Schizophrenia is a disorder, shrouded in myths and overgrown with “accurate” life symptoms. But the reality is that no one can exactly answer the question of what schizophrenia is and what its typical characteristics are. Today we will talk about this disease from the point of view of practice and academic psychology.

Schizophrenia is not just a disorder or a specific disease, but a multi-component disorder (or even a group of disorders), expressed in the breakdown of thinking, the pathological change of emotions and the breakdown of personality.

Schizophrenia is a severe mental illness that is found in vivid emotional disorders, inadequate behavior, and the destruction of sequential and normal mental activity. Because of this, social disadaptation sets in, a person loses the ability to exist in society and lead a social life. In men, the disease makes its debut at the age of 18-25 years, when at women it is a longer period: from 26 to 45 years. There is indirect evidence that suggests the possibility of inheritance of the disease.

The frequency of occurrence does not depend on gender, race, social status. Approximately every 100th person is potentially (or de facto) the carrier of this diagnosis.

Erroneously schizophrenia may be called personality disorder (outdated. - Psychopathy). However, unlike psychopathy, schizophrenia leads a person to a violation of the perception of reality, which is reflected in inappropriate behavior and anomalousness of emotional manifestations.

People with schizophrenia also often hear “voices”, which accordingly change their behavior. They lose the opportunity to work and keep in touch with people, even close relatives.

Without the necessary treatment, schizophrenics can descend to the "bottom" of life, cause serious harm to themselves or others. Approximately every tenth patient commits suicide.

Causes and symptoms of the disease

There is no exact data on the causes of this disorder.

However, it is known that genetic predisposition makes some contribution to the development of schizophrenia. In addition, the risk of the disease increases in people who have been in contact with a person with schizophrenia for a long time. This effect is called induced mental disorder (from fr. Folie à deux) and responds well to treatment.

For the emergence of "insanity together" a necessary condition is a close emotional relationship between the really sick and the person "infected." Dividing people, immediately found out really sick.

There is also evidence that prolonged stress, a serious loss or shock become the trigger for the development of the disease in people with a predisposition to it.

There is indirect evidence of the connection of schizophrenia with pathologies of the brain, but this is a separate issue and we will omit it.

Most often, schizophrenia develops gradually and begins with the loss of vitality by a person, which results in a loss of interest. If the trigger for schizophrenia was stress, then a big picture of the symptoms immediately takes place.

Sometimes, the course of schizophrenia is episodic in nature: acute psychotic states with delusions and a characteristic picture alternate with “bright” periods when the disease is absent in principle.

However, more often the course of schizophrenia is more or less constant.

The basic symptoms of schizophrenia include:

  • auditory hallucinations (voices, noises, sounds);
  • delusions of impact (it seems to the patient that someone is “controlling” them: the CIA, Martians, or ancestral spirits) and other forms of delusions
  • delusions of grandeur (and all its forms);
  • the mystification of simple events and objects (for example, the salt shaker for the patient has a sacred meaning);
  • pathological emotions (the patient is happy to hear about the death of his child, or gets depressed after learning about pleasant events);
  • pathologies of thinking and incoherent speech (leap of thoughts, resonance, pseudological thinking);
  • reducing the level of criticality (there is no reaction to praise and criticism, nothing changes);
  • anxiety and agitation.

A schizophrenic patient often looks deeply immersed in himself. At some point, a schizophrenic may lose interest in himself, which is manifested in negligence, lack of interest in his condition and appearance — social isolation is growing.

Some subspecies of the disease

In classifications, 3 or more types of diseases are distinguished, however, we will consider modern classifications of DSM and ICD (classification of diseases).

Hebephrenic schizophrenia

It stands out as a separate type because the symptoms are expressed in the excessive childishness of the patient, incredible foolishness, and a few feigned nonsense.

Predisposed to this form, most often, shy and lonely people.

Hebefrenia debuts in the range of 15-25 years.

Symptoms of this form:

  • foolishness;
  • persistent and inadequate mood;
  • stiffness and mannerism;
  • interspersing delusions;
  • occasional hallucinations;
  • mood swings;
  • malice and aggressive impulsiveness.

Sometimes ridiculous complaints about their physical health are found.

Unlike simple infantilism, hebephrenia is found in constant obscene and ridiculous behavior, given the groundlessness of emotional reactions and the senselessness of actions. Emotional reactions are flat, they are characterized by:

  1. giggles;
  2. grimaces and pranks;
  3. complacency and ceremonial manners.
Such patients are never serious.

Perhaps a superficial fascination with the philosophical sciences and various theories, religion. Deep knowledge is not found, much resonate. Over time, the disease progresses, patients become apathetic, lose interest in everything, and emotional reactions become extremely flattened.

Catatonic schizophrenia

A rare type of disease, occurs ~ 3% of cases from all patients and is characterized by strong psychomotor disorders.

The alternation of the stuporous state with extreme agitation is two typical signs of this form.

Catatonic stupor is expressed in the fact that the patient can be in one position for several days, even if physically uncomfortable. There is no reaction to the outside world. Often, patients in a stupor experience the oneiric syndrome — extensive hallucinations of fantastic scale and content, where they are the main characters. Voice contact in this state is not possible.

The phenomenon of waxy flexibility (aka “mental cushion” syndrome) is found: raising the patient's head, it will remain in the same position, lying on the “cushion”.

A bright negativism is found - resistance to external stimuli, even pleasant ones. There are three types:

  1. passive - ignoring and resisting (for example, when trying to feed);
  2. active - doing something else;
  3. paradoxical - performs the exact opposite action.

There are other psychomotor symptoms.

Residual schizophrenia

Chronic form, which reveals a bright schizophrenic defect after a psychotic episode for about a year. There are no bright psychotic symptoms during this form. Hallucinations, delusions, catatonic disorders are almost not detected, and there is no their emotional support.

Emotional dullness and social isolation are typical for this form.

The behavior of such patients is “unusual” and demonstrative, which does not coincide with the norms of society: conversations with oneself surrounded by people, untidiness, a tendency to vagrancy and drug addiction. Often there are delusional beliefs, such as superstition, belief in telekinesis and telepathy, etc.

It occurs in 3% of schizophrenics in remission. The features of this form are:

  1. mental weakness;
  2. fatigue;
  3. passivity;
  4. vulnerability;
  5. uncertainty.

Treatment of the disease

To return at least partial organization of mental processes and life, antipsychotic drugs are prescribed. In order to stop the bright manifestations of schizophrenia (delirium, fear, derealization) it takes 3-4 weeks to take potent substances. However, many substances from the antipsychotic class can have serious side effects: from tremor and obesity, to endocrine metabolism disorders and heart problems.

To minimize side effects, each drug is selected on the basis of analyzes individually. The same applies to the timing of taking into account the dosage of the substance.

Potentially dangerous patients are hospitalized in psychiatric clinics, but many are being treated at home. In the latter case, they need constant care, strict adherence to the medication schedule and a calm, safe for the patient atmosphere in the family. Patients need to be fenced off from stressful situations, since they can, with new force and new symptoms, “revive” the pathological symptoms. Constant contact with psychological services workers is also necessary to monitor the condition.

During the active phase of drug treatment, the patient’s relatives benefit from the advisory therapy, which conditionally teaches them to live in a new disease situation.

According to the decline of the psychopathological symptoms, psychotherapy is also prescribed to the person himself. The task of this stage is to track relatives of the relapse of the disease and timely contact specialized institutions.

Forecasts

Unfortunately, schizophrenia is a chronic disease. And yet, in approximately 1/5 of cases for unknown reasons, there comes a sharp moment of improvement and partial normalization of life.

However, the majority of patients live according to a “schedule”: from a light period of almost normal life to an acute psychotic attack with hospitalization. The use of modern medications does little to improve the prognosis, removing the dangerous symptoms. Medicines, however, are directed at the symptoms, and not at the causes of the disease, about which nothing is known for certain.

The most unfavorable and sadly irreversible prognosis is found in people whose disease has developed since adolescence.

And, probably, the most necessary in at least partially overcoming the disease is unprincipled care for the patient and social support in order to support at least a small level of social activity of the patient.

Psychologist Borisov, O. B.

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