Schizophrenia - Causes, Symptoms, Diagnosis and Treatment
Schizophrenia - A mental disorder, accompanied by the development of fundamental violations of perception, thinking and emotional reactions. It features significant clinical polymorphism. The most common symptoms of schizophrenia include fiction or paranoid delusions, auditory hallucinations, disturbances in thinking and speech, flattened or inadequate affects and gross violations of social adaptation. Diagnosis is based on history, interrogation of the patient and his relatives. Treatment - drug therapy, psychotherapy, social rehabilitation and readaptation.
Schizophrenia
a mental disorder characterized by a disintegration of the affects, thought processes and perception. Previously we pointed out in the specialized literature that schizophrenia affects about 1% of the population, but recent large-scale studies have shown a lower figure - 0.4-0.6% of the population. Men and women suffer equally often, but women usually develop schizophrenia later. In men, the peak incidence between the ages of 20-28 years, women - at the age of 26-32 years. The disorder rarely develops in early childhood, middle and old age.
Schizophrenia is often associated with depression, anxiety disorders, drug addiction and alcoholism. Significantly increases the risk of suicide. It is the third most common cause of disability after quadriplegia and dementia. Often entails pronounced social maladjustment, turns into unemployment, poverty and homelessness. City dwellers suffer from schizophrenia often people living in rural areas, but the reasons for this phenomenon are still not clarified. Treatment of schizophrenia carried out by experts in the field of psychiatry.
psychiatrists believe that schizophrenia is a multifactorial disease, arising under the influence of a number of endogenous and exogenous factors. It reveals a genetic predisposition. If you have a close relative (father, mother, brother or sister) with the disease, the risk of developing schizophrenia is increased to 10%, ie, approximately 20 times compared to the average risk for the population. However, 60% of patients have a family history of not burdened.
Among the factors that increase the risk of developing schizophrenia, include intrauterine infections, obstructed labor and time of birth. It is established that the disease most often affects people born in spring or winter. Note the strong correlation with the incidence of schizophrenia, a number of social factors, including - the level of urbanization (city dwellers suffer most villagers), poverty, poor living conditions in childhood, and the family moved due to adverse social conditions.
Many researchers point to the presence of early traumatic experiences, ignoring the vital needs of childhood sexual or physical abuse. Most experts believe that the risk of schizophrenia is independent of the parenting style, while some psychiatrists point to a possible connection of the disease with serious violations of family relations: neglect, rejection and lack of support.
Schizophrenia, alcoholism, drug addiction and substance abuse are often closely linked, however, to trace the nature of these relationships is not always possible. There are studies that indicate the relationship of exacerbations of schizophrenia with taking stimulants, hallucinogens and other psychoactive substances. However, the reverse can also dependency. At the first signs of schizophrenia patients sometimes try to eliminate the discomfort (suspiciousness, deterioration of mood and other symptoms), using drugs, alcohol and drugs with psychoactive effect, which entails an increase in the risk of development of drug addiction, alcoholism and other addictions.
Some experts point to a possible connection with schizophrenia abnormalities of brain structure, in particular - with an increase in the ventricles and decreased activity of the frontal lobe, responsible for reasoning, planning and decision-making. Patients with schizophrenia also identified differences in the anatomical structure of the hippocampus and temporal lobes. The researchers note that these violations may have occurred a second time, under the influence of pharmacotherapy, as the majority of patients taking part in studies of brain structure, previously received antipsychotic drugs.
There are also a number of neurochemical hypotheses linking the development of schizophrenia with impaired activity of certain neurotransmitters (dopamine theory keturenovaya hypothesis, the hypothesis of the disease due to abnormalities in the cholinergic and GABAergic systems). Some time was particularly popular dopamine hypothesis, but later many experts began to question it, pointing to the simple nature of the theory, its inability to explain the clinical polymorphism and numerous options of schizophrenia.
catatonia, interrupt thoughts, persistent hallucinations (except auditory), behavioral disorders and negative symptoms. Symptoms of first and second rank should be observed for a month or more. To assess the emotional state, mental status, and other parameters using various tests and scales, including - Luscher test, test Leary, Carpenter scale, MMMI test and scale of PANSS.
Schizophrenia Treatment includes medication, psychotherapy and social rehabilitation activities. The basis of pharmacotherapy are antipsychotic drugs with action. Currently, preference is often given to atypical antipsychotics, which are less likely to cause tardive dyskinesia and, according to experts, may reduce the negative symptoms of schizophrenia. To reduce the severity of side effects is combined with other antipsychotic drugs, usually - mood stabilizers and benzodiazepines. With the ineffectiveness of other methods prescribed ECT and insulin shock therapy.
After the reduction or disappearance of the positive symptoms of schizophrenia sent for psychotherapy. For training of cognitive skills, improve social functioning, assist in the realization of features of its own state, and to adapt to the use of cognitive-behavioral therapy. To create a supportive family atmosphere using family therapy. Conduct training sessions for the relatives of patients with schizophrenia, provide psychological support to relatives of patients.
The prognosis of schizophrenia
The prognosis of schizophrenia is determined by a number of factors. By the favorable prognostic factors include female sex, later age of disease onset, acute onset of the first psychotic episode, minor severity of negative symptoms, lack of long-term or frequent hallucinations and favorable personal relationships, good professional and social adaptation to the onset of schizophrenia. A role played by the attitude of society - according to the research, the lack of stigma surrounding adoption and reduces the risk of relapse.