According to National Institute of Mental Health (2003), Schizophrenia is considered to be the most disabilitating mental disorder, affecting more than 2 million Americans, in which 1 in every 10 eventually commit suicide. Between 20-40% make at least one attempt over the course of the illness.
The illness usually begins to manifest during teenage years or twenties; for men-23 years with peak onset occuring between 18 to 25; for women-27 years with peaks occuring between 20 to 27 and after 35 years of age.
Diagnostic Criteria (American Psychiatric Association, 1994):
A. Characteristic symptoms- Schizophrenia is characterized by 2 or more of the following symptoms, for a significant portion of time within a 1 month period;
- delusions
- hallucinations
- disorganized speech
- grossly disorganized or catatonic behavior
- negative symptoms
B. Social/Occupational Dysfunction
C. Duration
D. Schizoaffective and Mood Disorder Exclusion
E. Substance/General Medical Condition Exclusion
F. Relationship to a Pervasive Developmental Disorder
Phases of schizophrenia:
Prodromal and Residual Phases-
- Symptoms are present before or after active phase
- Symptoms may be mild
- Positive Symptoms- (unusual odd beliefs or perceptual experiences, understandable speech, yet vague and may be extreme abstract or concrete, peculiar behavior)
- Negative Symptoms-(social withdrawal, loss of interest in pleasurable activities, significant time spent in bed)
Active Phase-
- actively experiencing bizarre hallucinations and delusions involving voices commenting or conversing
Schizophrenia remarkably affects an individual's level of functioning in many major areas such as work, interpersonal relationships (60-70% do not marry and have limited social contacts), academic and occupational achievement, and self-care. The illness can impair a person's ability to interact with others, think clearly, and manage their emotions normally. Individuals with schizophrenia are not more dangerous than others. However, major predictors include male gender, younger age, violent history, noncompliance with antipsychotic meds, and excessive substance use (note, 80-90% are nicotine dependent).
The specific causes of Schizophrenia remain unknown. However, research has shown that the brains of those affected are different from the brains of those not affected (National Alliance for Mental Illness, 2003). It appears that the illness is caused by a combination of contributing variables such as, genetic vulnerabilities and environmental factors which occur during human development.
Course (Williams and Ell, 2001, p.160-161):
- Individuals who experience early onset are more aften male, have poorer premorbid adjestment, lower academic achievement, more evidence of brain abnormalities, more prominent negative symptoms, more cognitive impairment, and worse outcome
- Later onset; more females, less evidence of brain abnormalities, better outcome
- The course of the illness may vary with some persons experiencing phases of activity and remission, and others remaining chronically ill
- Remission not common and unlikely; some persons who remain ill may maintain a stable course, while others progressively worsen towards severe disability
