Schizophrenia is a psychotic disorder that generally affects cognition, movement and one’s emotions. Schizophrenia is distinguished by sudden breaks from reality, hallucinations, disorderly speech and behave that leaves others baffled. Schizophrenia is a disorder that comes with an array of symptoms. The diagnosis of this psychotic disorder is arrived at by taking into account all of the signs and symptoms exhibited by the patient. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition also, referred to as the DSM-5 give a distinctive diagnosis for Schizophrenia that is currently utilized by doctors today to diagnose patients. The DSM-5 explains the key factors to diagnose a patient with Schizophrenia by stating, “The individual must experience two or more of the symptoms listed in the manual for one month for longer duration of time” (page number). DSM-5 continues to discuss the major symptoms for diagnosis as “delusions, hallucinations, disorganized speech, catatonic behavior or dismantled emotional response” (page number).
Conditions With Similar Symptoms
Distinguishing between Schizophrenia and other mental disorders with similar signs and symptoms is crucial to get the patient the correct treatment.Delusion Disorder and Schizophrenia share similar symptoms however there is a major distinction between the two that have to be accessed during a clinical diagnosis.According to Carol Tamminga, professor and chairman at the UT Southwestern Medical Dallas, Delusional Disorder signs are “one or more firmly held false beliefs that persist for at least 1 month” (1). For instance, a person believes that there is a police officer that has been following them around. Yet, they have no proof or no logical reason for thinking this. Cleveland Clinic, an non-profit academic medical center, emphasizes that patients with Delusional Disorder also, tend to believe they’re being “poisoned, deceived, conspired against, or loved from a distance. These delusions usually involve the misinterpretation of perceptions or experiences. In reality, however, the situations are either not true at all or highly exaggerated. Both Schizophrenia and Delusional Disorder have to be clinically diagnosed based off the patient’s symptoms. If an individual only has persistent delusions it becomes apparent to the doctor that they aren’t schizophrenic. Schizophrenic requires multiple symptoms not just delusions. A person with delusional disorder are typically fully functioning individual except for their delusional episodes. According to Belmont Behavioral Hospital, emphasizes that “This condition could have an impact on the person’s daily living, although, fortunately, it does not necessarily prevent that individual from functioning within society on an ongoing basis”. In contrast to Schizophrenia, this psychotic disorder causes patience to be more dependent on friends and family due to lack of the ability to make decisions on their own.
Another, similar disorder whose symptoms have to be clinically distinguished from Schizophrenia is substance or medication induced psychotic disorder. Substance induced psychotic disorder is when a patient has been abusing a controlled substance that is mind altering. Examples of drugs that cause, hallucinations and or delusions would be LSD, Psilocybin Mushrooms, recreational marijuana, and opioids. The Substance Abuse and Mental Health Services Administration report the staggering statistic that in 2014, “approximately 1.2 million Americans are currently hallucinogenic drug users”. This goes to show the epidemic that psychiatrist have to take into account prior to clinically diagnosis an individual with Schizophrenia. The diagnosis for substance or medication induced psychotic disorder is to conduct a urine test to determine if the person is experiencing a “bad trip,” due to a controlled substance. The American Addiction Center, provides a description of a bad trip as “when brain levels of the drugs become “too” high, the effects become bizarre, and you start experiencing out-of-the-earth things”. An individuals with history of drug use that have been diagnosed with substance psychotic disorder often have recurrent bad trips even after the sobriety. It’s undeniable that mind altering drugs can lead to damaging the brain and permanently causing symptoms similar to Schizophrenia. However, Schizophrenia is typically a lifelong disorder while acute Substance Induced Psychotic Disorder symptoms with proper treatment and sobriety can go away. Schizophrenia can be linked by genetics while Substance Induced Psychotic Disorder, is due to abusing a controlled substance. Neither, are curable however, with treatment symptoms can subside or disappear.
Prevalence Rates of Schizophrenia
Physiatrist have observed that there is a difference in prevalence in women and men with Schizophrenia. According to Rena Li and Xi Ma, two Psychiatrist at the University of Tennessee, “Schizophrenia is more frequent in men. Female onset is typically 3–5 years later than males. It is now accepted that men has a single peak age for onset which is between 21 and 25 years old and women have two peaks age of onset, one between 25 and 30 years old”. There’s no research that has explained why women are diagnosed with Schizophrenia later than men except for the analogy that women with Schizophrenia are able to function with it longer. Most men at an early age begin to show signs of Schizophrenia by isolating themselves, pertaining in minuscule amounts of social activity, and abusing controlled substances. Which is alarming for a parent to see their child have this sudden change in behaviour often resulting in seeing a psychiatrist and being diagnosed with Schizophrenia. However, women generally show signs of Schizophrenia as a cry for help their mood begins to change acting particularly depressed and no longer having motivation to do anything. Severe obdurate lack of interest in the things within their life that they used to enjoy. Man also, are more likely to have cognitive issues early on and delayed memory. Yet, women that were diagnosed with the disorder later on down the line were more likely than men to have delusions and hallucinations.
Another prevalence that affects the diagnosis rate of Schizophrenia is race. Arnold Barnes, Associate Professor of Sociology at North Carolina A&T, the overdiagnosis of Schizophrenia in African Americans accompanied by the underdiagnosis of mood disorders. Which founded that African Americans were more likely to be misdiagnosed with schizophrenia than Caucasians leaving them susceptible to increased risk of being placed into psychiatric facilities and given the wrong drug treatment. Barnes addresses this racial disparity by stating, “signs of undesirable behavior that doesn’t specifically meet the guidelines of Schizophrenia but, they’re deemed to be unusual or alarming by psychiatrist were still labeled as Schizophrenia rather than a mental disorder” (668). Due to the fact that doctors perspective can often be tainted by their own personal beliefs of how an individual should conduct themselves. Robert Schwartz and David Blankenship, two psychologist at the University of Michigan, emphasize that this racial disparity leading to misdiagnosis is “when clinicians fail to elicit crucial and accurate diagnostic information because of insufficient attention to cultural and contextual factors that shape maladaptive behaviors” (85). Social norms and behavior vary culturally it’s important that this is taken into account so black behaviour or a black person with a mental disorder mistaken for pathology. Annie Murphy Paul, an African American historian, describes an occurrence that she witnessed at the John L. McClellan Veterans Hospital in North Little Rock, Ark. Paul notes that “All African-American men, all veterans of combat in the Vietnam War, they suffered from terrifying nightmares, gut-twisting anxiety, flashbacks of fighting — classic symptoms of post-traumatic stress disorder (PTSD)” (6). Yet, they’re diagnosed with Schizophrenia put on anti-psychotic medication and wait till someone discovers that they’re misdiagnosed but, often times before this can occur the individual may commit suicide from the medication causing other complications.
Also, an individual’s socioeconomic status at birth is directly correlated with the risk of having Schizophrenia. Among the socioeconomic risk factors that make an individual more susceptible to having Schizophrenia include income inequality, parental socio-economic status and urbanicity. Poverty is known to be the number one cause of stress. Stress is typically accompanied by disparity losing hope and interest in everyday life activities. The idea that Schizophrenia isn’t predetermined by bio-genetic factors instead it is caused by a number of psycho-social causes. According to John Read, a professor at the University of Auckland, in a “Can Poverty Drive You Mad?”, that “Most individuals that were diagnosed with Schizophrenia reported having a traumatic or unusual experience due to their economic circumstances prior to their first schizophrenic episode”. Those living in poverty are more susceptible to trying drugs because, they cannot cope with their stress. Many people with symptoms of Schizophrenia don’t have insurance or the same therapeutic resources that are open to the upper class.
Schizophrenia Impact on Social Functioning
Schizophrenia generally has a negative impact on relationships, employment and getting a education. Clazien Bouwmans and Caroline de Sonneville, both Professors at the report that “People with long-term mental illness, including schizophrenia, are sensitive to the negative effects of unemployment, and experience barriers to work, due to stigma, prejudice, and discrimination”. Since, Schizophrenia is a disorder with a harsh stigma surrounding it that individuals with the disorder are “lunatics,” or “crazy people,” that talk to themselves it’s difficult for them to obtain jobs. Also, the delusions can make it difficult to decipher between what’s real and what isn’t. Another hindering symptom is disorderly speech which would make it harder for someone with Schizophrenia to communicate in a job setting. According to Eric W.Wu, a professor at Howard University, in hi study on the “The Economic Burden of Schizophrenia in America,” “Families reported spending 68 million dollars on their loved one with Schizophrenia”. Due to spending money on medication, in patient facilities and therapy for their loved one that is unemployed.
Schizophrenia tends to take a toll on relationships, sexuality and romance for many patients. Schizophrenic patients tend to exhibit a lack of motivation to socialize with others. Without, proper medication an individual with Schizophrenia behaviour tends to fluctuate from acting normal one moment and the next having random outburst. The lack of motivation to socialize comes from onset depression being an side effect. This tends to occur when the individual isn’t balancing their condition with the right medication and therapy. Schizophrenia is a lifelong disease without a cure so, it’s important for those that are diagnosed with it to get the proper treatment in order so that their condition doesn’t limit their social life. When the delusions are at an all time high for people with Schizophrenia they tend to accuse their partner or their friends of betraying them for absolutely no reason.
24.2.2019