Mental disorders

Schizophrenia - symptoms, signs, treatment, forms of schizophrenia

Schizophrenia is a psychotic disorderPersonality or group of disorders, which is associated with the disintegration of mental processes and emotional reactions. For personality disorders, fundamental disorders in thinking, perception, reduced or inadequate affect are characteristic. And auditory hallucinations, fantastic, paranoid nonsense, disorganized speech, thinking and disability are the most frequent manifestations of the disease. The incidence of the disease, which is the same for men and women, however, women tend to late in age.
The disease of schizophrenia has a diverseSymptomatology, which in turn was the origin of debates about a single disease or a complex of individual syndromes. The very etymology of the word, which includes the understanding of the cleavage of the mind, causes confusion, because the disease is considered a split personality.

Schizophrenia Causes

Why does schizophrenia arise? This question interests concerned people to their health, having such deviations in the family. There is an opinion that schizophrenia is inherited. The genetic cause of schizophrenia lies in the group of genes that need to evolve in a certain way for the emergence of a predisposition to the disease. However, there are other supporters who refute the version of heredity. Suffice it to recall the facts from the history associated with Hitler, when he destroyed, because of "bad heredity", and castrated all schizophrenics, but this did not stop the disease and in a few generations everything returned in percentage to the previous level.
Social problems (divorce, unemployment,Homelessness, poverty) also provoke repeated episodes of the disease. Among patients with schizophrenia, the risk of suicide is increased, and health problems shorten the life expectancy of patients.
The causes of schizophrenia remain not fully understood, but the disease has many hypotheses about the alleged causes of origin.
Schizophrenia and drugs also have much in common. Chemicals that enhance dopaminergic activity (cocaine and amphetamines) produce symptoms that are difficult to distinguish from manifestations of schizophrenia. There is evidence that in some people some drugs cause schizophrenia or provoke another attack. However, it is suggested that patients with schizophrenia use psychoactive substances in a desire to prevent negative feelings that arise due to the action of antipsychotics or are caused by symptoms of the disease (negative emotions,
, Paranoia,
, Stress). Since these disorders all lower the level of dopamine, patients seek to improve the condition by taking alcohol, drugs that stimulate the release of dopamine.
And the most popular at the moment isDopamine theory of the origin of schizophrenia. This theory suggests that individual symptoms of schizophrenia (mania, hallucinations, delusions) are associated with an elevated as well as a prolonged level of dopamine in the mesolimbic brain, and other symptoms of schizophrenia are attributed to a decreased level of dopamine. In healthy people, the level of dopamine is within normal limits, which means that it is not overestimated or understated.
An interesting dependence of risk of developmentSchizophrenia from seasonality. Those born in winter, as well as in the spring, the probability of the disease is higher. There is evidence that antenatal (prenatal) infections increase the risk of developing schizophrenia.

Schizophrenia Symptoms

Symptoms of the disease are very diverse. The Western Psychiatric School marks symptoms of disease of the 1st and 2nd rank. The pictures show the progressive symptoms of a schizophrenic patient. The initial drawings of the cat were created at the very beginning of the disease, and then there are mosaic, split pictures, where the integrity is lost and the cat is barely caught. The last drawings were made at the height of the disease.

Cat with schizophrenic eyes at different stages of the disease

Symptoms of schizophrenia of the first rank areAudibility of voices, sounding of thoughts, sensations of physical influence, theft of thoughts, deluded thinking, delusional perception. Symptoms of schizophrenia of the second rank are prolonged hallucinations, loss of vital interests, confusion.
How is schizophrenia manifested? The disease of schizophrenia is a common mental disorder affecting the functions of behavior and consciousness, as well as thinking processes. Symptoms of schizophrenia are divided into productive (positive) and negative. Negative symptoms are understood as the loss of previously existing signs characteristic of a given person, as well as the reduction of the energy potential, including such states as alology, anhedonia,
,
,
And flattening out the emotional response. Positive symptoms are manifestations of new signs, expressed in delirium, mania, hallucinations. It happens that the positive symptoms - delirium or hallucinations in the disease may not be. Much worse manifestation of negative symptoms - the weakening of intellectual, emotional, volitional functions. Delirium and hallucinations are only the upper layer, and at the level of emotions, splitting occurs.
The opinion of psychotherapists regarding the voices inThe head of schizophrenics is: the voices that patients hear are what is called pseudo hallucinations, which are characterized by sound in the inner, some space or inside the head. This discovery belongs to a psychiatrist suffering from schizophrenia. The logic of votes is always very doubtful, but behind the voices is a serious emotional upset. These voices are directly related to fear, with a peculiar crumbling sense of peace, with unbearable suffering that persecute a person and prevent him from living. These voices are able to express experiences, reflect personal problems, traumas, conflicts. But these experiences are inverted and imbued with the schism. These voices are built into all the circumstances of a person's life, however, psychological problems are not their cause.
Schizophrenia and love are often an exciting topic forThe closest associates of the ill. Are able to experience a sense of love schizophrenics, or all the emotions so much they are greatly dulled, that they are not destined to understand, and the world of spiritual, as well as sensual pleasures begins and ends on the intima. Research in this area suggests that a good potency pushes schizophrenics toward a rapprochement with the opposite sex and men often use the services of easily accessible women.
There is also another opinion that people suffering fromOn schizophrenia, experience such a gamut of feelings, which constantly boils, rages, causing doubts, fears and experiences in the soul of the patient. Often, women are more prone to fears, feelings, psychoses than men. Associate this with inability to relax, hormonal leaps.
Simultaneously with the feeling of love and the associatedWell-being (plans for a wedding, moving to a loved one), the schizophrenic feels confusion, fear, panic. Such an extreme of feelings from one state to another knocks the patient out of the rut. To forget the sick person sits down to take alcohol. A schizophrenic patient does not know how to save love and build family relationships correctly. He has thoughts that prevent him from being happy. They are persecuted by the conviction that grief, misfortune, suffering is a payment for the fact that he was once happy. Therefore, patients are convinced that schizophrenia and love for them are incompatible.

Schizophrenia signs

All signs of schizophrenia characterize the international classification of diseases of the 10th revision (ICD-10). To diagnose a disease, it is important that at least one of these signs is noted.
The classification of ICD10 identifies such featuresSchizophrenia: the sounding of one's own thoughts (the echo of thoughts), the openness of thoughts to others, the withdrawal or investing of thoughts; Delusion of influence, mastery or passivity, which clearly refers to the limbs or body, actions, thoughts or sensations; Delusional perception; Hallucinatory voices that comment or discuss the behavior of the ill person or other types of voices coming from different parts of the body; The stability of inadequate delusions, manifested in absurdity or grandiosity in content.
Or two of the proposedA sign is: a broken speech, neologisms, sperrungs, persistent hallucinations with not completely formed or labile delirium, but without pronounced affect; Persistent, overvalued obsessions, catatonic disorders (waxy flexibility, excitement, mutism, congealing, negativism, stupor); Consistent and credible changes in the overall quality of behavior that manifest themselves in the loss of interests, aimlessness, and absorption in one's own experiences; Social autism; Depression, apathy, poverty, social isolation, inadequate emotional reactions, social unproductive. It is very important to diagnose schizophrenia so that symptoms persist for up to one month.

Forms of Schizophrenia

The disease can have various forms. The classification is presented by psychiatrist Schneider, who identified the main forms of psychotic symptoms that distinguish schizophrenia from other diseases. These are symptoms of the first rank: delirium of influence from outside forces; Voices that give comments to the thoughts and actions of a person or talk among themselves; Sounding their own thoughts and the full feeling that thoughts are made available to other people.
Countries of the West subdivide schizophrenia into simple, disorganized catatonic, paranoid and residual. ICD identifies two more subtypes: post-schizophrenic depression and simple schizophrenia.

Diagnosis of schizophrenia

Diagnosis of the disease is established on the basis ofAnalysis of patient complaints, as well as his behavior. This includes the story of the patient and his experiences, as well as possible additions to relatives, colleagues, friends. Next comes the clinical evaluation of the patient by a psychiatrist, a clinical psychologist.
Psychiatric evaluation usually includes analysisMental status, as well as the drafting of a psychiatric history. Standard diagnostic criteria indicate the presence of certain signs, as well as symptoms, their duration and severity. At present, there is no laboratory test to establish a diagnosis of schizophrenia.
Diagnosis of schizophrenia is successfully carried out according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), as well as ICD-10. ICD is usually used in European countries, and DSM in the United States.

Treatment of schizophrenia

Treatment of schizophrenia depends on the severity of the disease. Base drugs include neuroleptics, and they are supplemented with nootropics, vitamins, mood stabilizers. If there are difficulties at the initial stage of treatment and the patient refuses to see a doctor, go to the hospital, the psychiatrist is called to the house. This will be the right decision.
Victory over schizophrenia is simply not given. Patients with schizophrenia have a history of comorbid disorders. These include depression,
, Addiction, anhedonia, so treatment is directed to these disorders.
Is disability given in schizophrenia?
Schizophrenia often leads to disability inCommunication with this removal of the diagnosis of schizophrenia becomes impossible. However, if there is persistent remission within a year, there are no grounds for dispensary observation. Clinical supervision is established over those who are often in such a state that they are not able to adequately assess the environment, and also understand the consequences of their actions, can not assess the personal state of mental health and in this connection understand the importance of treatment.
The removal of the diagnosis of schizophrenia and dispensaryObservations can take place, however - this is a very big rarity. This happens if the diagnosis was initially incorrect, for example, the symptoms of reactive depression, psychosis were taken for schizophrenia, or a timely successful treatment of schizophrenia for the removal of initial symptoms. Usually, the patient receives counseling and treatment a year, after which the dispensary observation is removed from him. At present there is no compulsory consultative accounting or consultative supervision. Consultative and curative care is understood as a voluntary visit to a doctor or not a visit. This is the patient's personal matter and his choice. The mental state of a person will make a sensible decision himself, what he needs. Consultative and curative care includes voluntariness. If the patient has come to a psychiatrist, and therefore agreed to a diagnosis, he will get a card, identify a mental disorder, and this will mean that he applied for medical advice. Further, outpatient cards are deposited in the archive at the beginning of the year, if in the previous year the sick person no longer came.
Sometimes by "accounting" people understand storageInformation on available facts of treatment. Psychiatry, like all medicine is no exception. Surgery also stores information about all operated patients. There are rules of archival storage. The day hospital records the history of the disease for 50 years, and the outpatient card is 25 years old. This applies to everyone, including those who have ceased to apply for medical advice.
The course of the disease reveals the diversity andHas no inevitable chronic development, as well as a progressive increase in the defect. The generally accepted view of schizophrenia as a progressive disease for today is refuted by specialists. Individual cases have complete recovery or almost complete recovery. Factors conducive to a more favorable course of the disease are female sex, a greater age of the first episode, a predominance of positive symptoms, support from relatives and friends.
Severe variant of the disease course represents a riskBoth for the patient and for others. It may not be necessary to voluntary hospitalization, but in Western Europe, the timing and frequency of stay in the clinic has decreased significantly in comparison with earlier times, while in Russia everything remained at the same level and the situation did not change significantly.
Relatives are interested in how to communicate, ifDiagnosed with schizophrenia. Do not take the patient as a dangerous and not controlling their emotions, actions. It is necessary to maintain healthy parts of the personality, while not treating him like a madman. The psychotherapist also communicates with the patient, as with a healthy person. Patients with schizophrenia just need a lot more attention, more care, more love. And this is a very important point. Statistics have data that patients with a favorable climate at home, less likely to have repeated episodes with clinic hits, their lives are much more successful.

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