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The world shuns those who are labelled abnormal. Once a person is diagnosed with any kind of psychological state, their life and their loved one’s lives are forever changed. As much as any medical illness, Schizophrenia presents suffers with an enormous array of social, biological and economic conundrums. It also confronts us with profound human suffering, for it involves alternations in the core of a person’s subjectivity.

Somebody that has schizophrenic disorder suffers in several areas of their life; but, the medical and psychological communities are fighting for the understanding and freedom for all that are concerned. This subsequent essay is a brief over read of the Psychotic disorder schizophrenic disorder, the way the disorder affects people who suffer, and therefore the research that continues to fight for a cure.  Schizophrenia is a very common form of psychotic disorder (severe mental illness). It’s lifetime prevalence is almost 1% it’s annual incidence is about 10-15 per 100,000, and in the UK the average general practitioner cares for 10-20 schizophrenia patients depending on the location and social surroundings of the practice (Davies, T., & Craig, T. K. (2009).

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Schizophrenia is one of the most controversial psychiatric diagnoses. Over time, there has been debates whether a distinct state of schizophrenia exists, whether it results from genetic or environmental causes and whether it should be treated by using drug therapy, electroconvulsive therapy, or more social and psychological approaches.

The condition now labelled as schizophrenia was first described by Kraepelin (1883,1981) using the term dementia praecox. This label was chosen to show that it was a progressive and deteriorating illness with no return to pre-morbid levels of functioning. After some time, Bleuler (1908) identified four fundamental symptoms of what he termed the group of schizophrenias ‘split mind’ ambivalence, disturbance of association, disturbance of mood and fantasy over reality.

The exact cause of schizophrenia remains hotly disputed. However, the consensus view is that it comprises many related disorders characterized by fundamental distortions of thinking and perception. Disturbance in thought process is one of the most obvious symptoms of schizophrenia.

Symptoms are termed ‘positive’ or ‘negative’ depending on whether they are psychological add-ons e.g. delusions or deficits e.g. anhedonia.  Such that it is a syndrome with various presentations and variable, often relapsing, long term course. Although schizophrenia is sometimes misconceived as ‘split personality’, the diagnosis has great reliability over all even across any ages or cultures.

Symptoms of schizophrenia are characterised most usually only as positive or negative, although the traditional diagnostic subcategories as hebephrenic, paranoid, catatonic and simple have mixtures of both.

Positive symptoms and signs

Hallucinations

These are perceptions that occur without an appropriate sensory input. Although hallucinations can occur in any sensory form – auditory (sound), visual (sight), tactile (touch), gustatory (taste), and olfactory (smell) – hearing voices that other people do not hear is the most common type of hallucination. The hallmark of schizophrenia is that patients experience voices talking about them as ‘he’ or ‘she’ (third person auditory hallucinations). But second person ‘command’ voices also occur, as do olfactory, tactile both somatic and visceral and visual hallucinations.

Delusions

Delusions are abnormal beliefs held with absolute certainty, dominating the patient’s mind, and untenable in terms of the sociocultural background. Delusions are often deriving from attempts to make sense of other symptoms such as experience of passivity (sensing that someone or something is controlling one’s body, emotions or thoughts). For example, individuals experiencing paranoid type symptoms roughly about one – third of people diagnosed with schizophrenia – often have delusions of persecution or false and irrational beliefs that they are being cheated, harassed, poisoned or conspired against. These people may believe that they, or a member of their family or someone close to them, are the focus of this persecution. In addition, delusion of grandeur, in which a person may believe he or she is famous or important figure, may occur. However, such false beliefs are often very difficult to challenge. Sufferers are frequently able to defend their deluded beliefs in a coherent way and unable to understand that other people find their delusional beliefs implausible (McGuire, Junginger, Adams, Burright et al.. 2001).

Disorganised speech and thought behaviour

Psychotic symptoms frequently exhibit a range of attributes that show disordered thinking and disordered speech.

World Salad: language of person experiencing a psychotic episode appears so disorganised that there seems to be no link between one phrase and the next. This is known as word salad. Some word salads simply do not seem to be attempts to communicate anything structured and appear to drift without substance from one unconnected sentence to the next.

Neologisms: Making up words and use them in their attempts to communicate. These are constructed by condensing or combining several words.

Clanging: trying to communicate by using words that rhyme.

Negative Symptoms

A negative symptom is the absence of some ability or attribute a normal person would possess. These include loss of personal abilities such as initiative, interest in others and the sense of enjoyment (anhedonia). Blunted or fatuous emotions (flat affect), limited speech and much time spent doing nothing are typical behaviours. Subtle cognitive deficits often persist or even worsen despite continuing treatment.