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"SCHIZ-O-PHRE-NI-A, n. Any of a group of psychotic reactions characterized by withdrawal from reality with highly variable affective, behavioral and intellectual disturbances" (Long, Schizophrenia is the word for a group of mental illnesses marked by a multitude of symptoms. Literally, the term means "split mind" but, though many people think it, schizophrenia is not multiple personalities. It is generally thought of as the classic case of insanity. When most people think of someone as being crazy, they think of the hallucinations, confusing speech, and delusions of schizophrenics. But not all schizophrenics suffer the same mental illness. Attempts have been made to turn schizophrenia into several forms and groups. Knowing one form of the illness from another would help the patients and help researchers understand the causes and learn what treatments work best in what forms. But these efforts have been totally unsuccessful. It is not known whether or not people suffer from mild, undetectable forms of the disease. There is no objective way to diagnose schizophrenia, such as there are no chemicals in the blood, the brain, or the spinal fluid. X-rays and examinations of cells do not show it, either. Psychiatrists rely on symptoms, but many diseased may have similar symptoms. The requirements for diagnosis are found in the third edition of Diagnostic and Statistical Manual for Mental disorders (DSM III), which is the official diagnostic system of the American psychiatric association. At least one of the symptoms from the list of symptoms must be present for six months or more to be a schizophrenic symptom. If a person does not meet DSM III criteria, he or she is does not have schizophrenia. In the late 1800's there were three different mental diseases for modern schizophrenia. There was paranoia psychosis, discovered in 1868, hebephrenia, discovered in 1871, and catatonia, discovered in 1874. Then in 1896, Emil kraepelin grouped them all together into one disease called dementia praecox, which means early insanity to indicate the early age of onset. These three disorders still serve as a subgrouping. SUBTYPES OF SCHIZOPHRENIA Subtype Symptoms Comments Paranoia (paranoid psychosis) Delusions of grandeur or persecution, often by a large organization like the FBI Occurs among older and more intelligent victims. Delusions can dominate life if not treated. Hebephrenia Clownish or absurd outbursts. Gradual decrease in social contact. Patient seems to be playing like a child in some episodes, though no adult mental functions have actually been lost. Catatonia Extreme muscle tension. "Waxy flexibility." Robot-like movements or frenzied, even lethal motion. More treatable with drugs than other subtypes. Frenzy can lead to death by exhaustion if not stopped. Catatonia is Greek for tension. The most memorable symptom is changes in voluntary muscle tension. Catatonics may assume one position or they may run around in a frenzy. Some patients alternate such states. during a catatonic stupor, the patient may assume one statuesque position and remain there for hours, their limbs unmoving and their faces expressionless. Though they seem generally oblivious to the outside world, they perceive everything around them. If something is said by a doctor or nurse around a catatonic in such a state, the doctor or nurse may hear the patient say it again weeks, maybe months from when it was first said. If the limb of a catatonic is moved, it will stay in whatever position it is moved to. This is called "waxy flexibility." Catatonics also may have robotic movements, refuse to eat to the point of death, or lose control of their bowels and bladder. Another extreme behavior is rapid movements-they may run around, scream, cry, laugh, sing loudly, and bang on walls or floors. Their actions are frenzied and possibly lethal. Some catatonics die of exhaustion and heart failure due to their behavior. Hebephrenia is when the patient is disorganized. Their behavior is childish, silly, sometimes inappropriate, and absurd. They giggle, make faces into mirrors, and say nonsense rhymes. They suffer a gradual decrease in social contact. They have some hallucinations and delusions, but these are not the major features of this subgroup. Paranoia schizophrenia is delusions of persecution or grandeur, though it is usually both. These patients suffer hallucinations, anxiety, anger, arguementativeness, and are sometimes violent. This subgroup usually occurs later in life and the victims are usually more intelligent and alert. The delusions dominate their lives as they always feel that someone is out to get them. They come up with very specific and detailed evidence to support this and they know exactly why and who it is (usually a government institution such as the FBI or CIA or even aliens). They are also consumed with delusions of their own great importance. Sometimes they introduce themselves as the Virgin Mary, Jesus Christ, Abraham Lincoln, Napoleon Bonaparte, or Cleopatra and they often dress the part as well. There are others who say they bring messages of extreme importance, words from God, or other absurd things. But not all paranoids are schizophrenics. Less severe types are given other names, such as paranoid disorder, paranoia, of paranoid personality disorder. Of all the schizophrenia subtypes, paranoia is the most devastating. Some researchers believe that it is not even schizophrenia. They think it and all the other paranoid disorders should be classified as a different kind of mental illness. Though there are three categories, most schizophrenics have a mixture of the symptoms. But these symptoms change over time. Most schizophrenics suffer undifferentiated schizophrenia, which is a mixture of all the symptoms. The symptoms often change over time, thus changing the type of schizophrenia and the treatment. In all, schizophrenia is a devastating mental disorder and researchers are constantly searching for new medications and always look for a cure. Whether it is one or one hundred different disorders and a cure have yet to be found. "For the legions of suffering schizophrenics, that day cannot come too soon." (Nichols, 13) Bibliography "Schizophrenia." Internet Mental Health. Online. World Wide Web ( 12 March 1997. Young, Patrick. Schizophrenia. New York: Chelsea House Publishers, 1988. Nichols, Mark. "Schizophrenia: Hidden Torment." Macleans's Magazine. 30 Jan., 1995. Andreasen, Nancy C. "Schizophrenia." Lancet. 19 Aug. 1995: 477. "Schizophrenia." Funk and Wagnalls New Encyclopedia. 1990 ed.


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