The Concept Of Schizophrenia Is Coming To An End Here’s Why
by Simon Mccarthy-Jones, The Conversation
The concept of schizophrenia is dying. Harried for decades , it now appears to have been fatally wounded by psychiatry, the very profession that once sustained it. It’s passing will not be mourned.
Today, having a diagnosis of schizophrenia is associated with a life-expectancy reduction of nearly two decades. By some criteria, only one in seven people recover. Despite heralded advances in treatments, staggeringly, the proportion of people who recover hasn’t increased over time. Something is profoundly wrong.
Part of the problem turns out to be the concept of schizophrenia itself.
Arguments that schizophrenia is a distinct disease have been “fatally undermined“. Just as we now have the concept of autism spectrum disorder, psychosis is also argued to exist along a continuum and in degrees. Schizophrenia is the severe end of a spectrum or continuum of experiences.
Jim van Os, a professor of psychiatry at Maastricht University, has argued that we cannot shift to this new way of thinking without changing our language. As such, he proposes the term schizophrenia “should be abolished“. In its place, he suggests the concept of a psychosis spectrum disorder.
Breaking down breakdowns
Schizophrenia may instead turn out to be many different things. The eminent psychiatrist Sir Robin Murray describes how::
What comes next?
What Are The Schizophrenia Symptoms In Children And Teens
Children and teenagers can show symptoms of schizophrenia and develop the illness. According to the DSM-5 , its rare for schizophrenia to begin before adolescence, but it does happen. The earlier signs and symptoms appear, the worse the illness becomes for someone living with it as he or she ages. Therefore, knowing schizophrenia symptoms in children and teens can mean earlier treatment and potentially better functioning into adulthood.
Why Do Clinicians Have Such A Pessimistic View
The view that most people with schizophrenia become markedly disabled continues to be held by many clinicians. In their seminal article, The Clinicians Illusion, Cohen and Cohen cited schizophrenia as an example of an illness for which the Clinicians Illusion is particularly relevant. The Clinicians Illusion is, the attribution of the characteristics and course of those patients who are currently ill to the entire population contracting the illness. This illusion occurs because clinicians typically care for those patients currently suffering from the illness , rather than of all those who have ever contracted the illness . Patients who are remitted or well stabilized are less likely to be seen in specialized psychiatric services, and if they are seen at all, it is more likely to be by their family doctor. Cohen and Cohen demonstrated that the likelihood that a patient will appear in such specialized clinics is proportional to the duration of their illness. As a result, prevalence samples are greatly biased toward those who have been ill for many years, while those who have had brief periods of illness are underrepresented.
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Can Schizophrenia Be Cured Naturally Without Medication Not Completely
Many people with schizophrenia are in search of a cure for their condition. It is completely natural to look for cases of people that have been cured of debilitating mental illness and other diseases. The truth is that there is no cure for schizophrenia at this particular time. However, science and researchers are advancing and it is hoped that a cure will eventually be discovered.
Tip 6: Understand The Role Of Medication
If youve been diagnosed with schizophrenia, you will almost certainly be offered antipsychotic medication. The two main groups of medications used for the treatment of schizophrenia are the older or typical antipsychotic medications and the newer atypical antipsychotic medications. Its important to understand that medication is just one component of schizophrenia treatment.
Medication is not a cure for schizophrenia and only treats some of the symptoms.;Antipsychotic medication reduces psychotic symptoms such as hallucinations, delusions, paranoia, and disordered thinking. But is much less helpful for treating symptoms of schizophrenia such as social withdrawal, lack of motivation, and lack of emotional expressiveness.
You should not have to put up with disabling side effects.;Schizophrenia medication can have very unpleasanteven disablingside effects such as drowsiness, lack of energy, uncontrollable movements, weight gain, and sexual dysfunction. Your quality of life is important, so talk to your doctor if youre bothered by side effects.
Never reduce or stop medication on your own.
Sudden or unsupervised dosage changes are dangerous, and can trigger a schizophrenia relapse or other complications. If youre having trouble with your medication or feel like you dont need to take it, talk to your doctor or someone else that you trust.
Looking To The Brain For Answers
Schizophrenia and substance abuse can share symptoms. They also share the center of those symptoms: the brain. Whether someone has schizophrenia, a substance use disorder, or both, psychotic symptoms are caused by the effect within the brain.
Drugs act on neurotransmitters and receptors in the brain to produce hallucinations, delusions, and other symptoms. Schizophrenia is an illness of the brain, and the illness involves, in part, the same neurotransmitters .
Interestingly, both schizophrenia and drugs are implicated in chemical imbalances in the brain. Further, the brains reward mechanisms are activated and respond the same to drug use and certain aspects of schizophrenia. Many researchers believe that these connections cause the psychotic symptoms of both substances and schizophrenia as well as reinforce substance use in people with schizophrenia .
Experimenting On Balls Of Brain Cells
The Stanford scientists, collaborating with researchers from other institutions, uncovered the electrical defect in nerve cells, or neurons, by generating and manipulating tiny spherical clusters of brain cells in a dish. Each cluster contained hundreds of thousands of cells. These so-called cortical spheroids, composed of neurons and other important brain cells, were first developed by Pasca several years ago. Derived from skin cells and suspended in laboratory glassware, the spheroids self-organize to recapitulate some of the architecture of the human cerebral cortex, a brain region often associated with schizophrenia symptoms. The spheroids continue to develop for months and even years in a dish.
In the study, Pasca and his colleagues generated cortical spheroids from skin cells taken from 15 different 22q11DS carriers and 15 healthy control subjects. Pasca, the Bonnie Uytengsu and Family Director of the Stanford Brain Organogenesis Program, is the studys senior author. Lead authorship is shared by Stanford graduate student Themasap Khan; Stanford postdoctoral scholar Omer Revah, DMV, PhD; and Aaron Gordon, PhD, a postdoctoral scholar at UCLA.
Not all the 22q11DS donors had manifested schizophrenias hallmark symptoms. Whereas schizophrenia usually reveals itself in late adolescence or early adulthood, even asymptomatic 22q11DS carriers remain at elevated risk of developing schizophrenia throughout their lifetimes.
; ; ; ; ; ; Sergiu Pasca
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The Stages Of Schizophrenia
Perhaps the most fundamental change from re-conceptualizing schizophrenia as a neurodevelopmental disorder is the notion of trajectory of illness. If the disorder begins in prenatal or perinatal life, then the psychosis of late adolescence must be seen not as the onset but as a late stage of the disorder. Indeed, we can begin to hypothesize four stages of schizophrenia, from risk to prodrome to psychosis to chronic disability . At present, the diagnosis is based on the symptoms and signs of psychosis. With the advent of biomarkers and new cognitive tools as well as the identification of subtle clinical features, we are beginning to detect earlier stages of risk and prodrome.
Table 1 Stages of schizophrenia
Schizophrenia Symptoms Can Be Managed With Proper Treatment
Some people have noted that their symptoms can be temporarily cured with proper psychiatric treatments. In other words, there are people that are fully functioning despite their diagnosis. In some cases, you may not even be able to tell that they have this illness. Take Elyn Saks for example professor of Law, Psychiatry, and Psychology at University of Southern California. She has schizophrenia and is still high functioning to the point that most people would not be able to tell that she had this disease unless she told them.
Most medications on the market today are atypical antipsychotics. ;Although they carry a variety of side effects, their side effect profile is supposed to be lower than the old typical antipsychotics. ;These medications have been found helpful at managing symptoms and helping people with this condition be productive members of society.
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Remember Prevention And Early Detection Are Best
Though tardive dyskinesia can be reversed, it isnt always possible. The greatest chance of eliminating all symptoms occurs if tardive dyskinesia is detected early in its course. Of course, ideally you can prevent it from developing in the first place.
It helps to be aware of what can put you at higher risk of tardive dyskinesia, such as:
- Female sex
The Search For Progressive Brain Changes
Researchers have sought to identify structural brain changes in schizophrenia since the time of Kraepelin. Postmortem and pneumoencephalographic studies, provided support for the presence of atrophic brain changes in some patients with chronic schizophrenia. However, the opportunity to systematically investigate brain structure emerged in the 1970s and 1980s. Computed tomography revealed that patients with schizophrenia on average had larger intracranial cerebrospinal fluid volumes, including larger lateral ventricles, and cortical sulci., Subsequent MRI studies demonstrated widespread deficits in gray matter volumes, and white matter volumes. The magnitude of these group differences was observed to be greater for more chronically ill patients. From the outset, both CT and MRI studies sought to demonstrate associations between illness duration and the magnitude of CSF and gray matter volumes, but with little success.,
What Does Schizophrenia Recovery Mean
Coping with schizophrenia is a lifelong process. Recovery doesnt mean you wont experience any more challenges from the illness or that youll always be symptom-free. What it does mean is that you are learning to manage your symptoms, developing the support you need, and creating a satisfying, purpose-driven life.
A treatment plan that combines medication with schizophrenia self-help, supportive services, and therapy is the most effective approach.
Encouraging facts about schizophrenia
- Schizophrenia is treatable. Currently, there is no cure for schizophrenia, but the illness can be successfully treated and managed. The key is to have a strong support system in place and get the right treatment and self-help for your needs.
- You can enjoy a fulfilling, meaningful life. With the right treatment, most people with schizophrenia are able to have satisfying relationships, work or pursue other meaningful activities, be part of their community, and enjoy life.
- Just because you have schizophrenia doesnt mean youll have to be hospitalized.;If youre getting the right treatment and sticking to it, you are much less likely to experience a crisis situation that requires hospitalization.
- Most people with schizophrenia improve.;Many people with schizophrenia regain normal functioning and even become symptom-free. No matter what challenges you presently face, there is always hope.
Can I Live A Normal Life With Schizophreniform Disorder
Schizophreniform disorder can be extremely disruptive. It messes up how you think, act, express emotions, perceive reality and relate to others. This causes problems with relationships, employment and other aspects of normal life.
Some individuals with schizophreniform who have worked in the past find it easier to return to employment. If youve never worked, it might be helpful to do some volunteering for charity to see if a certain job appeals to you. To help make your choice consider questions like the following: Are you good with a hammer? Would you rather sit behind a desk inside or work in a park outside? Do you prefer to work independently or in a group? Figure out what you can and cant do with your disorder. Do your best to preserve the life you had before, while learning to accept the challenges you face now.
Some patients may need to be hospitalized. It may be necessary for your safety and the safety of others.
Many schizophreniform disorder patients engage in substance abuse. Such a decision will not help treat the symptoms of this disorder and can worsen your quality of life even more, making it harder to recover.
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Diagnosis & Classification Of High
In an attempt to better categorize the prodromal period of schizophrenia and other psychotic disorders, and to elucidate the process of change or deterioration that represents a deviation from an individuals previous experience or behavior, researchers have proposed several diagnostic and classification systems for individuals at high risk of developing a psychotic disorder .
The Personal Assessment and Crisis Evaluation clinic in Melbourne, Australia, was the first to develop a standardized classification of prodromal syndromes, which they referred to as the ultra-high-risk states. Risk factors such as age, family history of psychosis and symptom scores were combined in a multifactorial index of risk . From this work came the creation of the CAARMS, which takes into account the intensity, frequency and duration of emerging positive symptoms, as well as declines in functioning. Help-seeking individuals between the ages of 14 and 29 years are categorized as UHR if they experienced APS during the past year, experience brief limited intermittent psychotic symptoms , and/or have schizotypal personality disorder or a family history of psychosis in concert with a significant decrease in functioning during the past year.
Add Medications That Specifically Treat Tardive Dyskinesia
Two drugs have been approved to treat symptoms of tardive dyskinesia, valbenazine and deutetrabenazine . They decrease the abnormal dopamine signaling in your brain and can improve uncontrolled movements. Tetrabenazine is another medication that acts similarly but has a greater risk of serious side effects.
The supplement gingko biloba and the drugs clonazepam and amantadine may also improve symptoms of tardive dyskinesia.
Botulinum toxin injections can also be used to relax small areas of affected muscles and stop uncontrollable movements.
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Overcome Prejudices Associated With Mental Illness
Sometimes people can hesitate to consult a health professional given their own prejudices, or that of others, towards mental illness. As such, some people do not consult either because they fear being judged by others, or because they believe it is impossible that they have a mental illness. Mental illnesses are not a personality weakness but conditions that can be cured.
Stanford Scientists Solve Secret Of Nerve Cells Marking A Form Of Schizophrenia
A common genetic deletion boosts the risk for schizophrenia by 30-fold. Generating nerve cells from people with the deletion has showed Stanford researchers why.
A spherical cluster of hundreds of thousands of brain cells cultured in a lab dish. A team of researchers studied such neuronal clusters to better understand schizophrenia.Pasca lab
When nerve cells arent busy exchanging information, theyre supposed to keep quiet. If theyre just popping off at random, like in a noisy classroom, it obscures the signals theyre supposed to be transmitting.;
But in the most common genetic cause of schizophrenia, it seems that nerve cells wont shut up, Stanford University School of Medicine investigators have found. And they think they know why.
One in every 3,000 people carries the genetic defect called 22q11.2 deletion syndrome, or 22q11DS. Its one of the most widespread chromosomal deletions known to occur in humans. People carrying 22q11DS are at an astonishing 30-fold risk for schizophrenia compared with the general population, dwarfing the magnitude of all other known genetic or environmental risk factors. Plus, some 30%-40% of individuals with this deletion receive a diagnosis of autism spectrum disorder early in their lives.
Until now, nobody understood why this deletion so profoundly elevates the risk for these conditions.
The scientists identified a single gene that appears to be largely responsible for the electrical abnormality.
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Great Results With Intermediate Doses Of Cbd In Schizophrenia
After the study in 1982, which provided the first evidence that CBD might have antipsychotic properties, the same observation was confirmed in a study with THC administrated intravenously after oral pretreatment with CBD or placebo. In addition to blocking the psychotic symptoms induced by THC, CBD and THC demonstrated opposite effects.;
This led the scientists to carry out a pioneering study to test the effects of CBD on laboratory animals. The stereotypy induced in rats was clearly reduced by CBD, without producing catalepsy, the study has found. The next step was to evaluate the effects of CBD in a patient with schizophrenia. The patient was a chronically psychotic young female who has experienced many adverse effects from traditional antipsychotics, which presented the ethical justification for the first clinical test. After four weeks of treatment, the patient had a marked reduction in her psychotic symptoms.
The patient was given up to 1500 mg per day in two divided doses, with weekly reducing diazepam dose, which was being given for periods of great agitation and anxiety. The dose of diazepam was reduced from 16,3 to 5,7 mg per day. The improvements of her condition were observed in all the symptoms closely related to the psychosis, including thought disturbance and hostility-suspiciousness.
Seeking Support And Stability Through Long
Healing begins, always, with an accurate diagnosis. A long-term, dual-diagnosis treatment facility is the best place to establish such a diagnosis for your loved one, as the medical staff are specifically trained to identify and treat co-occurring disorders accurately and effectively. Residential treatment is a safe, healing environment where a team of psychiatrists, psychologists, therapists, and nurses will help you and your loved one understand and address the roots of both their trauma and their psychosis.
Residential treatment addresses all aspects of the healing process by taking a comprehensive approach to recovery. Psychiatric experts will work with your loved one to find the right medications and doses to manage and mitigate the effects of trauma and the symptoms of schizophrenia. A variety of therapeutic options, including cognitive-behavioral therapy and experiential therapies, will help support your loved ones recovery on a mental and emotional level and teach them healthy coping strategies to increase their quality of life and level of independence. Social therapies, such as group therapy and family therapy sessions, will help them work on improving social skills and healing familial relationships.
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