Schizophrenia

Subject: Sorry For Not Updating
Time: 9:06:39 PM CDT
Author:  glopsblink
Music:  the fan behind me.

           

Sorry I haven't updated in a looooooonnnnnnnnggggg time, I haven't given much thought to the next entry to be added. Are there any questions anyone has about schizophrenia? Please add your questions or concerns in the comments and I'll be sure to get to them. I haven't forgotten about this journal, I've just been lazy about it, sorry. God Bless everyone!!!

           

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Subject: The DSM-IV on MPD (or DID) and Schizophrenia
Time: 3:29:12 PM CDT
Author:  glopsblink

           
I recently was posed with the following question:

"hey do you know of more detailed symptoms of schizophrenia and mpd? because based on what you posted i have both of those things. id really appreciate it if you could email me at [anonymousperson]@aol.com"

Here's more about Multiple Personality Disorder (as copied and paste from: Multiple personality disorder):

Definition

Multiple personality disorder, or MPD, is a mental disturbance classified as one of the dissociative disorders in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). It has been renamed dissociative identity disorder (DID). MPD or DID is defined as a condition in which "two or more distinct identities or personality states" alternate in controlling the patient's consciousness and behavior. Note: "Split personality" is not an accurate term for DID and should not be used as a synonym for schizophrenia.

Description

The precise nature of DID (MPD) as well as its relationship to other mental disorders is still a subject of debate. Some researchers think that DID may be a relatively recent development in western society. It may be a culture-specific syndrome found in western society, caused primarily by both childhood abuse and unspecified long-term societal changes. Unlike depression or anxiety disorders, which have been recognized, in some form, for centuries, the earliest cases of persons reporting DID symptoms were not recorded until the 1790s. Most were considered medical oddities or curiosities until the late 1970s, when increasing numbersof cases were reported in the United States. Psychiatrists are still debating whether DID was previously misdiagnosed and underreported, or whether it is currently over-diagnosed. Because childhood trauma is a factor in the development of DID, some doctors think it may be a variation of post-traumatic stress disorder (PTSD). DID and PTSD are conditions where dissociation is a prominent mechanism. The female to male ratio for DID is about 9:1, but the reasons for the gender imbalance are unclear. Some have attributed the imbalance in reported cases to higher rates of abuse of female children; and some to the possibility that males with DID are underreported because they might be in prison for violent crimes.

The most distinctive feature of DID is the formation and emergence of alternate personality states, or "alters." Patients with DID experience their alters as distinctive individuals possessing different names, histories, and personality traits. It is not unusual for DID patients to have alters of different genders, sexual orientations, ages, or nationalities. Some patients have been reported with alters that are not even human; alters have been animals, or even aliens from outer space. The average DID patient has between two and 10 alters, but some have been reported with over one hundred.

Causes and symptoms

The severe dissociation that characterizes patients with DID is currently understood to result from a set of causes:

• An innate ability to dissociate easily
• Repeated episodes of severe physical or sexual abuse in childhood
• The lack of a supportive or comforting person to counteract abusive relative(s)
• The influence of other relatives with dissociative symptoms or disorders

The relationship of dissociative disorders to childhood abuse has led to intense controversy and lawsuits concerning the accuracy of childhood memories. The brain's storage, retrieval, and interpretation of childhood memories are still not fully understood.

The major dissociative symptoms experienced by DID patients are amnesia, depersonalization, derealization, and identity disturbances.

Amnesia

Amnesia in DID is marked by gaps in the patient's memory for long periods of their past, in some cases, their entire childhood. Most DID patients have amnesia, or "lose time," for periods when another personality is "out." They may report finding items in their house that they can't remember having purchased, finding notes written in different handwriting, or other evidence of unexplained activity.

Depersonalization

Depersonalization is a dissociative symptom in which the patient feels that his or her body is unreal, is changing, or is dissolving. Some DID patients experience depersonalization as feeling to be outside of their body, or as watching a movie of themselves.

Derealization

Derealization is a dissociative symptom in which the patient perceives the external environment as unreal. Patients may see walls, buildings, or other objects as changing in shape, size, or color. DID patients may fail to recognize relatives or close friends.

Identity disturbances

Identity disturbances in DID result from the patient's having split off entire personality traits or characteristics as well as memories. When a stressful or traumatic experience triggers the reemergence of these dissociated parts, the patient switches -- usually within seconds -- into an alternate personality. Some patients have histories of erratic performance in school or in their jobs caused by the emergence of alternate personalities during examinations or other stressful situations. Patients vary with regard to their alters' awareness of one another.

Diagnosis

The diagnosis of DID is complex and some physicians believe it is often missed, while others feel it is over-diagnosed. Patients have been known to have been treated under a variety of other psychiatric diagnoses for a long time before being re-diagnosed with DID. The average DID patient is in the mental health care system for six to seven years before being diagnosed as a person with DID. Many DID patients are misdiagnosed as depressed because the primary or "core" personality is subdued and withdrawn, particularly in female patients. However, some core personalities, or alters, may genuinely be depressed, and may benefit from antidepressant medications. One reason misdiagnoses are common is because DID patients may truly meet the criteria for panic disorder or somatization disorder.

Misdiagnoses include schizophrenia, borderline personality disorder, and, as noted, somatization disorder and panic disorder. DID patients are often frightened by their dissociative experiences, which can include losing awareness of hours or even days of time, meeting people who claim to know them by another name, or feeling "out of body." Persons with the disorder may go to emergency rooms or clinics because they fear they are going insane.

When a doctor is evaluating a patient for DID, he or she will first rule out physical conditions that sometimes produce amnesia, depersonalization, or derealization. These conditions include head injuries; brain disease, especially seizure disorders; side effects from medications; substance abuse or intoxication; AIDS dementia complex; or recent periods of extreme physical stress and sleeplessness. In some cases, the doctor may give the patient an electroencephalograph (EEG) to exclude epilepsy or other seizure disorders. The physician also must consider whether the patient is malingering and/or offering fictitious complaints.

If the patient appears to be physically normal, the doctor will next rule out psychotic disturbances, including schizophrenia. Many patients with DID are misdiagnosed as schizophrenic because they may "hear" their alters "talking" inside their heads. If the doctor suspects DID, he or she can use a screening test called the Dissociative Experiences Scale (DES). If the patient has a high score on this test, he or she can be evaluated further with the Dissociative Disorders Interview Schedule (DDIS) or the Structured Clinical Interview for DSM-IV Dissociative Disorders (SCID-D). The doctor may also use the Hypnotic Induction Profile (HIP) or a similar test of the patient's hypnotizability.

Treatment

Treatment of DID may last for five to seven years in adults and usually requires several different treatment methods.

Psychotherapy

Ideally, patients with DID should be treated by a therapist with specialized training in dissociation. This specialized training is important because the patient's personality switches can be confusing or startling. In addition, many patients with DID have hostile or suicidal alter personalities. Most therapists who treat DID patients have rules or contracts for treatment that include such issues as the patient's responsibility for his or her safety. Psychotherapy for DID patients typically has several stages: an initial phase for uncovering and "mapping" the patient's alters; a phase of treating the traumatic memories and "fusing" the alters; and a phase of consolidating the patient's newly integrated personality.

Most therapists who treat multiples, or DID patients, recommend further treatment after personality integration, on the grounds that the patient has not learned the social skills that most people acquire in adolescence and early adult life. In addition, family therapy is often recommended to help the patient's family understand DID and the changes that occur during personality reintegration.

Many DID patients are helped by group as well as individual treatment, provided that the group is limited to people with dissociative disorders. DID patients sometimes have setbacks in mixed therapy groups because other patients are bothered or frightened by their personality switches.

Medications

Some doctors will prescribe tranquilizers or antidepressants for DID patients because their alter personalities may have anxiety or mood disorders. However, other therapists who treat DID patients prefer to keep medications to a minimum because these patients can easily become psychologically dependent on drugs. In addition, many DID patients have at least one alter who abuses drugs or alcohol, substances which are dangerous in combination with most tranquilizers.

Hypnosis

While not always necessary, hypnosis is a standard method of treatment for DID patients. Hypnosis may help patients recover repressed ideas and memories. Further, hypnosis can also be used to control problematic behaviors that many DID patients exhibit, such as self-mutilation, or eating disorders like bulimia nervosa. In the later stages of treatment, the therapist may use hypnosis to "fuse" the alters as part of the patient's personality integration process.

Prognosis

Some therapists believe that the prognosis for recovery is excellent for children and good for most adults. Although treatment takes several years, it is often ultimately effective. As a general rule, the earlier the patient is diagnosed and properly treated, the better the prognosis.

Prevention

Prevention of DID requires intervention in abusive families and treating children with dissociative symptoms as early as possible.

Here are some links about MPD or DID:
MPD 1
MPD 2
MPD 3

Schizophrenia and DID are NOT the same thing, they are two distinctly different mental disorders. Hope this helps clear up some confusionand God Bless. :)
           

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Subject: Who Gets Schizophrenia?/Children and Schizophrenia/Misconceptions
Time: 4:06:30 PM CDT
Author:  glopsblink

           
Who Gets Schizophrenia?
1% of the world's population suffers from schizophrenia, 2 million of which are Americans. It is usually diagnosed between the ages of 16 and 35, though mostly between 18 and 25 years old. This is a scary finding in that this is also the most sensative group for suicide, so these people are watched for any signs of suicide. I do remember on one television show years ago an older homeless man had schizophrenia and jumped off a bridge. Likewise, my relative with schizophrenia had threatened suicide in the beginning of the illness. There is no one ethnic or economic group which is most suseptible to getting schizophrenia.

Children and Schizophrenia
Schizophrenia is rarely diagnosed in children, though they do get it. Signs to look out for are:
-hallucinations
-odd and eccentric behavior and/or speech
-unusual or bizarre thoughts and ideas
-confusing television and dreams with reality
-extreme moodiness
-ideas that peope are "out to get them," or that people are talking about them
-behaving like a younger child
-severe anxiety and fearfulness
-difficulty relating to peers, or keeping friends
-withdrawn and increased isolation
-decline in personal hygiene

Misconceptions about Schizophrenia
The following beliefs about schizophrenia and those who suffer from it are the following:
-Schizophrenia is not Multiple Personality Disorder; this is a completely different mental illness. Try to think of it this way: if I'm a schizophrenic, I may talk to someone who isn't there, while if I have MPD then one day I'll be Glopsblink and maybe tomorrow I'll have the personality of my professors or peers (or whoever, made up or not) and my real personality is dorment, not knowing what is going on.
-Schizophrenics are not at a higher risk for being violent criminals. In fact their violent crime rate is lower than that of the general population. If violent crime is important in the client's life it is most likely that they have a fear of being hurt, it's not that they want to hurt anybody.
-Schizophrenia is not caused by bad parenting or character flaws.
-It is not anisolated condition; it is estimated that 1 in 100 Americans has schizophrenia.
           
The following was provided by: http://www.aacap.org, http://www.helpguide.org, http://www.schizophrenia.com

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Subject: AOL Message Board For Schizophrenia
Time: 6:42:26 PM CDT
Author:  glopsblink


           
Hey everyone, I've just discovered a message board just for schizophrenia---> here's the link: Schizophrenia. They have different sub-message boards depending on what aspect of schizophrenia you want to talk about.
           

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Subject: Treatments, Prevention, and Pre-diagnostic Testing
Time: 5:31:46 PM CDT
Author:  glopsblink

           
There are many different treatments for schizophrenia and they are many times combined. However, keep in mind that there is no absolute cure for schizophrenia, though current treatments help clients with their everyday lives.

Interpersonal Therapies
-Psychosocial Treatment: This form of therapy focus' on the person's social functioning, such as home, work, and any other part of the person's life. This does not work well with the extremely psychotic.
-Cognitive/Behavioral Therapy:
     *Using cognitive therapy the psychologist uses the disorganized thoughts to assist the patient in correctly managing life's problems. The goal is to help the client use information from the world (other people, perceptions of events, etc.) to make adaptive coping decisions. The treatment goal of the therapist is not to cure schizophrenia, but to improve the client's ability to manage life's problems, to function independently, and to be free of extreme stress and other psychological symptoms.
     *Behavioral therapy teaches the client the social skills they never learned, whether because of lack of experience and/or along with their disorganized thinking, and helps them to understand when to apply particular skills to problems in the world.
There are many other types of therapy (in psychology, there are over 250 ways of doing therapy, these are the most popular for this disorder).

Group Therapy
-This form of therapy is not the most popular for treating schizophrenia, though is more widely used to help families cope with the disease. They use the same concept like Alcoholics Anonymous, only with schizophrenia.

Drug Therapy
-Drug therapy is almost always used in congunction with interpersonal therapy. Here is a list of the most commonly used drugs used in the treatment of schizophrenia:
     *Stelazine (Trifluoperazine)
     *Flupenthixol (Fluanxol)
     *Loxapine (Loxapack, Loxitane)
     *Perphenazine (Etrafon, Trilafon)
     *Haldol (Haloperidol)
-Atypical (Newer) Medications
     *Aripipazole (Abilify)
     *Clorazil (clorapine)
     *Geodon (ziprasidone)
     *Risperdol (risperidone)
     *Seroquel (Quetiapine)
     *Zyprexa (olanzapine)

All these medications, both those in circulation and those in the testing phase are antagonist, meaning that they block a neurotransmitter (brain messanger chemical). For example, many medications block brain receptors for dopamine and it has shown to help clients.  
Prevention
For now there are no preventative measures to be taken to avoid schizophrenia. However, there are many tests being done to try and find a way to do so. There are currently two ways of prevention being tested:
1. Preventative measures that are taken well prior to any measureable signs of early phase schizophrenia (also called "prodromal" phase, in medical terms).
2. Preventative measures taken during the prodromal period of schizophrenia; in other words, taking actions during the very first signs of schizophrenia well before it becomes full blown schizophrenia.
Case Study: A group of 59 clients with prodromal symptoms recieved either "supportive following" or a multimodal treatment regiment of low-dose resperdone, cognitive therapy, and (when necessary) anti-anxiety or antidepressive medications. Six months later, 10 of the 28 control participants (36%) were diagnosed with schizophrenia, while 4 out of 31 (13%) treated subjects were diagnosed with schizophrenia.
Prediagnostic Tests There is no one physiological exam that can say yes she has schizophrenia or no he doesn't. However, there are two forms of testing currently being tested.
1. Urine Test
     *British scientists have made a discovery that 90% of schizophrenics have high concentrations of sulphite in their urine than normal people (all schizophrenics have sulphite in their urine). Most healthy people have none in their urine, or if so the level is significantly low. Schizophrenics even have a higher amount of it in their urine than those with clinical depression, and keep in mind that those with clinical depression have also shown to have sulphite in their urine. One schizophrenic client was tested for sulphite prior to treatment when he exibited the symptoms and after treatment when all his symptoms were gone, and in both tests his levels of sulphite had not changed showing sulphite to be "a trait marker and not a state marker."
2. Blood Test
     *A possible link between levels of a body chemical dopamine, and the number of receptors to the chemical on the surface of nerve cells may be an early indication of schizophrenia. Post mortem (after death) results on these nerve cells suggests that schizophrenics have more of them than healthy normal people. Scans can now detect them without the death of the client, but with little, if any, precision. A possible alternative to this, however, is that there are also dopamine receptors on the surface of white blood cells called lymphocytes. A blood test done comparing heathy people and schizophrenic people showed that schizophrenics had 3.6 times more of the molecules, called D3 messanger RNA molecules, in their bodies than healthy people. Some scientists suggest that this blood test may be able to give reliable indication of when a client could have schizophrenia.   Ethical Issues: There is an ethical debate over the possible prevention of schizophrenia as well as the possible pre-diagnostic testing of it. First off, what if the person never would have needed treatment in the first place, yet recieved the treatment because they were at a higher risk of developing schizophrenia (say an identical twin)? Also, with the prediagnostic testing, employers, insurance agencies,....may discriminate against individuals who test positive for being higher at risk individuals for schizophrenia. Though these two things may help people, there are still problems to be overcome in terms of ethnicallity.
           
The above was provided by: http://psychologyinfo.com, http://www.schizophrenia.com, http://www.neuropsychiatryreviews.com, http://news.bbc.co.uk

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Subject: Types of Schizophrenia and Causes
Time: 7:55:37 PM CDT
Author:  glopsblink
Mood:  Quiet
Music:  the mexican music in the house behind my apartment.

           

Unknown to most people, there are five subtypes of schizophrenia. They are:

#1 Paranoid Schizophrenia
     *This is the most common form of schizophrenia most commonly known for its positive symptoms (positive symptoms are any symptom which is added onto or given to the client, it has nothing to do with good or bad), more prominently the hallucinations and delusions. Hallucinations are any sensory feeling a person recieves which isn't real, such as hearing, seeing, feeling, smelling, or tasting. Delusions are false beliefs in some form or another. People with this form of schizophrenia can either have just one episode of it without it recuring, the person could have multiple episodes separated by time intervals of non-psychotic being, or they could have the chronic form. To meet the medical diagnostic criteria for this form of schizophrenia, hallucinations and/or delusions must be prominent in the client and disturbances of affect, volition and speech, catatonic symptoms must be relatively inconspicuous.

#2 Disorganized (Hebephrenic) Schizophrenia
     *This form of schizophrenia is characterized by disorganized speech, disorganized behavior, and inappropriate or flat affect. These types of clients may switch subjects very quickly during speech, speak too quickly or slowly, or may have what is called "word salad" (what ever is on their mind right then they say all as one thought; sometimes it makes sense, sometimes it doesn't, it depends upon the person). They may also laugh during funerals or cry sadly during happy moments, or have no emotional reaction at all. Along with these, they may have sudden changes in mood, such as from happy to angry. All of the symptoms above are used in diagnosis when the client's actions are inappropriate for the given situations they are in.

#3 Catatonic Schizophrenia
     *This form of schizophrenia has to do with a person's volutary muscles. These clients may have one or more of the following catatonic states in any given episode of psychosis: staying in one position for hours on end and can be moved into any position by another person, staying in one position for hours on end and cannot be moved by any given person, or they may be in an extreme state of action (such as running too much, laughing excessively, sing loudly,...; this has also caused the deaths of some due to excessive exhaustion or heart failure). The following photograph is a woman with catatonic schizophrenia:
              

#4 Undifferentiated Schizophrenia
     *This is a miscellaneous catagory for those schizophrenia who do not meet the criteria for the three mentioned above, but still meet with criteria A (see journal entry below) for the diagnosis of schizophrenia.

#5 Residual Schizophrenia
     * The client has an absence of the prominent symptoms, such as hallucinations, delusions, or catatonic behavior. The client still has the characteristic negative symptoms (negative means to take away or is absent, such as lack of expression or speech). The person still has the odd perceptional experiences or odd beliefs, but is almost in a form of remission.

Causes of Schizophrenia:
*There are no absolute knowns as to what causes schizophenia, but there are the following hypotheses---
     -Heredity: It has been shown that schizophrenia runs through families. For example, those highest at risk are identical twins if one has schizophrenia the other twin has a 40-50% of having the disease; like wise, a child with one schizophrenic parent has a 10% chance of contracting the disease. Also, the chromosomes 6 and 13 are thought to be important factors in the cause of schizophrenia (possible chromosome defect).
     -Chemical Defect in the Brain: The neurotransmitters (brain messanger chemicals) glutamate and dopamine are thought to be another contributor to schizophrenia. Some strong evidence of dopamine being a contributor to schizophrenia is the fact that dopamine blocking medications have shown to improve some or most schizophrenics symptoms (hallucinations and/or delusions).
     -Physical Abnormality in the Brain: There is the possibility of prenatal brain deformality being a contributor to schizophrenia, though not all schizophrenics have brain abnormalities that are detected at the moment, such as enlarged brain vesicles.
              
     -Environment: Viruses during pregnancy could be another factor in the cause of schizophrenia; this has some good evidence of being true since the vast majority of schizophrenics are born in late winter or early spring. Also, a client's home, work, and/or other areas of the person's life may allude to him or her showing the symptoms of the disease earlier, later, not at all, or it could be the trigger that set the psychosis off.
     -Brain Trauma: Some speculate that problems during birth could be another factor in the cause of schizophrenia.
           
The information above was provided by: http://www.mentalhealthchannel.com; http://www.schizophrenia.com; Young, John.  The Encyclopedia of Health: Psychological Disorders and Their Treatment: Schizophrenia. Chelsa House Publishers, New York, 1988

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Subject: Diagnostic Criteria
Time: 8:11:20 PM CDT
Author:  glopsblink

           
When diagnosing any mental illness, psychologists use a diagnostic book called the DSM-IV (the last two Roman Numerals tell what edition it's in; currently it is in it's fourth edition). Here are the guide lines for schizophrenia from this book:

Criteria A: Characteristic symptoms: Two (or more) of the following, each present for a significant portion of time during a 1-month period (or less if successfully treated):

Delusions - false beliefs strongly held in spite of invalidating evidence, especially as a symptom of mental illness, for example:
1. Paranoid delusions, or delusions of persecution, for example that people are "out to get" you, or the thought that people are doing things when there is no external evidence that such things are taking place.
2. Delutions of reference-when things in the environment seem to be directly related to you even though they are not. For example it may seem as if people are talking about you or special personal messages are being communicated to you throught the TV, radio, or other media.
3. Somatic Delusions are false beliefs about your body-for example that a terrible physical illness exists or that something foreign is inside or passing through your body.
4. Delusions of grandeur-for example when you believe that you are very special or have special powers or abilities. An example of a grandiouse delusion is thinking you are a famous rock star.
Hallucinations - Hallucinations can take a number of different forms- they can be:
1. Visual (seeing things that are not there or that other people cannot see).
2. Auditory (hearing voices that other people can't hear.
3. Tactile (feeling things that other people don't feel or something touching your skin that isn't there).
4. Olfactory (smelling things that other people cannot smell, or not smelling the same thing that other people do smell).
5. Gustatory experiences (tasting things that aren't there).
Disorganized speech (e.g. frequent derailment or incoherence) - these are also called "word salads".
Grossly disorganized or catatonic behavior (An abnormal condition variously characterized by stupor/innactivity, mania, and either rigidity or extreme flexibility of the limbs.).
Negative symptoms - these are the lack of important abilities. Some of these include:
1. Lack of emotion- the inability to enjoy activities as much as before.
2. Low energy - the person sits around and sleeps much more than normal.
3. Lack of interest in life, low motivation.
4. Affective flattening - a blank, blunted facial expression or less lively facial movements or physical movements.
5. Alogia (difficulty or inability to speak).
6. Inappropriate social skills or lack of interest or ability to socialize with other people.
7. Inability to make friends or keep friends, or not caring to have friends.
8. Social isolation - person spends most of the day alone or only with close family.

Note: Only one Criterion A symptom is required if delusions are bizarre or hallucinations consist of a voice keeping up a running commentary on the person's behavior or thoughts, or two or more voices conversing with each other.

Cognitive Symptoms of Schizophrenia
Cognitive symptoms refer to the difficulties with concentration and memory. These can include:
1. disorganized thinking
2. slow thinking
3. difficulty understanding
4. poor concentration
5. poor memory
6. difficulty expressing thoughts
7. difficulty integrating thoughts, feelings, and behavior

Criteria B. Social/occupational dysfunction: For a significant portion of the time since the onset of the disturbance, one or more major areas of functioning such as work, interpersonal relations, or self-care are markedly below the level achieved prior to the onset (or when the onset is in childhood or adolescence, failure to achieve expected level of interpersonal, academic, or occupational achievement).

Criteria C. Duration: Continuouse signs of the disturbance persist for at least 6 months. This 6-month period must include at least 1 month of symptoms (or less if successfully treated) that meet Criterion A (i.e., active-phase symptoms) and may include periods of prodromal or residual symptoms. During these prodromal or residual periods, the signs of the disturbance may be manifested by only negative symptoms or two or more symptoms listed in Criterion A present in a n attenuated form (e.g., odd beliefs, unusual perceptual experiences).

Criteria D. Schizoaffective and mood disorder exclusion: Schizoaffective disorder and mood disorder with psychotic features have been ruled out because either (1) no major depressive, manic, or mixed episodes have occurred concurrently with the active-phase symptoms; or (2) if mood episodes have occurred during active-phase symptoms, their total duration has been brief relative to the duration of the active and residual periods.

Criteria E. Substance/general medical condition exclusion: The disturbance is not due to the direct physiological effects of a substance (e.g. a drug of abuse, a medication) or a general medical condition.

Criteria F. Relationship to a pervasive developmental disorder: If there is a history of autistic disorder or another pervasive developmental disorder, the additional diagnosis of schizophrenia is made only if prominent delusions or hallucinations are also present for at least a month (or less if successfully treated).
           
The above was provided by: http://www.schizophrenia.com

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