Mental Illness, Research Paper Example

Abstract

Schizophrenia has known to humans since the ancient times. A complex and controversial disease, schizophrenia was considered to be a product of the devil’s possession. This paper provides a brief insight into the history of schizophrenia, beliefs and misconceptions about it. The signs, symptoms, and neurotransmitters associated with schizophrenia are discussed. The paper provides brief information about how the disease is diagnosed and what treatments are currently available for schizophrenia. The differences between past and present treatments and the prospects for the future are discussed.

Schizophrenia has been well known to humans since the ancient times. Peoples of Ancient Egypt, China, and India considered schizophrenia as a product of evil’s possession. Ancient texts contain a wealth of information about schizophrenia, its signs, symptoms, and possible treatments. However, the myths and misconceptions about the disease did not leave much room for developing professional, medical treatments for schizophrenia. It was not before the beginning of the 1700s that first rational approaches for schizophrenia were proposed. The current ways of treating schizophrenia are dramatically different from the diagnosis and treatment of the disease in the past. Nevertheless, even now, schizophrenia remains severely under-researched. The future holds a promise to improve the medical knowledge of schizophrenia and reduce its incidence and prevalence in all population groups.

Humans have been familiar with the symptoms of schizophrenia since the ancient times. The history of schizophrenia can be traced back as far as the second millennium B.C. (Kyziridis, 2005). The ancient Egyptian book of Hearts provides extensive information about dementia, depression, and other clinical signs and symptoms of schizophrenia (Kyziridis, 2005). Similar descriptions of the disease are found in the ancient Hindu and Chinese texts (Kyziridis, 2005). Ancient societies treated schizophrenia as a product of evil’s possession (Kyziridis, 2005). That was one of the reasons why ancient strategies of treating schizophrenia involved religious exorcism (Kyziridis, 2005). Methods of exorcism ranged from as innocent as listening to certain types of music, to as dangerous as “drilling holes in the patient’s skull” (Kyziridis, 2005, p.43). Hippocrates was first to suggest that schizophrenia could spring from the human brain and be a result of emotional disturbances (Kyziridis, 2005). Ancient Romans and Greeks followed his empirical principles and developed the first enlightened strategies of treating schizophrenia (Kyziridis, 2005). Simultaneously, electric eels, starvation, flogging and fetters were among the most frequently used treatment methods, reflecting a persistent belief in schizophrenia as the product of gods’ anger (Kyziridis, 2005).

Years between ancient and medieval eras witnessed a rapid rise in the number of empirical theories of schizophrenia. Byzantine and Arabic physicians described brain diseases in their medical books, but the belief that demons were responsible for the development of mental health disorders persisted even after Christianity entered Europe (Kyziridis, 2005). In the 15-16^th century, European scholars and scientists developed rational attitudes toward mental health disturbances, whereas religious leaders supported a hypothesis that madness and hallucinations were the signs of being possessed by demons (Kyziridis, 2005). It was not before the beginning of the 1700s that the first rational explanations to schizophrenia were developed.

In the 19^th century, an explosion of scientific research into mental health disturbances led to the development of new, scientific theories of schizophrenia, but it was only in 1908 that Eugen Bleuler created and used the term “schizophrenia” (Kyziridis, 2005). The word “schizophrenia” comes from the two Greek words, denoting a split of mind (Kyziridis, 2005). The term was coined to describe the process of mental and emotional fragmentation characteristic of people with schizophrenia (Kyziridis, 2005). Later in the 20^th century, a detailed categorization of schizophrenia was developed and used in DSM-III and DSM-IV diagnostic manuals (Kyziridis, 2005). The first commercial antipsychotic drug was sold in 1950, and the pharmacological revolution during the 1960s was accompanied by the rapid development of other, non-drug treatments for schizophrenia (Kyziridis, 2005). Nevertheless, schizophrenia remains one of the least understood mental health disturbances.

According to Thomas, Hardy and Cutting (1997), the analysis of symptoms and signs of schizophrenia is inevitably associated with three fundamental issues. First, no sign or symptom is specific of schizophrenia – all symptoms and signs of schizophrenia can be easily found in other psychotic disorders (Sadock, Kaplan & Sadock, 2007). Second, symptoms and signs of schizophrenia change over time (Sadock, Kaplan & Sadock, 2007). Third, patients’ cognitive abilities, educational level, and cultural characteristics must be taken into account (Sadock, Kaplan & Sadock, 2007). Nevertheless, Thomas, Hardy and Cutting (1997) suggest that the symptoms of schizophrenia include hallucinations, delusions, thought disorders, negative symptoms like lack of motivation, volition, and social skills, catatonia, and mood problems. The latter implies that individuals experience mood changes, which cannot be attributed to medication, depression, or other emotional disturbances (Thomas, Hardy & Cutting, 1997). Here, neurotransmitters demand particular attention, as far as they are directly related with the illness.

Dopamine is believed to be one of the principal drivers of schizophrenia in patients. The current state of research suggests that schizophrenia is directly associated with chemical imbalances in the human brain (Psyweb, n.d.). Recent research findings from Northern Ireland support a hypothesis that dopamine receptor genes are responsible for the symptom severity and health outcomes in patients with schizophrenia (Anonymous, 2005). The severity of schizophrenia depends on the degree, to which excessive dopamine affects the frontal lobes of the human brain (Boerce, 2009). Antipsychotic drugs target and block excessive dopamine, to slow down the progression of the disease and reduce the severity of its symptoms.

The relationship between dopamine and schizophrenia is one of the most popular topics in the current research of schizophrenia. For example, Meyer and Feldon (2009) suggest that prenatal exposure to various infections significantly raises the risks of schizophrenia in the newborn babies. The researchers believe that prenatal exposure to infections leads to the development of severe brain abnormalities and results in an imbalance in the dopamine system later in life (Meyer & Feldon, 2009). Os and Kapur (2009) write that “schizophrenia, in its acute psychotic state, is associated with an increase in dopamine synthesis, dopamine release, and resting-state synaptic dopamine concentrations” (p.639). However, the current knowledge of the biological mechanisms behind schizophrenia is not exhaustive. The gap between biological alterations in the human brain and emotional and mental experiences reported by schizophrenia patients persists (Os & Kapur, 2009). The lack of objective diagnostic tests adds complexity to the situation. As a result, schizophrenia remains one of the most challenging conditions in the modern psychiatric science.

Contemporary medicine operates a limited set of diagnostic criteria for schizophrenia. The DSM-IV and IDC-10 criteria are the primary sources of information for clinicians (Os & Kapur, 2009). These clinical criteria show display significant diagnostic value and reliability (Os & Kapur, 2009). In the meantime, no objective tests or systems of diagnosis were ever developed for schizophrenia, and even dopamine tests do not secure modern clinicians from diagnostic mistakes. All current diagnostic strategies are either nonsensitive or not specific enough for schizophrenia (Os & Kapur, 2009). As a result, the process of diagnosing and managing schizophrenia is based on the key symptoms, patient history, and the effects of other, environmental factors (Os & Kapur, 2009). This is also one of the reasons why schizophrenia poses a challenge to medical professionals – difficulties with diagnosing the disease leave little room for the development of effective treatment strategies. Nevertheless, the growing body of knowledge about schizophrenia helps to create and manage complex approaches for mental health disturbances in medical science. Today, a combination of pharmacological and non-pharmacological treatments is used to reduce the severity of symptoms and improve health outcomes in patients with schizophrenia.

The first generation of antipsychotic drugs was called “neuroleptic agents” – they had limited medical efficacy and displayed serious adverse effects (Conley & Kelly, 2007). Chlorpromazine gained rapid popularity among clinicians, due to the absence of other, effective drugs (Conley & Kelly, 2007). For a long time, chlorpromazine was taken as the gold standard for treating schizophrenia, until the second generation of antipsychotic drugs (SGAD) was developed (Conley & Kelly, 2007). It took several years to turn SGADs into a regular form of treating schizophrenia, because they lacked tranquilizing effects, were expensive, and exhibited a number of serious side effects (Conley & Kelly, 2007). However, since 2006, more than 90% of patients in the U.S. have been treated with SGADs (Conley & Kelly, 2007). Non-pharmacological treatments include various types of psychosocial support, including social skills training, cognitive remediation, and cognitive behavior therapy (Conley & Kelly, 2007). The basic purpose of treatment is not simply to reduce the severity of clinical symptoms, but to improve social and functional outcomes in patients with schizophrenia. In this context, numerous environmental factors can detract patients from successful treatment, including season, related infections, stresses and even the pressure of urbanization (Conley & Kelly, 2007).

The current state of schizophrenia diagnosis and treatment differs from the diagnosis and treatment of schizophrenia in the past. Despite the lack of understanding, schizophrenia is no longer attributed to religious or spiritual factors but exemplifies a purely medical, biological condition. The development of rationalistic approaches for medicine produced a revolution in the mental health science and created conditions for implementing complex strategic of treatment. That the current goal of treatment is to achieve improved social and functional outcomes marks a profound shift in medical consciousness. The current body of knowledge about schizophrenia holds a promise to reduce the scope of adverse social and medical effects of disease in the future. However, many years will pass, before clinicians develop effective diagnostic criteria and medications with minimal adverse effects and increased social and medical advantages for patients.

Conclusion

Schizophrenia has been well-known to people since the ancient times. For centuries, people perceived schizophrenia as a complex product of evil’s possession and gods’ anger. It was not before the beginning of the 18^th century that rational approaches for schizophrenia were proposed. The term “schizophrenia” was coined by Eugen Bleuer in 1908, to describe emotional and cognitive fragmentation characteristic of patients with schizophrenia. The first antipsychotic drugs were developed later in the 20^th century. Today, the prevailing majority of people with schizophrenia are being treated with the help of second generation antipsychotic drugs (SGAD). Non-pharmacological treatment strategies are actively used to manage schizophrenia. The current ways of treating and diagnosing schizophrenia are dramatically different from diagnosis and treatment of this mental health illness in the past. Schizophrenia is no longer believed to be a product of evil’s possession but exemplifies a purely biological disorder. Unfortunately, the lack of objective diagnostic criteria leaves little room for developing effective treatments for schizophrenia. Many years will pass, before clinicians develop effective diagnostic criteria and medications with minimal adverse effects and increased social and medical advantages for patients.

References

Anonymous. (2005). Schizophrenia: Neurotransmitter receptor variants linked to treatment response. Pharma Business Week, May 9, 318.

Boerce, C. (2009). Neurotransmitters. General Psychology. Retrieved from http://webspace.ship.edu/cgboer/genpsyneurotransmitters.html

Conley, R.R. & Kelly, D.L. (2007). Pharmacologic treatment of schizophrenia. Professional Communications.

Kyziridis, T.C. (2005). Notes on the history of schizophrenia. German Journal of Psychiatry, 8(3), 42-48.

Meyer, U. & Feldon, J. (2009). Prenatal exposure to infection: A primary mechanism for abnormal dopaminergic development in schizophrenia. Psychopharmacology, 206, 587-602.

Os, J. & Kapur, S. (2009). Schizophrenia. Lancet, 374, 635-645.

Psyweb. (n.d.). Schizophrenia. Psyweb. Retrieved from http://psyweb.com/mdisord/MdisordADV/AdvSchid.jsp

Sadock, B.J., Kaplan, H.I. & Sadock, V.A. (2007). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/ clinical psychiatry. Lippincott Williams & Wilkins.

Thomas, B., Hardy, S. & Cutting, P. (1997). Stuart and Sundeen’s mental health nursing: Principles and practice. Elsevier Health Sciences.