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Taking A Glance At Schizophrenia 1 Research Paper Jami Detjens MHS 599 Concordia University Instructor: Dr.Sarah Nowlin 04/11/2015 Taking A Glance At Schizophrenia 2 In working with individuals who carry a mental health diagnosis it is important to understand the nature of the disease. The better educated a person is on a specific diagnosis the easier it is to separate individual traits unique to a person from the hallmarks of the disease. It is important for an individual with a diagnosis to figure out who they are both as an individual both separate from and with the disease so they can choose how to respond when seeking treatment. As a professional this distinction matters because the goal of treating the disease needs to include respecting an individual’s autonomy. Crisis Intervention training is a program geared towards law enforcement to help professionals understand how to deescalate individuals who are symptomatic without violence. Doctors and social workers are also invited to attend a shorter session. One of the most memorable segments of this training involves experiencing what it is like to hear voices. In this training participants are given an mp3 player, headphones, and a fourth grade level homework packet. The Participant does the homework while wearing headphones who are speaking to him in different voices both male and female. The voices vary from loud and persecutory, some are whispering and unintelligible, some are saying you are chosen. It is a very unsettling experience to try concentrating past voices in one’s head. Having this experience gives a small glimpse into the world of schizophrenia and what the bearer of this diagnosis contends with every day. This is why taking a closer look at schizophrenia is an appealing topic. By examining what is known with regards to causes, how symptoms typically manifest, and what happens at onset it is easier to put together a history and develop a treatment plan. By examining past methods of treatment and current treatment trends it is easier to plan for the future. The main goal should be to empower individuals to understand their disease and choose how they identify with it. In order to assist with that goal as a professional understanding what research says about diagnosis and prognosis needs to be relatively thorough. Taking A Glance At Schizophrenia 3 Schizophrenia is defined as “a persistent and recurrent disease characterized by disturbances of perception, thought, emotion and behavior.” (Ko, Smith, Liao, & Chiang, 2013) It is a disease which affects approximately 26.3 million people worldwide. It is present in every culture, socio economic group, gender, and race. Typical onset is between the ages of 19-25 with males generally presenting earlier than females. Many individuals diagnosed are unable to do work to sustain themselves. It is estimated that 20% of individuals are homeless and three times more likely to be in the criminal justice system than a hospital. “A century ago we had large public institutions for serious mental illness, tuberculosis and leprosy. Of these three, today only mental illness, especially schizophrenia, remains unchanged in prevalence and disability.” (Insel, 2010) In 100 years of research the cause is still relatively unknown, the best treatment results come from pharmaceuticals which can carry lasting unfavorable side effects. The risk of permanent neurological changes, (involuntary movements, tics and muscle constrictions), and metabolic problems (diabetes, obesity, hyperlipidemia, hypertension, and hyperglycemia) are a drawback to treatment and it is common for many diagnosed individuals to want to refuse treatment altogether. Psychiatrics have to continually monitor for involuntary movements and adjust medications accordingly. Physically people with schizophrenia have a life expectancy estimated to be about twenty five years shorter than the average. Heavy smoking and a sedimentary lifestyle complicate this. Other treatments include lobotomies (which are no longer performed), electroconvulsive therapy (which is not as commonly performed today but remains an effective treatment for some patients,) and the current recovery model (which has patients actively engage in treatment choices through psychoeducational training. The problems which researchers face when determining a cause is a matter of methodology difficulties. Dr. Samuel Eiduson points out that there are three major barriers to biochemical studies in Taking A Glance At Schizophrenia 4 schizophrenia. Limitations with being able to do studies on the brain, large variations in the way the disease presents and responds to treatment makes it difficult to put together a study group and account for variables. Research seems to suggest a genetic component but so far pinpointing where the connection lies has been elusive. Other suggestions are possible environmental causes. In the 1930’s Freud contended that schizophrenia was caused by painful experiences at the hands of a parent usually the mother. Psychoanalysis contended for years that schizophrenia was caused by the “schizophrenogenic mother.” The patient was inadequately mothered or had an “overprotective mother who was overinvolved with her child and derogatory of her husband.” (Wuerker, 2000) Schizophrenia was caused by mothers who were “cold, rejecting, and domineering,” and fathers who were “passive, detached, and ineffectual.” (Wuerker, 2000) This school of thought, that family dynamics and relationships caused schizophrenia continued, yet psychotherapy has not been shown to be an effective treatment for the disease. Blaming families has actually had a negative impact on treatment because families have not been encouraged to partner in treatment. It is clear that families can be the biggest and best advocates for people with diagnosis and much of the legislation and empowerment measures which have improved the circumstances of people with schizophrenia have come from their efforts. In the second half of the twentieth century pharmaceuticals came into play and while this has been much more effective than psychotherapy the application is limited to controlling symptoms not providing a cure. “Although there can be little argument that medications have transformed the treatment of psychosis, research focusing on the drugs instead of the illness has thus far yielded too little progress on the pathophysiology of schizophrenia.” (Insel, 2010) As previously mentioned the negative effects on a person’s health from medications has been widely documented. A new class of medications (Atypical antipsychotics) has been developed to replace the old generation of medications to address the side effects but these too have proven to have the same long term effects. Professionals Taking A Glance At Schizophrenia 5 are encouraged to rely heavily on pharmaceutical treatment as the baseline for treatment needs but David Cohen points out several problems with the methodology of pharmaceutical trials which skew results. He contends that professionals “must look afresh at the ideological, ethical, political, and commercial incentives that drive the field today.” (Cohen, 2002) While medications will continue to play an important role in psychiatric treatment, neurology is the direction the study of schizophrenia is moving in. 4.An explanation of what you would have done differently had you known this information when you needed it (1 to 2 pages). Taking A Glance At Schizophrenia 6 5.Total length of paper 7 to 9 pages not counting title page and reference pages. References Brill, N. Q., Cocoran, J. F., Eiduson, S., Judd, L. L., May, P. R., Stoller, R., & Walter, R. (1969 ). Schizophrenia. The UCLA Interdepartmental Conference (pp. 107-125). Los Angelos: College of Physicians. Crow, T. J. (1997). Aetiology of schizophrenia: an echo of the speciation event. International Review of Psychiatry, 321-330. Hinsie, L. E. (1999). The Treatment of Schitzophrenia: A Survey of the Literature. Psychiatric Quarterly, Vol. 70, No. 1, 1999 , 5-26. Insel, T. R. (2010). Rethinking Schizophrenia . Nature vol 468, 187-193. Jaeger, S., Weißhaupt, S., Flammer, E., & Steinert, T. (2014). Control Beliefs, Therapeutic Relationship, and Adherence in Schizophrenia Outpatients: A Cross-sectional Study. Am J Health Behav.™ issue 38, V 6, 914-923. Ko, C.-J., Smith, P., Liao, H.-Y., & Chiang, H.-H. (2013). Searching for reintegration: life experiences of people with schizophrenia. Journal of Clinical Nursing issue 23, 394–401. Rastad, C., Martin, C., & Åsenlo¨f, P. (2014). Barriers, Benefits, and Strategies for Physical Activity in Patients With Schizophrenia. Physical therapy Volume 94 Number 10, 1467-1479. Retrieved from http://ptjournal.apta.org/ Wuerker, A. K. (2000). The Family and Schizophrenia. Mental Health Nursing, 21, 127-141.