Schizophrenia is a serious mental illness. While a definitive cause of schizophrenia has yet to be determined, there is strong evidence of a genetic component. Medication and therapy can greatly reduce the occupationally and socially disruptive symptoms of the disease.
Facts
Schizophrenia is a brain disorder that affects about 1.1 percent of Americans each year. Symptoms of schizophrenia appear between the ages of sixteen and the late twenties. Men generally experience the onset of symptoms earlier, women later. It is rare for an individual to be diagnosed with schizophrenia after the age of forty-five.
History
The symptoms of schizophrenia have been noted throughout recorded history. However, it was not until the late 1800s that the symptoms were classified as a distinct illness. In its' diagnostic infancy, schizophrenia was thought to be a type of dementia or manic-depression. It was later distinguished from dementia because it primarily affected younger people rather than the elderly and from manic-depression because of the disease's consistency and longevity.
Symptoms
To be diagnosed as schizophrenic one must meet the A-F criterion in the DSM IV. Criterion A's focus is on the psychotic symptoms present in active-phase schizophrenia: delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior and negative symptoms (such as a flat affect, alogia or avolition). In addition to meeting two or more of the characteristics symptoms in criterion A, an individual must also exhibit a marked decline in occupational, relational or self-care skills since the onset of the disorder (criterion B). The psychological disturbance (symptoms of the disorder) must persist (criterion C) for at least six months and those six months must include at least one month of the active-phase symptoms found in criterion A.
Criterion D requires that a schizoaffective disorder and mood disorder be eliminated as the cause of the symptoms. Criterion E requires that any underlying medical conditions be ruled out as the cause of the schizophrenic-like symptoms. Finally, criterion F of the DSM IV states that if there is "a relationship to a pervasive developmental disorder, the diagnosis of schizophrenia must only be made if prominent delusions or hallucinations are also present for at least at least one month."
Sub types
Schizophrenia can be classified into subtypes. The first is the paranoid type. The primary feature of the paranoid type is the presence of delusions or auditory hallucinations. These delusions and hallucinations are usually persecutory in nature. The second subtype of schizophrenia is the disorganized type. This subtype is characterized by disorganized speech and behavior and a flat or inappropriate affect. The third is the catatonic type. This type is defined by immobility, exaggerated motor activity, rigid posturing, mutism, peculiar posturing, echolalia and echopraxia. The fourth subtype is the undifferentiated type. This subtype is a catchall category for the individual who meets criterion A requirements but does not fall into any of the other subtypes. The final subtype of schizophrenia is the residual type. The residual sub type is used when there has been a history of at least one episode of schizophrenia but the current clinical picture shows no active psychotic symptoms. The diagnosis of the residual subtype also requires current evidence of negative symptoms or two or more criterion A symptoms.
Prognosis
The DSM IV states that the time of onset can determine the course and severity of the disease. For instance, men typically have an earlier onset than women do. Because of the earlier onset (and the interruption of developmental progress), men can have a more complicated prognosis than women who have had more time to develop the cognitive and coping resources needed to manage the disease effectively. There is no cure for schizophrenia. However, medication therapy can make a positive and critical difference in the severity of the illness.
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