Class 12 IB Psychology Project report on CAUSES, CONSEQUENCES & TREATMENT OF SCHIZOPHRENIA with API Format references Class 12 Psychology Project, Causes of Schizophrenia, Consequences of Schizophrenia, Treatment of Schizophrenia, Symptoms of Schizophrenia

 

Class 12 IB Board Psychology Project report on

CAUSES, CONSEQUENCES & TREATMENT OF SCHIZOPHRENIA

Abstract

Schizophrenia is one of the most severe mental illnesses that is affecting 1 to 1.5 % percent population of the globe. It causes hallucinations, paranoia or bizarre delusions and disorganized thought or speech pattern which can result into social impairment of an individual (Sim et al. 2006). Research indicates that People with mental illnesses die at least 25 years earlier than the rest of the population. Schizophrenic people suffer from heart disease, diabetes and other disease which cause their death much before than normal population. Around 10 % of schizophrenic people die from suicide. However this disease is now curable to an extent with advancement in medical technology, rehabilitation process and through psychosocial interventions.

Treatment of this illness is of immense importance to save life of millions. Possible consequences of suffering from schizophrenia do not harm only patient but also put family into economic, mental and social loss. In order to develop a treatment it is very important to analyse various causes leading to this disease and understand the consequences to be faced in absence of treatment of this disease. Over a period of time, multiple researches into schizophrenia has been done; knowledge of this mental disorder has improved tremendously. Researchers have pinpointed various possible causes of schizophrenia which have helped to understand how this disease develops in an individual and consequences to be faced in schizophrenic scenario. Causation models assist researchers to devise cure for this disease.

This written work is based on identifying various causes of schizophrenia, its consequences and cure available to treat this mental disorder. A qualitative study has been done to achieve the objective of this work. Research work conducted in the past with regard to causes, consequences and treatment of Schizophrenia has been used to collect information material to this written work. Schizophrenia is caused due to genetic disorder, drug abuse and social environmental factors such as social exclusion, social disparity in terms of race discrimination; poor economic conditions are major causes of development of Schizophrenia. In terms of its consequences, Schizophrenia can lead to mortality, social disability, social stigma, impact caregivers and cause societal loss. Prevention intervention, family intervention, Psycho social interventions and medication are tools and strategies that can be used to cure schizophrenia.

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Introduction

Schizophrenia

Schizophrenia is a severe mental illness that weakens mental and social functioning of an individual. It impacts perception and sensory ability and cause drastic change in behaviour of the person suffering from this ailment. This mental illness hinders social and occupational functioning of the person and causes morbidity and mortality.

Symptoms of Schizophrenia

In order to identify whether a person is suffering from schizophrenia ailment, various symptoms have been identified which can be broadly classified into major categories:

1. Positive symptoms: 

·         Auditory hallucinations – Perceiving people talking and other sounds which are not actually existing.

·         Sensory feelings such as burning, stinging which does not have any real existence

·         Feeling of disconnect from their body

·         Visualizing images and objects which is not real.

·         Seeing things that aren’t there, or finding light too bright or blinding.

·         Experiencing delusions – false or erroneous belief about something.

2. Negative symptoms: 

Elements of negative symptoms include:-

·         Lack of expression – person not interested in and around surroundings, no emotions in voice, tone and on face.

·         Lack of motivation – trouble in doing routine activities, facing issues in interaction with people, feeling hazy, feels demotivate in doing anything.

·         Lack of pleasure – remaining sad and not enjoying doing things which pleases him and feels disconnected and disassociated with loved ones.

·         Inattention – easily gets distracted, not able to complete his work, finds difficulty and easily gets frustrated.

Some symptoms do not fall under either positive or negative symptoms such as:

·         Catatonia – contortion, repetition of certain gesture, or making frenzied gestures.

·         Catatonia inability – people remain in strange positions or gestures for very long period of time without realization.

·         Inappropriate effect – Responding to any stimulus in opposite way. For example on sad news, they laugh; on good news they cry.

                                                       Causes of Schizophrenia

1.Genetic Causes

Numerous genetic caused by different genes and environmental factors can lead to schizophrenia (Harrison and Owen 2003). However it is complex to separate genetic and environmental causes (O'Donovan et al. 2003). The theory of genetic causation firmly believes that schizophrenia is an illness of complex inheritance. Research has been done to identify group of genes that may cause this mental disorder (Owen et al. 2005). Result findings state that a group of fourteen genes cause this disease, but later on it is found that suggested group of genes is not linked with schizophrenia (Sanders et al. 2008). Schizophrenia may be caused due to duplications of DNA sequences in genes that are conscientious for neuronal signalization or brain development (Walsh et al. 2008). Abnormal connection between different gene networks has been found common in schizophrenic patients (Broyd et al. 2009). Result indicates that different neural network suppress each other leading to deactivation of functioning of many neurons. Major symptoms of schizophrenia, such as memory loss, attention disorder and social cognition have been explained using this result. (ibid.).

2.Drug Use

Link between Drug use and Schizophrenia has been established in research on effects of cannabis. It has been suggested in the analysis of research that Drug is a vital factor that stimulates risk of developing schizophrenia but not a significant factor in development of this disease. It is a complex combination of factors that cause it.  (Arsenault, Cannon, Witton, & Murray, 2004). Cannabis doubles the possibility of emergent of schizophrenia at individual level. This connecting association accounts for 8% percent of cases in the overall population (Arsenault et al ibid.). Hallucinogens and stimulant drugs such as amphetamines have been linked to causing schizophrenia. Amphetamines trigger the release of dopamine which triggers schizophrenia symptoms (Laruelle et al. 1996). Heavy use of hallucinogens sometimes also cause trigger for schizophrenia (Mueser at al. 1990). However, these drugs have not been necessarily caused development of this disorder. However, when a tendency exists, these drugs may prompt the inception of schizophrenia (Laruelle et al. 1996).

3.Social environmental causes

Research indicates that social exclusion, and exploitation due to social and economic weakness present at childhood lead to high risk of developing schizophrenia in later life of individuals (Wicks et al. 2005; Mueser et al. 2004). Migration history of individual or family linked with adverse social factors such as racism, discrimination, unemployment, family dysfunction and poor economics condition are major factors causing schizophrenia (Cantor-Graae and Selten 2005; Selten et al. 2007). In particular, abusive and traumatic experiences in childhood have been identified as strong contributing factors in development of this disorder at later stage of life (Janssen et al. 2004; MacMillan et al. 2001; Read et al. 2001; Schenkel et al. 2005). Residing in urban area is one of the most vital factor in the cause of development of schizophrenia even other factors such as drug abuse, migration, social disadvantage have been restricted or controlled (van Os 2004). The chance of suffering from this disease increases with increase in number of years spent living in urban areas during childhood and adolescence (Pedersen and Mortensen 2001).

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Consequences of Schizophrenia

Consequences of Schizophrenia is vital in terms of losses accrue due to it. Some of the major observations on consequences of it has been considered and explained below.

1.Mortality

Death rates of people having schizophrenic disorder are at least two times higher than the general population mortality rate (Allebeck, 1989). Suicide and other causes of death have been identified in both developing and developed countries with people suffering from schizophrenia recent studies of people with schizophrenia living in the community (Jablensky et al., 1992). Risk of suicide in schizophrenic disorders has been estimated above 10 % (Caldwell and Gottesman, 1990).

2. Social disability

·         Self Nourishment and care such as taking care of dressing, feeding and being hygienic.

·         Occupational performance such as jobs for which S/he gets paid, studies, homemaking etc.

·         Functioning with family and relatives in terms of expected interaction with them.

·         Functioning in society in terms of interaction with people and performance in social activities.

    3. Social stigma

Social stigma refers to a set of acute discrediting attributes, which is related with wrong beliefs and negative attitudes towards a set of people from whom thay have a fear that they can affect their social identity. These attributes lead to distortion of their self image in society through social rejection discrimination and social isolation (Goffman, 1963). Stigma may lead to use of derogatory language, Obstruction to housing or employment, limited access to social services, less chance of getting married (Desjarlais et al., 1995). Stigma also acts as an impediment to get cured not because they will be labeled as mentally ill because they have wrong perceptions regarding mental health feeling dependency powerlessness segregation from society and family (Deegan, 1990).

4. Impact on caregivers

Research indicates that people suffering from Schizophrenia who are living with their family is about 40 % in USA to more than 90 % in China (Torrey and Wolfe, 1986; Xiong et al., 1994). The burden on families or people living with mentally ill people has been recently recognised (Fadden et al., 1987). Some of the major impacts on caregivers have been analysed (Westermeyer, 1984; Davies and Drummond, 1994) such as-

·         Economic loss in terms of cost on hospitalization and loss of productivity of family.

·         Emotional feeling towards patient illness such as fear of loss of person, fear about future, guilty in terms of not taking care properly etc.

·         Frustration and distress to get adapted to disturbed behaviour.

·         Disturbance in daily routine of house;

·         Difficulties in handling awkward interpersonal behaviour;

·         Restriction of social activities.

Subjective emotional burden has been reported in 41% of families. Hostility, violence and disruption of family activities were perceived as the main source of stress (Salleh, 1994).

5. Social Cost

 Estimates on economic costs of schizophrenia are existing only for some developed countries. Direct costs of schizophrenia in western countries range between 1.6% and 2.6% of total health care expenditures, which in turn account for between 7% and 12% of the gross national product. However, these costs are very unevenly distributed. According to a British study, if we consider a sample of people with schizophrenia from onset to death, it can be estimated that care of patients with long-term disabling course (which represent only 10% of the affected population) will absorb about 80% of the total lifetime direct costs. Research analysis indicates that direct and indirect cost of impact of Schizophrenia in USA in terms of per capita estimates is equal to well known chronic disease diabetes. (Report of the National Advisory Mental Health Council, 1993).

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Prevention & Treatment of Schizophrenia

No set of treatment tool is available to cure schizophrenia completely. However, it can be reduced to minimal and person can come back in regular life using following treatment strategies and prevention measures.

1.Preventive Interventions

Preventive intervention can be categorized into primary and secondary intervention. Primary intervention refers to reduction in incidence of illness in a population which is not yet affected by the disease. Illness prevention and Health Promotion are two major strategies used in primary intervention. Illness prevention applies specific interventions by influencing risk factors while health promotion focuses on promoting healthy behaviors in well being (Eisenberg, 1993). Secondary prevention focuses on early identification and diagnosis of illness to reduce morbidity through timely treatment.

2. Drugs

Antipsychotics are used to treat Schizophrenia. These drugs treat schizophrenic psychotic symptoms by affecting dopamine system of brain. Two classes of antipsychotics drugs are available- older, first-generation medications, that usually cause more severe side effects, and newer, second-generation drugs that often cause fewer and less severe side effects. The second generation medications are usually preferred, or at least tried first, because of lesser side effects. Side effects of these drugs especially first generation can lead to diabetes, increase in weight and high cholesterol . latest guidelines on treatment of Schizophrenia prevent usage of clozapine (Clozaril) and olanzapine (Zyprexa) and recommend all other medicines before recommending these two medicines because they cause physical side effects. Treatment of schizophrenia often requires use of more than one or combination of medications to get maximum control of symptoms and minimal side effects. Treating patients with antipsychotics often requires trying more than one drug or sometimes combinations of drugs. The goal is to use the lowest dose possible to get maximum control of symptoms and the fewest and least severe side effects. To achieve that goal a patient may need to try more than one medication. (Bright Quest, USA)

3. Family interventions

This intervention refers to enhancement of resources of family in caring the person suffering from schizophrenia. Termed as Psycho educational interventions include elements (Goldstein, 1995), such as-

·         Family engagement in early stage of treatment with no fault atmosphere

·         Creating awareness and education about risk factors, suggestions to coping strategies various treatment models etc.

·         Training in communication process to increase communication clarity and sharing of negative and positive feedback within family.

·         Problem solving training to learn to manage day today activities, problems and stress caused due to social events and learning to deal with anticipated stressors, coping strategies to enhance relief.

·         Training on Crisis intervention in case of extreme stress or when incidence of relapse are witnesses.

A number of studies suggest that family intervention helps to reduce relapse and increases patients’ and relatives’ satisfaction with service.

4. Other psychosocial interventions

Cognitive approach on subjective response to dysfunctional thoughts or perceptions attempts to modify beliefs associated with delusions and ways of coping with auditory hallucinations.This model is based on natural coping strategies used when faced with positive symptoms of schizophrenia. It links professional interventions with self help efforts. This model emphasizes that psychotic symptoms prevails because of difference in thoughts rather than different psychological processes (Chadwick et al.1996).

Social skills training refers to a group of interventions in which which perceptual, motor and interpersonal skills are enhanced which is must to accomplish independence good relationship in society and ease in community survival. Complex behaviors are split into smaller elements with the help of behavioural and social techniques such as reinforcement, role play, modeling, behaviour rehearsal to improve the level of independency (Halford and Hayes, 1992).

Conclusion

Schizophrenia is a harsh mental ailment that causes 10 % of schizophrenic people to suicide. Person suffering from this mental illness gets disconnected from real environment due to distortion in mental ability to perceive stimulus thus showing abnormal behaviour in all aspects of life such as while talking, walking, sleeping and other social and functional activities of life. Major causes leading to schizophrenia relates to genital factor and social environmental causes. Schizophrenia can be reduced to an extent if social discrimination among people in the society can be minimized and an adequate balanced life could be fostered to children in the society.

Schizophrenia does not cause people to suicide but it also makes patients socially disable, they are not able to take care of themselves, perform occupational task and get disassociated with social activities, avoid social gathering, feels distorted while interacting and functioning with family and society. They get disgrace and start perceiving that they have been socially rejected. The whole life of the person becomes an evil or curse thus they start committing suicides.

Measures such as family intervention and preventive interventions can serve as a tool and healing to reduce stimulant factors causing this disorder. Medication and drugs are also used to cure this disease but side effects of these drugs must be considered while adopting drug medication to cure it. Psychosocial interventions such as social skills training and cognitive approach have also proved to be productive in cure of this disease. Combination of these preventive measures and treatment techniques under clinical guidance and supervision can lead to minimize impact of this disease in schizophrenic people.

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