Schizophrenia Research Paper
Introduction
This essay is about Schizophrenia and how it has many effects on a person’s ability to lead a meaningful life. Schizophrenia is a mental health disorder, mental health is described as level of psychological well-being, or an absence of a mental disorder. The disease is found in all cultures throughout the world. Both genders are equally affected. The age of onset of schizophrenia appears to be a factor in the presentation of symptoms. How different social classes can affect a person being diagnosed and treated. The different type’s treatments available and the types of schizophrenia. And the history of schizophrenia including asylums where mental health patents where often placed.
Schizophrenia is a major mental illness …show more content…
which causes its patients to experience progressive personality changes and also a failure in their relationships with the outside world. It is prevalent to about 1% of the worldwide population, with some countries having higher incidence of this disorder and some lower (Schizophrenia, 2001). Schizophrenic patients show signs of hallucinations which are seeing or hearing something that is not really there. It is common for them to hear unreal threatening voices. Delusions, which are false beliefs or opinions of self and others, are also a symptom to this disorder. Delusions of persecution results them to experience paranoia. They would also display disorganized thought and behaviour. This includes incomprehensible speech, aggressiveness, public exhibition and so forth. Other than that, the patients might also have difficulty showing or expressing emotion including unresponsiveness, immobility, and excessive motor activity. Looking at the severity of this disorder, it does not come as a surprise that the leading cause of death among patients with schizophrenia is suicide, as argued by Schwartz and Cohen (as cited in Walker et al., 2003).
Schizophrenia is a word derived from the Greek Language. Schizo, meaning split and phrenia, meaning mind. This definition is often why schizophrenia is misunderstood. Schizophrenia is one of the most common mental disorders in the UK.
Accounts of a schizophrenia-like syndrome are thought to be rare in historical records before the 19th century, although reports of irrational, unintelligible, or uncontrolled behaviours were common. Schizophrenia is the most common major mental disorder in the UK, and directly affects one in 100 people at some point during their lives. It usually begins during adolescence or the early twenties, and often causes very disturbing experiences – resulting in a large amount of personal suffering, family disruption and health and social care. ( Medical research council). Written documents that identify Schizophrenia can be traced to the old Paranoiac Egypt, as far back as the second millennium before Christ. Depression, dementia, as well as thought disturbances that are typical in schizophrenia are described in detail in the Book of Hearts. The Heart and the mind seem to have been synonymous in ancient Egypt. The physical illnesses were regarded as symptoms of the heart and the uterus and originating from the blood vessels or from purulence, faecal matter, a poison or demons
Differences in age of onset are the most replicated finding in studies into gender differences in schizophrenia. Men usually develop the illness at age 18–25, while in women, the mean age of onset is 25–35. Furthermore, the onset distribution curves for males and females are not isomorphic. Women seem to have two peaks in the age of onset of disease: the first after menarche and the second once they are over 40. (Gender differences in schizophrenia) Substance abuse is more common with men that it is with women with schizophrenia and men have more severe symptoms than women. Women have better remission and lower relapse rates than men. When there are stressful life events, women need more exposure to stressful life events than men to trigger a psychotic disorder. It seems that women with schizophrenia presented higher resilience than men to cope with stress situations and women need higher risk factors in order to develop a psychosis than men seem to do.
Many people who develop schizophrenia do not achieve or maintain the social class they were born into. By the time they have contact with psychiatric services, patients have often moved into a lower social class. Social classes used to be broken down into three groups, the lower, middle and upper. But now there are broken down into more category’s
The lower class is typified by poverty, homelessness, and unemployment. People of this class, few of whom have finished high school, suffer from lack of medical care, adequate housing and food, decent clothing, safety, and vocational training. The media often stigmatize the lower class as “the underclass,” inaccurately characterizing poor people as welfare mothers who abuse the system by having more and more babies, welfare fathers who are able to work but do not, drug abusers, criminals.
The working class are those minimally educated people who engage in “manual labour” with little or no prestige. Unskilled workers in the class—dishwashers, cashiers, maids, and waitresses—usually are underpaid and have no opportunity for career advancement. They are often called the working poor.
Skilled workers in this class—carpenters, plumbers, and electricians—are often called blue collar workers. They may make more money than workers in the middle class—secretaries, teachers, and computer technicians; however, their jobs are usually more physically taxing, and in some cases quite dangerous
The middle class are the “sandwich” class. These white collar workers have more money than those below them on the “social ladder,” but less than those above them. They divide into two levels according to wealth, education, and prestige.
The lower middle class is often made up of less educated people with lower incomes, such as managers, small business owners, teachers, and secretaries. The upper middle class is often made up of highly educated business and professional people with high incomes, such as doctors, lawyers and stockbrokers.
Upper class is statistically very small and consists of the peerage, gentry, and hereditary landowners. The majority of aristocratic families originated in the merchant class, and were ennobled between the 14th and the late 19th century. Those in possession of a hereditary peerage but not a life peerage – for example a Dukedom, a Marquisate, an Earldom, a Viscounts or a Barony – are typically members of the upper class However, this does not exclude the possibility that low social class increases the risk of later schizophrenia. Evidence is accumulating that the origins of the disorder lie in early life, and various environmental factors have been shown to be associated with an increased risk of later schizophrenia. These factors include obstetric complications, prenatal infections, and nutritional deprivation, all of which are more common among people in lower social classes. However, it remains unclear whether people born into lower social classes are at increased risk of schizophrenia.
People born into lower social classes often delay seeking treatment for schizophrenia. This can mean the delay in diagnosis can mean they are less likely to do well with treatment. Symptoms can appear at the same time as the higher classes but they are detected later. A schizophrenic of the upper and middle classes is more likely to be referred for treatment through medical channels while the lower class.
Lefley (1990) researched insights from Third World cultures and suggested that patients may function better in developing countries because more kinship networks, buffering mechanisms, and apparently greater respect to tolerance of difficult behaviour’s may exist within social dynamics.
For individuals with schizophrenia, there are also more opportunities for low-stress, non-competitive productive roles in communal societies and agrarian economics
Schizophrenia can usually be diagnosed if a person has at least two of the following symptoms: delusions, hallucinations, disordered thoughts or behaviour or the presence of negative symptoms, such as a flattening of emotions. Your symptoms have had a significant impact on their ability to work study or perform daily tasks. You have experienced symptoms for more than six months. All other possible causes, such as recreational drug use or depression, have been ruled out.
Disorganized Schizophrenia (Hebephrenic) also known as hebephrenia , disorganized schizophrenia is thought to be an extreme expression of disorganization syndrome. It is characterized by incoherent and illogical thoughts and behaviour’s; i.e., disinhibited, agitated, and purposeless …show more content…
behaviours. Psychiatrists say disorganized schizophrenia is a more severe schizophrenia type because the patient cannot perform daily activities, such as preparing meals and taking care of personal hygiene (washing). People may not be able to understand what the patient is saying. The sufferer can become frustrated and agitated, causing him/her to lash out
Catatonic Schizophrenia this type of schizophrenia includes extremes of behaviour, including: Catatonic excitement - overexcitement or hyperactivity, in which the patient may mimic sounds (echolalia) or movements (achopraxia) around them.
Catatonic stupor - a dramatic reduction in activity in which the patient cannot speak, move or respond.
Virtually all movements stop. Sometimes an individual with catatonic schizophrenia may deliberately assume bizarre body positions, or manifest unusual limb movements or facial contortions, occasionally resulting in the misdiagnosis with tardive dyskinesia Paranoid In this type of schizophrenia the patient has false beliefs (delusions) that an individual or group of people are conspiring to harm them or members of their family. As with most other types of schizophrenia, the patient commonly has auditory hallucinations (hearing things that are not real). The patient may also have delusions of personal grandeur - a false belief that they are much greater and more powerful and influential than they really are. He/she may spend a great deal of time thinking about ways to protect themselves from their supposed persecutors
Residual, This subtype is diagnosed when the patient no longer displays prominent symptoms. In such cases, the schizophrenic symptoms generally have lessened in severity. Hallucinations, delusions or idiosyncratic behaviour’s may still be present, but their manifestations are significantly diminished in comparison to the acute phase of the
illness. The undifferentiated subtype is diagnosed when people have symptoms of schizophrenia that are not sufficiently formed or specific enough to permit classification of the illness into one of the other subtypes.
The symptoms of any one person can fluctuate at different points in time, resulting in uncertainty as to the correct subtype classification. Other people will exhibit symptoms that are remarkably stable over time but still may not fit one of the typical subtype pictures. In either instance, diagnosis of the undifferentiated subtype may best describe the mixed clinical syndrome.
Disorders such as schizophreniform disorder or delusional disorder may present with the same symptoms as schizophrenia, with the exception of duration of symptoms. The symptoms of schizophreniform disorder have a duration that lasts at least one month but less than six months. Delusional disorder is an appropriate diagnosis if bizarre delusions have been present for at least one month in the absence of the other symptoms of schizophrenia or a mood disorder (Kaplan et al. 1994).
Just as the symptoms of schizophrenia are diverse, so are its ramifications. Different kinds of impairment affect each patient’s life to varying degrees. Some people require custodial care in state institutions, while others are gainfully employed and can maintain an active family life. However, the majority of patients are at neither of these extremes. Most will have a waxing and waning course marked with some hospitalizations and some assistance from outside support sources. (http://psychcentral.com/lib/types-of-schizophrenia/000714?all=1)
People having a higher level of functioning before the start of their illness typically have a better outcome. In general, better outcomes are associated with brief episodes of symptoms worsening followed by a return to normal functioning. Women have a better prognosis for higher functioning than men, as do patients with no apparent structural abnormalities of the brain. In contrast, a poorer prognosis is indicated by a gradual or insidious onset, beginning in childhood or adolescence; structural brain abnormalities, as seen on imaging studies; and failure to return to prior levels of functioning after acute episodes.
There are lots of varies of Treatments for schizhrenia. The National Institute for Health and Clinical Excellence (NICE) has produced guidelines for how people with schizophrenia should be cared for. NICE recommends anyone providing treatment and care for people with schizophrenia should:
•develop a supportive relationship with patients and their carers
•explain causes and treatment options to everyone, keep clinical language to a minimum, and provide written information at every stage of the process
•enable easy access to assessment and treatment
•work with patients, and their families and carers if they agree, to write advance statements (see below) about their mental and physical healthcare
•take into account the needs of the patient’s family or carers and offer a carers ' assessment.
•encourage patients and their families and carers to join self-help and support groups (http://www.nhs.uk)
Each person is different so a treatment that may help one person may not have the same effect on another. Each patient should have a carefully planed out care plan for just their psychic needs. This could include, prescribed neuroleptic drugs also known as antipsychotic drugs or major tranquillisers. Some people get short-term help from medication, then come off it and remain well. Others may benefit from more long-term treatment.
Talking therapies, such as psychotherapy, counselling and cognitive behaviour therapy (CBT), can help to manage and treat schizophrenia. Talking treatments help you to identify the things you have issues with, explore them and discuss strategies or solutions. They can allow people with schizophrenia to explore the significance of their symptoms, and so to defeat them. TMS is a fairly new treatment, which is still only used in research studies. Although still on trial, it’s non-invasive and seems to be quite safe. It uses magnetic impulses to stimulate the frontal regions of the brain. This may be helpful for people who have mainly ‘negative’ symptoms. (http://www.mind.org.uk/)
Schizophrenia has been described in all cultures and socioeconomic groups throughout the world. The perception of mental illness within the cultural dynamics may affect the diagnosis, treatment, and reintegration of an individual with schizophrenia. As culture influences the ways individuals communicate and manifest symptoms of mental illness, style of coping, support system, and willingness to seek treatment may be affected as well. In West Africa it was found that individuals with a family history of either schizophrenia or other psychiatric disorders were more likely to receive the diagnosis of ukuthwasa symptoms include social withdrawal, irritability, restlessness, and appearing to respond to auditory hallucinations, than amafufunyana, described as a hysterical condition characterized by people who speak in a strange muffled voice, cannot be understood, and have unpredictable behaviours. This state is believed to be induced by sorcery that led to possession by multiple spirits that may then speak through the individual ‘speaking in tongues’.
Similarly, among acculturated Mexican-American families, the term nervios, is used to refer to a wide range of mental illness and psychological distress. With this condition, the patient is not considered blameworthy. However, among Anglo-Americans, schizophrenia is an illness for which the patient’s personal character is implicated. (Lopez et al. 2004). .In 1911 if someone was diagnosed with schizophrenia there was no known cure, Shunned by society, they would have been treated with fear and suspicion by many they would be subjected to treatment by trial and error, some of which would have gruesome side-effects. Detained by the state, they could expect to be monitored by overworked, underpaid staff and going to church might have been suggested as a way to calm their chaotic mind. Institutions for the mentally ill were established beginning in the 14th century. These facilities, or asylums, were opened in Florence, Spain, Belgium, and England. One of the most renowned was St. Mary of Bethlehem, located outside London -- better known as Bedlam. Mental patients were first accepted in 1403, and by 1547 it was totally devoted to the care of the insane. This asylum was well known for the brutal treatment of the insane. Bedlam was later used as a term to refer to all asylums (http://www.medscape.org)
Conclusion Schizophrenia is a severe and persistent mental illness that crosses all racial, ethnic, cultural, and demographic lines. The influence of class status, ethnic and cultural identity in relation to the presentation and the reporting of schizophrenia must be considered. Communication, coping styles, support system, and willingness to seek treatment are also affected. The factors discussed influence beliefs, attitudes, and behaviour’s regarding the identification of illness and health and in the process of treatment and recovery. The lack of educational and financial resources may create a barrier, in terms of utilization of services and compliance with treatment. Understanding how psychosocial factors within the cultural dynamics of this population would promote more culturally relevant care. There’s a stigma attached to mental health problems. This means that people feel uncomfortable about them and don’t talk about them much.
References
http://www.bmj.com/content/323/7326/1398?sid=94b63c0e-029e-4fbb-9f66-a8e96d2cccf0( accessed 10/11/2013) http://www.hindawi.com/journals/schizort/2012/916198/ accessed (27/10/2013. ) http://www.medscape.org/viewarticle/418882_6 http://www.mind.org.uk/information-support/types-of-mental-health-problems/schizophrenia/treatment-and-support/ (accessed 9/11/2013) http://www.nhs.uk/Conditions/Schizophrenia/Pages/Treatment.aspx. (Accessed 10/10/3013) http://www.schizophrenia.com/history.htm (accessed 26/10/3013) http://www.schizophrenia.com/history.htm#( accessed 26/10/3013 )
Kaplan, H.I., Sadock, B.J., and Grebb, J.A. (1994). Kaplan and Sadock’s synopsis of psychiatry, behavioral science and clinical psychiatry (7th ed.). Baltimore, MD: Williams and Wilkins. Lefley, H.P. (1990). Rehabilitation in mental illness: insights from other cultures. Psychosocial Rehabilitation Journal, 14 (1), 5-12.
Lopez, S.R., Nelson, H., Polo, A.J., Jenkins J.H., et al. (2004). Ethnicity, expressed emotion, attributions, and course of schizophrenia: family warmth matters. Journal of Abnormal Psychology, 113 (3), 428-
Walker D. W., McColl G., Jenkins N. L., Harris J., Lithgow G. J. 2000 Evolution of lifespan in C. elegans. Nature 405, 296–297
This essay is about Schizophrenia and how it has many effects on a person’s ability to lead a meaningful life. Schizophrenia is a mental health disorder, mental health is described as level of psychological well-being, or an absence of a mental disorder. The disease is found in all cultures throughout the world. Both genders are equally affected. The age of onset of schizophrenia appears to be a factor in the presentation of symptoms. How different social classes can affect a person being diagnosed and treated. The different type’s treatments available and the types of schizophrenia. And the history of schizophrenia including asylums where mental health patents where often placed.
Schizophrenia is a major mental illness …show more content…
which causes its patients to experience progressive personality changes and also a failure in their relationships with the outside world. It is prevalent to about 1% of the worldwide population, with some countries having higher incidence of this disorder and some lower (Schizophrenia, 2001). Schizophrenic patients show signs of hallucinations which are seeing or hearing something that is not really there. It is common for them to hear unreal threatening voices. Delusions, which are false beliefs or opinions of self and others, are also a symptom to this disorder. Delusions of persecution results them to experience paranoia. They would also display disorganized thought and behaviour. This includes incomprehensible speech, aggressiveness, public exhibition and so forth. Other than that, the patients might also have difficulty showing or expressing emotion including unresponsiveness, immobility, and excessive motor activity. Looking at the severity of this disorder, it does not come as a surprise that the leading cause of death among patients with schizophrenia is suicide, as argued by Schwartz and Cohen (as cited in Walker et al., 2003).
Schizophrenia is a word derived from the Greek Language. Schizo, meaning split and phrenia, meaning mind. This definition is often why schizophrenia is misunderstood. Schizophrenia is one of the most common mental disorders in the UK.
Accounts of a schizophrenia-like syndrome are thought to be rare in historical records before the 19th century, although reports of irrational, unintelligible, or uncontrolled behaviours were common. Schizophrenia is the most common major mental disorder in the UK, and directly affects one in 100 people at some point during their lives. It usually begins during adolescence or the early twenties, and often causes very disturbing experiences – resulting in a large amount of personal suffering, family disruption and health and social care. ( Medical research council). Written documents that identify Schizophrenia can be traced to the old Paranoiac Egypt, as far back as the second millennium before Christ. Depression, dementia, as well as thought disturbances that are typical in schizophrenia are described in detail in the Book of Hearts. The Heart and the mind seem to have been synonymous in ancient Egypt. The physical illnesses were regarded as symptoms of the heart and the uterus and originating from the blood vessels or from purulence, faecal matter, a poison or demons
Differences in age of onset are the most replicated finding in studies into gender differences in schizophrenia. Men usually develop the illness at age 18–25, while in women, the mean age of onset is 25–35. Furthermore, the onset distribution curves for males and females are not isomorphic. Women seem to have two peaks in the age of onset of disease: the first after menarche and the second once they are over 40. (Gender differences in schizophrenia) Substance abuse is more common with men that it is with women with schizophrenia and men have more severe symptoms than women. Women have better remission and lower relapse rates than men. When there are stressful life events, women need more exposure to stressful life events than men to trigger a psychotic disorder. It seems that women with schizophrenia presented higher resilience than men to cope with stress situations and women need higher risk factors in order to develop a psychosis than men seem to do.
Many people who develop schizophrenia do not achieve or maintain the social class they were born into. By the time they have contact with psychiatric services, patients have often moved into a lower social class. Social classes used to be broken down into three groups, the lower, middle and upper. But now there are broken down into more category’s
The lower class is typified by poverty, homelessness, and unemployment. People of this class, few of whom have finished high school, suffer from lack of medical care, adequate housing and food, decent clothing, safety, and vocational training. The media often stigmatize the lower class as “the underclass,” inaccurately characterizing poor people as welfare mothers who abuse the system by having more and more babies, welfare fathers who are able to work but do not, drug abusers, criminals.
The working class are those minimally educated people who engage in “manual labour” with little or no prestige. Unskilled workers in the class—dishwashers, cashiers, maids, and waitresses—usually are underpaid and have no opportunity for career advancement. They are often called the working poor.
Skilled workers in this class—carpenters, plumbers, and electricians—are often called blue collar workers. They may make more money than workers in the middle class—secretaries, teachers, and computer technicians; however, their jobs are usually more physically taxing, and in some cases quite dangerous
The middle class are the “sandwich” class. These white collar workers have more money than those below them on the “social ladder,” but less than those above them. They divide into two levels according to wealth, education, and prestige.
The lower middle class is often made up of less educated people with lower incomes, such as managers, small business owners, teachers, and secretaries. The upper middle class is often made up of highly educated business and professional people with high incomes, such as doctors, lawyers and stockbrokers.
Upper class is statistically very small and consists of the peerage, gentry, and hereditary landowners. The majority of aristocratic families originated in the merchant class, and were ennobled between the 14th and the late 19th century. Those in possession of a hereditary peerage but not a life peerage – for example a Dukedom, a Marquisate, an Earldom, a Viscounts or a Barony – are typically members of the upper class However, this does not exclude the possibility that low social class increases the risk of later schizophrenia. Evidence is accumulating that the origins of the disorder lie in early life, and various environmental factors have been shown to be associated with an increased risk of later schizophrenia. These factors include obstetric complications, prenatal infections, and nutritional deprivation, all of which are more common among people in lower social classes. However, it remains unclear whether people born into lower social classes are at increased risk of schizophrenia.
People born into lower social classes often delay seeking treatment for schizophrenia. This can mean the delay in diagnosis can mean they are less likely to do well with treatment. Symptoms can appear at the same time as the higher classes but they are detected later. A schizophrenic of the upper and middle classes is more likely to be referred for treatment through medical channels while the lower class.
Lefley (1990) researched insights from Third World cultures and suggested that patients may function better in developing countries because more kinship networks, buffering mechanisms, and apparently greater respect to tolerance of difficult behaviour’s may exist within social dynamics.
For individuals with schizophrenia, there are also more opportunities for low-stress, non-competitive productive roles in communal societies and agrarian economics
Schizophrenia can usually be diagnosed if a person has at least two of the following symptoms: delusions, hallucinations, disordered thoughts or behaviour or the presence of negative symptoms, such as a flattening of emotions. Your symptoms have had a significant impact on their ability to work study or perform daily tasks. You have experienced symptoms for more than six months. All other possible causes, such as recreational drug use or depression, have been ruled out.
Disorganized Schizophrenia (Hebephrenic) also known as hebephrenia , disorganized schizophrenia is thought to be an extreme expression of disorganization syndrome. It is characterized by incoherent and illogical thoughts and behaviour’s; i.e., disinhibited, agitated, and purposeless …show more content…
behaviours. Psychiatrists say disorganized schizophrenia is a more severe schizophrenia type because the patient cannot perform daily activities, such as preparing meals and taking care of personal hygiene (washing). People may not be able to understand what the patient is saying. The sufferer can become frustrated and agitated, causing him/her to lash out
Catatonic Schizophrenia this type of schizophrenia includes extremes of behaviour, including: Catatonic excitement - overexcitement or hyperactivity, in which the patient may mimic sounds (echolalia) or movements (achopraxia) around them.
Catatonic stupor - a dramatic reduction in activity in which the patient cannot speak, move or respond.
Virtually all movements stop. Sometimes an individual with catatonic schizophrenia may deliberately assume bizarre body positions, or manifest unusual limb movements or facial contortions, occasionally resulting in the misdiagnosis with tardive dyskinesia Paranoid In this type of schizophrenia the patient has false beliefs (delusions) that an individual or group of people are conspiring to harm them or members of their family. As with most other types of schizophrenia, the patient commonly has auditory hallucinations (hearing things that are not real). The patient may also have delusions of personal grandeur - a false belief that they are much greater and more powerful and influential than they really are. He/she may spend a great deal of time thinking about ways to protect themselves from their supposed persecutors
Residual, This subtype is diagnosed when the patient no longer displays prominent symptoms. In such cases, the schizophrenic symptoms generally have lessened in severity. Hallucinations, delusions or idiosyncratic behaviour’s may still be present, but their manifestations are significantly diminished in comparison to the acute phase of the
illness. The undifferentiated subtype is diagnosed when people have symptoms of schizophrenia that are not sufficiently formed or specific enough to permit classification of the illness into one of the other subtypes.
The symptoms of any one person can fluctuate at different points in time, resulting in uncertainty as to the correct subtype classification. Other people will exhibit symptoms that are remarkably stable over time but still may not fit one of the typical subtype pictures. In either instance, diagnosis of the undifferentiated subtype may best describe the mixed clinical syndrome.
Disorders such as schizophreniform disorder or delusional disorder may present with the same symptoms as schizophrenia, with the exception of duration of symptoms. The symptoms of schizophreniform disorder have a duration that lasts at least one month but less than six months. Delusional disorder is an appropriate diagnosis if bizarre delusions have been present for at least one month in the absence of the other symptoms of schizophrenia or a mood disorder (Kaplan et al. 1994).
Just as the symptoms of schizophrenia are diverse, so are its ramifications. Different kinds of impairment affect each patient’s life to varying degrees. Some people require custodial care in state institutions, while others are gainfully employed and can maintain an active family life. However, the majority of patients are at neither of these extremes. Most will have a waxing and waning course marked with some hospitalizations and some assistance from outside support sources. (http://psychcentral.com/lib/types-of-schizophrenia/000714?all=1)
People having a higher level of functioning before the start of their illness typically have a better outcome. In general, better outcomes are associated with brief episodes of symptoms worsening followed by a return to normal functioning. Women have a better prognosis for higher functioning than men, as do patients with no apparent structural abnormalities of the brain. In contrast, a poorer prognosis is indicated by a gradual or insidious onset, beginning in childhood or adolescence; structural brain abnormalities, as seen on imaging studies; and failure to return to prior levels of functioning after acute episodes.
There are lots of varies of Treatments for schizhrenia. The National Institute for Health and Clinical Excellence (NICE) has produced guidelines for how people with schizophrenia should be cared for. NICE recommends anyone providing treatment and care for people with schizophrenia should:
•develop a supportive relationship with patients and their carers
•explain causes and treatment options to everyone, keep clinical language to a minimum, and provide written information at every stage of the process
•enable easy access to assessment and treatment
•work with patients, and their families and carers if they agree, to write advance statements (see below) about their mental and physical healthcare
•take into account the needs of the patient’s family or carers and offer a carers ' assessment.
•encourage patients and their families and carers to join self-help and support groups (http://www.nhs.uk)
Each person is different so a treatment that may help one person may not have the same effect on another. Each patient should have a carefully planed out care plan for just their psychic needs. This could include, prescribed neuroleptic drugs also known as antipsychotic drugs or major tranquillisers. Some people get short-term help from medication, then come off it and remain well. Others may benefit from more long-term treatment.
Talking therapies, such as psychotherapy, counselling and cognitive behaviour therapy (CBT), can help to manage and treat schizophrenia. Talking treatments help you to identify the things you have issues with, explore them and discuss strategies or solutions. They can allow people with schizophrenia to explore the significance of their symptoms, and so to defeat them. TMS is a fairly new treatment, which is still only used in research studies. Although still on trial, it’s non-invasive and seems to be quite safe. It uses magnetic impulses to stimulate the frontal regions of the brain. This may be helpful for people who have mainly ‘negative’ symptoms. (http://www.mind.org.uk/)
Schizophrenia has been described in all cultures and socioeconomic groups throughout the world. The perception of mental illness within the cultural dynamics may affect the diagnosis, treatment, and reintegration of an individual with schizophrenia. As culture influences the ways individuals communicate and manifest symptoms of mental illness, style of coping, support system, and willingness to seek treatment may be affected as well. In West Africa it was found that individuals with a family history of either schizophrenia or other psychiatric disorders were more likely to receive the diagnosis of ukuthwasa symptoms include social withdrawal, irritability, restlessness, and appearing to respond to auditory hallucinations, than amafufunyana, described as a hysterical condition characterized by people who speak in a strange muffled voice, cannot be understood, and have unpredictable behaviours. This state is believed to be induced by sorcery that led to possession by multiple spirits that may then speak through the individual ‘speaking in tongues’.
Similarly, among acculturated Mexican-American families, the term nervios, is used to refer to a wide range of mental illness and psychological distress. With this condition, the patient is not considered blameworthy. However, among Anglo-Americans, schizophrenia is an illness for which the patient’s personal character is implicated. (Lopez et al. 2004). .In 1911 if someone was diagnosed with schizophrenia there was no known cure, Shunned by society, they would have been treated with fear and suspicion by many they would be subjected to treatment by trial and error, some of which would have gruesome side-effects. Detained by the state, they could expect to be monitored by overworked, underpaid staff and going to church might have been suggested as a way to calm their chaotic mind. Institutions for the mentally ill were established beginning in the 14th century. These facilities, or asylums, were opened in Florence, Spain, Belgium, and England. One of the most renowned was St. Mary of Bethlehem, located outside London -- better known as Bedlam. Mental patients were first accepted in 1403, and by 1547 it was totally devoted to the care of the insane. This asylum was well known for the brutal treatment of the insane. Bedlam was later used as a term to refer to all asylums (http://www.medscape.org)
Conclusion Schizophrenia is a severe and persistent mental illness that crosses all racial, ethnic, cultural, and demographic lines. The influence of class status, ethnic and cultural identity in relation to the presentation and the reporting of schizophrenia must be considered. Communication, coping styles, support system, and willingness to seek treatment are also affected. The factors discussed influence beliefs, attitudes, and behaviour’s regarding the identification of illness and health and in the process of treatment and recovery. The lack of educational and financial resources may create a barrier, in terms of utilization of services and compliance with treatment. Understanding how psychosocial factors within the cultural dynamics of this population would promote more culturally relevant care. There’s a stigma attached to mental health problems. This means that people feel uncomfortable about them and don’t talk about them much.
References
http://www.bmj.com/content/323/7326/1398?sid=94b63c0e-029e-4fbb-9f66-a8e96d2cccf0( accessed 10/11/2013) http://www.hindawi.com/journals/schizort/2012/916198/ accessed (27/10/2013. ) http://www.medscape.org/viewarticle/418882_6 http://www.mind.org.uk/information-support/types-of-mental-health-problems/schizophrenia/treatment-and-support/ (accessed 9/11/2013) http://www.nhs.uk/Conditions/Schizophrenia/Pages/Treatment.aspx. (Accessed 10/10/3013) http://www.schizophrenia.com/history.htm (accessed 26/10/3013) http://www.schizophrenia.com/history.htm#( accessed 26/10/3013 )
Kaplan, H.I., Sadock, B.J., and Grebb, J.A. (1994). Kaplan and Sadock’s synopsis of psychiatry, behavioral science and clinical psychiatry (7th ed.). Baltimore, MD: Williams and Wilkins. Lefley, H.P. (1990). Rehabilitation in mental illness: insights from other cultures. Psychosocial Rehabilitation Journal, 14 (1), 5-12.
Lopez, S.R., Nelson, H., Polo, A.J., Jenkins J.H., et al. (2004). Ethnicity, expressed emotion, attributions, and course of schizophrenia: family warmth matters. Journal of Abnormal Psychology, 113 (3), 428-
Walker D. W., McColl G., Jenkins N. L., Harris J., Lithgow G. J. 2000 Evolution of lifespan in C. elegans. Nature 405, 296–297