The term schizophrenia comes from Greek words meaning “split mind”. Schizophrenics have a debilitating effect on their lives. Schizophrenia diminishes the ability of a person to perform his or her routine work and duties effectively. Schizophrenics are illogical and have inappropriate behavior. The person suffering from schizophrenia is unable to access his or her disturbed beliefs and perceptions or to rationally compare them to what is actually happening in the world.
Schizophrenia is a mental disorder that has symptoms like hallucinations, delusions, blunted emotions, disorganized thinking and withdrawal from reality. Five main types of schizophrenia are recognized, the paranoid, the hebephrenic, the catatonic, the simple or undifferentiated type and residual type. Schizophrenia is a symptomatic disease. (Robert, Alfred 41) Negative and positive Symptoms The characteristics of schizophrenia which have been described so far—hallucinations, delusions, and thought disorder—are frequently termed positive symptoms or productive symptoms because they are pathological by their presence.
A distinction is frequently made between these excesses and what are commonly termed negative symptoms, referring to deficits in functioning, such as flatness of emotion; inattention; lack of motivation and apathy; poor concentration and attention; social withdrawal; restricted levels of speech and communication; decrease in activity level; and an inability to obtain enjoyment from activities. Some workers have suggested a third category of symptoms, which are characterized by cognitive disorganization, such as types of thought disorder, but this three-category system is not as yet widely used. Research Methods Used to Identify Developmental Precursors The authors of DSM-III maintain that their concept of schizophrenic disorder is not chiefly couched in terms chronicity. Although it is true that the C criterion requiring a continuous period of illness for at least six months can be regarding as one reflecting an insidious onset and not necessarily one denoting chronicity, the additional requirement of deterioration from a normally higher level of everyday functioning apparently favors the identification of cases with a certain tendency towards chronicity.
Moreover, some of the additional terms of diagnostic classification that DSM-III uses for its subtypes of schizophrenic disorder are carried out on the basis of course features in which the primary focus is on chronicity (more than two years) and subchronicity (between six months and two years); acute exacerbations in this system, when they occur, are viewed merely as secondary phenomena of the sub chronic and chronic course types. In other words, the terminology upon which DSM-III draws in defining schizophrenic disorder implies the presence of an illness that at some point in time must have been, if not chronic, at least sub chronic.
Current trend to diagnose schizophrenic disorder Etiology of schizophrenia has posed a perplexing question since Kraeplin first classified “dementia praecox,” which was later termed “schizophrenia” by Bleuler in 1911. Both believe the condition to be organic in origin. Biological research has attempted to relate dopamine and monoamine oxidase irregularities to schizophrenia. A prominent psychodynamic theory is advanced by R. D. Laing (1969) who proposed the development of a false self-system in response to parental expectation.
Other investigations have covered such areas as information processing, decision processes, attention, eye-tracking, pharmacological effects, communication patterns, obstetric factors, family relationships, and social and cultural influences. Nevertheless, etiology still remains baffling, although current thinking trend points towards a genetic contribution and biochemical correlates (supported by numerous studies) probably in interaction with environmental factors.
On the other hand, Szasz (1970) introduces sociological considerations in describing mental illness diagnosis and institutionalization as our society’s method of ostracizing threatening deviancy. (Wadeson 113) Treatment of schizophrenia Treatment in most settings relies heavily on pharmacologic intervention, particularly chlorpromazine, to combat delusions and hallucinations. Megavitamin therapy, now called orthomolecular psychiatry, is utilized by some clinicians. Psychotherapy, family therapy, mileu treatment, behavior modification, and rehabilitation are also used, often in combination with pharmacological treatment.
In sum, schizophrenic disorder remains a puzzling array of conditions whose classification has varied across tome and place. Its etiology is unknown, and treatment varies according to the condition of the patient, the treatment setting, and the persuasion of the clinician. In trying to explain the seeming arbitrariness of the DSM-III, one wonders if attention to the prevailing mode of treatment of the schizophrenic disorders and the prevailing mode of treatment of the manic-depressive disorders has not over-ridden the basic tenets of diagnosis.
That is, if one is already “sold” on phenothiazine treatment and lithium treatment, the tendency is to apply the label schizophrenic to those whose (positive) symptoms are reduced by phenothiazines, and to call manic-depressive those whose mania (also a positive symptom) a reduced and popularity of certain treatment substances. The DSM-III-R (1987) specifically encourages making a diagnosis of schizophrenic disorder “that has validity in terms of differential response to somatic therapy”. This approach fails to ground diagnosis in criteria that are truly independent of either diagnosis or treatment.
This approach also postulates, or even claims outright, specific etiologies, implying that manic-depressive disorder is a lithium deficiency and that schizophrenic disorder is a phenothiazine deficiency; the latter etiology is based on the theory that schizophrenic persons suffer from excessive dopamine reception in the brain and that phenothiazines help patients by reducing dopamine reception. Dopamine reception may be reduced, but neither the need for its reduction not the supposed benefits have been proves, whereas the harmful effects are becoming well documented.
Conclusion Throughout its history, the concept of the schizophrenic disorder has been surrounding by controversy. The developments of more reliable diagnostic systems and methods have improved on the rigor of the concept by more strictly delineating the core symptoms that are necessary for a schizophrenic diagnosis. Improvements in establishing the validity of the disorder have progressed less rapidly. The disorder is defined by a group of what has been termed positive symptoms.
However, sufferers are also frequently handicapped by what are termed negative symptoms, or gross deficits in functioning. Theoretical explanations were frequently polarized in their explanatory focus, and were usually inadequate to satisfactorily account for the disorder(s) or produce adequate treatment approaches. The development of vulnerability- stress models that incorporated both biological and environmental factors in explaining both the development of schizophrenia and the occurrence of subsequent episodes has been a watershed.