Selasa, 15 Desember 2009

What is schizoprenia?

Preference

Melinda herman (2008).schizophren is neeurogical disease that affects a persons perception, thinhking, language, emotion, and social behaviour.

Sheila L Veedback,(2004) schizophrenia is causes distorted and bizarre thoughts, perceptions, emotions, movements, and behaviour.

A person’s basic type of personality will be the predisposing factor as to which form psychosis he or she will develop. It occasionally happens that a person with recurrent psychosis may show a different form that the one evidenced earlier. As rule, however, if psychosis occurs several times in the life of a person, it tend to follow the same behavioral pattern each time.

Predisposing factors to schizophrenia

Schizophrenia is a complex condition with many predisposing factors. These can be grouped into biological, sociological, sociocultural, genetic, environmental and racial factors.

Biological

Behaviors related to maladaptiveneurobiological esponses have been described in writing and art since biblical times. Causes proposed for thesestrange behaviors ranged from demon possession, bad blood, and witchcraft, to the full moon. Fortunatelly, modern science is now identifying many clues to the actual causes of these disorders.

Psychological

In the past, in the absence of identified biological causes for schizophrenia, psychological, sociological, and environmental influences became the focus. For most of the twentieth century schizophrenia has been viewed as an illness that caused partly by the family and partly by someindividual character flaw. The mother was believed to be anxious, overprotective,or cold and unfeeling; the father was distant or over bearing. Marital conflict and families that stayed together for the sake of the children were blamed. There were theories describing a schizophrenic mother and theories that described how communicating in double messages could”double bind” a person in to developing schizophrenia.

Sociocultural

Some theorists proposed that poverty, society, and cultural disharmony could cause schizophrenia or that individuals chose to become schizophrenic to cope with insanity of the modern world. Others proposed that schizophrenia was caused by living in the city or living in isolation in the country. Altough accumulated stress related to environmental factors is likely to contribute to the onset of schizophrenia and to relapses, neurobiological findings point to other causes for the primary development of psychotic disorders.


Genetic factors

Schizophrenia has a strong genetic component. If an individual's parent or parents had schizophrenia, then that individual has a much higher risk of also developing schizophrenia. This does not just apply to parents; the more relatives have schizophrenia, the higher the risk of developing the condition.

Being male is also recognised as a predisposing factor for schizophrenia.


Environmental factors

Some of the environmental factors that have been associated with an increased risk of schizophrenia are:

  • Maternal smoking, diabetes, and rubella infection during pregnancy
  • Premature birth and low birth weight
  • Complications during birth that cause a baby to be without oxygen for some time
  • Lower socioeconomic status
  • Living in large cities
  • Stressful events in early childhood
  • Drug taking. Drugs such as amphetamines and cocaine have effects similar to the positive symptoms of schizophrenia. These drugs can also trigger schizophrenia. There is an increasing amount of evidence that cannabis damages the brain and can lead to schizophrenia. It is thought that cannabis doubles a person's risk of schizophrenia.


Racial factors

The highest rates of schizophrenia are among African immigrants in the USA and UK. There are also higher rates in many other ethnic minority groups.

SCHIZOPRENIC DISORDERS

The behavioral patterns of schizophrenic clients arre characterized by much disorganitation and discord of the personality. Schizoprenia comes from two greek words-one meaning to split, and the other mind. Schizoprenia includes a large group of disorders characteristic by disturbances of thinking, mood, and behaviour. Disturbances of thinking are shown by changes in concept formation that often lead to misintrpetation of reality and, on occasion, to delusions and hallucination. These delutions and halutinations often appear to be phsychologicaly self-protective.

Accompaniying mood changes may include ambivalent, constricted, and inaproprviate emotional responsiveness and loss emphaty with others. Behaviour may be withdrawn, regressive, and bizarre. In the schizophrenia, the mental stsus is primarily due to thought disorders. These states must be distinguished from the major affective disorders, which are disorders ofn moods. In paranoid states, psychotic symtomps, other than a narrows but deep distortion of reality, are absent.

THEORIES OF SCHIZOPRENIA

Today’s researchers are probing into body and brain chemistry to see if there is, perhaps, some chemical substance affecting the nervous tissues off these disorganized people. The biochemical substances released in the brain are known as neurotransmitters. The purpose of the nmeure transmitters is, as their name implies, to transmit or send messagas within the brain or between the brain and various part of the body. There are many known neurotransmitter substances in the brain, and perhaps others that have not been identified by neurobiologist. The neurotransmitter that is most frequently mention as possibles factor in the development of schizophrenia is dopamine. Research has demonstrated that there is a possible association between the behavioral symtomps of schizophrenia and the presence of elevated levels of dopamine in schizophrenic clients.

One of the factors that contributed to research into the relationship between neurotransmitters and schizophrenia was the recognition that the mental status that resulted from the use of lysergic acid diethilamine(LSD) was similar in many ways to the mentals status changes experienced by people with schizophrenic illness.

Should research bear our that the teory perhaps the schizophrenic has a chemical or phsycologic basis for his or her pshycosis, we shall hve to classify this large group of psychoses as organic rather than functional. An alternatve finding may be that the schizoprenichas both a phsycologic and a phsycological causes for his or her psychotic state.

According to psycoanalitc theory, the schizophrenic person appears to have a childhood deprived of meaningful relationship with the important people in his or her family circle. An outstanding fact is the most of these people have felt that as children they were unvolved, unwanted, and unimportant to their familes. This lack of good, firm interpersonal relationships at an earlyage results in immature adult personalities that find it difficult to adjust socialy or to releate intimately with other people.

SYMPTOMS OF SCHIZOPRENIA

Thought disorder is evidences by behaviour or spoken thoughts that are disorderly, unrealistic, and often irrasional. Autism in common people with thought disordes disregard external reality to a large extent. When expressing thought in word, the schizophrenic shows a loss off orderly progression of thought by using unconnected words. This termed fragmentation, or word salad. He or she may also coin new words neologism. The schizophrenic clients speech lacks unity, cleamest, and coherence, reflecting the confusion ef his or her mind.

The schizophrenic client is often given to eccentric, unexplained, and sudden activities. Undirected restlessness, fitful behaviour, and invulsive, apparently unpremeditated act are frequent. To sump up, the schizophrenic client’s behaviour is autistic(ie, actions, thoughts, feelings, ideas, and experiences are inappropriate, disorted, and not easily understood by other people). He or she may laugh or show pleasure as the results off painful experiences, or mayweep when the occasion would call for laughter(inappropriate emotional responses).

A lack of affect, or emotional blunting,is coldnessof emotional response to others. The client fail to relate to others in a meaningful way. He or she is emotionally shallow, and any amotion shown is often inappropriate.

Withdrawl is progressive shutting out of the world. There is reduction in interest, intiative, and spontaneity. Many clients seem to have withdrawn behind barriers, which if the could be penetrated, would reveal roneliness, hopelessness, hatred and fear. The client mey build a shell indifference in self defense. The withdrawl may vary from a mild degree of isolation to one so profound that the client seems severely withdrawn people, in spite of appearances, are sometimes acutely aware of all that goes on in environment.

Regresion varies in degree from slight to profound. There is a tendency for the schizophrenic client to retreat to a more primitive and infantile levelof thinking and behaving.

A delusion is a fixed, flalse belief based on misinterpretation of fact. Since the ideas, or mental content, of the schizophrenic client are so often delusional, and since the client needs are so often disguised by simbolysm, his or her thought content often appears complicated and difficult to understand.

Halusination are another common symptom of schizophrenia. Hallucination are sensory perception that have no basic in fact.

Types of schizophrenia

  • Paranoid type

The paranoid schizophrenic adds suspiciousness, projection, and delusions of persecution to his or her other basic schizophrenic traits. Delusion occupy a prominent place in his or her mental conceps, and hallucinations are tied in with these delusions.

  • Disorganized type

The disorganized type, formerly known as the hebephrenic type, has an insidious onset that usually begins in adolescence. The clients emotions become shallow and inappropriate.

  • Catatonic type

The catatonic type appears primarily in two mayor forms. One form is characterized by apparent stupor, immobility, mutism, and negativism, the other phase is characterized by unorganized, excessive, impulsive and sometimes destructive behaviour.

  • Undifferentiated type

The undifferentiated type refers to less severe psychotic symptoms that cannot be classified in the types describe previously or to symptoms that meet the criteria for more than one of the other schzoprenic categories.

  • Schizoprenic residual

Is a classification used when the client has had at the least one episode of schizophrenia but does not display acute psychotic symptoms.

Reference

  • Videbeck, Sheila L. Psychiatric Mental Health Nursing. Lipincolt Williams and wilkins.2004
  • Patricia D Bary,1998. lippincolt publisher. Mental health and mental illness,USA
  • Stuart and sundeen,1995.Principles and practice 0f psychiatric nursing.Mosby-year Book,inc. St louis, Missouri
  • Yosep,i. Keperawatan jiwa.2007.refika aditama.bandung
  • Website:http://www.virtualmedicalcentre.com/diseases.asp?did=74&page=1#Predisposing_Factors
  • Varcarolis, Carson, shoemaker. 2006. Foundations of psychiatric mental health nursing.fifth edition. Sander elselver