Imagine a young man beginning to experience serious problems. He hears whispers telling him that everyImagine a young man starting to have serious problems. He hears whispers telling him that everyone is against him, making him feel scared and paranoid. He often talks to himself and responds to voices only he can hear. His laughter turns into nervous giggles, and he begins to avoid his friends and family, thinking he cannot trust anyone. As his behavior grows stranger, he spends hours pacing back and forth, mumbling about shadows following him.
What might this situation be called? A Psychotic Disorder.
Before proceeding deeper into today’s article, we must first be familiar with the fundamental term “psychosis.” We will explore psychotic disorders and their counterpart, neurotic disorders. Let us first take a closer look at what psychotic disorders entail.
Psychotic Disorders
Psychotic disorders are abnormalities involving a clear loss of contact with reality. Individuals experiencing these disorders may have disturbances in their sensory modalities, leading to hallucinations, such as hearing strange voices or seeing things that aren’t present. In addition to hallucinations, individuals often have falsehoods or delusions—error beliefs they cannot distinguish from reality. They may also display disorganized and distorted thinking and speech patterns, making it hard for them to behave normally among others. Their behavior can be confusing or inappropriate for the situation.
Furthermore, those with psychotic disorders might exhibit negative symptoms, such as a lack of emotional responses, low motivation, and a reduced ability to express feelings. These symptoms significantly affect their daily lives and functioning.
Some major types of psychotic disorders include schizophrenia, schizoaffective disorder, brief psychotic disorder, shared psychosis, and delusional disorders. In this article, our main focus will be on schizophrenia, a serious mental illness that significantly impacts brain function by altering perception, thoughts, beliefs, or consciousness.
Introduction
Eugen Bleuler introduced the term “schizophrenia” in 1908, but it was Emile Kraepelin who first formally characterized this mental illness in 1887, referring to it as “dementia praecox.” The literal translation of “schizophrenia” is “fragmented mind,” highlighting the disorder’s nature. Schizophrenia is recognized as one of the most intricate, long-lasting, and challenging psychotic disorders, significantly affecting an individual’s thoughts, emotions, and behaviors.
Characteristics
Schizophrenia is characterized by:
- Disorganized Thoughts and Speech: Confused thinking makes it hard for individuals to speak clearly or stay on topic during conversations.
- Delusions: Individuals hold strong false beliefs they think are true, even when clear evidence disproves them.
- Hallucinations: People sense things that aren’t there, such as hearing voices or seeing nonexistent objects.
- Impaired Psychosocial Functioning: Many struggle with interacting with others, self-care, and completing everyday tasks effectively.
Etiology
The etiology of schizophrenia is multifaceted, involving several factors:
Genetic Factors
Schizophrenia has a strong genetic influence. The more genes two people share, the greater their risk of developing the disorder.
| Relation | Risk (%) |
|---|---|
| Monozygotic twins | 40-50 |
| Children with two parents | 40-60 |
| Children with one parent | 10-15 |
| Non-twin siblings | 8-18 |
| General population | 0.7-1 |
Prenatal and Perinatal Factors
- Prenatal problems, such as maternal viral infections, poor nutrition, or high stress during pregnancy, increase risk.
- Perinatal issues, including low birth weight, premature birth, and birth injuries, are linked to a higher risk of schizophrenia.
Drug Abuse
Using drugs, especially cannabis, cocaine, LSD, or amphetamines, increases the likelihood of developing schizophrenia or similar mental disorders.
Biochemical Influences
The dopamine hypothesis suggests that issues with dopamine in certain brain areas are linked to schizophrenia. Neurotransmitter imbalances may result in symptoms like hallucinations and delusions.
Types of Schizophrenia
Although the DSM-5 no longer recognizes these subtypes as separate diagnostic categories, understanding them provides insight into symptom variations:
- Paranoid Type: Features delusions and hallucinations, especially auditory, with intense paranoia but relatively clear communication.
- Disorganized Type: Marked by disorganized speech, behavior, and flat affect, leading to emotional detachment.
- Catatonic Type: Involves movement abnormalities, including mutism, echolalia (repeating others’ words), and echopraxia (mimicking gestures).
- Undifferentiated Type: A mix of symptoms that don’t fit into a single category.
- Residual Type: History of schizophrenia with prominent negative symptoms but minimal positive symptoms like delusions.
Symptoms
Schizophrenia is characterized by three main symptom types: positive, negative, and psychomotor.
Positive Symptoms
Positive symptoms refer to the addition of abnormal thoughts and behaviors. These include:
| Symptom | Description |
|---|---|
| Delusions | Distorted perceptions of reality or unusual, false beliefs. |
| Hallucinations | Projecting internal feelings onto external stimuli, like hearing voices. |
| Disorganized Speech | Thoughts transition rapidly, leading to communication challenges. |
| Heightened Perception | Sensory inputs feel overly intense or significant. |
Negative Symptoms
Negative symptoms refer to the reduction or removal of normal behaviors. These include:
| Symptom | Description |
|---|---|
| Alogia | Reduction in speech output, leading to brief responses. |
| Avolition | Lack of motivation to initiate or sustain activities. |
| Anhedonia | Difficulty finding joy in positive experiences. |
| Blunted Affect | Limited emotional expressions, appearing less emotional than typical. |
| Flat Affect | Complete lack of emotional expression. |
Psychomotor Symptoms
Psychomotor symptoms involve abnormal bodily movements:
| Symptom | Description |
|---|---|
| Abnormal Posturing | Unusual body positions held for extended periods. |
| Catatonia | Rigid posture for hours without movement. |
Conclusion
Schizophrenia is a complex mental disorder affecting thoughts, emotions, and behaviors. While its causes are not entirely known, it likely results from genetic and environmental factors. Symptoms can vary but often include hallucinations, delusions, and disorganized speech. Early recognition and treatment, involving medications and therapy, are crucial for effective management. With awareness and support, individuals with schizophrenia can overcome challenges and contribute positively to society.
