Just the word diagnosis can sound frightening and clinical. However, diagnoses
are nothing more than the names given to various physical and mental
disorders or diseases. A diagnosis is a generalization that describes what
the average person with that disorder or disease experiences, and what can
be expected in the future based on criteria that are periodically revised by
the medical community.
The value of a diagnosis is that it provides a shorthand way of communicating
important information about a medical condition, such as:
- The characteristic symptoms of the disorder
-The expected course (how it may vary over time)
-The prognosis of the disorder (the outlook for the future)
- Most important, options for treatment
Saturday, June 5, 2010
Friday, June 4, 2010
Dispelling the Myths Associated with Schizophrenia.
People wrongly associate the symptoms of schizophrenia with split or multiple
personalities (like Dr. Jekyll and Mr. Hyde), antisocial behavior (similar to
what we see in serial killers), and developmental disabilities. Others believe
that schizophrenia is a character defect and that the individual could behave
normally if he really wanted to.
Here are a few of the most common misconceptions about schizophrenia:
- Schizophrenia is the same as a split or multiple personality.
Schizophrenia is not the same as multiple personality, which is an
exceedingly rare, totally different disorder that is now more commonly
called a dissociative identity disorder. (Under stress, people with this
disorder often assume different identities, each with different names,
voices, characteristics, and personal histories.)
- People with schizophrenia are violent.
People with schizophrenia are
more likely to be victims rather than perpetrators of crimes. Many
people believe that most people with schizophrenia have a propensity
for violence, but the reality is that most people with schizophrenia
don’t commit violent crimes, and most violent criminals don’t have
schizophrenia.
For example, serial killers (people who commit three or more subsequent
murders) usually aren’t psychotic (out of touch with reality);
they’re likely to be diagnosed with an antisocial personality disorder
(a disorder in which people disregard commonly accepted social rules
and norms, display impulsive behavior, and are indifferent to the rights
and feelings of others).
However, people with untreated schizophrenia, who refuse to take
medication and whose thinking is out of touch with reality are at
increased risk of aggressive behavior and self-neglect. The risk of violence
also increases if someone with schizophrenia is actively abusing
alcohol or illicit drugs. For better or worse, the aggressive behavior is
usually directed toward family or friends rather than toward strangers.
- Poor parenting causes schizophrenia.
For many years, clinicians were
taught and actually believed that schizophrenia was caused by parents
who were either too permissive or too controlling. The term schizophrenogenic
mother was once used to describe such parents — the blame
usually fell heavily on mothers because they tended to spend the most
time with their offspring. Another outdated theory is the double-bind
theory, which suggested that schizophrenia is due to inconsistent
parenting, with conflicting messages.
These ideas were not based on controlled studies, and these theories no
longer have credibility today.
Schizophrenia is a no-fault disorder of the brain.
- People with schizophrenia are mentally retarded.
Some people think
that schizophrenia is synonymous with mental retardation (now called
developmental disabilities). No. Like the general public, people with
schizophrenia have a wide range of intellectual abilities. They may
appear less intelligent because of the impaired social skills, odd behaviors,
and cognitive impairments that are characteristic of schizophrenia.
However, they’re not lacking in intelligence, and schizophrenia is
distinct from developmental disabilities (physical and mental deficits
that are chronic and severe and that generally begin in childhood).
- Schizophrenia is a defect of character.
Negative symptoms of schizophrenia
give people the mistaken impression that those with the disorder
are lazy and could act “normally” if they wanted to. This idea is no
more realistic than suggesting that someone could prevent his epileptic
seizures if he really wanted to or that someone could “decide” not to
have cancer if he ate the right foods. What often appears as character
defects are symptoms of schizophrenia.
When the negative symptoms of schizophrenia are persistent and primarily
caused by schizophrenia, they’re referred to as deficit syndrome.
- There’s no hope for people diagnosed with schizophrenia. Sixty years
ago when people were diagnosed with schizophrenia, they were
either kept at home behind closed doors by embarrassed and forlorn
families who saw no other alternative, or consigned to long-term stays
in distant state hospitals for care that was largely custodial (they weren’t
treated — they were just taken care of). Other than using highly sedating
drugs, doctors had few tools available to them to relieve the agitation
and torment of their patients or to help restore their functioning.
In contrast to how things were in the past, schizophrenia is now considered
highly treatable. Several generations of new medications and the
emergence of new forms of therapies have enabled doctors to treat the
symptoms of the large majority of patients with schizophrenia enabling
them to live meaningful, productive lives in their communities.
personalities (like Dr. Jekyll and Mr. Hyde), antisocial behavior (similar to
what we see in serial killers), and developmental disabilities. Others believe
that schizophrenia is a character defect and that the individual could behave
normally if he really wanted to.
Here are a few of the most common misconceptions about schizophrenia:
- Schizophrenia is the same as a split or multiple personality.
Schizophrenia is not the same as multiple personality, which is an
exceedingly rare, totally different disorder that is now more commonly
called a dissociative identity disorder. (Under stress, people with this
disorder often assume different identities, each with different names,
voices, characteristics, and personal histories.)
- People with schizophrenia are violent.
People with schizophrenia are
more likely to be victims rather than perpetrators of crimes. Many
people believe that most people with schizophrenia have a propensity
for violence, but the reality is that most people with schizophrenia
don’t commit violent crimes, and most violent criminals don’t have
schizophrenia.
For example, serial killers (people who commit three or more subsequent
murders) usually aren’t psychotic (out of touch with reality);
they’re likely to be diagnosed with an antisocial personality disorder
(a disorder in which people disregard commonly accepted social rules
and norms, display impulsive behavior, and are indifferent to the rights
and feelings of others).
However, people with untreated schizophrenia, who refuse to take
medication and whose thinking is out of touch with reality are at
increased risk of aggressive behavior and self-neglect. The risk of violence
also increases if someone with schizophrenia is actively abusing
alcohol or illicit drugs. For better or worse, the aggressive behavior is
usually directed toward family or friends rather than toward strangers.
- Poor parenting causes schizophrenia.
For many years, clinicians were
taught and actually believed that schizophrenia was caused by parents
who were either too permissive or too controlling. The term schizophrenogenic
mother was once used to describe such parents — the blame
usually fell heavily on mothers because they tended to spend the most
time with their offspring. Another outdated theory is the double-bind
theory, which suggested that schizophrenia is due to inconsistent
parenting, with conflicting messages.
These ideas were not based on controlled studies, and these theories no
longer have credibility today.
Schizophrenia is a no-fault disorder of the brain.
- People with schizophrenia are mentally retarded.
Some people think
that schizophrenia is synonymous with mental retardation (now called
developmental disabilities). No. Like the general public, people with
schizophrenia have a wide range of intellectual abilities. They may
appear less intelligent because of the impaired social skills, odd behaviors,
and cognitive impairments that are characteristic of schizophrenia.
However, they’re not lacking in intelligence, and schizophrenia is
distinct from developmental disabilities (physical and mental deficits
that are chronic and severe and that generally begin in childhood).
- Schizophrenia is a defect of character.
Negative symptoms of schizophrenia
give people the mistaken impression that those with the disorder
are lazy and could act “normally” if they wanted to. This idea is no
more realistic than suggesting that someone could prevent his epileptic
seizures if he really wanted to or that someone could “decide” not to
have cancer if he ate the right foods. What often appears as character
defects are symptoms of schizophrenia.
When the negative symptoms of schizophrenia are persistent and primarily
caused by schizophrenia, they’re referred to as deficit syndrome.
- There’s no hope for people diagnosed with schizophrenia. Sixty years
ago when people were diagnosed with schizophrenia, they were
either kept at home behind closed doors by embarrassed and forlorn
families who saw no other alternative, or consigned to long-term stays
in distant state hospitals for care that was largely custodial (they weren’t
treated — they were just taken care of). Other than using highly sedating
drugs, doctors had few tools available to them to relieve the agitation
and torment of their patients or to help restore their functioning.
In contrast to how things were in the past, schizophrenia is now considered
highly treatable. Several generations of new medications and the
emergence of new forms of therapies have enabled doctors to treat the
symptoms of the large majority of patients with schizophrenia enabling
them to live meaningful, productive lives in their communities.
What are the Symptoms of Schizophrenia?
There are almost 300 named psychiatric disorders, and schizophrenia is one
of them. Although many mental illnesses have symptoms that overlap,
schizophrenia has a distinct pattern of symptoms. No two cases of schizophrenia
look exactly the same, but most people with schizophrenia display
three types of symptoms:
-Positive symptoms: The term positive symptoms is confusing, because
positive symptoms (as the term might suggest) aren’t “good” symptoms
at all. They’re symptoms that add to reality, and not in a good way.
People with schizophrenia hear things that don’t exist or see things that
aren’t there (in what are known as hallucinations). The voices they hear
can accuse them of terrible things and can be very jarring (for example,
causing them to think that they’ve hurt someone or have been responsible
for some cataclysmic world event).
People with schizophrenia can also have delusions (false beliefs that
defy logic or any culturally specific explanation and that cannot be
changed by logic or reason). For example, an individual may believe that
there is a conspiracy of people driving red cars that follows his every
movement. He will use the fact that there are red cars everywhere he
goes as evidence that the conspiracy is real.
-Negative symptoms: These symptoms are a lack of something that
should be present; behaviors that would be considered normal are
either absent or diminished. For example, people with schizophrenia
often lack motivation and appear lazy. They may be much slower to
respond than most other people, have little to say when they do speak,
and appear as if they have no emotions, or exhibit emotions that are
inappropriate to the situation. They may also be unable to get pleasure
from the things that most people enjoy or from activities that once
brought pleasure to them. Families often get frustrated when a relative
with schizophrenia does nothing but sleep or watch TV — they wrongly
attribute this behavior to the patient not being willing to assume
responsibility or “pull himself up by his bootstraps.”
Negative symptoms are part and parcel of the illness for at least 25
percent of people with schizophrenia.
-Cognitive symptoms: Most people with the disorder suffer from impairments
in memory, learning, concentration, and their ability to make
sound decisions. These so-called cognitive symptoms interfere with an
individual’s ability to learn new things, remember things they once
knew, and use skills they once had. Cognitive symptoms can make it
hard for a person to continue working at a job, going to school, or
participating in activities she may have enjoyed at one time.
In addition to the symptoms mentioned above, people with schizophrenia
may also have sleep problems, mood swings, and anxiety. They may experience
difficulties forming and maintaining social relationships with other
people. They may look different enough that other people notice that something
is very odd or strange about them and that they don’t quite look
“normal.” They may have unusual ways of doing things, have peculiar habits,
dress inappropriately (such as wearing a heavy coat or multiple layers of
clothes in the summer), and/or be poorly groomed, which can discourage
other people from getting involved with them.
of them. Although many mental illnesses have symptoms that overlap,
schizophrenia has a distinct pattern of symptoms. No two cases of schizophrenia
look exactly the same, but most people with schizophrenia display
three types of symptoms:
-Positive symptoms: The term positive symptoms is confusing, because
positive symptoms (as the term might suggest) aren’t “good” symptoms
at all. They’re symptoms that add to reality, and not in a good way.
People with schizophrenia hear things that don’t exist or see things that
aren’t there (in what are known as hallucinations). The voices they hear
can accuse them of terrible things and can be very jarring (for example,
causing them to think that they’ve hurt someone or have been responsible
for some cataclysmic world event).
People with schizophrenia can also have delusions (false beliefs that
defy logic or any culturally specific explanation and that cannot be
changed by logic or reason). For example, an individual may believe that
there is a conspiracy of people driving red cars that follows his every
movement. He will use the fact that there are red cars everywhere he
goes as evidence that the conspiracy is real.
-Negative symptoms: These symptoms are a lack of something that
should be present; behaviors that would be considered normal are
either absent or diminished. For example, people with schizophrenia
often lack motivation and appear lazy. They may be much slower to
respond than most other people, have little to say when they do speak,
and appear as if they have no emotions, or exhibit emotions that are
inappropriate to the situation. They may also be unable to get pleasure
from the things that most people enjoy or from activities that once
brought pleasure to them. Families often get frustrated when a relative
with schizophrenia does nothing but sleep or watch TV — they wrongly
attribute this behavior to the patient not being willing to assume
responsibility or “pull himself up by his bootstraps.”
Negative symptoms are part and parcel of the illness for at least 25
percent of people with schizophrenia.
-Cognitive symptoms: Most people with the disorder suffer from impairments
in memory, learning, concentration, and their ability to make
sound decisions. These so-called cognitive symptoms interfere with an
individual’s ability to learn new things, remember things they once
knew, and use skills they once had. Cognitive symptoms can make it
hard for a person to continue working at a job, going to school, or
participating in activities she may have enjoyed at one time.
In addition to the symptoms mentioned above, people with schizophrenia
may also have sleep problems, mood swings, and anxiety. They may experience
difficulties forming and maintaining social relationships with other
people. They may look different enough that other people notice that something
is very odd or strange about them and that they don’t quite look
“normal.” They may have unusual ways of doing things, have peculiar habits,
dress inappropriately (such as wearing a heavy coat or multiple layers of
clothes in the summer), and/or be poorly groomed, which can discourage
other people from getting involved with them.
What Causes Schizophrenia?
Schizophrenia is a no-fault, equal-opportunity illness most likely caused
by a number of factors, both genetic and environmental. Most scientists now
accept a two-hit theory for the cause of schizophrenia, which suggests that
the genetic susceptibility is compounded by one or more environmental
factors:
-Genetic susceptibility: Based on family genetic history, some people are
more vulnerable to the disorder than other people are.
- Environmental factors: In someone genetically predisposed, certain
environment factors may come into play, such as:
• Physical trauma that occurs to the fetus during childbirth
• Oxygen-deprivation or some psychological or physical problem
that occurs to the mother during pregnancy and affects the developing
fetus
• Emotional stress, such as the loss of a parent or loved one during
young adulthood
Although schizophrenia is genetically influenced, more than genetics is
involved in its development. Studies of identical twins show that, if one twin
develops schizophrenia, the other twin has only a 40 percent to 50 percent
chance of also developing the illness. There’s also an increased risk among
fraternal twins when one develops schizophrenia, the other has between a 10
percent and 17 percent chance, far less than that of identical twins. Having a
parent with schizophrenia also increases a person’s risk of developing the
disease, to about 10 percent. And if you have a sibling with the disorder —
not your twin — you have a 6 percent to 9 percent chance of developing the
disorder yourself.
Scientists still don’t know the precise causes of schizophrenia for any particular
individual, yet family members and patients themselves tend to dwell on
(or even obsess about) finding a “reason” or a “cause” for the illness.
Although this instinct is a natural one, finding the precise cause or explanation
is impossible, not to mention counterproductive — finding a reason
doesn’t help treatment, and it often creates unnecessary and misplaced guilt,
with one family member blaming another
by a number of factors, both genetic and environmental. Most scientists now
accept a two-hit theory for the cause of schizophrenia, which suggests that
the genetic susceptibility is compounded by one or more environmental
factors:
-Genetic susceptibility: Based on family genetic history, some people are
more vulnerable to the disorder than other people are.
- Environmental factors: In someone genetically predisposed, certain
environment factors may come into play, such as:
• Physical trauma that occurs to the fetus during childbirth
• Oxygen-deprivation or some psychological or physical problem
that occurs to the mother during pregnancy and affects the developing
fetus
• Emotional stress, such as the loss of a parent or loved one during
young adulthood
Although schizophrenia is genetically influenced, more than genetics is
involved in its development. Studies of identical twins show that, if one twin
develops schizophrenia, the other twin has only a 40 percent to 50 percent
chance of also developing the illness. There’s also an increased risk among
fraternal twins when one develops schizophrenia, the other has between a 10
percent and 17 percent chance, far less than that of identical twins. Having a
parent with schizophrenia also increases a person’s risk of developing the
disease, to about 10 percent. And if you have a sibling with the disorder —
not your twin — you have a 6 percent to 9 percent chance of developing the
disorder yourself.
Scientists still don’t know the precise causes of schizophrenia for any particular
individual, yet family members and patients themselves tend to dwell on
(or even obsess about) finding a “reason” or a “cause” for the illness.
Although this instinct is a natural one, finding the precise cause or explanation
is impossible, not to mention counterproductive — finding a reason
doesn’t help treatment, and it often creates unnecessary and misplaced guilt,
with one family member blaming another
Who Gets Schizophrenia?
No group is risk-free when it comes to schizophrenia, but some people are
more likely than others to develop the disorder. The following statistics may
surprise you:
-Schizophrenia is more common than you might think. About 1 out of
100 people develop schizophrenia over the course of their lifetime.
Schizophrenia is twice as common as Alzheimer’s disease or HIV/AIDS,
five times as common as multiple sclerosis, and six times as common as
Type 1 (insulin-dependent) diabetes.
Although new cases of schizophrenia are somewhat rare, the number
of individuals with the disorder remains relatively high because
schizophrenia is a chronic disorder that often lasts for an extended
period of time.
- Schizophrenia affects both sexes equally and is found among people
of all races, cultures, and socioeconomic groups around the world.
- Although schizophrenia is more likely to affect people between the
ages of 17 and 35 (the onset tends to be earlier in men than in
women), it can begin in children as young as age 5 or have a late
onset in a person’s 50s, 60s, or 70s.
Childhood-onset schizophrenia is extremely rare, affecting about 1 in
40,000 children. Only 1 in 100 adults now diagnosed with the disorder
had symptoms before the age of 13. Because the disorder tends to
surface more gradually in children, it often goes unnoticed.
An earlier onset is often indicative of poorer outcomes because the
disorder can interfere with education, development, and social
functioning. On the other hand, early recognition can help improve
outcomes and minimize disability.
more likely than others to develop the disorder. The following statistics may
surprise you:
-Schizophrenia is more common than you might think. About 1 out of
100 people develop schizophrenia over the course of their lifetime.
Schizophrenia is twice as common as Alzheimer’s disease or HIV/AIDS,
five times as common as multiple sclerosis, and six times as common as
Type 1 (insulin-dependent) diabetes.
Although new cases of schizophrenia are somewhat rare, the number
of individuals with the disorder remains relatively high because
schizophrenia is a chronic disorder that often lasts for an extended
period of time.
- Schizophrenia affects both sexes equally and is found among people
of all races, cultures, and socioeconomic groups around the world.
- Although schizophrenia is more likely to affect people between the
ages of 17 and 35 (the onset tends to be earlier in men than in
women), it can begin in children as young as age 5 or have a late
onset in a person’s 50s, 60s, or 70s.
Childhood-onset schizophrenia is extremely rare, affecting about 1 in
40,000 children. Only 1 in 100 adults now diagnosed with the disorder
had symptoms before the age of 13. Because the disorder tends to
surface more gradually in children, it often goes unnoticed.
An earlier onset is often indicative of poorer outcomes because the
disorder can interfere with education, development, and social
functioning. On the other hand, early recognition can help improve
outcomes and minimize disability.
What Is Schizphrenia?
Schizophrenia is a brain disorder characterized by a variety of different
symptoms, many of which can dramatically affect an individual’s way of
thinking and ability to function. Most scientists think that the disorder
is due to one or more problems in the development of the brain that results
in neurochemical imbalances, although no one fully understands why
schizophrenia develops.
People with schizophrenia have trouble distinguishing what’s real from
what’s not. They are not able to fully control their emotions or think
logically, and they usually have trouble relating to other people. They often
suffer from hallucinations; much of their bizarre behavior is usually due to
individuals acting in response to something they think is real but is only in
their minds.
Unfortunately, because of the way schizophrenia has been inaccurately
portrayed in the media over many decades, the illness is one of the most
feared and misunderstood of all the physical and mental disorders.
Schizophrenia is a long-term relapsing disorder because it has symptoms
that wax and wane, worsen and get better, over time. Similar to many
physical illnesses (such as diabetes, asthma, and arthritis), schizophrenia is
highly treatable — although it isn’t yet considered curable.
symptoms, many of which can dramatically affect an individual’s way of
thinking and ability to function. Most scientists think that the disorder
is due to one or more problems in the development of the brain that results
in neurochemical imbalances, although no one fully understands why
schizophrenia develops.
People with schizophrenia have trouble distinguishing what’s real from
what’s not. They are not able to fully control their emotions or think
logically, and they usually have trouble relating to other people. They often
suffer from hallucinations; much of their bizarre behavior is usually due to
individuals acting in response to something they think is real but is only in
their minds.
Unfortunately, because of the way schizophrenia has been inaccurately
portrayed in the media over many decades, the illness is one of the most
feared and misunderstood of all the physical and mental disorders.
Schizophrenia is a long-term relapsing disorder because it has symptoms
that wax and wane, worsen and get better, over time. Similar to many
physical illnesses (such as diabetes, asthma, and arthritis), schizophrenia is
highly treatable — although it isn’t yet considered curable.
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