Total Costs Of Schizophrenia Amount To Nearly $63 Million A Year
Despite the low prevalence rates of schizophrenia, this is quite a costly disease. Its overall cost includes direct and indirect expenses. First, direct costs are counseling and medication. Second, indirect expenses are lost productivity and financial assistance. Both can reach up to $63 million per year. Furthermore, this disorder contributes 13.4 million YLDs to the global burden of the disease, or 1.7% of total YLDs in 2016.
Leonhard’s Alternative Classification Of The Endogenous Psychoses
In a clinical tradition aiming to group psychotic illnesses on the basis of presumed localized cerebral dysfunction, Karl Leonhard developed an elaborate classification of the endogenous psychoses which departed substantially from the Kraepelinian and Bleulerian nosology. Leonhard defined sharply delineated disease entities, described by a detailed psychopathology emphasizing objective signs , course and outcome, and family history. The nonaffective psychoses were split into systematic and unsystematic groups of schizophrenias, and a third group of cycloid psychoses, each containing further subtypes , for which Leonhard claimed distinct categorical disease status. While the unsystematic schizophrenias were considered to be primarily genetic, hereditary factors were thought to play a secondary role in the cycloid psychoses and the systematic schizophrenias, which were presumed to be exogenously determined, eg, by maternal obstetric complications or early failure of social learning. Notably, Leonhard’s classification neither expands, nor constricts, the outer boundaries of schizophrenia, but carves up the schizophrenia spectrum in a different way.
Schizoaffective Disorder: History Symptoms And Treatment
26 June, 2018
The main characteristic of schizoaffective disorder is that there are symptoms of schizophrenia alongside symptoms of a mood disorder
But even with all those changes to the guidelines, its still the best diagnosis for patients who might get the wrong kind of clinical treatment if their doctor saw it as just schizophrenia or just a mood disorder.
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Medical Expenditure Panel Survey
- The MEPS collect data from community-dwelling people in the U.S. It does not include patients living in group homes, supported living arrangements, prisons, and institutions. In addition, homeless people and undocumented immigrants are excluded. These groups may have a higher prevalence of schizophrenia. MEPS survey responses were obtained from a single respondent for all the members of the family, therefore some recall bias may be associated with the responses.
- Patients for the schizophrenia study were selected based on ICD-9 codes only. Due to the stigma associated with the condition, physicians are known to give patients an interim non-schizophrenia diagnosis when uncertain about schizophrenia until it can be confirmed. To capture patients who may be given an interim non-schizophrenia diagnosis, researchers used the ICD-9 code for non-organic psychoses in addition to that for schizophrenic disorder in their study.5 MEPS collects information about conditions through patient interviews and some miscoding may occur as the household participants describe their conditions during the interviews and the coders record the ICD-9 codes for the diagnosis.
Schizophrenia: A Brief History
Early references to schizophrenia
Schizophrenia has been around for a long time. References to people who are clearly insane appear in classical writings and the bible, for instance in Mark 5 we hear of the Gerasene Demoniac who, All day and all night among the tombs and in the mountains he would howl and gash himself with stones. In fact the oldest recorded description of an illness like schizophrenia dates back to the Ebers Papyrus of 1550BC from Egypt.1
Descriptions of episodes of madness involving hearing voices, seeing visions and erratic and unruly behaviour start to appear in the literature from the 17th century. It is interesting to note that even then madness was seen as a medical problem rather than some possession by evil spirits although they were denied the effective remedies that we have today.7
Dr Emil Kraepelin who first described schizophrenia in 1896.
Schizophrenia was first described by Dr Emil Krapelin in the 19th century. He was director of the psychiatric clinic at the university in Estonia. He first used the term Dementia Praecox or premature dementia and he believed that the condition always had a steadily worsening course or if there was any improvement over time it would only be partial.
Although Krapelins understanding of schizophrenia was still incomplete his work was pioneering in the way that he distinguished the condition from the other psychotic disorders such as bipolar disorder.5
The Victorian Asylums
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Schizophrenia Statistics By State Show That California Has The Most Adults With This Condition
With 335,242 adults diagnosed with schizophrenia, California has the highest incidence. The 2017 Census data also shows that Texas is second with 230,324 cases and Florida comes third with 184,607. On the other hand, Wyoming has the lowest prevalence rate of schizophrenia only 4,871 cases in 2017. Sadly, 1,948 of those cases were untreated.
There Is No Cure For Schizophrenia
Even though there isnt a cure for this disorder, schizophrenia is still a treatable and manageable disease. Taking antipsychotic schizophrenia medication is one of the essential steps. That said, it shouldnt be the only method of treatment. A combination of community support, healthy and balanced nutrition, and self-care are just as important.
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How Do You Treat Schizoaffective Disorder
The main ways to treat this disorder are hospitalization, medication, and psychosocial interventions. The basic principles they outline for treating these disorders with medication say that you should use the same rules as you do with antidepressant and antimanic drugs. You should only use antipsychotics if the patient needs some short term relief.
If the treatments for improving their mood dont help control their symptoms, that would also be a reason to use antipsychotics. Some examples of these are haloperidol and risperidone.
The things we use to treat people with the bipolar kind of schizoaffective disorder are lithium, carbamazepine, valproate, or some combination of those. People with the depressive kind of schizoaffective disorder should get antidepressants and electroconvulsive therapy. You should always do that so that you can see if they respond to antidepression treatments.
As wee seen, this is a complicated disorder. And thats true both when it comes to defining it and treating it. But the most important thing you have to be clear about is that the symptoms of this disorder are the same as schizophrenia, manic episodes, and depressive disorders. And thats exactly what makes it so complicated.
Harold I. Kaplan, Benjamin J. Sadock. Kaplan and Sadocks Synopsis of Psychiatry. Williams & Wilkins, Philadelphia. 1998
Affective and Schizoaffective Disorders. ed Marneros, Andreas and Tsuang, Min T. Springer Science and Business Media, New York. 2012
Nonadherence Rates Range From 265% To 588% Of The Population
People living with schizophrenia consistently show low adherence to their medication. That could affect the development of the disease and the rate of schizophrenia hospitalization, statistics show. According to one study, the most common reason for not taking the medication is a lack of awareness. In fact, 55% of respondents stated that they dont take medication because they dont believe theyre sick.
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Development Of Treatments In The 20th Century
Harry Stack Sullivan applied the approaches of Interpersonal psychotherapy to treating schizophrenia in the 1920s viewing early schizophrenia as a problem-solving attempt to integrate life experiences, arguing that recovered patients were made more competent after a psychotic experience than before.:76
In the early 1930s insulin coma therapy was trialed to treat schizophrenia but faded out of use in the 1960s following the advent of antipsychotics.
Antipsychotics were introduced to US hospitals in 1950s, following the discovery of chlorpromazine in 1952 and its trialing in French hospitals. Adoption was encouraged by advertising by the Smith, Kline & French company after it received permission to advertise use of the drug in 1954. Advertised under the brand name Thorazine, more than 2 million people had received the drug within 8 months. In the first report on chloropromazine’s use in the US, John Vernon Kinross-Wright suggested that the drug could be used as an adjunct to psychotherapy to improve its effectiveness. :3335
Does Substance Abuse Play A Part In Causing Schizoaffective Disorder
Its hard to prove a clear relationship between taking drugs and developing psychotic disorders. But there is evidence specifically linked to using marijuana. The more cannabis a person consumes, the more likely it is theyll develop a psychotic disorder. The risk factors are also higher if they consume it as a teenager.
A study done at Yale University in 2009 found that cannabinoides increase the symptoms of an established psychotic disorder and can lead to relapses. The two parts of cannabis that cause these effects are tetrahydrocannabinol and cannabidiol .
On top of that about half of all people with schizoaffective disorders use drugs or alcohol excessively. Theres also evidence that alcohol abuse can lead to a person developing a psychotic disorder.
Taking amphetamines and cocaine can also lead to psychotic episodes. Lastly, even though its not a cause of the disorder, studies say that people with schizoaffective disorder consume more nicotine than the general public.
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Fish Oil Could Reduce The Risk Of Developing The Condition
Fish oil, a rich source of omega-3 acids, can reduce inflammation in the body and aid brain development and function. According to the data on the prevalence of schizophrenia, a lack of these fatty acids can have links to the disorder. This discovery prompted scientists to carry out a study on 81 young people at risk of schizophrenia. The study confirmed that those who took fish oil supplements were less likely to develop the condition.
Over 69% Of Individuals With Schizophrenia Dont Get The Care They Need
One of the reasons why most people with schizophrenia do not get proper treatment is social stigma. Facts about schizophrenia report that feeling stigmatized makes them less likely to seek medical care. Whats more, 90% of people with untreated schizophrenia live in low- and middle-income countries. That translates to the lack of access to adequate mental health care.
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There Are Four Different Types Of Schizophrenia
This disorder exhibits different symptoms for everyone. However, there are four major categories into which patients generally fall:
- Paranoid schizophrenia. Facts show its main characteristics paranoia, suspicion, and fear of other peoples intentions.
- Catatonic schizophrenia. It causes people to shut down physically, as well as emotionally and mentally.
- Undifferentiated schizophrenia. It displays different symptoms, like confusion, paranoia, or abnormal behavior.
- Schizoaffective disorder. Delusions and hallucinations might come hand in hand with at least one symptom of a mood disorder, such as depression and mania.
How Does Schizoaffective Disorder Show Up
The signs and symptoms of this disorder are the same as schizophrenia, manic episodes, and depressive disorders. But the symptoms of schizophrenia or a mood disorder can show up at the same time or not.
It can progress in different ways. So there might be cycles where the person gets better and then worse with their symptoms before they take a clear downturn. A lot of researchers and doctors have wondered about the psychotic symptoms that dont line up with mood. What that would mean is that the psychotic content dont match the patients mood.
In general, when these kinds of symptoms show up in a mood disorder it usually means the person has been diagnosed wrong. This might also be true for people with schizoaffective disorder, but we still dont have enough information to be sure.
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No Test Can Determine If A Person Has Schizophrenia Schizophrenia Facts Show
According to the DSM-5, schizophrenia is diagnosed if a person exhibits two or more core symptoms for at least one month. Still, schizophrenia is usually a diagnosis of exclusion. First, a medical professional excludes other physical conditions and mental disorders. Once that is done, a schizophrenia diagnosis can come around.
Modern History Of Schizophrenia
While schizophrenia treatment once consisted of exorcisms and insulin shock treatment, the major breakthrough in the history of schizophrenia treatment came in 1952. Thats when Henri Laborit, a Parisian surgeon, discovered that chlorpromazine effectively treated the symptoms of schizophrenia. This discovery ushered in a time when people with schizophrenia were no longer confined to asylums but could live in the community.
In the 1970s, as growing numbers of people with schizophrenia were being successfully treated with antipsychotic medication, groups and programs began to emerge to support them. Assertive Community Treatment was developed to help these individuals and its programs are still in use and considered the gold standard for service delivery today. The National Alliance on Mental Illness also came into being in the 1970s to fight for the rights of those with a mental illness.3
Atypical antipsychotics, or second-generation antipsychotics, are now more commonly used to treat schizophrenia as they are thought to have a more tolerable side effect profile than first-generation antipsychotics. Psychosocial therapies are now also used to treat schizophrenia. Psychosocial interventions include:
- Family therapy
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The Present Diagnostic Classifications: Dsm
There are both similarities and differences in the way the two classifications define schizophrenia. In contrast to DSM-IV, which provides a single set of operational diagnostic criteria for all users, ICD-10 was designed as a family of inter-related versions addressing different users. While the ICD-10 volume Clinical Descriptions and Diagnostic Guidelines is the conceptual core of the system, the ICD-10 Diagnostic Criteria for Research and the WHO Guide to Mental Health in Primary Care are derivatives for use in specific context. A comparison of the two sets of diagnostic criteria is provided in Tables IV and V.
C4 Prunes Synapses To Increase Schizophrenia Risk
Next, the team set out to gain a better understanding of how certain C4 gene structures increase the risk of schizophrenia.
The researchers adapted a molecular genetics technique previously used in mouse models to study the pruning of synapses the connections between brain cells, or neurons and the role of C4 in the immune system.
Using this adapted method to see what role C4 plays in the brains of mice, the researchers found that the gene is key for synaptic pruning the process by which synapses are streamlined, which normally occurs in late adolescence/early adulthood in humans.
Specifically, the team found that C4 activity was required in order for a protein called C3 to be transferred onto synapses, which acts as a signal that the synapses should be pruned.
Additionally, the researchers found that the greater the C4 activity in the brains of the mice, the more synaptic pruning they experienced during maturation.
The team says their findings may explain why schizophrenia tends to develop in late adolescence or early adulthood excessive synaptic pruning caused by increased C4 activity at this point in time may trigger symptom onset.
The results may also explain why some people with schizophrenia have a thinner cerebral cortex with fewer synapses. The cerebral cortex is the outer layer of the brain that plays a role in memory, language, intelligence and consciousness.
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Around 20 Million People In The World Have Schizophrenia
To begin with, schizophrenia has direct links to cognitive, perceptive, and emotional disruptions. The main symptoms are hallucinations, delusions, and disorganized behavior . Another symptom is emotional disturbances. In other words, there is a disconnection between the emotions reported and corresponding body language.
Schizophrenia Symptomsfall Into Three Categories Facts About Schizophrenia Suggest
Symptoms can be positive, such as hallucinations and delusions, or negative. The latter are the symptoms that disrupt normal behavior. Those include feeling no pleasure, problems speaking, and difficulty starting or finishing activities. The third category is the cognitive symptoms. These affect a persons way of thinking. Such symptoms range from memory issues and trouble focusing to difficulties in the decision making process.
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In Latin America Chile Had The Highest Share Of Years Lived With Disability Due To Schizophrenia
According to 2018 schizophrenia statistics by country, Chile contributed to 2.1% of all YLDs the highest share of all the countries in the region. Its followed by Argentina and Uruguay, which contributed to 1.9% of all YLDs. Haiti is on the other side of the spectrum it had the lowest share at 1.1% of all YLDs in Latin America.
Divine Madness: A History Of Schizophrenia
The label schizophrenia is a recent term, first used in 1908 by Eugen Bleuler, a Swiss psychiatrist, and was meant to describe the disunity of functioning between personality, perception, thinking and memory. Whilst the label is new, accounts of schizophrenia-like symptoms can be found in ancient texts dating back to 2000 BC, and across a number of cultural contexts. The oldest of these texts is the ancient Egyptian Ebers papyrus, around two millennia old.
There are descriptions of illnesses marked by bizarre behaviour and lack of self-control in the Hindu Arthava Veda, dating approximately 1400 BC, and a Chinese text from approximately 1000 BC called The Yellow Emperors Classic of Internal Medicine, which attributes insanity and seizures to supernatural and demonic forces.
The Greeks and Romans are also found to have a general awareness of psychotic illnesses. Plato, who lived in the fourth and fifth centuries BC, spoke of a madness of divine origin, which could inspire poets and create prophets. Demonic possession and supernatural forces as the cause of mental illness are a common theme in the ancient literature.
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Genetic Variations Increase Your Risk By 80% According To Schizophrenia Stats And Facts
Although there isnt just one factor listed among schizophrenia causes, studies reveal that genetic variation plays a considerable role. In fact, one research discovered that chances of having the disorder increase by 10% if a parent or a sibling has it. If both parents have it, then there is a 40% chance that their child will have schizophrenia, too. Still, the greatest risk is if an identical twin has it. In that case, the other twin has a 50% chance of having schizophrenia.