Schizophrenia: Early Warning Signs
Early detection and treatment of conditions such as heart disease and cancer have improved survival rates and quality of life for people who suffer from these conditions. A new approach involves identifying people who show minor symptoms of psychosis, such as unusual thought content, paranoia, odd communication, delusions, problems at school or work, and a decline in social functioningwhich are coined prodromal symptomsand following these individuals over time to determine which of them develop a psychotic disorder and which factors best predict such a disorder. A number of factors have been identified that predict a greater likelihood that prodromal individuals will develop a psychotic disorder: genetic risk , recent deterioration in functioning, high levels of unusual thought content, high levels of suspicion or paranoia, poor social functioning, and a history of substance abuse . Further research will enable a more accurate prediction of those at greatest risk for developing schizophrenia, and thus to whom early intervention efforts should be directed.
Kraepelin : Dementia Praecox And Chronicity
It was a rather strange move. In 1886, at the age of 30, an aspiring young psychiatrist from Germany was appointed to the chair of psychiatry at the University of Dorpat , a place where the vast majority of the population spoke languages he did not understand and also could not acquire quicklynamely Estonian, Russian, and Latvian. When I read his memoirs, I was particularly struck by the following passage: The majority of the ordinary patients spoke and understood only Estonian …. I was, therefore, unable to communicate with most of them without continuous interpreting .. it was impossible for me to perceive slight deviations in pronunciation, ways of expressing a thought or formation of words or sentences.
Kurt Schneider, whose decisive influence on the definition of schizophrenia will be discussed below, said much later that Kraepelin’s concept of the human person was that of the positivist natural sciences of the 19th century where he looked only from outside on the psychotic person. This assessment corresponds to that of a later scholar of Kreapelin, and his work who pointed out that Kraepelin showed a lack of empathy with his patients .
Where Did The Term Autism Come From
The word “autism” comes from the Greek word “autos,” which means “self.” It describes conditions in which a person is removed from social interaction. In other words, they become an âisolated self.â
Eugen Bleuler, a Swiss psychiatrist, was the first person to use the term. He started using it around 1911 to refer to one group of symptoms related to schizophrenia.
In the 1940s, researchers in the United States began to use âautismâ to describe children with emotional or social problems. Leo Kanner, a doctor from Johns Hopkins University, used it to describe the withdrawn behavior of several children he studied. At about the same time, Hans Asperger, a scientist in Germany, identified a similar condition thatâs now called Aspergerâs syndrome.
Autism and schizophrenia remained linked in many researchersâ minds until the 1960s. It was only then that medical professionals began to have a separate understanding of autism in children.
From the 1960s through the 1970s, research into treatments for autism focused on medications such as LSD, electric shock, and behavioral change techniques. The latter relied on pain and punishment.
During the 1980s and 1990s, the role of behavioral therapy and the use of highly controlled learning environments emerged as the primary treatments for many forms of autism and related conditions. Currently, the cornerstones of autism therapy are behavioral therapy and language therapy. Other treatments are added as needed.
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Re: Schizophrenia Does Not Exist And Prof Stephen M Lawrie’s Trite Assertion Response
As a mother who has survived, and made a full recovery from, 3 separate episodes of psychoses, two of them postpartum in 1978 and 1984, the other menopausal in 2002, and the subsequent coercive psychiatric drug treatment , I agree with Prof Jim van Os’s Article and concluding paragraph:
“The best way to inform the public and provide patients with diagnoses, therefore, is to forget about devastating schizophrenia as the only category that matters and start doing justice to the broad and heterogeneous psychosis spectrum syndrome that really exists.”
I was given the diagnosis of schizoaffective disorder in 2002 which, even after my recovery, remains in my notes like a label. And I have family members who received the schizophrenia diagnosis/label. Resulting in “family history of …” being written in the notes of any of us who happened to be treated for psychosis in the same health board area of Scotland. The schizophrenia and related diagnoses are very difficult to get erased from one’s medical notes, regardless of recovery. In my case I tapered the drug cocktail in 2003, of Risperidone, Venlafaxine and Lithium, under my own steam. Stigma and discrimination, in my experience, are linked to the diagnoses and “family history of” assumptions.
I do not agree with Dr Stephen Lawrie’s closing paragraph:
Competing interests: No competing interests
14 February 2016
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Schizophrenia Does Exist : It Is Kraepelins Disease
Schizophrenia does exist : it is Kraepelins disease
We read with interest the personal view by Van Os with the provocative title Schizophrenia does not exist with the subtitle Disease classifications should drop this unhelpful description of symptoms. On reading the article it appears that it would have been more aptly entitled renaming schizophrenia.
We support the case for the need to rename schizophrenia as highlighted by Lasalvia et al , in their review of the limited literature in the field, who proposed that the term schizophrenia should be abandoned given that the advantages outweigh the disadvantages overall. However the paper does emphasise that it is not just a change in name that is required but complex shifts in public perception, services, legislation along with the education of professionals to improve outcomes for this population. The authors hoped that the Work Group engaged in revising the psychoses for ICD 11 would give careful attention to the term schizophrenia in view of the exceptional opportunity to remove the word from the public and professional vocabulary. Their review listed proposed terms to replace schizophrenia amongst which were Kraepelin-Bleuler disease and Bleulers Syndrome .
Concerning the renaming of the other related psychotic conditions such as schizoaffective disorder and schizophreniform disorders, these names could be dropped and replaced with the term psychosis.
Mohammed T Abou-Saleha and Helen L Millarb
References
Family Education: People With Schizophrenia Are Often Discharged From The Hospital Into The Care Of Their Families So It Is Important That Family Members Know As Much As Possible About The Disease With The Help Of A Therapist Family Members Can Learn Coping Strategies And Problem
Cognitive behavioral therapy: Cognitive behavioral therapy is a type of psychotherapy that focuses on thinking and behavior. CBT helps patients with symptoms that do not go away even when they take medication. The therapist teaches people with schizophrenia how to test the reality of their thoughts and perceptions, how to not listen to their voices, and how to manage their symptoms overall. CBT can help reduce the severity of symptoms and reduce the risk of relapse.
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Environmental Causes Of Schizophrenia
As for the environmental factors involved, more and more research is pointing to stress, either during pregnancy or at a later stage of development. High levels of stress are believed to trigger schizophrenia by increasing the bodys production of the hormone cortisol.
Research points to several stress-inducing environmental factors that may be involved in schizophrenia, including:
Prenatal exposure to a viral infection
Low oxygen levels during birth
Exposure to a virus during infancy
Early parental loss or separation
Physical or sexual abuse in childhood
Treatments
The causes of schizophrenia are still unknown , treatments focus on eliminating the symptoms of the disease. Treatments include antipsychotic medications and various psychosocial treatments.Schizophrenia is a chronic condition, where patients require lifelong treatment. This disorder affects the ability to think.
Antipsychotic MedicationsAntipsychotic medications have been available since the mid-1950. The older types are called conventional or typical antipsychotics. Some of the more commonly used typical medications include: Chlorpromazine Perphenazine Fluphenazine .In the 1990s, new antipsychotic medications were developed. These new medications are called second generation, or atypical antipsychotics.
One should always consult their psychiatrists or psychologists before taking any anti-psychotic medications as they have their own side effects too.
Positive Versus Negative Features Of Schizophrenia
Current nosology emphasizes the positive and negative syndrome of schizophrenia50-52,63,97101 References to these concepts appear in the writings of Reynolds, Jackson, Bleuler, and Berze., – Reynolds wrote that negative features resulted from negation of vital properties, and positive features derived from an excess of vital properties. Jackson asserted that positive features of schizophrenia result from uninhibited normal brain activities after inhibitory influences were destroyed. Crow first linked positive and nega- tive features of schizophrenia to validators such as premorbid functioning, response to treatment, neuro-radiological findings, and cognitive functions., He, like Jackson, hypothesized that positive feat- ures were associated with good premorbid function, acute onset, normal cognition, and good response to treatment, and negative features were associated with poor premorbid functioning. Dominant negative features were consistent with an illness starting early in life, impairing cognition, and poorly responsive to treatment., His hypotheses challenged a single cause of schizophrenia. Deficit and non-deficit forms of schizophrenia have been conceptualized and validated., Further work emphasized the coexistence of positive and negative features of schizophrenia in the same patient.,
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The Name Schizophrenia Is Heard Worldwide
Robert M. Kaplan, MBChB, MA , MPhil , FRANZCPPsychiatric Times
This month in history: Determined to regard his patients as individuals, Swiss psychiatrist Eugen Bleuler sought to understand his patients and coined the term schizophrenia.
Looking Back to Look Forward
-Series Editor Gregory Eghigian, PhD
THIS DAY IN HISTORY
Dr Eugen Bleuler became Director of the Burghölzli Hospital in 1898. He attracted outstanding psychiatrists-including Carl Jung, Herman Rorschach, Ludwig Binswanger, and Karl Abraham-encouraging them to try new methods and tests. Determined to regard his patients as individuals, Bleuler made prolific notes, taking as much time as necessary to understand his patients.
On April 24, 1908, at the German Psychiatric Association meeting, Bleuler delivered a lecture titled Die Prognose der Dementia Praecox .1 Thus the world first heard the name schizophrenia defined as a disease characterised by a specific type of alteration of thinking, feeling and relation to the external world.
Bleuler wanted to widen Kraepelins characterization of dementia praecox. He conceived of schizophrenia as a genus, rather than a species.2 His list of secondary symptoms, largely derived from psychoanalysis, implied an etiology. This was the critical difference with Kraepelins view: a disturbance or exaggeration of normal psychic function was light years away from his categorical distinction between psychosis and sanity.
Disclosures:
Patient Discussion About Schizophrenia
Q. how to treat schizophrenia?
A.
Q. How can we treat a schizophrenic person? A member of my family is a schizophrenic and was diagnosed when he was 25 years old. Today at almost 60 he refuse to be treated and certain that nothing is wrong with him. The problem is me and my family feels that his illness is getting worst and we can’t help him. How can we get treatment for him and if not what is the next phase we should expect to encounter?
A.
Q. Am i going to get schizophrenia and what are the signs towards it? My mother is 50 years old and i knew she was bi polar and tonight i found out she has schizophrenia too from a nurse at the hospital she was sent to for going crazy out of no where tonight. I am very different from her and i am 17 years old. My dad side of the family has no disorders. How likely am i to develop schizophrenia? What are the first symptoms? Can i see signs now? and any other info.
A.
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What Myths Are There About Schizophrenia
There are some myths or mistaken beliefs about schizophrenia which come from the media. For example,
- Schizophrenia means someone has a split personality
This is not the case. The mistake may come from the fact that the name ‘schizophrenia’ comes from two Greek words meaning ‘split’ and ‘mind’.
- Schizophrenia causes people to be violent
Research shows that only a small number of people with the illness may become violent. The same way as a small minority of the general public may become violent.
People with schizophrenia are far more likely to be harmed by other people than other people are to be harmed by them. But as these incidents can be shocking, the media often report them in a way which emphasises the mental health diagnosis. This can create fear and stigma in the general public.
It’s About Historic Honour Recognition And Remembrance Not Semantic Onomasiology
Heroic clinicians and pioneering researchers of the past, in dark superstitious ages, took a stand on evidence based diagnoses in order to better care for their patients.
They combined two ancient Greek words to express a complex new pathological concept, and used accessible scientific data of that era.
Nowadays it is easy, yet indecent, for us to criticize their nomenclature, based on recent scientific research.
Instead of indulging ourselves in pointless onomatopoeic exercises, we should wonder if we retain ourselves capable of ever discovering and describing a novel disease.
After all, even if psychosis spectrum syndrome might sound more appropriate today, many Agnostics and Materialists would still oppose the unfitting word “psychosis”, since they doubt the presence of the soul .
Skeptics would opt for something like “telencephalic regional dysfunction”.
Competing interests: No competing interests
05 February 2016
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Politicization In The Soviet Union
In the Soviet Union the diagnosis of schizophrenia has also been used for political purposes. The prominent Soviet psychiatrist Andrei Snezhnevsky created and promoted an additional sub-classification of sluggishly progressing schizophrenia. This diagnosis was used to discredit and expeditiously imprison political dissidents while dispensing with a potentially embarrassing trial. The practice was exposed to Westerners by a number of Soviet dissidents, and in 1977 the World Psychiatric Association condemned the Soviet practice at the Sixth World Congress of Psychiatry. Rather than defending his claim that a latent form of schizophrenia caused dissidents to oppose the regime, Snezhnevsky broke all contact with the West in 1980 by resigning his honorary positions abroad.
Is It Possible To Recover From Schizophrenia
Many people who live with schizophrenia have recovery journeys that lead them to live meaningful lives.
Recovery can be thought of in terms of:
- clinical recovery, and
- personal recovery.
What is clinical recovery?
Your doctor might have talked to you about recovery. Some doctors and health professionals think of recovery as:
- no longer having mental illness symptoms, or
- where your symptoms are controlled by treatment to such a degree that they are not significantly a problem.
Sometimes this is called clinical recovery.
Everyones experience of clinical recovery is different.
- Some people completely recover from schizophrenia and go on to be symptom free.
- Some who live with schizophrenia can improve a great deal with ongoing treatment.
- Some improve with treatment but need ongoing support from mental health and social services.
What is personal recovery?
Dealing with symptoms is important to a lot of people. But some people think that recovery is wider than this. We call this personal recovery.
Personal recovery means that you can live a meaningful life.
What you think of as being a meaningful life might be different to how other people see it. You can think about what you would like to do to live a meaningful life and work towards that goal.
Below are some ways you can think of recovery.
What can help me recover?
You may want to think about the following questions.
The following things can be important in recovery.
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Kurt Schneider : First Rank Symptoms And Craziness
It took a few decades until the next U-turn. Delusions and hallucinations, downgraded by Eugen Bleuler to accessory symptoms in 1911, were upgraded to the top by the German psychiatrist Kurt Schneider in a brochure for general practitioners published in 1939. There, he suggested seven types of hallucinations and delusions which he called First Rank Symptoms. They included audible thoughts, voices arguing and/or discussing, voices commenting, somatic passivity experience, thought withdrawal/influenced thought, thought broadcasting, and delusional perceptions . And Kurt Schneider added: If they are present without a doubt and no underlying physical disease can be identified, then we clinically speak in all modesty of schizophrenia.
At the time, the publication remained practically unnoticed because of the Second World War. But also after the war, when Kurt Schneider came to be the chair of the University of Heidelberg, the impact of his suggestion to use specific delusions and hallucinations for diagnosing schizophrenia was very limited. However, after a long latency period, the situation changed in the 1960s and 1970s due to several developments in psychiatry, which will be discussed belowthe First Rank Symptoms were suddenly highly appreciated by American and international psychiatry and found a prominent place in the classification systems 40 years after their first publication.
Eugen Bleuler : The Term Schizophrenia And Its Misinterpretation As Split Personality
Kraepelin’s concept of Dementia praecox was soon criticized, first for its chronicity criterion, which was suggested to be overrated, and, second, for neglecting psychopathological theory and presenting only an unstructured mosaic of symptoms. What was neglected by Kraepelin became a major concern of Eugen Bleuler, a Swiss psychiatrist, just one year younger than Kraepelin, who had worked in several psychiatric hospitals in Switzerland, before he became director of the Burghölzli, the psychiatric university hospital of the city of Zürich, in 1898, where he stayed until his retirement in 1927.
Bleuler introduced the term schizophrenia first in 1908. In 1911, the lengthy monograph Dementia praecox oder Gruppe der Schizophrenien was published. The title was most carefully devised. It politely uses Kraepelin’s term Dementia praecox, linking it to Bleuler’s two suggested alternative concepts with the word or. The alternative concepts are represented, first, by the word group and the plural used, suggesting that the disorder has several forms of manifestation , and second, by the term schizophrenias, signalizing Bleuler’s focus on psychopathology, actually rejecting Kraepelin’s concept of dementia praecox and making a complete conceptual U-turn.
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