Review of Schizophrenic Disorders Lecture

Here is another lecture I came across which is quite suited to my blog. This lecture is from the course “Psychology of Human Behaviour” taught by Professor David W. Martin from North Carolina State University.

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The course has 36 lectures, but the one lecture that caught my eye is lecture number 10 called “Schizophrenic Disorders”. I felt this lecture is important for a carer as myself since I am looking after someone suffering from such a condition.

So lets delve into this lecture further.

Professor David starts off from the lecture that he is going through the various mental disorders from the DSM IV, which as we know has gone up to DSM V, which stands for “Diagnostic and Statistical Manual of Mental Disorders”. This manual is very helpful to psychiatrists and others interested in mental health, but the manual also has a difficult and controversial history, but we can explore that for another time.

Prof David mentions that usually a small number of the population (referring to the US) are diagnosed with Schizophrenia, but the illness is one of the most devastating out of the many mental health disorders. Prof David points out that people are often hospitalized at very high rates from Schizophrenia.

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The lecturer explains that Schizophrenia is a psychotic disorder and can be termed as a break with/from reality. It is one of the main disorders that has sufferers breaking from reality. Diagnoses can usually be done by person, place and time oriented questions as in

– Do they know who they are.
– Do they know the place.
– Do they know the time.

I remember at one time a mental health professional asked the person I was looking after, if they remembered who I was, which is why I fairly understand why such questions are asked to people suffering Schizophrenic disorders.

The lecture then continues on to the Symptoms of Schizophrenia. Unfortunately some people think this involves the sufferer having split personalities, but this is not the case. Prof David points out that split personalities are part of the dissociative identity disorder and not under psychotic illnesses.

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Positive and Negative symptoms of the Symptoms of Schizophrenia.

To clear things up further Prof David begins to talk about what are the Positive and Negative symptoms of Schizophrenia.

First we look at the Positive symptoms, which means what behavior is added to the normal behavior of a sufferer. The first usually can be delusion as in false beliefs (perhaps they think they are someone else perhaps, or feel that someone is watching inside their heads). These delusions can mean that they are hearing things, experiencing sensory difficulties or even hallucinations.

Some people feel these voice are very REAL to them and the type of voices can make a lot of difference if the voices say certain things.  Some voices may be reassuring, others aggressive, some voices are very loud, while worst of all a sufferer can hear multiple voices at the same time.

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Other positive symptoms are disorganised speech where some examples are brought up in the lecture. One example was where the sufferer can sometimes use words that rhyme with each other or using neologisms (words that aren’t real words).

Other symptoms are disorganised behaviour being Hygiene, dress behaviour, health difficulties and how personal interactions are with others. Plus one of the worse symptoms is catatonic behaviour, which the lecturer goes into more detail later on in this lecture.

Professor David then talks about the Negative symptoms, where we have behaviour subtracting from normal behaviour. David mentions that some therapies used to combat Symptoms of Schizophrenia are anti-psychotic drugs, but the problem for older anti-psychotic medicines is that the negative symptoms still remains.

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Here the negative symptoms are what is absent from normal behaviour, such as flattening of emotions, where the sufferer has less speech sometimes called Allosia. Other negative symptoms are Avolition, apathetic or withdrawn emotions. There seems to be less “will” to do anything, hence the term “negative symptoms” that something is taken away.

The lecture then moves on to What defines the disorder or who are most likely to get schizophrenia. Professor David specifies that the symptoms tend to hit those from late adolescence to early adulthood and gave an example of how his friend, who ended up acting oddly and was in and out of hospital for most his life.

Professor David mentions that men tend to get disorder earlier and more severe than women who tend to get this later on life. David talked about some theories that felt this could be linked to the levels of oestrogen. David also mentioned that children born to older people are high risk of developing the disorder.

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The lecture then moves on to the different Subtypes of Schizophrenia, there seems to be some confusion that Schizophrenia is just one type of disorder, but there are different and varying levels of Schizophrenia.

The most common type is the paranoid type of Schizophrenia

This is where someone thinks someone else is after them. They also feel that there are multiple enemies and this can have an affect where carers or those trying to help the sufferer are pushed away. Other effects are delusions of grandeur where someone feels they are someone famous either from the past or present. Remember this is a very basic description of paranoid Schizophrenia and I am sure there are more. Prof David mentions that cognitive functions can tend to be higher and some suffers can to recover from this cluster.

Another type is disorderized type behaviour

Which unfortunately is not so easy to recover from. Here we have sufferers displaying inappropriate emotions such as uncontrolled giggling or in some cases tearing off clothing and screaming, which can be distressful for sufferers of this type and their carers.

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The next type is catatonic Schizophrenia Where the sufferer has a fixed posture and in this lecturer an example was given about the flexibility of the sufferer where someone can move part of their body and they remain in that posture.

Another type is undifferentiated schizophrenia which general symptoms of Schizophrenia, but harder to define.

The lecture then touches on residual type Schizophrenia. Where the person is not showing the serve positive symptoms, but has the negative symptoms. Hence we are given examples of low emotion and how apathetic the person is. For instance when a sufferer was interviewed, the person was open to suggestion on what name their mother was.

Interviewer : What is the name your mother?
Sufferer : My mother is Mary
Interviewer : Are you sure that is her name? I mean it couldnt be Jane perhaps?
Sufferer : I don’t know, I guess you are right, it could be Jane
Interviewer : So your mother’s name is Jane then.
Sufferer : If you say so, my mother’s name is Jane.

As you can see from this scenario, this raises alarm with families and carers who care for those suffering from this type of schizophrenia. It can mean people can take advantage of them and they can be easily victimised even unfortunately by some carers themselves.

The last section of this interesting lecture explores –  What are the possible causes of Schizophrenia.

Professor David mentions that if he did this lecture 50 years ago, he would have mentioned that the disorder was caused by uncaring parents, which was the behaviourist view at the time. Now in 2014 this is not the case.

David feels that the genetic connection seems likely due to the identical twin study explored in the lecture although this is not 100 percent, also first degree relatives tend to be less likely to develop the disorder, but if both parents have the illness, you are at a higher risk, but I do not know the percentage.

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The lecture states that there seems to be not a single gene that causes Schizophrenia and that the genes are spread out, which makes it difficult to cure the symptom. There are higher incident rates of those at risk of  schizophrenia if caused by their mothers emotional health or the delivery at birth. Another section of the lecture looked at some studies examining brain sizes, but this does not predict the illness completely. Lastly Prof David explored how emotional tension can raise Schizophrenia episodes or relapses.

All in all although the lecture is interesting for those interested in the basics of mental health disorders, the lecture raises questions as well as answers, which is a good thing. The lecture can be a springboard to looking into further lectures, books or studies in mental health disorders.

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