schizophrenia (redirected from Schyzophrenia)

schizophrenia (skĭt'səfrē`nēə), group of severe mental disorders characterized by reality distortions resulting in unusual thought patterns and behaviors. Because there is often little or no logical relationship between the thoughts and feelings of a person with schizophrenia, the disorder has often been called "split personality." However, the condition should not be confused with multiple personality, a disorder in which the individual has two or more distinct personalities that dominate at different times.

In 1896, the German psychiatrist Emil Kraepelin grouped what were previously considered unrelated mental diseases under the term dementia praecox. It was not until 1908, however, that an influential essay by Swiss psychiatrist Eugen Bleuler

Bibliography

See E. Bleuler Dementia Praecox (1911, tr. 1950).
.....  corrected Kraepelin's theory that the disease was an organic brain deterioration and thus incurable. Bleuler introduced the term schizophrenia to replace dementia praecox, emphasizing the dissociative phenomena in the mind and avoiding the implications of early onset and progressive brain deterioration.

Schizophrenic disorders generally begin in the late teenage years or early adulthood and tend to occur in withdrawn, seclusive individuals. The lifetime prevalence worldwide has been estimated to be just under 1%, and the disorder affects 1.5 to 2 million people in the United States alone. Symptoms include disturbances of thought, both in form and content (see delusion), and disturbances of perception, most commonly appearing as visual or aural hallucinations.

There are five major types of schizophrenia listed by the American Psychiatric Association in its Diagnostic and Statistical Manual of Mental Disorders. The most severe are disorganized (hebephrenic) schizophrenia, characterized by hallucinations, delusions, inappropriate laughing and crying, incoherent speech, and infantile behavior; and catatonic schizophrenia, characterized by physical rigidity or hyperactivity. Paranoid schizophrenics can often function relatively normally, although they may be disturbed by persecutory delusions and hallucinations, and they tend to exhibit argumentative behavior. The presence of a combination of symptoms from other types is classified as undifferentiated schizophrenia. Residual schizophrenia is constituted by minor symptoms, which occur as an active episode diminishes.

The cause of schizophrenia is unknown. Genetic factors appear to be involved in producing susceptibility to the condition, with studies among identical twins showing a 30%–50% concordance rate, a figure that has been confirmed by the results of adoption studies. Biochemical research suggests that high levels of the neurotransmitter dopamine, or excessive numbers of receptors for dopamine, may be at the root of schizophrenia. Medical imaging studies have revealed various physical and physiological anomalies in some patients. Other research has focused on mistiming of neural responses to stimuli in the brain. Many researchers maintain that a combination of influences, including such environmental factors as viral illness or malnutrition in the patient's mother during pregnancy, may lead to schizophrenia,

Antipsychotic drugs (see psychopharmacology), sometimes in conjunction with psychotherapy, have greatly improved the treatment of schizophrenia. Hospitalization is sometimes needed initially to provide basic personal needs (safety, food, and hygiene) while acute symptoms are treated. Most patients return to the community with varying degrees of independence and with good prospects for long-term remission of symptoms.

Bibliography

See R. Miller and S. Mason, Diagnosis: Schizophrenia (2002); studies by I. I. Gottesman (1991) and H. Häfner and W. F. Gattaz, ed. (1991).

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schizophrenia

Any of a group of severe mental disorders that have in common symptoms such as hallucinations, delusions, blunted emotions, disorganized thinking, and withdrawal from reality. Five main types are recognized: the paranoid, characterized by delusions of persecution or grandeur combined with unrealistic, illogical thinking and frequent auditory hallucinations; the disorganized (hebephrenic), characterized by disordered speech and behaviour and shallow or inappropriate emotional responses; the catatonic, characterized by motor inflexibility or stupor along with mutism, echolalia, or other speech abnormalities; the simple or undifferentiated type, which conforms to basic definitions of schizophrenia but does not exhibit particular behaviours in the aforementioned types; and the residual type, which is a chronic stage indicating advancement toward later-stage schizophrenia. Schizophrenia seems to occur in 0.5–1% of the general population, and more than half of those so diagnosed will eventually recover. There is strong evidence that genetic inheritance plays a role, but no single cause of schizophrenia has been identified. Stressful life experiences may help trigger its onset. Treatment consists of drug therapy and counseling.

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schizophrenia

any of a group of psychotic disorders characterized by progressive deterioration of the personality, withdrawal from reality, hallucinations, delusions, social apathy, emotional instability, etc.

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schizophrenia [‚skit·sə′frē·nē·ə]

(psychology)

A group of mental disorders characterized by withdrawal from reality and by alterations in thinking, feeling, and concept formations. Also known as dementia praecox.

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Schizophrenia

A brain disorder that is characterized by bizarre mental experiences such as hallucinations and severe decrements in social, cognitive, and occupational functioning. Patients with schizophrenia demonstrate a series of biological differences when compared to other groups of psychiatric patients. However, no biological marker has yet been found to conclusively indicate the presence of schizophrenia. A diagnosis is made on the basis of a cluster of symptoms reported by the patient, and of signs identified by the clinician.

People with schizophrenia may report perceptual experiences in the absence of a perceptual stimulus. Most common are auditory hallucinations, often reported in the form of words spoken to the person with schizophrenia. The language is often derogatory, and it can be tremendously frightening. See Hallucination

People with schizophrenia often maintain beliefs that are not held by the overwhelming majority of the general population. To be considered delusions, the beliefs must be unshakable. In many cases, these beliefs may be bizarre and stem from odd experiences. In some instances, the delusions have an element of suspicion to them, such as the belief that others are planning to cause the person harm. The delusions may or may not be related to hallucinatory experiences.

Many schizophrenics suffer from social isolation, lack of motivation, lack of energy, slow or delayed speech, and diminished emotional expression, often referred to as blunted affect. They may manifest an odd outward appearance due to the severity of their disorganization. This presentation may include speech that does not follow logically or sensibly, at times to the point of being incoherent. Facial expression may be odd or inappropriate, such as laughing for no reason. In some cases, people with schizophrenia may move in a strange and awkward manner. The extreme aspect of this behavior, referred to as catatonia, has become very rare since pharmacological treatments have become available.

Perhaps the most devastating feature of schizophrenia is the cognitive impairment found in most people with the disorder. On average, such people perform in the lowest 2–10% of the general population on tests of attention, memory, abstraction, motor skills, and language abilities.

The onset of schizophrenia generally occurs in people in the late teens to early twenties. However, schizophrenia is possible throughout the life span. While the onset of symptoms is abrupt in some people, others experience a more insidious process, including extreme social withdrawal, reduced motivation, mood changes, and cognitive and functional decline. The course of schizophrenia is normally characterized by episodes of relative remission in which only subtle symptoms remain, and episodes of exacerbation of symptoms, which are often caused by failure to continue treatment.

It is likely that there are various forms of schizophrenia, perhaps with different causes. Although schizophrenia appears to be inherited in some cases, the influence of genes is far from complete. Many arguments have been put forth regarding environmental factors that could cause schizophrenia. Very few of these theories are consistently supported.

Magnetic resonance imaging (MRI) has revealed that people with schizophrenia often have changes in the structure of their brain such as enlargement of the cerebral ventricles (the fluid-filled spaces in the brain close to the midline). Various brain regions have been found to be smaller in patients with schizophrenia, including the frontal cortex, temporal lobes, and hippocampi. In addition, studies of patients with schizophrenia have found patterns of abnormal activation of the brain while performing tests of memory and problem solving. See Brain, Medical imaging

Either a pharmacological or behavioral approach may be used in treating schizophrenia. A variety of antipsychotic medications have been used, and research continues into how to minimize the side effects which are often associated with such drugs. There are several targets for behavioral treatments in schizophrenia. Structured training programs have attempted to teach patients how to function more effectively in social, occupational, and independent living domains. Family interventions have been designed to provide a supportive environment for patients, and have been demonstrated to reduce risk of relapse. Another behavioral treatment area is teaching patients how to cope with hallucinations and delusions. Most patients with schizophrenia do not spontaneously recognize their symptoms as unusual and their experiences as unreal. Cognitive-behavioral treatments have been employed to help patients realize the nature of their symptoms and to develop plans for coping with them. See Psychopharmacology, Psychotherapy