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ASSIGNMENT

STUDENT’S NAME

INSTRUCTOR’S NAME

COURSE

DATE

MARCH, 2022

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TABLE OF CONTENT

COVER PAGE ………………………………………………………………………………..1

TABLE OF CONTENT ………………………………………………………………………2

ABSTRACT …………………………………………………………………………………..3

INTRODUCTION …………………………………………………………………………….4

ETIOLOGY …………………………………………………………………………………...5

PATHOPHYSIOLOGY ………………………………………………………………………6

CLINICAL FEATURES ……………………………………………………………………...7

SUBTYPE AND VARIANTS ………………………………………………………………..9

DIAGNOSTICS ……………………………………………………………………………..10

TREATMENTS ……………………………………………………………………………..10

SCHIZOPHRENIA PREVENTION ………………………………………………………...11

PROGNOSIS ………………………………………………………………………………...12

STATISTICS OF SCHIZOPHRENIA IN CANADA ………………………………………13

THE ROLE OF A COMMUNITY SUPPORT WORKER TO A PERSON LIKE THIS …13

CONCLUSION ……………………………………………………………………………...14

REFERENCES ………………………………………………………………………………15

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ABSTRACT

The purpose of the article is to investigate the many characteristics of schizophrenia, a mental

condition. The symptoms of the condition, its features, and the right diagnostic settings are all

important considerations. The purpose of this study is to provide the reader with additional

information about the illness in all aspects. The reasons, appropriate diagnosis, how others

will be affected, and various therapies for the disease will be examined. In addition, this study

will examine previous and present research on this condition. This will aid in determining

what needs to be investigated in future schizophrenia research.

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INTRODUCTION

Schizophrenia is a mental illness that affects millions of individuals throughout the world.

This illness can be treated with counselling, medicine, or even a combination of the two.

People with this illness will experience things like confusion, and due to the disorder's

intricacy, there have been on-going investigations. Patients who are being treated for this

condition need to know not just how to treat the disorder properly, but also how to avoid the

symptoms.

At least two symptoms, such as delusions, hallucinations, disordered speech, highly

disorganized or catatonic conduct, or negative symptoms, must be present for a patient to be

diagnosed with schizophrenia (Nolen-Hoeksema, 2017). These symptoms must occur over a

six-month period, cause the patient's functioning to be degraded below normal, and have an

onset and ongoing sign pattern. Patients who fit these criteria and exhibit these symptoms,

unfortunately, usually have a detrimental impact on their daily life. Further tests will be

required to determine the optimum therapy for the patient's daily needs.

Schizophrenia is a mental illness that has afflicted individuals for ages. However, it wasn't

until 1887 that Emile Kraepelin, a German physician, established the term for this condition.

The word's origin may be traced back to Greek expressions. Schizo means divided in the

initial half of the word. The second half, phrene, is the Greek word for mind. The broken

cognitive processes that patients with this illness have are defined by putting the words

together. Researchers discovered that this illness predates Christ and has undergone various

transformations in its meaning over time. The subject of this condition has been studied

extensively throughout the years, primarily to determine the disorder's risk factors. Basically,

to gain a better understanding of the subject and investigate if genetics has any bearing on its

growth (Clarke, Roddy, & Cannon, 2012).

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Even the therapies have evolved throughout time as researchers discover new and better

techniques. Getting a lobotomy was one of these therapies. Drilling two holes into a patient's

skull in an attempt to destroy nerve cells in the brain is how this is done. Other therapies in

the past included putting people in hospitals and institutions, taking different drugs, and

undergoing other types of therapy (Nolen-Hoeksema, 2017). There have been both poor and

favorable outcomes in the various sorts of therapeutic studies. Several illnesses, like others,

have been considered to have suffered throughout history in order to aid sufferers in the

future. As a result, there is now a much better technique to treat the illness and a more

accurate diagnosis.

ETIOLOGY

Several variables have been shown to have a role in the development of schizophrenia. Sick

families, faulty brain chemistry, irregular brain architecture, and even environmental

variables are some of the culprits. When a person has schizophrenia, they go through three

stages, the first of which appears in late adolescence or in their mid-thirties (Nolen-

Hoeksema, 2017). Schizophrenia is divided into three categories, each with its unique set of

positive and negative symptoms. The three varieties of paranoia are catatonic, disorganized,

and paranoid. Delusions, hallucinations, mental issues, and even speech impairments are

some of the positive indications of this illness. On the other hand, unpleasant symptoms such

as alogia, flat affect, and avolition exist.

Researchers have been trying to figure out what causes schizophrenia for centuries. Even

biological ties to the illness have been discovered by researchers. There have been hereditary

variables connected to dopamine in the brain as a result of stress caused by family

difficulties, as well as biological anomalies (Nolen-Hoeksema, 2017). Paul Thompson

conducted a research that compared the rate of gray matter loss in healthy and schizophrenic

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teens over a five-year period. The healthy teenager's loss was 1%, whereas the schizophrenic

teenager's loss was 5% (Hockenbury & Hockenbury, 2011).

Also, the loss of matter followed the progression of the phases, and by the age of 19, the

brain resembled that of people suffering from mental illness (Hockenbury & Hockenbury,

2011). Families, adopted persons, and even twins have all been the subject of research. These

investigations have all proven the existence of a genetic link. All of this suggests that persons

who are closely linked to someone who has schizophrenia symptoms are more likely to get it

themselves. The similar effect may be observed with adopted people (Wynne & other, 2006).

PATHOPHYSIOLOGY

In schizophrenic patients, there has been a considerable decline in intracranial volume. Other

aberrant brain development, such as white and grey matter volume reduction, persists after

brain growth is completed around the age of 13. White matter loss in the frontal cortex and

hippocampus is linked to hereditary risk and oligodendrocyte loss. Cannabis usage,

pharmaceutical use, and psychotic relapses are all known to cause cortical thinning in the

frontal and temporal areas, resulting in a reduction in grey matter volume. These brain

abnormalities are linked to cognitive deterioration in schizophrenia's early stages.

Dopaminergic dysregulation, hypofunction of the N-methyl-D-aspartate receptor (NMDAr),

and increased chronic inflammation in the brain are three processes that might lead to

schizophrenia.

Dopaminergic dysregulation can be caused by abnormal brain development. Dopamine levels

can be increased by increasing dopamine synthesis and release capability in the striatum. The

most common mechanism of schizophrenia is increased dopamine turnover. It might be the

general terminal route in schizophrenia that causes psychotic symptoms. The NMDAr plays a

critical function in brain maturation and the formation of learning and memory during

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development. The activation of NMDAr is reduced as a result of NMDAr hypofunction,

resulting in reduced GABA-ergic signaling efficiency. When the mesolimbic dopamine

pathway is less inhibited, a significant excitatory impact occurs on striatal dopamine neurons,

causing them to release more dopamine, which causes psychotic symptoms.

Viruses and bacteria can more easily infect the juvenile brain, resulting in brain

inflammation. Anti-NMDAr antibodies are produced in the first place during inflammation.

Anti-NMDAr antibodies bind to the NMDA receptor and inhibit its activation. Second,

tryptophan catabolism can be altered during low-grade inflammation. The NMDAr is

inhibited by kynurenic acid, which is the end product. The inactivation of NMDAr causes

dopamine release to rise, resulting in psychosis. Third, activated microglial cells cause

neurotoxicity by producing neurotoxic substances such as free radicals and cytokines.

Microglial cell activation also increases glutamate synthesis, which is hazardous at high

levels. Neurotoxicity has the potential to cause cognitive impairment.

CLINICAL FEATURES

Schizophrenia symptoms commonly appear in early adolescence to mid-twenties. When

psychotic symptoms appear in individuals, the abnormality process has already been going on

for years. Confusion, jumbled ideas, and difficulty concentrating are all signs of impaired

cognition in the early stages of schizophrenia. Psychosis can manifest itself in the form of

delusions, visual hallucinations, auditory hallucinations, and unpleasant symptoms in patients

with schizophrenia. Patients, their families, and friends can recognize the early signs of

schizophrenia and investigate treatments more quickly if they have a thorough understanding

of the various pathological characteristics.

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Figure: Early Signs of Schizophrenia: Onset and Symptoms

Biological changes may now be seen using a variety of neuroimaging equipment thanks to

technological improvements. PET and MRI can be used in clinical situations to show

dopamine production, glutamine levels, and microglial cell activity. APRNs will be able to

give referrals and connect patients to appropriate mental health institutions by identifying the

cause and beginning of disease. When patients are in the acute stage and are a threat to

themselves or others, APRNs will be allowed to provide involuntary service.

Surprisingly, the majority of contemporary antipsychotic drugs, such as Chlorpromazine and

Haloperidol, are dopamine receptor blockers. Blocking dopamine receptors on cholinergic

interneurons, on the other hand, can put patients at risk for extrapyramidal adverse effects.

Understanding NMDAr malfunction and the inflammatory condition of the brain in

schizophrenia may lead to new and more effective treatment options. Potential negative

effects can be reduced without the use of dopamine receptor antagonists.

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APRNs can use NMDAr activators or anti-inflammatory drugs to test novel therapeutic

techniques. Furthermore, some GABA-ergic medicines may be utilized to help people with

schizophrenia improve their cognitive performance (Kahn & Sommer, 2015). APRNs can

also educate patients about the importance of physical activity. Physical exercise, according

to Kahn and Sommer (2015), has positive impacts on mood, self-esteem, antipsychosis,

antiinflammation, and the prevention of brain volume reduction.

SUBTYPE AND VARIANTS

 Paranoid type: Where there are delusions and hallucinations but no thinking

dysfunction, disordered conduct, or emotional flatness.

 Disorganized type: In the International Classification of Diseases, it is known as

hebephrenic Schizophrenia. When there is a combination of thinking dysfunction and

flat affect.

 Catatonic type: The individual may be almost still or move in an agitated, aimless

manner. Catatonic stupor and waxy flexibility are two common symptoms.

 Undifferentiated type: The symptoms of psychosis are present, but they do not meet

the criteria for paranoid, disorganized, or catatonic forms.

 Residual type: Positive signs are only present at a modest level of intensity.

 Post-schizophrenic depression: A depressed episode that occurs following a

schizophrenia illness and is accompanied by certain low-level schizophrenic

symptoms.

 Simple Schizophrenia: With no history of psychotic episodes, the onset of strong

negative symptoms is gradual and insidious.

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DIAGNOSTICS

The process of diagnosing schizophrenia include ruling out other mental illnesses and

determining that symptoms are not caused by substance misuse, medicine, or a physiological

disease. The following factors may be considered when making a schizophrenia diagnosis:

 Physical exam: This may be done to rule out any issues that might be producing

symptoms and to look for any consequences that may arise.

 Tests and screenings: Tests to exclude out illnesses with comparable symptoms, as

well as alcohol and drug screening, may be included. Imaging investigations, such as

an MRI or CT scan, may be requested by the doctor.

 Psychiatric evaluation: A doctor or mental health expert assesses a person's mental

health by looking at their appearance and behavior and inquiring about their thoughts,

emotions, delusions, hallucinations, substance abuse, and risk of violence or suicide.

A review of family and personal history is also included.

 Diagnostic criteria for schizophrenia: The criteria in the Diagnostic and Statistical

Manual of Mental Disorders (DSM-5) issued by the American Psychiatric Association

can be used by a doctor or mental health practitioner.

TREATMENTS

When it comes to the therapy of these disorders, there are a variety of options available, some

of which can last a lifetime. Antipsychotic drugs are one of the most used methods of

schizophrenia therapy. The medicine has been shown to alleviate 65 percent of the symptoms

experienced by persons with this illness. Which, if taken as directed, can endure for a long

period (Nolen-Hoeksema, 2017). Psychotherapy is another therapeutic option. Individual

counseling, social skill training, family therapy, and vocational and supported employment

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are examples of psychosocial treatments (Hales, 2008). There has been study done on the

effectiveness of family therapy.

During the therapy process, it was discovered that the entire family was participating. There

were substantially greater findings (Smerud & Rosenfarb, 2011). However, in order for some

of these therapies to be effective, the patient must first comprehend the illness. Patients who

suffer from this condition can learn more about it in a variety of methods. There are support

groups to join to ensure that objectives are created, that focus is maintained on what is

essential, and that stress is managed more successfully. It was discovered that joining a group

and having some form of community ties was incredibly successful.

Even though community-based therapy for this illness has been highly beneficial, it is not

widely available in regions that offer group treatments, leaving many sufferers of this

disorder without care (Nolen-Hoeksema, 2017). Despite the fact that there are several

methods of therapy for schizophrenia, the majority of people will have a relapse at some

point (Ascher-Svanum et al., 2010).

SCHIZOPHRENIA PREVENTION

Because of the hereditary elements that surround this condition, some researchers believe

there is no method to avoid it, just a means to decrease the symptoms as long as it is detected

early. However, Rapoport points out that there is a particular prenatal diet that can help

prevent schizophrenia before the kid is born (Rapoport, 2013). A few studies have also

demonstrated that maternal contagion is a genetic risk factor for the psychological problem,

leading to the use of specific maternal contagion drugs in order to prevent schizophrenia in

embryos (Brown and Patterson, 2011).

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There are also many who believe that healthy nutrition and a regular exercise routine might

help with the symptoms of this condition (McGroth et al., 2011). There has also been debate

about patents who are at high risk for schizophrenia and how intervention might assist more

than just one person, giving them a chance to prevent the condition from being any worse

than it is now (Mojtabai, Malaspina, & Susser, 2003).

PROGNOSIS

Although there is no known treatment for schizophrenia, the prognosis for those who suffer

from it is improving. Treatment for schizophrenia can be done in a variety of methods,

ideally in a group setting. Medication, psychotherapy, behavioral therapy, and social

assistance, as well as job and educational treatments, are examples of these therapies.

Psychiatrists, primary care doctors, psychologists, social workers, and other mental health

professionals play a critical role in assisting persons with schizophrenia and their families in

identifying treatment options. The sooner you get therapy, the higher your chances are of a

positive outcome. Many persons with schizophrenia can recover to the point that they can

live functioning, rewarding lives in their communities with the right therapy.

The prognosis of schizophrenia disorder is difficult to predict. According to some research,

roughly 47% of people with this disease or schizophrenia are in remission after five years,

and about a quarter of persons with this illness or schizophrenia have adequate social

functioning for two years or more. People with schizophrenia disorder have a prognosis that

is determined by how well they were functioning before the illness began, their compliance

with prescribed medication to treat the illness, the number of illness episodes they have, the

persistence of their psychotic symptoms, their level of cognitive functioning, and how much

emotional support they receive from loved ones.

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Individuals with schizophrenia disorder, on the other hand, tend to exhibit psychotic

symptoms for longer before being treated and have a more difficult trajectory than those with

bipolar disease. Whether a person has schizoaffective disorder or schizophrenia, they are

more likely to have frequent, distressing hallucinations and anxiety, as well as more

difficulties attending work on a consistent basis over time, than persons who do not have such

disorders.

STATISTICS OF SCHIZOPHRENIA IN CANADA

Schizophrenia affects roughly 1% of Canadians, or approximately 40,000 persons in British

Columbia. While scientists are still trying to find out what causes schizophrenia, we do know

that it has an impact on the following people:

 Young people: Schizophrenia commonly manifests itself in men between the ages of

18 and 25, and in women between the ages of 25 and 35.

 Men and women: Schizophrenia strikes both men and women in equal numbers.

Symptoms often begin in males at a younger age than in women.

 Families: Schizophrenia appears to be inherited. If a close family member (such as a

parent or sibling) has schizophrenia, you may be at a higher risk of developing it

yourself. It's crucial to remember, though, that schizophrenia is caused by more than

just your genes are just one of multiple risk factors.

THE ROLE OF A COMMUNITY SUPPORT WORKER TO A PERSON LIKE THIS

Specialists in the condition argue that helping someone with schizophrenia is best done with

the support of a coordinated team of persons who are either experts in the disorder, such as

healthcare professionals, or who take the time to learn about it, such as family members and

friends.

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Hallucinations, delusions, and disordered thought and speech patterns define schizophrenia, a

severe mental condition. It usually manifests itself between the ages of 15 and 25.

Because of the intensity of the symptoms and the timing of their onset during critical

developmental years when people are pursuing educational, professional, or relationship

aspirations. The condition usually causes significant interruption in development.

People with the condition might benefit from care teams to assist them manage their daily

life. Individuals with schizophrenia must be mindful of stressors and events that might

exacerbate symptoms. They frequently benefit from help with feeding and sleep regimens, as

well as maintaining social contacts.

Experts advise that care teams be created as soon as feasible after a diagnosis. Coordinated

specialty care (CSC) is a phrase that is frequently used to describe programs for patients who

have completed treatment for their first episode of psychosis. Medical assistance, case

management, employment and educational assistance, and family education and support are

all part of this team. The patient and support team collaborate to determine treatment and care

decisions.

CONCLUSION

Schizophrenia manifests itself in a variety of ways and affects people in different ways. Even

with what we now know about the disorder, there is still work to be done in terms of

diagnosing it, treating it, and preventing it. Thankfully, as technology progresses and more

information become available, individuals who are affected will have a better quality of life.

From a better understanding of the disorder to more effective treatments for schizophrenia,

we've come a long way. Only time will tell if they will be able to find a strategy to prevent

people from developing the illness in the first place.

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