Schizophrenia and Psychosis
The
extent of the problem
Schizophrenia is a severe mental illness. It affects approximately
one person in every hundred in all countries around the
world. More hospital beds are filled by people suffering
from schizophrenia than from any other single illness. Schizophrenia
frequently has a debilitating affect on all aspects of the
sufferer’s life and can extract an enormous emotional toll
on their family and relations, who will often be responsible
for their care.
What
is Schizophrenia?
Positive
symptoms
A diagnosis of schizophrenia is made when a person experiences
certain key symptoms. These include specific types of hallucinations,
delusions and disturbances of thinking. Hallucinations are
false perceptions. The sufferer hears things, sees things
or smells things that are not heard, seen or smelt by other
people. Hearing voices, often talking about the person in
a hostile manner, is a very common symptom of schizophrenia.
Delusions are false beliefs, that are frequently bizarre
and held with often unshakable conviction but are not shared
by other people. Delusions vary in content but some common
ones include: a belief that an external force has taken
control of the person’s mind or body; a belief that a group
of people or an organisation is trying to harm or persecute
the person for no good reason; a belief that things the
person reads or sees have special meaning or influence;
an extreme and specific belief in the influence and action
of magic, telepathy, laser beams or other alien forces.
Disturbances of thinking or thought disorder refer to a
disorganisation of thought that can result in strange and
jumbled language. These types of key symptoms are often
referred to as positive symptoms, and they can be extremely
distressing and frightening to people who experience them.
They can frequently be associated with very high levels
of anxiety and disturbed behaviour, especially when severe
or in the acute phase.
Negative
symptoms
Unlike positive symptoms, which are dramatic changes in
the person’s experiences, negative symptoms are usually
apparent as changes in the person’s behaviour. They are
termed negative because they are indicated by a decrease
or absence of behaviour. These include: a decrease in motivation;
a decrease in activity; a decrease in conversation and talking;
social withdrawal; an apparent lack of emotion; poverty
of thought and a difficulty in getting on with people.
Negative
symptoms can vary in their extent from being quite mild
to severely impairing a person’s ability to function and
take care of themselves.
Course
Schizophrenia often has its onset in late adolescence or
early childhood. The course or development of the disorder
can vary widely between individuals.
Although
some people will make a good recovery after their initial
episode, the disorder is frequently episodic. Some people
experience frequent relapses with persistent symptoms and
disability throughout most of their lives.
Causes
The cause of schizophrenia continues to remain an enigma.
It is probable that there is a genetic component and that
there is a disruption of the brain’s neurotransmitters (chemicals
which carry messages within the brain). There is also strong
evidence that emotional and social stresses are important
in precipitating episodes of illness.
Treatment
and care
At present there is no cure for schizophrenia. Powerful
tranquillising drugs called neuroleptics are the mainstay
of treatment. These are used for two purposes: to reduce
positive symptoms during acute exacerbations or relapses
and prophylactically to prevent further relapse. Because
the medication protects against further episodes it is probable
that the schizophrenia sufferer will be prescribed it for
long periods of time, and to increase compliance with medication,
it is often given through injection. Medication can cause
unpleasant side effects which may need to be treated in
their own right. New drugs are becoming available which
it is claimed have fewer side effects and also improve negative
symptoms.
Acute
symptoms of schizophrenia often involve inpatient hospital
treatment. When the illness has caused pervasive deficits
in aspects of the person’s social and personal functioning,
lengthy rehabilitation will be as important as physical
treatment. This can involve varying levels of community
support and outreach such as sheltered accommodation or
day hospital provision. Many approaches are designed to
help people improve their ability to live independently
in the community.
Over
recent years psychosocial and psychological treatments have
been developed. These include helping the family to manage
the illness which can have a marked effect on decreasing
relapse rates, and cognitive behavioural methods to reduce
persistent positive symptoms. These methods are new but
have enormous promise in improving the sufferer’s quality
of life when used in combination with medication. Because
of the severity of schizophrenia and the disabilities which
are often associated with it, sufferers should have all
access to all the resources of a comprehensive mental health
system.
What
are Behavioural and Cognitive Psychotherapies?
Behaviour
Therapy, Cognitive Therapy and Cognitive Behaviour Therapy
have some common features. They are based firmly on research
findings and derive from specific theories. The focus is
mainly on the here-and-now, rather than the past, and the
main goal of therapy is to help bring about changes in the
person’s life which are measured and evaluated. Goals for
change may involve:
- A
way of acting eg. being more outgoing
- A
way of feeling
eg. being less scared or less depressed
- A
way a thinking eg. learning to problem solve or get
rid of self defeating thoughts
- A
way of dealing with physical or medical problems eg.
lessening the difficulties associated with back pain.
- A
way of coping eg. training developmentally disabled
people to care for themselves
Cognitive
or Behaviour Therapists may work with individuals, groups
or families, and therapy is time limited. The approaches
can be used to help any person – irrespective of intelligence,
insight or other abilities.
For more information on referring to the clinic please contact us on 01323 430831 or complete our online enquiry form.
|
