Jerry Wartak

In everyday life we see ads on TV about medication for depression, bipolar ect. We get

many news segments covering the significant increases in diagnosis of depression in today’s

American populous. But, one mental disorder that lives in the shadows of all that media coverage

is schizophrenia.

Schizophrenia “is a disturbance that lasts for at least 6 months and includes at least 1

month of active-phase symptoms (i.e., two [or more] of the following delusions, hallucinations,

disorganized speech, grossly disorganized or catatonic behavior, negative symptoms).”

(American Psychiatric Association [DSM-IV-TR], 2000). Schizophrenia is described as having

positive and negative symptoms. Positive symptoms in other words refer to thoughts,

perceptions, and behaviors that are usually absent in most people, but are present in people with

Schizophrenia. The unique thing about these symptoms is that they vary in intensity over a

lifetime and can be absent for long periods of time. Positive symptoms include: delusions,

hallucinations, and thought disorder. Negative symptoms are the total opposite of the positive

symptoms. Negative symptoms describe as lack of thoughts, perceptions, and behaviors that are

usually present in most people, but are present in people that have schizophrenic characteristics.

Negative symptoms include: blunted affect , alogia, and avolition. In the following paragraphs, I

will describe the negative and positive symptoms in more detail.

To understand positive symptoms we have to look at the specific “sub-symptoms” that

fall under this category, the first being delusions. Delusions are thoughts that are often bizarre

and repeating. Meaning that if a person one day thinks that someone is watching him and there is

no repeating frequent pattern, than that person can’t be diagnosed with schizophrenia. Examples

of such phenomenon are described in statements like: “The man next door has control over what
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I think” or “An alien abducted me and now I know the meaning of life, call me Jesus 2 from now

on”. Such statements are considered by reason as false, but a person experiencing this symptom

strongly believes it.

Hallucinations are characterized by inaccurate or completely false perception of the

environment or internal thought. There are different types of hallucinations but the most common

type of hallucinations is auditory hallucinations. People experiencing auditory hallucinations

hear voices or voices that come from outside his or her head. The voices usually make comments

on the sick person’s behavior or how they are acting in a certain situation. “When a person with

schizophrenia is in a room alone, loudly telling someone to go away, that someone is probably a

voice. Mind you, no lie being told here, no story made up.” (Walsh 46). Visual hallucinations are

also symptoms of a person with schizophrenia, but are not as common as auditory hallucinations.

Finally thought disorder means that logical connections and associations are often

absent. In other words when a person is speaking or trying to convey information to a person

with a thought disorder, the receiver of the information hardly understands, formulates and

analyses what was told or shown to him/her. The sufferer understands little or even no

information that is presented to him. An example of this would be asking a person, “How was

your day sir?” and the sufferer answering “Well, ok my green light, this is why think people

make is this day so bad.” The answer to this simple question doesn’t make sense, because the

sufferer has great difficulty to formulate a proper response due to his or her struggle to logically

connect thought. An important note to remember when using the diagnostic criteria for

schizophrenia offered by the DSM-IV is: “Only one Criterion A symptom is required if delusions
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are bizarre or hallucinations consists of a voice keeping up a running commentary on the

person’s behavior , thoughts, or two or more voices conversing with each other.”

Negative Symptom like the blunted effect is characterized as a person not expressing

much emotion or very little of it. To put it in more familiar terms “acting like a zombie”. But it

should be noted that a person that expresses little or no emotion on the outside, might experience

highly emotional struggle on the inside. That means that the person doesn’t react in a correct

manner. A person that laughs when they just received the news that their mother died is an

example of such phonemoenon.

Alogia which means poverty of words so the sufferers experiences a lack of words.

Where most people like to elaborate off of their responses people with alogia tend to have short

responses. Example would be: “Do you own a car?” person suffering from alogia “yes”. In this

scenario while most people would say yes and most likely expand as to what type of a car is it

ect. The person with alogia will stick to short answers and will avoid expanding on what he or

she said.

Avolition is characterized as lack of motivation, interest, and desire. Parents whose

schizophrenic sons and daughters can’t get or keep jobs are familiar with problems of avolition.

There seems to be lack of interest in the world and their own courses in it. People commonly

view this as a smug on ones character instead it should be recognized as a symptom illness.

After reading the previous it doesn’t give the reader (you) the ability or credentials to start

diagnosing people with schizophrenia. This should be left to psychologist and psychiatrists only.

This brings me to my next point. It is important to mention the diagnostic criteria used by
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professionals in order to diagnose one with schizophrenia. These criteria can be found in the

DSM-IV which is a manual used by psychologists and psychiatrists that is published by the

American Psychiatric Association. According to the DSM- IV the following 6 criteria must be

met: DSM-IV-TR criteria for schizophrenia:

1. Characteristic symptoms: Two or more of the following, each present for much of

the time during a one-month period (or less, if symptoms remitted with treatment).

* Delusions

* Hallucinations

* Disorganized speech, which is a manifestation of formal thought disorder

* Grossly disorganized behavior (e.g. dressing inappropriately, crying frequently)

or catatonic behavior

* Negative symptoms: Blunted affect (lack or decline in emotional response),

alogia (lack or decline in speech), or avolition (lack or decline in motivation)

If the delusions are judged to be bizarre, or hallucinations consist of hearing one

voice participating in a running commentary of the patient's actions or of hearing two or

more voices conversing with each other, only that symptom is required above. The

speech disorganization criterion is only met if it is severe enough to substantially impair

communication.

2. Social/occupational dysfunction: For a significant portion of the time since the onset of the

disturbance, one or more major areas of functioning such as work, interpersonal relations, or

self-care, are markedly below the level achieved prior to the onset.
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3. Duration: Continuous signs of the disturbance persist for at least six months. This six-month

period must include at least one month of symptoms (or less, if symptoms remitted with

treatment).

4. Schizoaffective and mood disorders are not present and are not responsible for the

signs and symptoms.

5. Not caused by substance abuse or general medical disorder.

All of the above criteria are directly quoted or paraphrased from the DSM- IV 2000.

So what causes Schizophrenia? Well there has been a lot of research done, but even now

with our advances in medicine we can’t pin point what directly causes schizophrenia. There are a

number of factors that seem to predispose a person to schizophrenia. The biggest is heredity, but

even identical twins only have a fifty percent chance of getting schizophrenia if their identical

sibling has it. That is fifty times greater than the population at large, but if schizophrenia were

totally genetics, the percent chance would be one hundred. In the field of genetics using DNA

techniques, researchers have recently found that “28% of the schizophrenia sufferers that they

studied had traces of a virus in their brains, suggesting that for some, schizophrenia may occur

through an infection.” (Phillips 82) The researchers looked at DNA from the brain, spinal fluid,

the liquid that surround the brain, of the patients with schizophrenia. They then compared DNA

with those that didn’t have the disease. They found the virus hiding in the DNA, suggesting that

there was an infection before. Whether this exact virus can cause the symptoms of schizophrenia

is unknown. In drug studies “research has shown that while about 25 to 30 percent of the adult
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population of the U.S smokes, greater than 90% of schizophrenia sufferers do.” (Phillips 85).

Some have found that nicotine calms sufferers and makes him or her more able to focus, but this

is a brief phenomenon, lasting only a couple of minutes. Making drugs that act like nicotine can

help calm some of the symptoms that schizophrenics experience. Today’s research into the

causes of schizophrenia is going in many different directions. While most of the studies focus on

medication some are aimed at understanding the disease and the way it affects the body. Not

many studies will come up with definite data, but the knowledge obtained from these studies will

benefit sufferers of schizophrenia worldwide.

Methods of treating schizophrenia have improved drastically over the years. Not only due to the

introduction of new medication but also due to a better understanding of the role the therapist, as

well as the patient and the family, can play in healing the patient. Treatment is broken up into

different categories or types. Medication is the most common way of treatment. None of the

medications used today can cure schizophrenia, but in most cases they can make the disease

much less devastating of the victim. Antipsychotics are medications that are currently available

to treat schizophrenia. Antipsychotics are broken down into two categories: neuroleptics which

are old medication used to treat schizophrenia. Atypicals are the newer types of medications that

fall under the antipsychotic drug category. “The neuroleptics have been used since the early

1950s to treat patients with schizophrenia, and they worked quite well for many patients. The

atypical are considered better than older medication because they have fewer side-effect and they

seem to work for patients who did not respond to the older medication.” (Ketelsen 94)

Neurolrptic medication includes haloperidol and chlorpromazine. Neuroleptics work by blocking

the action of a very common chemical in the brain called dopamine which is a neurotransmitter

that is used by the brain cells to send signals to other cells in the body. “People suffering from
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schizophrenia may be too sensitive to dopamine in some areas of the brain. For this reason,

neuroleptics may work better for patients who are abnormally sensitive to this compound.”(Szasz

163) Atypical medication includes: riseridone, clozapine, and olanzapine. Smaller side-effects

than the previous. But the use of drugs like clozapine can lead to agranulocytosis or a very low

white blood cell count, making the patient very venerable to infections and disease. Most people

who are diagnosed with schizophrenia find themselves turning to therapy. With schizophrenia, it

is not enough to just take medication. Patients need to learn to understand their disorders and

how to take care of their lives. Many feel that the education of the patient is second only to

medication in preventing a relapse.

Schizophrenia isn’t curable by today’s medication. But with treatment, the symptoms of

schizophrenia are greatly muted. And the results are much batter in people who are diagnosed

right away and given adequate treatment. It is sometimes hard for doctors to make the right

choice on the course of medical care. Currently, there are several medications and many different

types of counseling available. Some will work for one patient where they would not work for

another. There is significant research being done on schizophrenia. Genetics seems to be the

most significant player in determining the cause of the disease. Hopefully with the introduction

of new DNA sequencing and/or analysis might reveal the direct cause of schizophrenia. With

that information pharmaceutical companies can design and engineer drugs to cure schizophrenia.

But, that is in the future, till then pharmaceutical companies will be working on a better

developed drugs, cutting the side effect and increasing its effectiveness. It seems that the use of

medication with therapy helps patients significantly. But the dark and deeming side of this

prognosis is that “people who suffer from schizophrenia commit suicide at a much higher rate

than the general population does. In fact, one out of every six schizophrenia sufferers will end up
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killing him or herself.”(Cullen 212) Schizophrenia might not be in the spotlight like depression

and bi-polar disorder, but it should be dually noted that schizophrenia should be awarded with

equal or even great attention by media, scientific community, and society. Due to the fact that

these people suffer in ways that are unimaginable to us. But, most importantly we should fight

schizophrenia for the fact that no one deserves to live this way especially in the 21st century.
 Jerry Wartak

WORK CITED

American Psychiatric Association. Diagnostic Statistical Manual of Mental Disorders.

Fourth ed. Washington, DC: American Psychiatric Association, 2000.

Walsh, T. A. “Schizophrenia- Straight Talk for Families and Friends” Progress in Nero-

Psychopharmacology and

Biological Psychiatry

Ketelsen, Marcelo T., Betina S. Mattevi, Paulo Belmonte-de-Abreu and Timothy J. Crow.

“The Etiology of Schizophrenia and the Origin of Language: Overview of a

Phillips, Spencer and Jeffrey Nevid. Abnormal Psychology. Prentice Hall; 1991

Crow, T. J. “Schizophrenia as the Price that Homo sapiens Pay for Language: a

Resolution of the Central Paradox in the Origin of Species.” Brain Research

Szasz, Thomas Stephen. The myth of mental illness: foundations of a theory of personal conduct. San

Francisco: Harper & Row; 1974.

Cullen KR, Kumra S, Regan J Atypical Antipsychotics for Treatment of Schizophrenia Spectrum

Disorders. Psychiatric Times. 2008

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