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Schizophrenia means a splitting of mental functions (but not split personalities; that's a separate condition). It is a mental disorder often characterized by abnormal social behavior, cognitive dysfunction, and failure to recognize what is real. Common symptoms include false beliefs, convincing auditory hallucinations (visual hallucinations are possible and common but not characteristic), confused or unclear thinking, inactivity, and reduced social engagement and emotional expression.
Schizophrenia is a type of psychosis. There is a considerable degree of heterogeneity in symptoms of schizophrenia; the presence and degree of symptoms vary wildly from patient to patient. However, common symptoms are categorised in three distinct areas:
Positive symptoms refer to phenomena normal people do not experience, but are experienced by schizophrenic patients. Individuals with schizophrenia may experience hallucinations (most reported are hearing voices), delusions (often bizarre or persecutory in nature, hence the term "paranoid schizophrenic"), and disorganized thinking and speech. The last may range from loss of train of thought (something called thought blocking), to sentences only loosely connected in meaning (tangentiality), to speech that is not understandable, known as word salad in severe cases. In some cases patients can become catatonic, a trance-like state of abnormal motor activity in which the patient may stay frozen in the same position (often quite awkward and uncomfortable) for hours without moving or speaking, allow themselves to be posed by others (something called waxy flexibility), or in some cases enter an agitated motor frenzy. They are relatively easy to manage with antipsychotic medication. When talking about delusions, sometimes a delusional belief can vary in its degree of rationality, some delusions can be blatantly irrational (alien abduction fantasies, visits from angels, speaking with dead people). Paranoid delusions also include entirely plausible things, such as the idea that your partner is cheating on you, or you are being stalked, these at least can happen and are much more likely. The important part is incorrigible belief, and lack of evidence. It is also important to note that even though some delusions can be later proven to be true, they are still delusional.
Negative symptoms refer to various social and emotional deficits present in individuals with schizophrenia. Social withdrawal, sloppiness of dress and hygiene, and loss of motivation and judgment are all common in schizophrenia. People with schizophrenia often find facial emotion perception to be difficult. Poorness of speech (alogia), little to no emotion (blunted affect) and inability to experience joy or pleasure (anhedonia) are also very common. Despite what one might think at first, negative symptoms contribute more to poor quality of life than the positive symptoms do. On top of that, negative symptoms are not very responsive to medication.
Cognitive dysfunctions are a central feature of schizophrenia. The extent of the cognitive dysfunction experienced by the patient is quite often an accurate predictor of functionality and treatment compliance; they're also known to determine quality of life to an even larger extent than the negative symptoms. The cognitive dysfunctions affect a wide range of activity; attention, working memory, short and long-term memory, learning and verbal processing, among others, are all affected by schizophrenia.
Schizophrenia is a major cause of disability, with active psychosis ranked as the third-most-disabling condition after quadriplegia and dementia and ahead of paraplegia and blindness. In a large, representative sample from a 1999 study, 12.8% of Americans believed that individuals with schizophrenia were "very likely" to do something violent against others, and 48.1% said that they were "somewhat likely" to. Over 74% said that people with schizophrenia were either "not very able" or "not able at all" to make decisions concerning their treatment, and 70.2% said the same of money management decisions.
Self-medication and alternative medicine
A significant proportion of people with schizophrenia use cannabis and/or nicotine. It has been widely thought that cannabis and/or tobacco use is a form of self-medication, but there is some evidence that usage is actually causative of psychosis.
Religion, depending on how a patient views it, can be paralyzing and quite harmful, in that a patient may refuse treatment based on religious beliefs; in certain instances, one might believe that their delusions and hallucinations are actually a divine experience, and therefore deny any need for treatment. On the other hand, religion can also be a very valuable tool in coping with the disorder, especially for those who are active in a religious community. Why this might be the case is unclear, but it may allow the schizophrenic to become better able to define their relationship with the perceived source of the hallucinations, ideally into something that is positive or at least benign in nature.
In a 2014 cross-cultural study, researchers found that schizophrenics from different countries tended to have different types of hallucinations. In the United States, schizophrenics tended to hallucinate of "disembodied voices that hurl insults and make violent commands", whereas in India and Ghana, schizophrenics often reported "positive relationships with hallucinated voices that they recognize as those of family members or God."
Political abuse of diagnosis
Sluggish schizophrenia was coined by Andrei Snezhnevsky, who as one of the chief architects of Soviet psychiatry broadened the symptoms of schizophrenia to include any pesky political dissidents and even those indirectly affected by alcoholism.
Famous people who have suffered from schizophrenia
- John Forbes Nash Jr. Nobel prize winning economist and mathematician who made contributions to game theory, differential geometry, and the study of partial differential equations
- Vashishtha Narayan Singh Indian mathematician
- Valerie Solanas American radical feminist who attempted to murder artist Andy Warhol (see Valerie Solanas)
- Larry "Wild Man" Fischer, a outsider musician who was promoted by Frank Zappa
- Wesley Willis, another outsider musician, promoted by Jello Biafra
- Syd Barrett of Pink Floyd
- Science fiction writer Philip K. Dick, though diagnosis has been contested
- Roky Erickson of The 13th Floor Elevators
- John Hinckley, Jr., would-be assassin of Ronald Reagan
- Brian Wilson of the Beach Boys was diagnosed with schizophrenia, but the diagnosis was later retracted. He has stated that he suffers from schizoaffective disorder, a somewhat similar condition.
- Gene Ray, of Time Cube fame
- Terry A. Davis, creator of TempleOS
- Baucum, Don (2006). Psychology (2nd ed.). Hauppauge, N.Y.: Barron's. p. 182.
- Reminds me of conservative Christians.
- Carson VB (2000). Mental Health Nursing: The Nurse-Patient Journey W.B. Saunders. ISBN 978-0-7216-8053-8. p. 638
- Kohler CG, Walker JB, Martin EA, Healey KM, Moberg PJ (September 2010). "Facial emotion perception in schizophrenia: a meta-analytic review". Schizophr Bull 36 (5): 1009–19.
- Ustun TB, Rehm J, Chatterji S, Saxena S, Trotter R, Room R, Bickenbach J, and the WHO/NIH Joint Project CAR Study Group (1999). "Multiple-informant ranking of the disabling effects of different health conditions in 14 countries". The Lancet 354 (9173): 111–15.
- Pescosolido BA, Monahan J, Link BG, Stueve A, Kikuzawa S (September 1999). "The public's view of the competence, dangerousness, and need for legal coercion of persons with mental health problems". American Journal of Public Health 89 (9): 1339–45.
- Gregg L, Barrowclough C, Haddock G (2007). "Reasons for increased substance use in psychosis". Clin Psychol Rev 27 (4): 494–510.
- Sagud M, Mihaljević-Peles A, Mück-Seler D, et al. (September 2009). "Smoking and schizophrenia". Psychiatr Danub 21 (3): 371–5
- Pot Can Trigger Psychotic Symptoms For Some, But Do The Effects Last? by Angus Chen (March 06, 2015 11:54 AM ET) NPR.
- New analysis of smoking and schizophrenia suggests causal link Fri Jul 10, 2015 4:31am IST Reuters.
- Danbolt, Lars J.; Møller, Paul, Lien, Lars, Hestad, Knut A. (31 March 2011). "The Personal Significance of Religiousness and Spirituality in Patients With Schizophrenia". International Journal for the Psychology of Religion 21 (2): 145–158.
- Mohr, Sylvia; Borras, Laurence, Rieben, Isabelle, Betrisey, Carine, Gillieron, Christiane, Brandt, Pierre-Yves, Perroud, Nader, Huguelet, Philippe (11 October 2009). "Evolution of spirituality and religiousness in chronic schizophrenia or schizo-affective disorders: a 3-years follow-up study". Social Psychiatry and Psychiatric Epidemiology 45 (11): 1095–1103.
- Hallucinated voices’ attitudes vary with culture: Schizophrenia symptom turns positive in non-Western nations
- Differences in voice-hearing experiences of people with psychosis in the USA, India and Ghana: interview-based study by T. M. Luhrmann et al. (2014) BJPsych Vol 206 Issue 3 DOI: 10.1192/bjp.bp.113.139048.
- Lavretsky H; The Russian Concept of Schizophrenia: A Review of the Literature; Schizophrenia Bulletin 24 (4): 537–557.