Schizophrenia Full

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Table of Contents

Content PageDeclaration by Student 3Certification by Supervisor(s) 4Why did I take up this topic for detailed study? 5Review of Literature 6Summary 17List of References 18

Acknowledgment 19

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DECLARATION BY STUDENT

I hereby declare that I have written this special study module Schizophrenia

in my own words. Wherever appropriate, I have referred to the sources from

where I reviewed literature, as well as images or any other material. I

understand that I am responsible if this work is found to be faulty or

fraudulent.

Signature:

Full Name: Sivakumaran Rajandran

Date of submission to Supervisor: 9. May. 2011

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CERTIFICATION BY SUPERVISOR:

This is to certify that this SSM titled Schizophrenia was done under my

guidance. In terms of scope, quantum of work and the quality of presentation, I

find this work by name of the student, ID number satisfactory.

Supervisors Signature:

Name:

Designation:

Date:

Special Remarks by Supervisor (if any):

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BACKGROUND

Why did I take this up for detailed study?

As a medical student, I always have special interest about diseases and their effect to

the human body. When it comes to mind, my interests shoot up. It is because brain is

one of important organ in our body that weights only around 300g yet it can control

various activity of brain.

Schizophrenia is a mental disorder, which caused by disorientation of brain. So I take

this topic in order to know more about this disease as well as function of brain. i hope

this topic can enlighten me about function of brains and details of Schizophrenia.

REVIEW OF LITERATURE:

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Schizophrenia is a mental disorder characterized by disintegration of

thought processes and of emotional responsiveness. It most commonly

manifests as auditory hallucinations , paranoid or bizarre delusions , or

disorganized speech and thinking , and it is accompanied by significant

social or occupational dysfunction. The onset of symptoms typically occurs

in young adulthood, with a global lifetime prevalence of about 0.30.7%.

Diagnosis is based on observed behavior and the patient's reported

experiences.

Schizophrenia, also sometimes called split personality disorder, is a

chronic, severe, debilitating mental illness that affects about 1% of the

population, corresponding to more than 2 million people in the United States

alone. Other statistics about schizophrenia include that it affects men about

one and a half times more commonly than women. It is one of the psychotic

mental disorders and is characterized by symptoms of thought, behavior,

and social problems. The thought problems associated with schizophreniaare described as psychosis, in that the person's thinking is completely out of

touch with reality at times.

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http://en.wikipedia.org/wiki/Mental_disorderhttp://en.wikipedia.org/wiki/Auditory_hallucinationhttp://en.wikipedia.org/wiki/Paranoiahttp://en.wikipedia.org/wiki/Delusionhttp://en.wikipedia.org/wiki/Thought_disorderhttp://www.medicinenet.com/script/main/art.asp?articlekey=42992http://en.wikipedia.org/wiki/Auditory_hallucinationhttp://en.wikipedia.org/wiki/Paranoiahttp://en.wikipedia.org/wiki/Delusionhttp://en.wikipedia.org/wiki/Thought_disorderhttp://www.medicinenet.com/script/main/art.asp?articlekey=42992http://en.wikipedia.org/wiki/Mental_disorder


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There are five types of schizophrenia, each based on the kind of symptoms

the person has at the time of assessment:

Paranoid schizophrenia: The individual is preoccupied with one or more

delusions or many auditory hallucinations but does not have symptoms of

disorganized schizophrenia.

Disorganized schizophrenia: Prominent symptoms are disorganized speech

and behavior, as well as flat or inappropriate affect. The person does not

have enough symptoms to be characterized as catatonic schizophrenic.

Catatonic schizophrenia: The person with this type of schizophrenia

primarily has at least two of the following symptoms: difficulty moving,

resistance to moving, excessive movement, abnormal movements, and/or

repeating what others say or do.

Undifferentiated schizophrenia: This is characterized by episodes of two or

more of the following symptoms: delusions, hallucinations, disorganized

speech or behavior, catatonic behavior or negative symptoms, but the

individual does not qualify for a diagnosis of paranoid, disorganized, or

catatonic type of schizophrenia.

Residual schizophrenia: While the full-blown characteristic positive

symptoms of schizophrenia (those that involve an excess of normal

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behavior, such as delusions, paranoia, or heightened sensitivity) are absent,

the sufferer has less severe forms of the disorder or has only negative

symptoms (symptoms characterized by a decrease in function, such as

withdrawal, disinterest, and not speaking).

Causes, incidence, and risk factors

Schizophrenia is a complex illness. Even experts in the field are not

sure what causes it.

Genetic factors appear to play a role. People who have family

members with schizophrenia may be more likely to get the illness

themselves.

Some researchers believe that environmental events may trigger

schizophrenia in people who are already genetically at risk for the disorder.

For example, infection during development in the mother's womb or

stressful psychological experiences may increase the risk for developing

schizophrenia later in life. Social and family support appears to improve the

illness.

Schizophrenia affects about 1% of people worldwide. It occurs

equally among men and women, but in women it tends to begin later and be

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milder. For this reason, males tend to account for more than half of patients

in services with high numbers of young adults. Although schizophrenia

usually begins in young adulthood, there are cases in which the disorder

begins later (over age 45).

Childhood-onset schizophrenia begins after age 5 and, in most cases,

after normal development. Childhood schizophrenia is rare and can be

difficult to tell apart from other developmental disorders of childhood, such

as autism .

Symptoms

Schizophrenia may have a variety of symptoms. Usually the illness

develops slowly over months or years. Like other chronic illnesses,

schizophrenia cycles between periods of fewer symptoms and periods of

more symptoms.

At first, you may feel tense, or have trouble sleeping or concentrating.

You can become isolated and withdrawn, and have trouble making or

keeping friends.

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As the illness continues, psychotic symptoms develop:

Appearance or mood that shows no emotion (flat affect)

Bizarre movements that show less of a reaction to the environment

(catatonic behavior)

False beliefs or thoughts that are not based in reality (delusions)

Hearing, seeing, or feeling things that are not there (hallucinations)

Problems with thinking often occur:

Problems paying attention

Thoughts "jump" between unrelated topics (disordered thinking)

Symptoms can be different depending on the type of schizophrenia:

Paranoid types often feel anxious, are more often angry or argumentative,and falsely believe that others are trying to harm them or their loved ones.

Disorganized types have problems thinking and expressing their ideas

clearly, often exhibit childlike behavior, and frequently show little emotion.

Catatonic types may be in a constant state of unrest, or they may not move

or be underactive. Their muscles and posture may be rigid. They may

grimace or have other odd facial expressions, and they may be less

responsive to others.

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A psychiatrist should perform an evaluation to make the diagnosis.

The diagnosis is made based on a thorough interview of the person and

family members.

No medical tests for schizophrenia exist. The following factors may suggest

a schizophrenia diagnosis, but do not confirm it:

Course of illness and how long symptoms have lasted

Changes from level of function before illness

Developmental background

Genetic and family history

Response to medication

CT scans of the head and other imaging techniques may find some changes

that occur with schizophrenia and may rule out other disorders.

Treatment

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During an episode of schizophrenia, you may need to stay in the

hospital for safety reasons, and to receive basic needs such as food, rest, and

hygiene.

The choice of which antipsychotic to use is based on benefits, risks,

and costs. It is debatable whether as a class typical or atypical antipsychotics

are better. Both have equal drop-out and symptom relapse rates when

typicals are used at low to moderate dosages.There is a good response in 40

50%, a partial response in 3040%, and treatment resistance (failure of

symptoms to respond satisfactorily after six weeks to two of three different

antipsychotics) in 20% of people. Clozapine is an effective treatment for

those who respond poorly to other drugs, but it has the potentially serious

side effect of agranulocytosis (lowered white blood cell count) in 14%.

MEDICATIONS

Antipsychotic medications are the most effective treatment for

schizophrenia. They change the balance of chemicals in the brain and can

help control the symptoms of the illness.

These medications are helpful, but they can have side effects. However,

many of these side effects can be addressed, and should not prevent people

from seeking treatment for this serious condition.

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Common side effects from antipsychotics may include:

Sleepiness (sedation) or dizziness

Weight gain and increased chance of diabetes and high cholesterol

Less common side effects include:

Feelings of restlessness or "jitters"

Problems of movement and gait

Muscle contractions or spasms

Tremor

Long-term risks of antipsychotic medications include a movement

disorder called tardive dyskinesia. In this condition, people develop

movements that they cannot control, especially around the mouth. Anyone

who believes they are having this problem should check with their doctor

right away.

For people who try and do not improve with several antipsychotics,

the medication clozapine can be helpful. Clozapine is the most effective

medication for reducing schizophrenia symptoms, but it also tends to cause

more side effects than other antipsychotics.

Because schizophrenia is a chronic illness, most people with this

condition need to stay on antipsychotic medication for life.

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For people who are unwilling or unable to take medication regularly,

long-acting depot preparations of antipsychotics may be used to achieve

control. When used in combination with psychosocial interventions they

may improve long-term adherence to treatment.

SUPPORT PROGRAMS AND THERAPIES

Supportive and problem-focused forms of therapy may be helpful for

many people. Behavioral techniques, such as social skills training, can be

used during therapy or at home to improve function socially and at work.

Family treatments that combine support and education about schizophrenia

(psychoeducation) appear to help families cope and reduce the odds of

symptoms returning. Programs that emphasize outreach and community

support services can help people who lack family and social support.

Important skills for a person with schizophrenia include:

Learning to take medications correctly and how to manage side effects

Learning to watch for early signs of a relapse and knowing how to react

when they occur

Coping with symptoms that are present even while taking medications. A

therapist can help persons with schizophrenia test the reality of thoughts and

perceptions.

Learning life skills, such as job training, money management, use of public

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transportation, relationship building, and practical communication

Family members and caregivers are often encouraged to help people

with schizophrenia stick to their treatment.

Expectations (prognosis)

The outlook for a person with schizophrenia is difficult to predict.

Most people with schizophrenia find that their symptoms improve with

medication, and some can get good control of their symptoms over time.

However, others have functional disability and are at risk for repeated

episodes, especially during the early stages of the illness.

To live in the community, people with schizophrenia may need

supported housing, work rehabilitation, and other community support

programs. People with the most severe forms of this disorder may be too

disabled to live alone, and may need group homes or other long-term,

structured places to live. Some people with milder forms of schizophrenia

are able to have satisfying relationships and work experiences.

Complications

People with schizophrenia have a high risk of developing a substance abuse

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problem. Use of alcohol or other drugs increases the risk of relapse, and

should be treated by a professional.

Physical illness is common among people with schizophrenia due to an

inactive lifestyle and side effects from medication. Physical illness may not

be detected because of poor access to medical care and difficulties talking to

health care providers.

Not taking medication will often cause symptoms to return.

Calling your health care provider

Call your health care provider if:

Voices are telling you to hurt yourself or others.

You feel the urge to hurt yourself or others.

You are feeling hopeless and overwhelmed.

You are seeing things that aren't really there.

You feel like you cannot leave the house.

You are unable to care for yourself.

Prevention

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There is no known way to prevent schizophrenia.

If you do have the condition, the best ways to prevent symptoms from

coming back are to take the medication your doctor prescribed, and see your

doctor or therapist regularly. Always talk to your doctor if you are thinking

about changing or stopping your medications.

SUMMARY

Schizophrenia is a severe, lifelong brain disorder. People who have it

may hear voices, see things that aren't there or believe that others are

reading or controlling their minds. In men, symptoms usually start in the late

teens and early 20s. They include hallucinations, or seeing things, and

delusions such as hearing voices. For women, they start in the mid-20s toearly 30s. Other symptoms include

Unusual thoughts or perceptions

Disorders of movement

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Difficulty speaking and expressing emotion

Problems with attention, memory and organization

No one is sure what causes schizophrenia, but your genetic makeup

and brain chemistry probably play a role. Medicines can relieve many of the

symptoms, but it can take several tries before you find the right drug. You

can reduce relapses by staying on your medicine for as long as your doctor

recommends. With treatment, many people improve enough to lead

satisfying lives.

LIST OF REFERENCES

1. Leucht S, Corves C, Arbter D, Engel RR, Li C, Davis JM. Second-generation versus first-generation antipsychotic drugs for schizophrenia: a meta-analysis. Lancet . 2009;373:31-41. Epub 2008Dec 6.v

2. Freudenreich O, Weiss AP, Goff DC. Psychosis and schizophrenia.

In: Stern TA, Rosenbaum JF, Fava M, Biederman J, Rauch SL, eds.

Massachusetts General Hospital Comprehensive Clinical Psychiatry .

1st ed. Philadelphia, Pa: Mosby Elsevier;2008:chap 28.

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3. ^ Buckley PF, Miller BJ, Lehrer DS, Castle DJ. Psychiatric comorbidities

and schizophrenia . Schizophr Bull . 2009;35(2):383402.

4. Www. Wikipedia.com

ACKNOWLEDGMENT:

I would like to take this opportunity to thank my lecturer who allows me to do this

topic. Besides that I would to thank my friends who helped me throughout the process.

Without their moral support and guidance I could not finish this assignment on date.

Thanks to everybody.

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