Sciences de la Santé
A ROAD BACK TO REALITY
( Contribution)
ReMed Magazine
Our ability to distinguish reality from �iction is a blessing we know little of, and like many blessings, only those who live each day without it can appreciate the real meaning of its loss. Therefore, because this loss is the result of a dysfunction in one of the most mysterious, most intriguing and most controversial organs ever to be studied in the history of medical science, and that is the brain, we will be talking about one of the most stigmatizing, scaring and historically misunderstood mental illness and that is schizophrenia.
R I H A B F E L L A H
Schizophrenia is?
The word“ schizophrenia” is the combination of two Greek words.“ Schiz” which means split, and“ phren” which means mind. It �irst saw light in 1908 and was the invention of the German psychiatrist Bleuer who de�ined the schizophrenic patient as“ one who has simultaneously opposing thoughts”. It is what we call commonly suffering from“ split personality”.
Schizophrenia is a disease that touches young adults and manifests itself in an individual having both: 1) genetic abnormalities( explaining thus its recurrence in certain families) originating in a molecular dysfunction in his brain. 2) being exposed to certain environmental factors such as psychological stress or substance abuse.
What are its signs and symptoms?
The clinical manifestation of this disorder is the presence of either positive symptoms and / or negative symptoms through at least a 6 month period.
The positive symptoms or psychotic symptoms are symptoms that are“ added”. They consist mainly of delusional ideas and hallucinations. While delusional ideas are the misinterpretation of real existing stimuli by the brain, such as seeing a monster or a man in a simple shadow, hallucinations however are any stimuli perceived by the individual with no real ground whatsoever. In this case, the stimulus most frequently found in schizophrenics is auditory: The patient often complains of hearing voices that are not originating from him. Another common positive symptom is paranoia or excessive suspiciousness. It manifests as an individual who always thinks Negative symptoms are, on the other hand, what lacks in the individual’ s behavior, such as the lack of affect( a“ don’ t care” attitude), the lack of initiative or avolition which is an unusual disinterest in any activity or hobby, and attentional problems or the inability to focus.
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Clinically speaking, we can notice that a patient who has negative symptoms alone differs completely from a patient presenting predominantly positive symptoms. Therefore we can only imagine what a wide range of manifestation this disorder includes, and the great challenge presented to psychiatrists by its diagnosis. The solution presented itself through the use of a revolutionary manual: the Diagnostic and Statistical Manual of mental disorders( or DSM), created by The American Psychiatric Association. It contains diagnostic criteria for schizophrenia, among other mental disorders, and has made it a lot easier to retain a certain diagnosis, in a very ef�iciently rapid way, while allowing physicians to use the same vocabulary.
Clinicians thrive today to do more than mere diagnosis, because they noticed the existence of a prodromal phase; in which the individual presents early signs of schizophrenia or pre-psychotic signs, such as a decline in academic functioning, an increase in social isolation, and a subtle change in behavior or thought patterns. Therefore, it is psychiatrists’ general ambition to �ind a way to diagnose the disorder at this stage and delay the onset of schizophrenia or even stop it.
What causes it?
Efforts have been made and theories have been speculated on the origin of schizophrenia. It was thought to be the result of abusive, emotionally un-nurturing environment in the early upbringing of the person. The notion of the schizophrenogenic mother was even introduced in the early 1960’ s, and describes a hard cold mother whose children are more prone to developing schizophrenia. Other theories proclaimed that children who were often faced with double bind situations( which are situations you cannot win no matter the choice you make), were at higher risk of becoming schizophrenic. But these theories were not speci�ic to schizophrenia and thus didn’ t stand long as rational explanations for it.
The admitted theory today is what is called“ the Dopamine theory” which was accidently discovered and led to a breakthrough in both the understanding and treating of the malady.