Schizophrenia is an intricate, chronic mental health ailment with many symptoms, including delusions, hallucinations, disorganized speech or behavior, and diminished cognitive ability. Often the disease develops in individuals in their late adolescence or early adulthood. The manifestation of the disease in its early stages and its persistent course impair infirmity for most affected victims and their families. Several disabilities exhibiting schizophrenia often occur from negative symptoms and mental disconnection, such as attention and working memory impairments. Additionally, relapse comes about due to positive symptoms such as suspiciousness, delusions, and hallucinations. Individuals who have schizophrenia may sometimes hear sounds or voices, which makes them highly paranoid, believing they possess some unusual powers or maybe a person is controlling their thoughts or thinking that some world events link to them. Diagnosis for schizophrenia can be challenging, and families of the victims are always in denial; nevertheless, it is a devastating and heart-breaking diagnosis to comprehend.
Types of Schizophrenia
There are five types of schizophrenia classified based on distinct symptoms and manifestations exhibited by the assessed individuals. These types include:
Paranoid Schizophrenia
Paranoid-type schizophrenia is characterized by paranoid behaviors such as delusions, auditory dysfunctions, and hallucinations. The paranoid behaviors manifest by emotions of persecution, being watched or scrutinized; most times, these behaviors link with a celebrated or renowned figure such as a politician, musician, or corporation. In addition, individuals who have paranoid-type schizophrenia may exhibit anger, be anxious, or become hostile. However, these persons often have adequate intellectual propriety, functioning, and expressions.
Disorganized Schizophrenia
Persons suffering from disorganized-type schizophrenia display behaviors that are distinctly out of order or speeches that are disconnected and challenging to understand. Additionally, they may exhibit unfitting emotions or feelings that are not relative to situations at the time. These may well affect their daily activities, including hygiene, how they take meals and disrupted work plans, and sometimes negligence attributed to their disconnected and disorganized thought patterns.
Catatonic Schizophrenia
Disruptions of movement characterize Catatonic-type schizophrenia. Individuals suffering from this type of schizophrenia are varied based on extremes, some may become immobile, and others may be all over and about the place. Another characteristic of this type is that patients may become quiet for hours or repeat everything another person says or does. These behavioral attributes caused by this type of schizophrenia may put these patients in compromising situations since they often cannot care for themselves or finish daily activities.
Undifferentiated Schizophrenia
This type of schizophrenia occurs when an individual displays behaviors that fit symptomatic descriptions of two or more other types of schizophrenia. For example, some symptoms exhibited in undifferentiated schizophrenia include delusions, hallucinations, impaired speech, and disorganized and catatonic behaviors.
Residual Schizophrenia
Individuals detailed to have past episodes of schizophrenia, however, in the present day do not exhibit symptoms characterizing the disease, such as delusions, hallucinations, and disorderliness in speech and behavior, and are attributed to be suffering from residual-type schizophrenia. Such persons may be in total remission or resume the disease’s characteristic symptoms later.
Diagnosis
As mentioned earlier, schizophrenia is a complicated and persistent disorder with several nonpathogenic symptoms. Diagnosis for schizophrenia is by examining the patient exhibiting signs and symptoms, as demonstrated in the Diagnostic and Statistical Manual of Mental Disorders. Firstly, diagnosis for schizophrenia is performed by ruling out any other underlying medical issues or disorders that may cause behavior changes. Additionally, it is performed by examination of the occurrence of characteristic symptoms of the condition. The medical practitioner attending to the patient will perform tests to affirm the presence of delusion, hallucination, speech impairment, and behavior. Another element the doctor assesses is social withdrawal and disruptions at work in the patient’s daily activities for at least six months. The physician may employ physical assessment, psychological examination, lab tests, and CT scans to assemble and generate a general picture of the patient’s condition. Thus, mental health screening and assessment is a critical aspect of the diagnosis procedure for schizophrenia.
Nevertheless, diagnosis for schizophrenia is usually challenging since other mental disorders like bipolar, schizoaffective disorder, depression, and substance abuse often imitate symptomatic manifestations of schizophrenia. Therefore, the medical practitioner performing diagnosis must first rule out any symptoms displayed by other medical conditions. Proficient examination of the illness’s duration, the timing of delusions and hallucinations, and the intensity of depressive or manic manifestations can effectively distinguish this.
Treatment Options
Nonpharmacological Therapy
The objective and aim of treating schizophrenia entail targeting the disease symptoms, minimizing the chances of a relapse, and elevating adaptive functioning so that the affected individuals can merge back into society. In rare circumstances, patients return to their baseline level of adaptive functioning; nonpharmacological and pharmacological must optimally utilize treatment models for periodic results. Therefore, nonpharmacological treatment models such as psychotherapy are essential. Psychotherapy is a gradually developing therapeutic field. Emanating psychotherapies incorporate meta-cognitive training, narrative therapy, and mindfulness therapies. Nonpharmacological treatments are used as additional treatment forms to treat schizophrenia but never substituted since these models of treatment aid in ensuring patients stay adherent to their medications.
Pharmacological Therapy
In most schizophrenia patients, it is challenging to execute practical and working rehabilitation programs without antipsychotic agents. Therefore, the timely institution of drug treatment is crucial, most notably within the first five years after an acute episode appears since many illness-related variations in the brain occur. Therefore, in an acute psychotic episode, drug therapy should be administered as soon as possible. In the first few days of treatment, the main objective is diminishing hostility and returning the patient to normal functioning, such as having enough sleep and taking meals at stipulated hours. Therefore, titrating the dosage at the beginning of the first treatment phase is essential based on the patient’s response. The treatment precedes maintenance therapy, which aims to improve socialization, care for oneself, and build a more excellent mood.
Coordinated Specialty Care
It entails a team-effort approach toward offering treatment when the first acute episode appears. It involves the combination of medicine and therapy with social services as well as educational interventions.
Hospitalization
Several individuals who have schizophrenia may receive treatment as outpatients. However, hospitalization appears to be the best option for multiple schizophrenic individuals with extreme symptoms, severe hostility, and those unable to take care of one-self. It also entails Psychoeducation, which helps patients and those around them understand the disorder, thus enabling them to help the patient manage it.
Electroconvulsive Therapy (ECT)
During this process, electrodes are placed on the patient’s scalp then the doctors send tiny electric shocks to the brain. Every shock treatment leads to a formation of controlled seizures. Following a series of these treatment modules over a defined period causes massive improvements in the patient’s mood and cognitive ability. Nevertheless, the treatment model is not fully approved in helping schizophrenia other than depression and Bipolar disorder; thus, not utilized occasionally when mood symptoms disappear.
Research
Multiple research works, and studies are in progress to find formidable treatment options for schizophrenia. For instance, researchers are currently reviewing the deep brain stimulation (DBS) treatment option mainly utilized in treating Parkinson’s disease and essential tremors through experimental tests to treat psychiatric disorders. This treatment option involves implanting electrodes into a schizophrenic patient’s brain surgically to help stimulate specific brain segments that control thinking and perception.
Drugs
There are multiple drugs utilized in the treatment of schizophrenia. Some antipsychotic medications include Chlorpromazine (Thorazine), Oxilapine, Perphenazine, and Haloperidol. Some new drugs for treating schizophrenia include Aripiprazole, Asenapine, Cariprazine, Clozapine, etc. Medications are for initial control of the symptoms, and once the symptoms are under control, one would need maintenance therapy to not relapse.
