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Taking A Glance At Schizophrenia
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Research Paper
Jami Detjens
MHS 599
Concordia University
Instructor: Dr.Sarah Nowlin
04/11/2015
Taking A Glance At Schizophrenia
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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.
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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
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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
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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).
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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.