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  • Schizo means split, and phrenia, in this case refers to the mind.

  • Even though schizophrenia can be interpreted to meansplitting of the mind”, it does

  • not refer to a split personality, like some media sources might portray, but rather schizophrenia

  • describes a scattered or fragmented pattern of thinking.

  • Schizophrenia's actually a syndrome, meaning there're all sorts of symptoms that might

  • be associated with it and different patients might experience different symptoms, although

  • the symptoms can be broadly categorized into three major areas: positive symptoms, negative

  • symptoms, and cognitive symptoms.

  • Alright taking a step back, most human symptoms from any illness are extreme versions of a

  • normal physiologic process (for example everyone has a heartbeat and tachycardia is a fast

  • heartbeat, everyone has a normal body temperature, but during a fever that temperature is higher).

  • In schizophrenia, patients have positive symptoms which aren't positive in the sense that

  • they're helpful, but positive in the sense that they're some new feature that doesn't

  • have somenormalor physiologic counterpart.

  • These are the psychotic symptoms, so delusions, hallucinations, disorganized speech, and disorganized

  • or catatonic behavior; none of which occur physiologically.

  • Delusions are false beliefs that the patient might feel very strongly about, so much so

  • that they won't change their mind, even if you give them evidence against it.

  • There are all sorts of different delusions, like, for example, a delusion of control,

  • where somebody thinks that some outside force or person or thing is controlling their actions.

  • They could also be delusions of reference, where someone might think that insignificant

  • remarks are directed at them, like a newscaster is speaking directly to them through the TV.

  • Hallucinations are a second type of positive symptom, and can be any kind of sensation

  • that's not actually there, including visual but also including auditory sensations, like

  • hearing voices or commands.

  • A third type is disorganized speech An example being something like a “word salad”, which

  • seems like just a random jumbling of words or phrases, likepencil dog hat coffee

  • blue”.

  • Disorganized behavior on the other hand could be like if they exhibit bizarre or silly behavior

  • that's out of context and doesn't seem to have much of a purpose, like for example

  • wearing multiple layers of jackets on a hot summer day.

  • Also sometimes the behavior is described ascatatonic”, which has to do with their

  • movements, posture, and responsiveness.

  • So like they might be super resistant to moving, or be in an unresponsive stupor.

  • Negative symptoms, are like when there's this reduction or removal of normal processes,

  • and this is like a decrease in emotions they can express, or a loss of interest in things

  • they once found interesting.

  • One type of a negative symptom is called flat affect, where they don't respond with an

  • emotion or reaction that would seem appropriate, like if they saw something very unexpected

  • like a small monkey playing in their living room, they might simply sit and watch idly

  • as if nothing was happening.

  • Another type is alogia, or poverty of speech, which is a lack of content in speech, so like

  • if somebody asked themdo you have any children?”, they might respond withyes”,

  • instead ofyes, one boy and two girls”.

  • A third type of negative symptom is avolition, which is this decrease in motivation to complete

  • certain goals, so someone might stay at home for long periods of time, without trying to

  • reach out to friends or find work.

  • Cognitive symptoms include things like not being able to remember things, learn new things,

  • or understand others easily.

  • These symptoms are more subtle though, and more difficult to notice and might only be

  • detected if they have really specific tests performed.

  • An example might be somebody not being able to keep track of several things at once, like

  • a phone number and an address.

  • People with schizophrenia seem to cycle through three phases, typically in order.

  • During the prodromal phase, patients might become withdrawn and spend most of their time

  • alone, and often this seems similar to other mental disorders like depression or anxiety

  • disorders.

  • During the active phase, patients experience more severe symptoms like delusions, hallucinations,

  • disorganized speech, disorganized behavior, or catatonic behavior.

  • Following an active phase, patients often enter into a residual phase, where they might

  • exhibit cognitive symptoms like not being able to concentrate or becoming withdrawn

  • again, as with the prodromal phase.

  • For an official diagnosis of schizophrenia, patients need to be diagnosed with two of

  • the following symptomsDelusions, hallucinations, disorganized speech, disorganized behavior

  • or catatonic behavior, or negative symptoms, and at least one of them has to be either

  • delusions, hallucinations, or disorganized speech, So basically they couldn't have

  • just disorganized behavior and negative symptoms.

  • Even though some patients have cognitive symptoms as well, they aren't specifically needed

  • for a diagnosis.

  • Also though, for a diagnosis, signs of these disturbances must be ongoing for at least

  • 6 months, meaning they're likely in one phase or another for 6 months, but there must

  • be at least one month of active-phase symptoms.

  • And finally, those symptoms can't be attributable to another condition, like substance abuse.

  • Now that we've diagnosed it...why does it even happen in the first place?

  • What causes schizophrenia?

  • Well we don't really know, since it seems like the signs and symptoms of schizophrenia

  • are pretty unique to humans, or at least they're hard to imagine or notice in animal models

  • like mice or rats.

  • One clue is that the majority of antipsychotic medications that improve schizophrenia symptoms

  • block the dopamine receptor D2, which reduces dopamine levels in neurons.

  • This suggests that maybe schizophrenia has something to do with increased levels of dopamine.

  • These medications, though, are neither universally nor completely effective, and don't work

  • for everyone with schizophrenia, which adds to the confusion and means there's probably

  • more to it than just the D2 receptors.

  • Interestingly, one of the most effective antipsychotic drugs, clozapine, is a weak D2 antagonist,

  • suggesting that other neurotransmitter systems like norepinephrine, serotonin, and GABA are

  • involved.

  • Twin studies have shown support for a genetic basis as well, even though there haven't

  • been any specific genes conclusively linked to schizophrenia yet.

  • Also, environmental factors, like early or prenatal exposure to infection, and certain

  • autoimmune disorders like celiac disease have been linked with schizophrenia.

  • Finally, another important set of clues involves the epidemiology, schizophrenia seems to happen

  • slightly more in men than women, with onset in the mid-twenties for men but late-twenties

  • for women; and the clinical signs of schizophrenia are often less severe.

  • Some studies suggest this difference might be due to an estrogen regulation of dopamine

  • systems.

  • There doesn't, however, seem to be any differences among race.

  • Now treating schizophrenia can be really tricky, and antipsychotic medications are often used,

  • but it's super important to combine the efforts of several clinicians and health professionals,

  • including professionals in therapy or counseling, medicine, and psychopharmacology.

  • Antipsychotics can be very effective at reducing symptoms, but they often come a lot of additional

  • considerations to keep in mind, like cost and the potential for unwanted side effects

  • like tolerance, dependence, and withdrawal.

Schizo means split, and phrenia, in this case refers to the mind.

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精神分裂症 - 原因、症狀、診斷、治療和病理。 (Schizophrenia - causes, symptoms, diagnosis, treatment & pathology)

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    amychan248 發佈於 2021 年 01 月 14 日
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