Schizophrenia: A Critical Evaluation of Aetiology, Clinical Picture, and Treatment Approaches

This essay critically evaluates the aetiology, clinical picture, and treatment approaches of schizophrenia, a serious mental illness that affects a person's way of thinking and behaving. It discusses the DSM criteria, various explanations of the aetiology, clinical symptoms, and treatment options, with a focus on antipsychotics as the most appropriate treatment option.

SCHIZOPHRENIA

Table of Contents
INTRODUCTION...........................................................................................................................2
MAIN BODY..................................................................................................................................2
Concept of normality and abnormality........................................................................................2
Understanding of schizophrenia..................................................................................................2
Evaluation of various explanations of the aetiology of schizophrenia........................................3
Explanation of clinical picture of schizophrenia.........................................................................4
Nature of evidence and its applicability to clinical psychology..................................................5
Treatment approaches..................................................................................................................6
One of the most appropriate treatment options that can be used for schizophrenia patients.......6
CONCLUSION................................................................................................................................8
REFERENCES................................................................................................................................9
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INTRODUCTION
There are many different kinds of disorders that can be suffered by a person
(McCutcheon, Marques & Howes, 2020). Most of these disorders are associated with mental
wellbeing of a person n which a person is in state of confusion or shock or normal functioning of
that person is affected. Schizophrenia is one of a kind of mental illness or disorder because of
which a person interpret reality abnormally. It is one of the most serious kind of mental illness or
disorder that can affect way of thinking, behaving of a person. This essay will lay emphasis upon
critical evaluation of aetiology of schizophrenia, its clinical picture, one treatment option in an
appropriate manner.
MAIN BODY
Concept of normality and abnormality
Normality is regarded as a behavior that can be considered normal for an individual when
it shows the characteristics of consistency and with the most common behavior for that person.
In addition to this, the concept of normality also describes that behavior of an individual which
conforms to the behavior which is most commonly observed in the society as a whole (Freeman
and et.al., 2019). In contrast to this, abnormality is defined as a behavior that s unusual and
different from the norm. This is the behavior which cannot be conformed to the social
expectations or demands.
Understanding of schizophrenia
Schizophrenia is one of the most common type serious mental illness which is being
encountered by most of the clinical practitioners during their practice. It is a kind of mental
illness in which people interpret reality in an abnormal manner. Due to this, such kind of people
might suffer from hallucinations, delusions, and extremely disordered thinking and behaviour
because of which their daily functionality can get disturbed. Such kind of patients require
lifelong treatment (Fonseca & et. al., 2020). Various studies have helped in understanding that a
person’s behaviour and attitude is impacted due to Schizophrenia because of which its diagnosis
in timely manner and treatment becomes important because change in attitude and behaviour can
become dangerous for both the person as well as for near and dear one’s of person suffering from
Schizophrenia
DSM criteria of schizophrenia
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DSM criteria’s stands for descriptions, symptoms, and other criteria’s for diagnosing
mental disorders. It is mostly used as a common language for clinicians for communicating
current condition of patient with other professionals related to the mental disorder from which
they are suffering from. Schizophrenia is made if a person has two or more than two core
symptoms, such as: hallucinations, delusions, or disorganized speech for at least a month (Curtis
& et. al., 2018). But other than this, its main core symptoms are: diminished emotional
expression and gross disorganization. Other than this, Schizophrenia directly affects thinking
ability of a person. Such kind of patients face difficulty in concentrating. Not only this, overall
memory of such patients is also affected drastically because of negative effects of Schizophrenia.
DSM criteria for Schizophrenia have been explained below:
Work level, inter-personal relationship, self- care is much lower than before start of symptoms.
Signs of disturbance have lasted of about 6 months.
Results of Schizoaffective disorder and depressive or bipolar disorder with psychotic symptoms
are ruled out (Billingsley & et. al., 2018).
Disturbance within patient is only caused because of Schizophrenia and is not caused because of
any other kind of medical condition or because of substance abuse.
Evaluation of various explanations of the aetiology of schizophrenia
Aetiology can be defined as a cause or set of causes that can result in occurrence or
development of a disease. Aetiology of schizophrenia can directly help in understanding its cause
because of which this disease is developed or suffered by a patient. The main exact cause of
schizophrenia is still unknown. But as per results of various research it has been observed that
combination of physical, genetic, psychological and environmental factors can make a person
likely to develop schizophrenia condition. Some people might be prone to schizophrenia and
because of a stressful and emotional life this psychotic episode of schizophrenia might get
triggered and chances of development of this condition can increase. However, there are no
scientific proof that these conditions can result in causing schizophrenia because some people do
develop symptoms of schizophrenia and while others do not (Haddad & Correll, 2018).
However, many other research has helped in explaining that schizophrenia tends to run
within families but a particular single gene is not responsible for the same. However, as per some
studies it has been identified that combination of different kinds of genes can make people
vulnerable to schizophrenia condition and physical, genetic, psychological and environmental
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factors can increase chances of person suffering from this mental illness. But having such genes
does not necessarily mean that, that particular person might develop schizophrenia. Various
researches have helped in explaining that if one of the identical twins suffer from schizophrenia
then the other one has 50 percent chances of developing schizophrenia despite of the fact that
they are raised separately (MacKenzie & et. al., 2018). Whereas non identical twins have
different genetic make-up because of which if one twin develop schizophrenia then the other has
only 12.5 percent chances that they well suffer from or develop schizophrenia.
However, many other researches have successfully helped in explaining that if a general
overview of reason or cause of cause of which a person develop schizophrenia then it can be said
that there are some of the main reasons that might be one of the main reasons because of which
development of this disease take place. One of the causes is structural change in brain. Structural
changes within brain might occur because of many different reasons such as presence of any
kind of psychiatric disorder can bring structural changes within brain because of chances of
suffering from schizophrenia can increase (Taipale & et. al., 2018). Another reason is chemical
chances within brain. There are many different kinds of reasons because of which chemical
changes within brain can occur because of any kind of substance abuse or sometimes because of
dopamine. Another factor is pregnancy or birth complications. During birth complications of
development of schizophrenia by a person can increase. Lastly many times due to any kind of
childhood drama, or abuse people can hallucinate related abuse or violence because of which
chances of development of schizophrenia can increase.
Explanation of clinical picture of schizophrenia
Clinical picture is a kind of visualization of illustrating clinical points that are related to a
disease or illness treatment. Clinical picture of schizophrenia can directly help in understanding
clinical presentation of schizophrenia in an appropriate manner. Schizophrenia can involve range
of thinking, behaviour and emotions (Onwordi & et. al., 2020). Its sigs and symptoms might
vary from person to person but usually some of the common symptoms that are observed within
such patients are delusions, hallucinations or disorganized speech, and reflect an impaired ability
to function. In order to understand its clinical picture, it is important to understand above
identified symptoms in an appropriate manner.
Delusions: These are false beliefs that are not at all based upon reality. Due to delusion a person
might think that they are being harmed or harassed or certain comments are being passed upon
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them only. Not only this, many times people also hear voices that are not even present. It is one
of the main things that occur within schizophrenia patients (Munawar & et. al., 2021).
Hallucinations: this usually involve seeing things that does not even exist. Such people not
imagine that they are seeing imaginary things that they think might be real or hear imaginary
voices or sounds that might not be present. It is another thing which is present within
schizophrenia patients.
Disorganized speech or thinking: disorganized thinking might result in disorganized speech.
Communication effectiveness might get affected or impaired. Many times, such people put
meaning less words together that do not have any kind of meaning. It is another factor that might
help in understanding that a particular individual is suffering from schizophrenia mental illness.
Abnormal motor behaviour: I can include child like behaviour such as resistance to any kind of
instruction, inappropriate postures, lack of response or excessive movements (Takeuchi & et. al.,
2019). These are other factors that help n understanding that, that particular person is suffering
from schizophrenia mental illness.
Negative symptoms: There are many different kinds of negative symptoms that can be directly
observed among such people such as neglection of hygiene, non- changing facial expression,
lack of emotions. Not only this, such kind of patients might also lose interest within daily routine
activities. These negative symptoms might also help in understanding that, that person is
suffering from schizophrenia.
Nature of evidence and its applicability to clinical psychology
Various researches have been conducted on schizophrenia and find suitable applications
in clinical psychology. The primary association of schizophrenia is with dopamine dysfunction.
Yang and Tsai (2017) conducted a study to explore new targets for treatment of schizophrenia
beyond dopamine synthesis. Therefore, novel targets for treatment of the chosen disease have
been addressed by the authors which include serotonin, GABA, inflammatory cytokines and
glutamate. This is applicable to clinical psychology as it would assist in determining various
combination strategies for treatment of schizophrenia. Stępnicki, Kondej and Kaczor (2018)
presented novel concepts in schizophrenia as well as its treatment. The novel mechanisms of
GPCRs signaling can be applied to the field of clinical psychology for better treatment of
schizophrenia.
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Silva and Restrepo (2017) conducted a study on the topic Functional recovery in
schizophrenia. Key questions regarding the recovery from the disease were answered by the
authors in this review. Similarly, Severance, Dickerson and Yolken (2018) carried out a review
to present biochemical and epidemiological evidence regarding autoimmune component in
schizophrenia. The authors also reviewed new pharmacotherapeutic horizon regarding
schizophrenia.
Treatment approaches
Various treatment approaches are available for treating schizophrenia. Antipsychotics are
considered to be initial treatment option for the chosen condition. The symptoms of an acute
episode of schizophrenia can be treated using antipsychotic as these block the work of dopamine
chemical on brain. These work by reducing the feelings of anxiety. However, it can be critically
evaluated that antipsychotics may not resolve symptoms such as hallucination immediately. It
may take several days or even weeks for these symptoms to be treated using antipsychotics.
There are w types of antipsychotics namely, typical and atypical. However, it can be critically
evaluated that both the types of antipsychotics may have side effects such as shaking, muscle
twitches, trembling etc. Psychological treatment is another approach that can be used for treating
schizophrenia (Horan and Green, 2019). These include cognitive behavioral therapy (CBT),
family therapy and arts therapy. CBT is used for identification of thinking patterns that cause the
person to have unwanted feelings. Family therapy involves family members in the treatment of
the condition. This comprises of a number of informal meetings which are conducted over a
period of 6 months. In addition to this, Arts therapy helps in promotion of creative expression by
allowing individuals to express their experiences.
One of the most appropriate treatment options that can be used for schizophrenia patients.
Out of all kinds of treatments, antipsychotics one of the best and highly recommended
treatment approach for patients suffering from schizophrenia. Antipsychotic treatment approach
is a recommended approach to be adopted as an initial treatment. It directly helps in blocking
effect of chemical dopamine on the brain. It is one of the most preferred treatment approaches
because use of antipsychotic can directly help in reducing feeling of anxiety or aggression within
few hours of its use (Takeuchi & et. al., 2019). This treatment might take several days or weeks
for reducing other varied symptoms for example delusional thoughts and hallucinations.
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But there are certain things that are required to be considered before giving this treatment,
such as it becomes extremely important for doctors to give a thorough physical examination of
the patient before opting provision of antipsychotic drugs or treatment. This is because through
physical examination can directly help healthcare practitioner in u8nderstanding and identifying
appropriate antipsychotic drug or treatment for them that can lead them towards correct path.
There are many different kinds of ways in which antipsychotic treatment can be provided to
schizophrenia patients. For example, it can be taken as a pill, can be provided as an injection.
These antipsychotic drugs are available for patients in slow release as well as of higher dose in
high release. Selection of appropriate type of antipsychotic is important in order to enhance
effectiveness of the treatment (Takeuchi & et. al., 2019). Not only this, it further helps in
reducing requirement of number of dosages to be given to the patient. Mostly or generally only
one injection is required to by provided to such patients in every 2 to 4 weeks. Analysis of
physical examination of current conditions of patient can directly help understanding time
duration till which this treatment is required to be provided. Effective provision of this treatment
can directly help in reducing chances of occurrence of adverse effect of this treatment. Mostly
requirement of provision of antipsychotic treatment to schizophrenia patients is required only
until acute schizophrenia episode has been passed. But mostly professionals prefer providing
these drugs to patient for 1 or 2 more years even after passing of first psychotic episode in order
to prevent chances of occurrence of occurrence of future schizophrenic episodes so that adverse
effects of this illness on patient can be reduced and ways in which it can harm patient and their
family members can also get reduced.
It is one of the main and important type of treatment that can be provided to schizophrenia
patients because adoption of this treatment can provide fast positive changes within an
individual. But dose which is required to be given to patient suffering from schizophrenia should
be evaluated and analysed for reducing changes of suffering from its side effects (Takeuchi & et.
al., 2019). But before opting this treatment it is extremely important to take advice of a
professional and experienced person so that only its effectiveness is seen upon a person and its
negative or drastic consequences are not seen upon patient. When a patient is diagnosed with
schizophrenia and when that patient is at its peak or having psychotic episodes then in such case
provision of this treatment can help in recuing chances of occurrence of this episode and
suppression of chances of occurrence of negative symptoms can also be reduced or surpassed.
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CONCLUSION
From the above assignment it has been summarized that schizophrenia is one of the most
serious type of mental illness or disorder that can directly affect way of thinking, believing and
behaving of a person. It has further been concluded that there is not specific cause that can help
in explaining reason that can result in development of schizophrenia because some of the most
common type of causes are genetic, chemical change in brain, structural change in brain etc.it
has further been explained that there are many different kinds of treatment that can be
appropriate for schizophrenia treatment but out of all of those antipsychotic treatment is most
appropriate and effective treatment.
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REFERENCES
Books and journals
Billingsley, K.J., & et. al., (2018). Regulatory characterisation of the schizophrenia-associated
CACNA1C proximal promoter and the potential role for the transcription factor EZH2 in
schizophrenia aetiology. Schizophrenia research, 199, pp.168-175.
Curtis, D., & et. al., (2018). Weighted burden analysis of exome-sequenced case-control sample
implicates synaptic genes in schizophrenia aetiology. Behavior genetics, 48(3), pp.198-
208.
Fonseca, L., & et. al., (2020). Schizophrenia and COVID-19: risks and
recommendations. Brazilian Journal of Psychiatry, 42, pp.236-238.
Freeman, D. and et.al., (2019). Treatable clinical intervention targets for patients with
schizophrenia. Schizophrenia Research. 211. 44-50.
Haddad, P. M., & Correll, C. U. (2018). The acute efficacy of antipsychotics in schizophrenia: a
review of recent meta-analyses. Therapeutic advances in psychopharmacology, 8(11),
303-318.
Horan, W. P., & Green, M. F. (2019). Treatment of social cognition in schizophrenia: Current
status and future directions. Schizophrenia research. 203. 3-11.
MacKenzie, N. E., & et. al., (2018). Antipsychotics, metabolic adverse effects, and cognitive
function in schizophrenia. Frontiers in psychiatry, 9, 622.
McCutcheon, R.A., Marques, T.R. & Howes, O.D., (2020). Schizophrenia—an overview. JAMA
psychiatry, 77(2), pp.201-210.
Munawar, N., & et. al., (2021). Hidden role of gut microbiome dysbiosis in schizophrenia:
Antipsychotics or psychobiotics as therapeutics?. International Journal of Molecular
Sciences, 22(14), 7671.
Onwordi, E.C., & et. al., (2020). Synaptic density marker SV2A is reduced in schizophrenia
patients and unaffected by antipsychotics in rats. Nature communications, 11(1), pp.1-11.
Severance, E. G., Dickerson, F. B. and Yolken, R. H., (2018). Autoimmune phenotypes in
schizophrenia reveal novel treatment targets. Pharmacol Ther. 189. pp.184-198.
Silva, M. A. and Restrepo, D., (2017). Functional Recovery in Schizophrenia. Rev Colomb
Psiquiatr. 48(4).
Stępnicki, P., Kondej, M. and Kaczor, A. A., (2018). Current Concepts and Treatments of
Schizophrenia. Molecules. 23(8).
Taipale, H., & et. al., (2018). Antipsychotics and mortality in a nationwide cohort of 29,823
patients with schizophrenia. Schizophrenia research, 197, 274-280.
Takeuchi, H., & et. al., (2019). Does relapse contribute to treatment resistance? Antipsychotic
response in first-vs. second-episode schizophrenia. Neuropsychopharmacology, 44(6),
1036-1042.
Yang, A. C. and Tsai, S., (2017). New Targets for Schizophrenia Treatment beyond the
Dopamine Hypothesis. Int J Mol Sci. 18(8).
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