schizophrenia full
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Table of Contents
Content PageDeclaration by Student 3Certification by Supervisor(s) 4Why did I take up this topic for detailed study? 5Review of Literature 6Summary 17List of References 18
Acknowledgment 19
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DECLARATION BY STUDENT
I hereby declare that I have written this special study module Schizophrenia
in my own words. Wherever appropriate, I have referred to the sources from
where I reviewed literature, as well as images or any other material. I
understand that I am responsible if this work is found to be faulty or
fraudulent.
Signature:
Full Name: Sivakumaran Rajandran
Date of submission to Supervisor: 9. May. 2011
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CERTIFICATION BY SUPERVISOR:
This is to certify that this SSM titled Schizophrenia was done under my
guidance. In terms of scope, quantum of work and the quality of presentation, I
find this work by name of the student, ID number satisfactory.
Supervisors Signature:
Name:
Designation:
Date:
Special Remarks by Supervisor (if any):
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BACKGROUND
Why did I take this up for detailed study?
As a medical student, I always have special interest about diseases and their effect to
the human body. When it comes to mind, my interests shoot up. It is because brain is
one of important organ in our body that weights only around 300g yet it can control
various activity of brain.
Schizophrenia is a mental disorder, which caused by disorientation of brain. So I take
this topic in order to know more about this disease as well as function of brain. i hope
this topic can enlighten me about function of brains and details of Schizophrenia.
REVIEW OF LITERATURE:
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Schizophrenia is a mental disorder characterized by disintegration of
thought processes and of emotional responsiveness. It most commonly
manifests as auditory hallucinations , paranoid or bizarre delusions , or
disorganized speech and thinking , and it is accompanied by significant
social or occupational dysfunction. The onset of symptoms typically occurs
in young adulthood, with a global lifetime prevalence of about 0.30.7%.
Diagnosis is based on observed behavior and the patient's reported
experiences.
Schizophrenia, also sometimes called split personality disorder, is a
chronic, severe, debilitating mental illness that affects about 1% of the
population, corresponding to more than 2 million people in the United States
alone. Other statistics about schizophrenia include that it affects men about
one and a half times more commonly than women. It is one of the psychotic
mental disorders and is characterized by symptoms of thought, behavior,
and social problems. The thought problems associated with schizophreniaare described as psychosis, in that the person's thinking is completely out of
touch with reality at times.
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There are five types of schizophrenia, each based on the kind of symptoms
the person has at the time of assessment:
Paranoid schizophrenia: The individual is preoccupied with one or more
delusions or many auditory hallucinations but does not have symptoms of
disorganized schizophrenia.
Disorganized schizophrenia: Prominent symptoms are disorganized speech
and behavior, as well as flat or inappropriate affect. The person does not
have enough symptoms to be characterized as catatonic schizophrenic.
Catatonic schizophrenia: The person with this type of schizophrenia
primarily has at least two of the following symptoms: difficulty moving,
resistance to moving, excessive movement, abnormal movements, and/or
repeating what others say or do.
Undifferentiated schizophrenia: This is characterized by episodes of two or
more of the following symptoms: delusions, hallucinations, disorganized
speech or behavior, catatonic behavior or negative symptoms, but the
individual does not qualify for a diagnosis of paranoid, disorganized, or
catatonic type of schizophrenia.
Residual schizophrenia: While the full-blown characteristic positive
symptoms of schizophrenia (those that involve an excess of normal
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behavior, such as delusions, paranoia, or heightened sensitivity) are absent,
the sufferer has less severe forms of the disorder or has only negative
symptoms (symptoms characterized by a decrease in function, such as
withdrawal, disinterest, and not speaking).
Causes, incidence, and risk factors
Schizophrenia is a complex illness. Even experts in the field are not
sure what causes it.
Genetic factors appear to play a role. People who have family
members with schizophrenia may be more likely to get the illness
themselves.
Some researchers believe that environmental events may trigger
schizophrenia in people who are already genetically at risk for the disorder.
For example, infection during development in the mother's womb or
stressful psychological experiences may increase the risk for developing
schizophrenia later in life. Social and family support appears to improve the
illness.
Schizophrenia affects about 1% of people worldwide. It occurs
equally among men and women, but in women it tends to begin later and be
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milder. For this reason, males tend to account for more than half of patients
in services with high numbers of young adults. Although schizophrenia
usually begins in young adulthood, there are cases in which the disorder
begins later (over age 45).
Childhood-onset schizophrenia begins after age 5 and, in most cases,
after normal development. Childhood schizophrenia is rare and can be
difficult to tell apart from other developmental disorders of childhood, such
as autism .
Symptoms
Schizophrenia may have a variety of symptoms. Usually the illness
develops slowly over months or years. Like other chronic illnesses,
schizophrenia cycles between periods of fewer symptoms and periods of
more symptoms.
At first, you may feel tense, or have trouble sleeping or concentrating.
You can become isolated and withdrawn, and have trouble making or
keeping friends.
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As the illness continues, psychotic symptoms develop:
Appearance or mood that shows no emotion (flat affect)
Bizarre movements that show less of a reaction to the environment
(catatonic behavior)
False beliefs or thoughts that are not based in reality (delusions)
Hearing, seeing, or feeling things that are not there (hallucinations)
Problems with thinking often occur:
Problems paying attention
Thoughts "jump" between unrelated topics (disordered thinking)
Symptoms can be different depending on the type of schizophrenia:
Paranoid types often feel anxious, are more often angry or argumentative,and falsely believe that others are trying to harm them or their loved ones.
Disorganized types have problems thinking and expressing their ideas
clearly, often exhibit childlike behavior, and frequently show little emotion.
Catatonic types may be in a constant state of unrest, or they may not move
or be underactive. Their muscles and posture may be rigid. They may
grimace or have other odd facial expressions, and they may be less
responsive to others.
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A psychiatrist should perform an evaluation to make the diagnosis.
The diagnosis is made based on a thorough interview of the person and
family members.
No medical tests for schizophrenia exist. The following factors may suggest
a schizophrenia diagnosis, but do not confirm it:
Course of illness and how long symptoms have lasted
Changes from level of function before illness
Developmental background
Genetic and family history
Response to medication
CT scans of the head and other imaging techniques may find some changes
that occur with schizophrenia and may rule out other disorders.
Treatment
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During an episode of schizophrenia, you may need to stay in the
hospital for safety reasons, and to receive basic needs such as food, rest, and
hygiene.
The choice of which antipsychotic to use is based on benefits, risks,
and costs. It is debatable whether as a class typical or atypical antipsychotics
are better. Both have equal drop-out and symptom relapse rates when
typicals are used at low to moderate dosages.There is a good response in 40
50%, a partial response in 3040%, and treatment resistance (failure of
symptoms to respond satisfactorily after six weeks to two of three different
antipsychotics) in 20% of people. Clozapine is an effective treatment for
those who respond poorly to other drugs, but it has the potentially serious
side effect of agranulocytosis (lowered white blood cell count) in 14%.
MEDICATIONS
Antipsychotic medications are the most effective treatment for
schizophrenia. They change the balance of chemicals in the brain and can
help control the symptoms of the illness.
These medications are helpful, but they can have side effects. However,
many of these side effects can be addressed, and should not prevent people
from seeking treatment for this serious condition.
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Common side effects from antipsychotics may include:
Sleepiness (sedation) or dizziness
Weight gain and increased chance of diabetes and high cholesterol
Less common side effects include:
Feelings of restlessness or "jitters"
Problems of movement and gait
Muscle contractions or spasms
Tremor
Long-term risks of antipsychotic medications include a movement
disorder called tardive dyskinesia. In this condition, people develop
movements that they cannot control, especially around the mouth. Anyone
who believes they are having this problem should check with their doctor
right away.
For people who try and do not improve with several antipsychotics,
the medication clozapine can be helpful. Clozapine is the most effective
medication for reducing schizophrenia symptoms, but it also tends to cause
more side effects than other antipsychotics.
Because schizophrenia is a chronic illness, most people with this
condition need to stay on antipsychotic medication for life.
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For people who are unwilling or unable to take medication regularly,
long-acting depot preparations of antipsychotics may be used to achieve
control. When used in combination with psychosocial interventions they
may improve long-term adherence to treatment.
SUPPORT PROGRAMS AND THERAPIES
Supportive and problem-focused forms of therapy may be helpful for
many people. Behavioral techniques, such as social skills training, can be
used during therapy or at home to improve function socially and at work.
Family treatments that combine support and education about schizophrenia
(psychoeducation) appear to help families cope and reduce the odds of
symptoms returning. Programs that emphasize outreach and community
support services can help people who lack family and social support.
Important skills for a person with schizophrenia include:
Learning to take medications correctly and how to manage side effects
Learning to watch for early signs of a relapse and knowing how to react
when they occur
Coping with symptoms that are present even while taking medications. A
therapist can help persons with schizophrenia test the reality of thoughts and
perceptions.
Learning life skills, such as job training, money management, use of public
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transportation, relationship building, and practical communication
Family members and caregivers are often encouraged to help people
with schizophrenia stick to their treatment.
Expectations (prognosis)
The outlook for a person with schizophrenia is difficult to predict.
Most people with schizophrenia find that their symptoms improve with
medication, and some can get good control of their symptoms over time.
However, others have functional disability and are at risk for repeated
episodes, especially during the early stages of the illness.
To live in the community, people with schizophrenia may need
supported housing, work rehabilitation, and other community support
programs. People with the most severe forms of this disorder may be too
disabled to live alone, and may need group homes or other long-term,
structured places to live. Some people with milder forms of schizophrenia
are able to have satisfying relationships and work experiences.
Complications
People with schizophrenia have a high risk of developing a substance abuse
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problem. Use of alcohol or other drugs increases the risk of relapse, and
should be treated by a professional.
Physical illness is common among people with schizophrenia due to an
inactive lifestyle and side effects from medication. Physical illness may not
be detected because of poor access to medical care and difficulties talking to
health care providers.
Not taking medication will often cause symptoms to return.
Calling your health care provider
Call your health care provider if:
Voices are telling you to hurt yourself or others.
You feel the urge to hurt yourself or others.
You are feeling hopeless and overwhelmed.
You are seeing things that aren't really there.
You feel like you cannot leave the house.
You are unable to care for yourself.
Prevention
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There is no known way to prevent schizophrenia.
If you do have the condition, the best ways to prevent symptoms from
coming back are to take the medication your doctor prescribed, and see your
doctor or therapist regularly. Always talk to your doctor if you are thinking
about changing or stopping your medications.
SUMMARY
Schizophrenia is a severe, lifelong brain disorder. People who have it
may hear voices, see things that aren't there or believe that others are
reading or controlling their minds. In men, symptoms usually start in the late
teens and early 20s. They include hallucinations, or seeing things, and
delusions such as hearing voices. For women, they start in the mid-20s toearly 30s. Other symptoms include
Unusual thoughts or perceptions
Disorders of movement
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Difficulty speaking and expressing emotion
Problems with attention, memory and organization
No one is sure what causes schizophrenia, but your genetic makeup
and brain chemistry probably play a role. Medicines can relieve many of the
symptoms, but it can take several tries before you find the right drug. You
can reduce relapses by staying on your medicine for as long as your doctor
recommends. With treatment, many people improve enough to lead
satisfying lives.
LIST OF REFERENCES
1. Leucht S, Corves C, Arbter D, Engel RR, Li C, Davis JM. Second-generation versus first-generation antipsychotic drugs for schizophrenia: a meta-analysis. Lancet . 2009;373:31-41. Epub 2008Dec 6.v
2. Freudenreich O, Weiss AP, Goff DC. Psychosis and schizophrenia.
In: Stern TA, Rosenbaum JF, Fava M, Biederman J, Rauch SL, eds.
Massachusetts General Hospital Comprehensive Clinical Psychiatry .
1st ed. Philadelphia, Pa: Mosby Elsevier;2008:chap 28.
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3. ^ Buckley PF, Miller BJ, Lehrer DS, Castle DJ. Psychiatric comorbidities
and schizophrenia . Schizophr Bull . 2009;35(2):383402.
4. Www. Wikipedia.com
ACKNOWLEDGMENT:
I would like to take this opportunity to thank my lecturer who allows me to do this
topic. Besides that I would to thank my friends who helped me throughout the process.
Without their moral support and guidance I could not finish this assignment on date.
Thanks to everybody.
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