cause a reaction in the brain
of the fetus. Other studies have shown that stress on the mother herself, such as depression or
malnutrition, late in the pregnancy may also have an effect on the child (Leask).
The treatment of schizophrenia is designed to help control an individual’s psychotic
episodes and improve their social interactions and involves the use of antipsychotic medicines,
therapies, and alternative/natural remedies. The use of medicine to treat schizophrenia is
normally a two step process, one called the acute phase and the second being the maintenance
phase. The first process involves giving the patient a higher than normal dose of medication in
order to control any current schizophrenic symptoms. Once the initial problem has been
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controlled, the dosage amount is slowly lowered to the point so that the medicine can continue to
be taken safely but prevent new psychotic episodes. The use of medication in this way is highly
effective since the drugs can be temporarily increased if there is a chance of a relapse to prevent
it from happening. One of the largest problems when it comes to medicating individuals with
schizophrenia is the fact that since paranoia is one of the main symptoms often times the person
will discontinue the medication thinking that it is affecting them negatively. These types of
patients need a regulated treatment plan developed for them so that they can be closely
monitored if they hope to get better (“Schizophrenia Guide”).
Initially developed as an anti-histamine, the antipsychotic drug chlorpromazine (marketed
as Thorazine in the US) was first used to treat the positive symptoms of schizophrenia in the
1950’s. This neuroleptic drug, along with others that had been formulated, were found not to be
very effective in treating the negative symptoms of schizophrenia, such as loss of motivation. In
the late 1980’s a new group of drugs called “atypical antipsychotics” were introduced that
produced fewer side effects than the previous drugs. The newest class of drugs available for the
treatment of mental disorders have managed to solve the neurological side effects found in
previous drugs, though there is evidence that shows it effects a person’s white blood cell count
and also do not become effective until several weeks after the first dosage (“Schizophrenia
Guide”).
In conjunction with drug treatment, people suffering from schizophrenia also need some
form of therapy, as this will help develop some of the skills lost to the negative symptoms related
to the lack of social skills. One of the most effective types of therapy available is individual
psychotherapy sessions since it allows the patient to interact with a doctor on a personal level.
During these sessions a variety of problems can be addressed helping the individual come to
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grips with what is and isn’t based in reality. Besides individual therapy sessions, patients can
also benefit from rehabilitation clinics where they can work on a wide variety of social, personal,
and work skills that were not developed or were lost due to the disease. These clinics also offer
group therapy sessions so they can begin to interact in more social situations and discuss with
others about what is going on since they are also suffering from similar symptoms
(“Schizophrenia Guide”).
The third and most controversial therapy in use today for the treatment of mental
disorders is called electroconvulsive therapy, or ECT. During an ECT treatment, the patient is
given anesthesia and a muscle relaxer before an electric stimulus is applied briefly to the brain.
This electric stimulus creates a small seizure which seems to help several of the symptoms of
schizophrenia. The effectiveness of the treatment is argued between researchers, debating if the
pros of such a treatment outweigh the side effects, and why this procedure even works. The
controversy grows even more since patients who undergo ECT seem to have more relapses even
though some cases show an 80% improvement in symptoms after treatment. The maximum
benefits of this treatment come when the patient is diagnosed correctly and is properly
administrated by qualified health officials (Electroconvulsive Therapy).
Recently there has been a lot of studies and research into using natural treatments and
alternative medicines to help those that suffer from schizophrenia in hopes that the reliance of
medications can be lessened. “Animal-assisted Therapy” is the use of pets, such as cats and
dogs, as an effective way to treat some of the negative symptoms of schizophrenia. Having a
well trained animal helps the patient learn everyday responsibility, and provides a companion for
them since they are so often withdrawn from social situations. Music therapy is also becoming a
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great outlet as it assist the patient with cognitive skills, as well as a way to work on personal and
communication skills (“Complementary”).
There has also been a lot of advancement recently in the treating of schizophrenia with
more natural remedies. A recent study shows that using high quality fish oil pills can help teens
that suffer from psychotic episodes. It appears that the omega-3 fatty acids in the capsules is the
key as it has been shown that those with schizophrenia are often lacking this particular chemical
used pass signals in the brain. Another one of the benefits of fish oil is the lack of neurological
and physical side effect in patients. (DeNoon). The use of Asian ginseng has also been used
recently to treat some of the negative symptoms schizophrenia, including lack of motivation.
The effect of ginseng on the brain is similar to that of anti-psychotic medicines, without the
negative side effects (Laino). Another one of the benefits of fish oil is the lack of neurological
and physical side effect in patients.
Schizophrenia is a very complex disease of the mind, causing those that suffer from it
great mental anguish. Even though this mental disorder affects a relatively small segment of the
population, it is important to understand the disease so that we better understand those that suffer
from it, instead of just stereotyping them as crazy, odd, or anti-social. The advancement of
technology and understanding has led and will continue to lead to a better understanding of the
mental illness and new ways to treat those who have it so that they may also lead a normal life.
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Works Cited
“Complementary Schizophrenia Treatments.” Schizophrenia.com. The Internet Mental Health
Initiative, 2010. Web. 30 Oct. 2010.
DeNoon, Daniel. “Fish Oil May Fight Psychosis.” Schizophrenia Health Center. WebMD, 2010.
Web. 21 Oct. 2010.
Drummond, Katie. “Schizophrenia Takes Major Toll on Children.” AOL Health News. AOL Inc,
2010. Web. 17 Oct. 2010.
“Electroconvulsive Therapy (ECT).” Mental Health America. National Mental Health
Association, 2010. Web. 20 Oct. 2010.
“History of Schizophrenia.” Schizophrenia.com. The Internet Mental Health Initiative, 2010.
Web. 30 Oct. 2010.
Laino, Charlene. “Ginseng May Help Schizophrenia.” Schizophrenia Health Center. WebMD,
2008. Web. 21 Oct. 2010.
Leask, Stuart. “Environmental Influences in Schizophrenia: The Known and the Unknown.”
Advances in Psychiatric Treatment. The Royal College of Psychiatrists, 2004. Web. 24
Oct. 2010.
Mayo Clinic Staff. Schizophrenia. MayoClinic.com, 2010. Web. 15 Oct. 2010.
“Schizophrenia.” Encyclopedia Britannica. Encyclopedia Britannica Online, 2010. Web. 24
Oct. 2010.
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“Schizophrenia.” NARSD. National Alliance for Research on Schizophrenia and Depression,
2010. Web. 17 Oct. 2010.
“Schizophrenia.” National Institute of Mental Health. U.S. Department of Health and Human
Services, 2009. Web. 15 Oct. 2010.
“Schizophrenia Guide.” Schizophrenia Health Center. WebMD, 2010. Web. 21 Oct. 2010.
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