Schizophrenia is mental illness with a genetic basis and its complexity is presents in form of chronic psychosis and the cognitive ability of the individual becomes impaired. The definitive cause of schizophrenia is not established yet. However, various contributors including genetics, malfunctions in the brain, and environmental factors have been cited as possible causes. Schizophrenia develops over three stages with the first being the onset stage, followed by the prodromal stage and the first psychotic episode is the third stage (Rubin, Springer and Trawver, 2010). This progression of schizophrenia is characterized by various symptoms.
Schizophrenia presents in several ways and its symptoms are grouped as either positive symptoms or negative symptoms. Positive symptoms are the symptoms that are clearly psychotic. These include delusions- unfounded beliefs, hallucinations- these can be audio, visual or even feeling whose basis is unfounded. Disorganized speech and behavior is also considered as psychotic symptoms of schizophrenia. Finally, catatonic behaviors are also considered as a positive symptom of schizophrenia. The negative symptoms of this illness are those symptoms which have less likelihood of having psychotic presentations. These include decreased or even complete lack of motivation, inhibited facial expression and failed speech (Dyren-Edwards & Stoppler, n.d.).
The diagnosis of schizophrenia is done using the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria which requires that at least two among five symptoms recognized by DSM-IV be present. When focusing on the symptoms, a positive diagnosis of this illness is confirmed if at least two of the positive or negative symptoms persist for at least one month. The positive symptoms include hallucinations, catatonic behavior, disorganized speech as well as delusions. Among the negative symptoms include avolition, alogia and affective flattening (Beck, Rector & Stolar, 2009). The social dysfunction aspect of diagnosis requires that at least one of the various social areas of the patient be affected in a significant way from the time the onset of the illness. These social areas include work, academics, self-care and interpersonal among others. While diagnosing schizophrenia using duration as an indicator, DSM-IV requires that psychosis symptoms be present continuously if there is no treatment and the active symptoms (positive and negative) should be present for not less than six months. An important focus when diagnosing schizophrenia focuses on excluding other conditions that have psychiatric symptoms. Such disorders include dementia, head injury, stroke or major depression among others (Rubin, Springer and Trawver, 2010).
Possible treatment considerations
Schizophrenia can be treated using tow approaches-medication approach and psychosocial intervention. It is well recognized that medication is the most effective treatment for schizophrenia as they usually address the psychotic (positive) symptoms. Among the first antipsychotics used to treat schizophrenia include phenothiazine. Some generation antipsychotics, which work better than most antipsychotics, for schizophrenia include olanzapine, aripiprazole and risperidone (Dyren-Edwards & Stoppler, n.d.). Other older medications (first generation) include molindone, haloperidol and perphenazine. Some other medications are recommended since they act as mood stabilizers especially in persons who have mood disorders co-occurring with psychotic symptoms. Such drugs include lithium, lamotrigine and divalproex. If depression accompanies schizophrenia, it is advisable to administer anti-depressants such as fluoxetine, citaprolam and bupropion among others (Dyren-Edwards & Stoppler, n.d.). It is sometimes advisable to have electroconvulsive therapy as a treatment for persons who show little or no improvement even after both drug and psychosocial treatment.
Psychosocial treatments are also viable in schizophrenia. These are usually supportive interventions as provided by the family, community and work place environments. As such, psychosocial interventions include family psycho-education, assertive community treatment, social skill training, cognitive behavioral therapy, supported employment and substance abuse treatment when substance abuse is involved (Dyren-Edwards & Stoppler, n.d.).
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