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183 Schizophrenia Essay Topics & Examples

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🔝 Top 10 Schizophrenia Research Topics for 2024

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• Brain Abnormalities in Schizophrenia
• Risk Factors of Adolescent Schizophrenia
• Cognitive Impairment in Schizophrenia Patients
• Family Support in Schizophrenia Management
• Ways of Enhancing Social Skills in Schizophrenia
• Schizophrenia and Comorbid Medical Conditions
• Early Detection and Intervention in Schizophrenia
• Genetic and Environmental Factors in Schizophrenia
• The Relationship between Schizophrenia and Substance Use
• Efficacy of Antipsychotic Medicines and Side Effects
• Schizophrenia: An Informative View It discusses the symptoms of the disorder, the cause, and the impact it has on both the individual suffering from it and the people surrounding the victim, both within and outside the family unit.
• Schizophrenia in The Center Cannot Hold by Elyn Saks Nevertheless, in college, Saks faced stress due to the need to study, communicate, and care about herself and was left without the support of the Center, which led to the first episode of acute psychosis.
• Schizophrenia Explained by “A Beautiful Mind” It is a disease which can emotionally devastate the [patient as well as the relatives and the loved ones of the patient causes the patients to have hallucinations as well as delusions and even in […]
• Dimensional Approaches to Schizophrenia and their Inclusion in the DSM-V The inclusion of the dimensional diagnosis of schizophrenia and other disorders to DSM-V will help to avoid some of the problems that are currently faced by the system.
• Schizophrenia in ‘A Beautiful Mind’ Film The main symptom of a schizophrenic patient depicted in the film is the patient’s inability to distinguish between the real world and the subconscious pattern created within the imaginations of his mind.
• The Movie “A Beautiful Mind” and Display of Schizophrenia This paper offers an in-depth analysis of the movie A Beautiful Mind to ascertain its display of schizophrenia as well as societal and cultural attitudes towards the disorder.
• Freud’s Psychoanalysis for Schizophrenia Patients In this paper, the author’s approaches to this ailment are considered, and the ways of applying the specific observations of human behavior are discussed. Freud’s contribution to the development of psychoanalysis is significant, and his […]
• A Beautiful Mind: Understanding Schizophrenia and Its Impact on the Individual and the Family The psychological disorder presented in the movie refer to one of the most common of schizophrenia paranoia. The disorder, however, is still subjected to experimental treatments by means of medications and psychotherapy.
• Schizophrenia Patients Using Atypical Medication The research procedure follows a timed experiment with several trials beginning with a fixation point displayed in the middle of the black rectangle. A participant’s task is to identify accurate locations of the stimuli after […]
• Schizophrenia and Its Effects on the Brain This shows that functional variations are not a product of long consequences of the condition or therapy for the disorder, just like the structural alterations in gray matter and white matter.
• Negative versus Positive Symptoms of Schizophrenia Schizophrenia is a condition that hinders the ability of a person to think, feel, and act. In Schizophrenia, a decrease or absence of normal motivational and interest-related behaviors or expressions are referred to as negative […]
• The Brief Psychotic Disorder, Schizophreniform Disorder, and Schizophrenia People with “delusions, hallucinations, and disorganized behavior, with a return to normal functioning over a short time span” are diagnosed with a brief psychotic disorder.
• Schizophrenia and Schizoaffective Disorder He is calm and cooperative. There is no evidence of any suicidal or homicidal ideation, and he denies them as well.
• Schizophrenia: Causes and Symptoms People with this condition can live full lives and perform independently because of the accessibility of medicine, counseling, and support. Additionally, the ideal way to perceive Schizophrenia is when it is promptly diagnosed and treated.
• Schizophrenia: Neurochemical Theories and Medications The dopamine theory regarding schizophrenia, the serotonin theory of depression, and the glutamate theory will get discussed in detail in this paper. The dopamine hypothesis of schizophrenia holds that the overall neurotransmitters associated with dopamine […]
• Schizophrenia and Bipolar Disorder Portrayal in Mass Media Thus, the portrayal of the disorder in the media is the mix of symptoms that belong to bipolar I and II disorders in the textbook.
• Indian, Chinese, and American Approaches to Treating Schizophrenia Thus, the perception of mental illnesses in Chinese traditional medicine should be discussed it will benefit the patients and reduce the destructive effects such disorders as schizophrenia may have on one’s life.
• Health Information: Schizophrenia The critical components that I used to evaluate the sites are the owners, mission, references, and information review. The benefits of WebMD are that it mentions the author’s name and the person who medically reviewed […]
• Schizophrenia Spectrum and Psychosis Disorders Management The psychopharmacology of risperidone shows the correlation between the drug’s impact on the brain and the behavior of patients. The FDA addresses the management of risperidone based on its class and its mechanism of action.
• Schizophrenia: Case Analysis Paper The purpose is to inform the reader about a comprehensive case study with a schizophrenia diagnosis and the rationale for a nursing care plan.
• The Current Concept of Schizophrenia Is Neither Valid and Useful The primary research question is ‘Is the current concept of schizophrenia valid and useful?’ Hence, it is crucial to evaluate the empirical basis to answer the question and discuss the alternative system.
• Plan for Management of Patient with Schizophrenia and Heart Disease About 1% of the world’s population suffers from schizophrenia About 0. 7% of the UK population suffers from schizophrenia Schizophrenia can manifest any time from early adulthood onwards, but rarely when a person is below […]
• Quality of Life With Schizophrenia The main difference between the former and new guidelines in patients’ professional and personal life will only be that people with schizophrenia will have to consider the symptoms of their illness and maintain a distance […]
• Schizophrenia: The Etiology Analysis Disrupted epigenomic regulation in response to environmental triggers leads to decreased brain function and the onset of schizophrenia. The Khavari & Cairns, article focuses on the epigenomic factors that contribute to the development of the […]
• Schizophrenia as a Chronic Mental Disorder The first signs of the disease began to appear at the age of 28, which, according to his friend, coincided with the patient’s loss of a loved one.
• Schizophrenia and Its Effects on the Lives of Patients Schizophrenia is a mental disorder that affects the lives of patients diagnosed with the condition on multiple levels, as evident from the individual in question.
• Schizophrenia Diagnostics and Its Challenges In addition to the core symptoms of hallucinations, delusions, or persistent disorganized speech, schizophrenia may be manifested through psychosis, which accounts for the majority of acute admissions to the inpatient setting.
• Schizophrenia: Symptoms and Therapy Schizophrenia is a complex condition involving a number of cognitive, behavioral and emotional symptoms, all of which can present differently depending on the person. In addition, there are a number of symptoms that can help […]
• Schizophrenia Disorder: Definition, Treatment, and Medication Schizophrenia is linked to anatomical and functional alterations in the pallium, the layer of the unmyelinated neurons, as well as variations in the networks in the middle of cortical areas.
• Schizophrenia: Cause, Consequence, Care Considering the assessment above, the diagnosis of paranoid schizophrenia can be established due to Caroline’s concerns about being a target for her social environment.
• Social Risk Factors for Schizophrenia However, genetic predisposition is not the only risk factor for psychoses in general and schizophrenia in particular. One of them is possibly social isolation, as most patients used to be somewhat reserved in their childhood […]
• Analysis of Article Related to Schizophrenia Treatment The objective of the study is to evaluate the effectiveness and safety application of cannabidiol as an adjunctive treatment for patients with schizophrenia.
• Neuroscience: Schizophrenia and Neurotransmitters From the definition of neurotransmitters, it is clear that schizophrenia is caused by the irregular functioning of neurotransmitters. Physical abnormalities in the brain have been suspected to be causes of schizophrenia.
• Treatment Plan For Schizophrenia Patient Bill will fully recover and be in a position to perform the activities of the daily living on his own. Bill complies with the treatment regimen because treatment will help him recover and be in […]
• Mental Health: Analysis of Schizophrenia In the early years, signs related to the disease were said to be resulting from possession of evil spirits. The history of development in respect to mental health can be traced to antiquity.
• Paranoid Schizophrenia: Psychosocial Rehabilitation The behavior of being a social loner is reinforced by the indoor equipments that motivate his stay in the house. Barhof et al, explains that recognition of the value or importance of change is wholly […]
• Principles and Practice of Psychosocial Rehabilitation: Schizophrenia The objective of this study was to evaluate the literature accumulated so far and address the issues surrounding the principles and practice of Psychosocial Rehabilitation.
• Schizophrenia and Primary Care in Britain The illness causes distress in the form of severe suffering for the patient, his family and friends. The annual costs for care and treatment of schizophrenia in the United Kingdom in the 1990s were 397 […]
• The Schizophrenia Drugs: Lithium and Abilify Lithium overdose affects primarily two systems of the human body: the central nervous system and the kidneys since it is through the latter that the drug is excreted from the body.
• Collaborative Care in a Schizophrenia Scenario For example, the social worker will be in a position to emphasize the human dimensions of the problem, such as Simon’s preferences and social aspirations.
• Alcoholism and Schizophrenia: Interconnection In addition to its physical effects on the chronic drinker’s body, alcohol is associated with a variety of mental impairments. Alcoholic dementia and Wernicke-Korsakoff syndrome are among the most prominent concerns in the matter. The former is a blanket term for a variety of cognitive deficiencies caused by the substance. The latter is a two-stage […]
• “Schizophrenia: A Sibling’s Tale” by Stephan Kirby The primary purpose of this article seems to inform the readers about the effective strategies that can be implemented in order to help the families of the affected people to go through a number of […]
• Schizophrenia and Workplace Behaviors Besides, their condition and performance at work may be significantly improved in case of a proper help from the company’s leadership.
• Schizophrenia and Health Strategy Proposal The use of qualitative analysis is thus justified, since the amount of detail and quality of information required would only be provided using this method.
• Schizophrenia and Biological Therapeutic Approach The level of social stigma associated with this condition has been identified as a major obstacle to the recovery of patients from this condition.
• Schizophrenia: An Abnormal Human Behavior Despite there not being a cure for the disorder as yet, there are current treatments available and meant to eliminate the majority of symptoms associated with the disorder thus enabling such individuals to live healthy […]
• Schizophrenia & Neurosis and Lifespan Development The learning objectives are to comprehend worrying conduct in the scope of the growth missions, series, and procedures that show human development.
• Schizophrenia Diagnostic Assessment As is mentioned above, the client does not understand or is not able to see the original appearance of objects and people around her.
• Analyzing Psychological Disorders: Schizophrenia Nevertheless, the damage to the brain as a result of this disorder seems to target two main areas: the frontal lobe, and the parietal cortex.
• Schizophrenia Study and Rehabilitation Outcome In fact, the results of this prospective study can reasonably be projected to the universe of Germans with mental disorders only if Rehabilitation Psychisch Kranker in the city of Halle is a kind of secondary […]
• Theme of Schizophrenia in “Slaughterhouse-Five” by Kurt Vonnegut The Tralfamadorian subplot includes a vision of the end of the world and the perpetuation of war, but these seem distant threats compared with the miseries of battlefield.
• Schizophrenia in Adults: Causes, Diagnosis, and Management Among the usual characteristics of schizophrenia is low motivation; which consequently makes the victim withdraw from other members of the society.”Although studies have shown that, women are equally likely to develop the mental disorder as […]
• Schizophrenia Causes, Symptoms, and Risk Factors This paper aims to research and analyze the causes, symptoms and the risk factors associated with the mental disease and discuss some of the prevention measures of the disease.
• Haldol and Negative Symptoms of Schizophrenia Very often this disease is treated with the help of haloperidol, a kind of injection used as a medicine against brain disorders and psychotic states.
• Schizophrenia: The Role of Family and Effect on the Relations The role of family members and other social support is essential and form part of the management of this illness. The illness causes the others in the family to have stress.
• Schizophrenia as a Common Mental Disorder Before a patient is diagnosed to have schizophrenia, the person must have two or more of the following symptoms for at least a month according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth […]
• Delusional “Pseudotranssexualism” in Schizophrenia But it was in the middle of the twentieth century that the name transsexualism was fixed for this disorder for the first time by Cauldwell and after a few years Benjamin in the US and […]
• Schizophrenia Symptoms, Etiology, and Treatment The treatment as well as the prognosis for recovery is highly dependent on the stage in which schizophrenia is diagnosed and the age of first onset.
• Schizophrenia Causes and Treatment Analysis There exist several theories about the causes of schizophrenia, the most convincing of them are: the theory of genetic predispositions, the theory of prenatal or vital antecedents and the theory of social and environmental causes.
• Schizophrenia: Characteristics, Types and Symptoms This disease is a type of brain disease which if remain unnoticed affects the entire personality and life of the patient.
• Schizophrenia: Biological & Environmental Causes The indications of schizophrenia are varied but the results are the same, causing a breakdown of individuality and the consequent inability of the personage to purpose in reality.
• Schizophrenia and Its Special Symptoms Talking to the patients in a way that could enhance their hopes in life and activities they usually engage in is one way of reducing patients’ overwhelmed, as well as keeping them with the hope […]
• Can Cannabis Cause Schizophrenia? Regarding this assignment, I am going to address the importance of this topic in the field of addiction and healthcare, assessing the research that suggests that cannabis plays a role in schizophrenia and the strengths […]
• People With Schizophrenia Diagnosis in Prisons As a result, the behavior of the individuals with the condition is a threat to the members of the family and the society.
• Schizophrenia Symptoms and Treatment Complications Schizophrenia is one of the most complex examples of these disorders because it leads to the inability to live independently and hold a job.
• Paranoid Schizophrenia in “A Beautiful Mind” The film A Beautiful Mind depicts the impact of progressive paranoid schizophrenia on the mathematician John Nash and the burden that it places on social and personal relationships.
• Schizophrenia: History and Diagnosis The process of diagnosing involves a comprehensive assessment of the patient’s symptoms, in which a specialist searches for the symptoms of schizophrenia and other disorders, which need to be ruled out for the diagnosis to […]
• Schizophrenia Diagnosis, Planning and Treatment Peter is 18 years old He lives at home with his parents. The patient has gained 20 pounds without any diet changes His glucose is at 145 He has not been taking his Olanzapine […]
• Schizophrenia Research: Ethical Principles and Steps The issue of beneficence is also put into consideration to ensure the research is done to improve the well being of the subjects and the society at large.
• Prevention of Suicide in People with Schizophrenia As a strategy to prevent suicide in schizophrenic patients, the drugs are aimed at controlling the symptoms associated with the condition.
• Readmissions in Schizophrenia and Reduction Methods After this, the regression model will be developed applying the variables associated with predictors of readmission and the dichotomous variable as the outcome.
• Schizophrenia Therapy: “People Matter” by Marley The study indicates how the targeted respondents supported the “use of different interpersonal interactions towards reducing the symptoms associated with schizophrenia”. This author supports the use of interpersonal interactions in every patient with schizophrenia.
• Schizophrenia Effects on Patient Development This essay explores schizophrenia in a bid to understand what it really is, how it affects the development and relational abilities of its victims, and why these effects qualify it as a mental disorder.
• Courtesy Stigma: Relatives of Schizophrenia Patients The quota sampling method was used in the research survey. In regards to the analytic strategy, the inductive formation of categories was used to analyze the transcripts.
• Schizophrenia Symptomatology and Misdiagnosis Although it was previously believed that the incidence and prevalence of schizophrenia in men and women were approximately the same, newer studies point out that the use of more restrictive criteria for diagnosis results in […]
• Schizophrenia and Cognitive Therapy Interventions The onset of the mental disorder usually occurs in the first half of life; however, many episodes of schizophrenia have been registered beyond the age of 60 years.
• Schizophrenia and Bipolar Disorder in Children and Adolescents It is acknowledged by the researchers that the symptoms indicate the possibility of bipolar disease and not schizophrenia. Psychiatric and physiological factors, among others, contribute to the prevalence of self-harm in children and young people.
• Schizophrenia Drugs’ Mechanism of Action In the case of M.Y.is can be useful to prescribe a second-generation antipsychotic, and if it proves to be ineffective, clozapine can be used.
• Schizophrenia Treatment: 25-Year-Old Male Patient The symptom of social isolation also contributes to the development of schizophrenia in Mr. Dashiell to identify the cause of the condition.
• Schizophrenia Hypothesis and Treatment The dopamine theory hypothesizes that the activation of post-synaptic dopamine receptors in the mesolimbic pathway of the brain increases dopaminergic activity, resulting in positive symptoms delusions and hallucinations.
• The Diagnostic Concept of Schizophrenia Cultural and historical contexts have largely influenced the perception of this mental disorder, and the assessment of this disease and its features in different cultures is not the same.
• Schizophrenia: Diagnosis and Treatment Approaches A detailed analysis of the factors that affect the patient’s condition, including the internal and the external ones, must be mentioned as one of the essential strengths of the studies that have been conducted on […]
• Schizophrenia in Young Men and Women Thus, the research of the problem among the young people is the primary task. The feelings of people with schizophrenia are contradictory and uncertain.
• Paranoid Schizophrenia in “A Beautiful Mind” Movie John Nash is the protagonist in the movie, A Beautiful Mind. The movie did a good job of depicting the disorder in John Nash.
• Schizophrenia, Ethical and Multicultural Issues For instance, the assumption that the absence of evidence implies the same outcomes as the actual absence of the disorder symptoms often hinders the process of determining and addressing schizophrenia in patients.
• Schizophrenia, Its Symptoms, Prevalence, Causes Noteworthy, hallucinations and delusions are reflections of the distortions of the human mind, which in turn causes distortions of the person’s perceptions and interpretations of reality.
• Pharmacological & Psychotherapeutic Schizophrenia Interventions The use of clozapine is a medical intervention that targets the biological functioning of patients by blocking serotonin receptors and thus bringing about the release of dopamine receptors in specific parts of the brain.
• Schizophrenia Effects on Patient, Caregiver, Society The purpose of this paper is to discuss the effects of schizophrenia on the victim, caregiver, as well as the society.
• Schizophrenia and the Reduction of Readmissions Thus, this research will be rather useful because it will discuss the effectiveness of self-management programs for people with schizophrenia and their influence on the reduction of readmissions.
• Self-Management Programs for Schizophrenia Therefore, the significance of the problem that is reviewed in this paper consists in the fact that the approaches to the treatment of schizophrenia can be optimized.
• Schizophrenia and Frequent Readmission Rates This literature review is focused on the exploration of self-management programs for patients with schizophrenia and their effectiveness in terms of the reduction readmission rates and the overall management of the condition.
• Schizophrenia and Its Functional Limitation The situation advances in severity with the age of the patient. This condition may affect work, social, training, and interpersonal relations and skills among people with the schizophrenia condition.
• Schizophrenia and Self-Management Programs In order to collect the data for further analysis that will help to answer the defined research question, it will be necessary to conduct the study allowing the researchers to track changes in behavior and […]
• Schizophrenia Readmissions Reduction: Data Analysis A simple random sampling technique will be used to select participants, and it implies that each respondent will be randomly chosen to take part in the study to avoid bias and ensure the validity of […]
• Readmission Rates in Schizophrenia Patients The purpose of this paper is to propose a research analyzing the frequency of admission rates among patients with schizophrenia treated with long-acting injectable antipsychotics or with oral antipsychotics.
• Eating Disorders, Insomnia, and Schizophrenia Of course, this readiness does not exclude the necessity to identify such people and provide the necessary treatment to them, which is proved to be effective.
• Schizophrenia as an Extreme Form of Schizotypy The use of Meehl’s model to expose extreme forms of schizotypy as a manifestation of schizophrenia also informs the findings of this paper. Nonetheless, the similarities between schizophrenia and schizotypy do not show that one […]
• Schizophrenia: Psychiatric Evaluation and Treatment Plan The purpose of this paper is to examine the symptoms characteristic for Oscar in order to determine whether it is necessary to conduct the psychiatric evaluation for the young man and propose the plan of […]
• Schizophrenia – Mental Health Disorder The neurotransmitters at the ending of the nerve cells transmit messages from one area to another nerve cell in the body.
• Schizophrenia: Symptoms and Treatment The positive symptoms of the disease incorporate hallucinations associated with hearing, illusions, and disordered language and behavior. The symptoms of schizophrenia captured in the DSM IV TR includes illusions, hallucinations, and disordered language.
• Undifferentiated Schizophrenia: Sally’s Case Sally could have inherited some patterns of the disease from her maternal grandfather and her mother’s continued smoking patterns and flu during her pregnancy.
• Schizophrenia Patients Biochemical and Behavioral Changes It is also important to note that microscopic studies on the tissues of brain have shown slight variations in the number of cells of the brain and their distribution patterns. Biochemical changes in the brain […]
• Schizophrenia and Delusional Disorder For example, a range of scholars have attempted to identify schizophrenia and the delusional disorder as phenomena. Therefore, the instances of delirium must be viewed as possible indicators of schizophrenia.
• Psychiatric Issues: Schizophrenia’s Demystify The web is an internet community that is dedicated to the provision of high-quality data, elucidation, and assistance to the kin, providers, and persons that have been impacted by the condition.
• Non-Clinical Indicators in Patients with Schizophrenia The collaboration between the clinicians and the family is beneficial to the patient especially in administering the daily routines of the patient.
• Schizophrenia: Pathophysiology and Treatment The treatment methods commonly in the application are based on a clinical research that has been conducted on the disease as well as on the experience of the physician on the treatment of the disease.
• Schizophrenia: Description, Development and Treatment According to Van Dyke, schizophrenia begins to develop in the early adulthood years of the victim from the age of 15 to 30 years.
• A Critical Examination of the Link between Nicotine Dependence and Schizophrenia Over the years, there have been strong indications that heavy cigarette smoking can be linked to schizophrenia and that smoking may have a connection to the neurobiology of schizophrenic illness.
• Schizophrenia Genetic and Environmental Factors The research paper explores schizophrenia by providing a general overview, a comprehensive discussion of clinical synopsis, genetics and environmental factors in relation to schizophrenia, limitations of the methods of analyses, and a clear demonstration of […]
• Childhood Schizophrenia: Causes and Management of This Mental Disorder Hardman et al.are of the view that the risk of a child suffering from this condition is one percent when there are no recorded cases of the condition in the family.
• Smoking as Activity Enhancer: Schizophrenia and Gender Once learning the effects which nicotine has on people’s health and the relation between gender and schizophrenia, one can possibly find the ways to prevent the latter and to protect the people in the high-risk […]
• Clinical and Neuropsychological Characteristics in Subjects With Schizophrenia The need to understand the complex interplay between a number of variables, including genetics, environmental factors, clinical, psychological and social processes, in the development of brain disorders and the resultant behavioural and cognitive deficiencies informed […]
• Psychological Classification of Schizophrenia The paper is composed of a matrix that gives detailed information on the major DSM IV-TR categories of schizophrenia and psychosis, and lifespan development as well as the various classifications of schizophrenia and psychosis, and […]
• Cognitive Behavioural Therapy in Schizophrenia The basic idea in cognitive therapy is the fact that the cognitive aspect of esteem, the way we perceive problems, the world, and other mundane aspects of life like expectations and beliefs are chief determinants […]
• Schizophrenia a Psychological Disorder The main purpose of this research study was to investigate the relationship between Schizophrenia and reading impairments that are usually experienced by individuals when assessed in terms of Oculomotor Control and phonological Processing The research […]
• Homelessness and Schizophrenia It is essential to consider that lack of a proper home can exert pressure in an individual, to the extent of mental burdening.
• Should Persons Suffering From Schizophrenia Be Forced to Take Medications? Though many studies have pointed out that its causes are poorly understood, Dora is of the view that it results from the interplay of the immediate environment that a person is exposed to and the […]
• Bipolar Disorder and Schizophrenia Genetically, an alteration in the serotonin, dopamine and glutamate genes may be the cause of the disease. Therefore, the close interactions of genetic, psychological and environmental factors lead to severe cases of bipolar disorder.
• Schizophrenia, Psychosis and Lifespan Development Schizophrenia is a complicated condition not only due to its nature but also due to the fact that it results from a wide range of factors.
• Diagnosis and Treatment of the Schizophrenia The prevalence rate of the disease is around 1% in the whole world and despite the fact that its rate is higher among the poor; there is no much difference from one culture to another. […]
• Physical Health and Its Relations to Schizophrenia Smith is the fact that the disease got him at a time in life when he wanted to settle in marriage and due to the changes brought about by the mental disorder, he lost his […]
• Neurological Disorder: Effects of Schizophrenia on the Brain and Behavior Furthermore, as identified earlier, the neurological basis of the disorder may also involve abnormalities in the structure of the forebrain, the hindbrain and the limbic system.
• What Makes Schizophrenia One of the Worst Mental Illnesses?
• Are Bipolar Disorder and Schizophrenia Neuroanatomically Distinct?
• What Predicts Stigmatization About Schizophrenia?
• How and Why Affective and Reactive Virtual Agents Will Bring New Insights on Social Cognitive Disorders in Schizophrenia?
• What Do Visual Illusions Teach Us About Schizophrenia?
• Can Neurostimulation Prevent the Risk of Alzheimer’s Disease in Elderly Individuals With Schizophrenia?
• How Can Nurses Deal With a Patient With Paranoid Schizophrenia?
• What Is Connection Between Schizophrenia and Social Isolation?
• Are Continuum Beliefs About Psychotic Symptoms Associated With Stereotypes About Schizophrenia?
• What Is the Link Between Drug Addiction and Underdiagnosed Schizophrenia?
• How Does Gray Matter Effect Schizophrenia and Bipolar?
• What Is Schizophrenia Disorder?
• Can N-Methyl-D-Aspartate Receptor Hypofunction in Schizophrenia Be Localized to an Individual Cell Type?
• How Should People With Schizophrenia Be Treat?
• Are Patients With Schizophrenia Impaired in Processing Non-emotional Features of Human Faces?
• How Does Schizophrenia Affect Development and Aging?
• Did Andrea Yates Have Schizophrenia?
• How Does Schizophrenia Affect the Lifespan?
• Are Patients With Schizophrenia Spectrum Disorders More Prone to Manifest Nocebo-Like-Effects?
• How Does the Environment Influence Schizophrenia and Possible Prevention?
• Does Co-morbid Obsessive-compulsive Disorder Modify the Abnormal Language Processing in Schizophrenia Patients?
• How Will the Mild Encephalitis Hypothesis of Schizophrenia Influence Stigmatization?
• Are People With Schizophrenia Dangerous and Unpredictable?
• Does Non-adherence Increase Treatment Costs in Schizophrenia?
• What Are the Major Main Barriers to Treatment of Schizophrenia?
• Is Schizophrenia an Incurable Mental Illness?
• How Do Genetic Factors Contribute to the Development of Schizophrenia?
• Is Any Particular Race More Vulnerable to Schizophrenia?
• How Does Schizophrenia Affect People Who Live In States That Opted Out of the State Healthcare Exchanges?
• Is Schizophrenia a Genetically Transmittable Illness?
• How Do Environmental Factors Contribute to the Development of Schizophrenia?
• What Are the Most Effective Pharmacological Interventions for Managing Positive and Negative Symptoms of Schizophrenia?
• How Does Early Intervention Impact the Long-Term Outcomes of Individuals with Schizophrenia?
• What Are the Most Common Cognitive Deficits Experienced by Schizophrenia Patients?
• How Can Dual Diagnosis Treatments for Substance Use and Schizophrenia Be Optimized?
• What Are the Treatment Considerations for Managing Schizophrenia in Young Adults?
• How Can Family Psychoeducation and Support Programs Help Improve Treatment and Outcomes in Schizophrenia?
• What Are the Social Functioning Difficulties Faced by Individuals with Schizophrenia?
• How Can Holistic Care Approaches Help Address Physical Health Comorbidities Associated with Schizophrenia?
• How Can Neuroimaging and Brain Research Advancements Contribute to Our Understanding of Schizophrenia?
• A Multimedia Presentation Explaining the Neurobiological Basis of Schizophrenia
• An infographic that Educates the Public about Early Warning Signs and Symptoms of Schizophrenia.
• A Survey Assessing the Awareness and Understanding of Schizophrenia in the School Community.
• Video Simulation Demonstrating the Experiences of Individuals Living with Schizophrenia
• Plan of a Mental Health Awareness Event to Reduce the Stigma Surrounding Schizophrenia
• Research Paper on the Impact of Family Support on Improving Outcomes of Schizophrenia Patients
• Interviews with Schizophrenia Patients and Their Families
• A Classroom Presentation on the Connection Between Creativity and Schizophrenia
• Literature Review on the Effectiveness of Cognitive Remediation Interventions for Schizophrenia
• Mental Health Awareness Campaign Focused on Schizophrenia
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• Mental Illness Research Topics
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• v.11(6); 2021 Jun

Schizophrenia outcomes in the 21st century: A systematic review

Peter huxley.

1 Centre for Mental Health and Society, School of Health Sciences, Bangor University, Bangor UK

Anne Krayer

Louise prendergast, sanjaya aryal.

2 Department of Sociology, University of Essex, Colchester UK

Richard Warner

3 Clinical Professor of Psychiatry and Adjunct Professor of Anthropology, University of Colorado, Denver CO, USA

Associated Data

The authors confirm that the data supporting the findings of this study are available within the article [and/or] its supplementary materials.

We report a review of outcomes in schizophrenia in the twenty‐first century, replicating and extending work undertaken by the late Richard Warner in his seminal book, “ Recovery from Schizophrenia: Psychiatry and Political Economy” (1985;2004).

Warner's methods were followed as closely as possible. Only observational/naturalistic studies were included. Six scientific databases were searched from 2000 to 2020. 6,640 records were retrieved. 47 met inclusion criteria.

Overall, complete recovery is higher in this study than in Warner's (37.75% cf 20.4%), especially for first episode psychosis (FEP) (57.1% cf 20.7%). Clinical recovery, annualized remission rate (ARR), and employment outcomes were significantly superior for first episode psychosis compared with multiple episode psychosis (MEP). ARR shows a trend toward reduction over time, from 2.2 before the financial crash of 2008 to 1.6 after (t = 1.85 df 40 p  = .07). The decline is statistically significant for the MEP group (t = 2.32 df 18 p  = .03). There were no differences in outcome by region, sample characteristics, outcome measures used, or quality of studies. Heterogeneity of clinical outcome measures across the literature makes evidence synthesis difficult. Weak and inconsistent reporting of functional and employment outcomes mean that findings lack meaning with respect to lived experience.

Future research strategies should aim to reduce heterogeneity in clinical outcome measures and to increase the emphasis on capture and reporting of more sophisticated measures of social and functional outcome. Outcome domains should be disaggregated rather than conflated into unitary recovery constructs.

A systematic review of the 21st century outcomes in schizophrenia.

1. INTRODUCTION

This paper reports a review of outcomes in schizophrenia in the twenty‐first century and is an extension of the work undertaken by the late Dr Richard Warner in his seminal book, “Recovery from Schizophrenia: Psychiatry and Political Economy” (1985 (Warner,  1985 ); 2004 (Warner,  2004 )). The present work was started with Dr Warner's involvement, and the preliminary results were presented at the XVII World Congress of Psychiatry in Berlin in 2017. Here, we present the final results based on research findings published between 2000 and 2020. Initially, we intended to conduct a systematic review and meta‐analysis, but study heterogeneity and paucity of data, including data capture problems and reporting weaknesses, means that meta‐analysis was not possible. The relevance of these issues is considered further below.

2. BACKGROUND

In 1985, Warner used empirical evidence to strongly challenge the prevailing view of schizophrenia, which largely arose through the influence of Kraepelin (Kendler,  2020 ), who suggested that psychosis was strongly characterized by poor clinical and social outcomes. Since then, evidence from epidemiological, sociological, psychological, and biological studies has made many aspects of the Kraepelinian model of schizophrenia unsustainable (Murray,  2017 ). Few hold to the concept of schizophrenia as a unitary disorder, or even, as Bleuler suggested when he coined the term, a distinct group of psychoses. (Bleuler and Zinkin, 1950 )

Richard Warner was one of the first to systematically bring together and analyze data from outcome studies of schizophrenia in the twentieth century. Although we (and others) regularly refer to his work in the 2004 edition of Recovery from Schizophrenia, it is important to remember that the first edition was published in 1985, almost two decades earlier. He was interested in shedding light on whether “schizophrenia is an inherently catastrophic illness from which only modern psychiatric treatment can afford relief; or that it is a condition with a considerable spontaneous recovery rate upon which treatment has little long‐term effect.” (p.60). Most importantly, he showed that conditions such as social and political attitudes and the state of the economy, “mould the course and outcome of the illness and influence, along with other factors, its incidence.” (p. xii) and by implication, outcome. Subsequent work has confirmed his challenge to the Kraepelinian notion of a dementia‐like psychotic process, mainly determined by biological factors. His work has contemporary relevance.

Warner distinguished between “complete recovery” and “social recovery.” He defined the former as loss of psychiatric symptoms and return to preillness level of functioning, where as he defined social recovery in functional terms, economic and residential independence with low social disruption, an important component of which is employment.

Since Warner's 1985 edition of Recovery from Schizophrenia, there has been intense debate over the concept of recovery. In particular, there has been controversy over the ownership of definitions of recovery; the preferred model of patient self‐definition of recovery creates methodological problems for quantitative researchers, whereas the emergence of a “Recovery Model” in statutory services has led to accusations that service definitions of “recovery” are sometimes euphemisms for withholding care and treatment. Consequently, the literature is marked by a variety of definitions of “recovery,” “complete recovery,” and “partial recovery,” some of which are agreed by some groups of researchers, some of which are idiosyncratic (Cornish,  2020 ; Liberman & Kopelowicz,  2002 ; Livingston, 2020 ). We must acknowledge the existence of these differences and their impact on our conclusions.

Warner (Warner,  2009 ) provided a neat attempt to weave the scientific and experiential approaches to “recovery” together. He rightly pointed out that “the proportion of patients considered to have recovered will depend on how rigorously recovery is defined” (p61). A number of issues of definition are of significance here. First, it seems to us that to combine both clinical remission and social function into a single recovery definition is not helpful and risks the loss of important outcome information. As Warner himself said, measures of social functioning are hard to standardize and can cover a wide range of behaviors and activities. In the experiential approach to recovery, individuals value different behaviors and activities (work, family contact etc) differently and the importance attributed to them may vary overtime. Warner hypothesized that social environment had a profound effect on the outcome of psychosis, so that circumstances that support people to social inclusion led to a virtuous cycle of improved well‐being. This being the case, his thesis was that the political economy is a key modifiable factor in improving rates of recovery. In line with this, we believe that employment status ought to receive more attention as an outcome indicator. This is not without its difficulties, which we mention later. Nevertheless, we have included employment outcomes in this review.

Second, with regard to the rigor of the definition, it is the case that the length of “recovery” needs to be defined. Warner himself did not include an explicit time criterion in his definition, although a 12 month criterion was implicit in his selection of studies. Although the Remission17 criteria for proposed evidence‐based and consensus‐based criteria for defining clinical remission does include a 6‐month time criterion, this is not adhered to in all studies.

We believe that the most satisfactory definition of “complete recovery” is clinical remission and sustained functional outcomes, which should include employment, for at least 6 months, but it is in the nature of a review of this sort that the relevant information is not always available in the public domain.

In his most recent review, Warner included 114 studies from the 1,880 to 2004. He found that recovery rates overall were little changed since the 1900s. In the last period of his review between 1976 and 1995, he separately reported on clinical recovery and social recovery for people with first episodes of psychosis (FEP) and for those who experienced multiple episodes of psychosis (MEP). In MEP, the mean complete recovery rate was 20% and social recovery 33%, which was not very different from the overall recovery rate from 1901 to 1910 (20% and 41%, respectively). In FEP, recovery occurred in 27%, and social recovery in 35%; higher compared to the earliest figure he gave (for the years 1921–1940) which were 12% and 28%, respectively. He was unable to present detailed findings for what he termed “the developing world” (that is, low‐ and middle‐income countries or LMICs), but he did break down the US and UK results. From 1976 to 1995, complete recovery occurred in 17% in the USA and 19% in the UK, while social recovery in the USA was 43% and in the UK 30%.

Since Warner's work there have been several reviews, some of which report pooled outcomes (Cohen et al.,  2008 ; Leucht & Lasser,  2006 ; Van Eck et al.,  2018 ), and two reviews of reviews (Miettunen, 2015 ; NeuRA (Neurosciences Research Australia). Remission and recovery), 2020 ). The reviews reporting pooled outcome data use very different methodologies. In fact, the heterogeneity that scholars bemoan in individual outcome studies is equally present in the reviews (cited chronologically in the Supplementary Material A ). For instance, Menezes (Menezes et al.,  2006 ) did not require included studies to report both clinical remission and social outcome and did not specify a time period for outcomes. Clemmensen et al. (Clemmensen et al.,  2012 ) looked at FEP and included patients with mood and other disorders (mixed samples) as well as some retrospective studies, hospital discharge and outpatient samples. The studies were categorized as reporting outcome by use of both the General Functioning Scale (GFS) and study‐specific functioning (SSF) outcomes. The GFS studies were categorized by the study authors as a “poor” outcome (score ≤50), “moderate” outcome (score 51–70), or “good” outcome (score >70), but there was no consistency in the use of these precise cutoff points across all studies. The authors subjectively and independently rated the SSF outcome data in the papers as “poor,” “moderate,” or “good.”

In 2003, the Remission in Schizophrenia Working Group (RSWG) (Andreasen et al.,  2005 ) proposed evidence‐based and consensus‐based criteria for defining clinical remission. Remission was defined as “a level of core symptoms (positive, negative, and disorganized) that does not interfere with an individual's behavior and is also below that required for an initial diagnosis of schizophrenia to be made according to the Diagnostic and Statistical Manual of Mental Disorder, fourth edition (DSM‐IV)” (Nasrallah & Lasser, 2006 ). AlAqeel and Margoleses’ review (AlAqeel & Margolese,  2012 ) used the RSWG criteria and included only those papers that provided data with a minimum six‐month follow‐up of patients—the length of follow‐up originally suggested by the RSWG.

Jääskeläinen et al. (Jääskeläinen et al.,  2013 ) included both clinical and social outcomes using the RSWG definition of recovery with persistence for two years. They commented on the “high” heterogeneity of recovery estimates (I 2 statistic=99.8%) and found a median annual recovery rate of 1.4%, with no statistically significant difference in outcome by gender. There was a significantly higher rate of recovery LMICs, as suggested by Warner and others (although this has been disputed by some (Cohen et al.,  2008 ) and rejoindered by others (Bromet,  2008 ; Jablensky & Sartorius,  2008 )). Their recovery figure for the 1976–1995 period (9.9%) was much lower than Warner's. They reported, however, that the strictness of the definition of recovery used had no effect on outcome results. The difference between their results and Warner's is almost certainly due to their use of a persistence criterion in the definition. We will examine the relevance of a persistence criterion in the analysis section of this paper.

Lally et al. (Lally et al.,  2017 ) included FEP studies only and used Jääskeläinen's criteria for recovery but also examined improvement persisting over one year. Studies that failed to meet the Jääskelänen criteria were designated “broad criteria.” The pooled rate of clinical remission for all included diagnoses was 58% (56% for schizophrenia). Only 23% achieved full recovery. They reported no difference in remission rates by study quality, duration of follow‐up, study setting, or use of narrow/broad remission criteria/the RSWG criteria. Recovery rates were higher in Africa (73%; 2 studies only), Asia (66%; 2 studies only), and North America (65%; 17 studies) compared with Europe and Australia. In the most recent period, 2005–2016, recovery rates remained higher but not significantly so. Miettunen (Miettunen, 2015 ) reviewed systematic reviews of schizophrenia outcomes and reported an overall recovery rate of 13.5% and also found higher rates of recovery in poorer countries. NeuRA (NeuRA (Neurosciences Research Australia). Remission and recovery, 2020 ) reported a review of six reviews conducted through three search engines (all these engines are included in our searches). They suggest that the quality of the evidence in the six reviews is at best moderate, that the overall recovery rate for schizophrenia in the 21st century has been between 13% and 16%, and that the five year outcome for first episode is 58% clinical recovery, but they do not provide pooled averages for social or employment outcomes.

We do not believe that the existence of this marked heterogeneity should be a reason to cease all comparative outcome research. In our opinion, researchers should continue to strive to reduce heterogeneity and to use indicators where greater consensus can be achieved. Employment status is one such candidate. A contextualized measure of financial strain might be another. The advantage of the present review is not that it reduces heterogeneity but that it allows a meaningful longitudinal view because, by using the same methods as Warner, it compares like with like.

Since the first edition of Warner's book, there has been a substantial increase in outcome research: in first episode psychosis (FEP), in early onset, in intervention samples, and, most recently, in high‐risk groups. This has led to intense interest in the role of duration of untreated psychosis. This variable is excluded from the present review (as there is nothing in Warner's 1985 & 2004 editions to compare it with). Since Warner's original work there has been a growing awareness of the need to incorporate other features of recovery other than simply clinical remission (Andreasen et al.,  2005 ; Emsley et al.,  2011 ; Gorwood & Peuskens,  2012 ; Harvey,  2009 ; Karow et al.,  2012 ; Lally et al.,  2017 ; Lambert et al.,  2009 ; Vita & Barlati,  2018 ). Employment is considered as an outcome in some reviews, but pooled data are not given (Cohen et al.,  2008 ). None of the reviews (summarized in the Supplementary Material A ) include employment status as an outcome indicator in spite of its growing relevance and evident support for its consideration. (Bouwmans et al.,  2015 ; Kinoshita et al.,  2010 ; Lloyd‐Evans et al.,  2013 ; Srinivasan & Thara,  1997 ; Srinivasan & Thara,  1999 ; Tsang et al.,  2010 ).

As indicated earlier, wherever the data were presented, we have included employment outcome in this review.

The purpose of the present review is to assess the extent to which Warner's conclusions, and the conclusions of subsequent reviews, hold in the twenty‐first century. Are remission rates stable, are they influenced by different definitions of remission and by different persistence criteria, are they affected by duration of follow‐up or other study features? How do clinical, social, and employment outcomes differ in MEP and FEP studies and are outcomes better in LMICs? To explore the evidence supporting Warner's hypothesis concerning the importance of changes in the political economy, we have taken the opportunity to look for any noticeable difference in outcomes for data gathered before and after the 2008 crash.

We followed Warner's methods as closely as possible. As in his original review, only observational/naturalistic studies were included, and study samples comprised at least 80% individuals with diagnoses of schizophrenia, schizophreniform, and schizoaffective disorder (i.e., broadly defined “schizophrenia”) with at least 6 months follow‐up (Warner included those of one year or over, but we adhered to the more recent RSWG criteria). In studies where a “schizophrenia” subsample of 30 or more cases was fully described independently within the paper, we used only those data. In addition, if early intervention or first episode studies included persons with a schizophrenia diagnosis and reported these results separately, then the schizophrenia group results are also included in our analysis. FEP is defined as patients who are making their first treatment contact for psychotic symptoms OR are in their first episode of psychosis AND do not meet diagnostic criteria for an affective disorder (i.e., only schizophrenia‐spectrum diagnoses included).

Exclusion criteria were as follows:

• Age <18 years old at study inception (but not for FEP studies where no lower age limit was applied).
• source not written in English language;
• clinical trials;
• primary diagnosis other than schizophrenia (e.g., bipolar disorder);
• selected outpatient and hospital discharge samples;
• retrospective studies;
• cross‐sectional studies;
• small studies ( n  < 25);
• cognitive and neurological function only assessed;
• data gathered entirely or mainly in the 20th century.

We also excluded studies where outcome ratio data could not be computed (see also Hegarty (Hegarty et al.,  1994 )). Where a study was reported in more than one paper using the same data, the paper with usable and latest results was included (as in Jääskeläinen et al. (Jääskeläinen et al.,  2013 )). In some cases where different outcomes (clinical and functional) from the same study were reported in separate papers (e.g., Addington et al. (Addington et al.,  2003 ; Addington et al.,  2003 )), both outcomes were included in the results, but the total number of subjects was adjusted to avoid double counting. Where a research group reported single study results separately for MEP and FEP cases, we entered both sets of results into the analysis, but did not double count respondents. We examined four types of outcome: clinical; social; complete recovery (which we defined as meeting both RSWP and Warner criteria), and employment (measures of social recovery are listed in Supplementary Material B ). Given Warner's thesis regarding the influence of the political economy, we felt it was important to consider social and employment outcomes (employed/not) as well as clinical outcome, and complete recovery (as defined above). In some studies, the only usable outcome data were on employment (Segarra et al.,  2012 ). The abrupt contextual changes in the global economy in 2008 (the generally accepted date of the global financial crash) created an opportunity to assess any changes from pre‐ to postcrisis.

RW and PH began the search and review process, using Warner's inclusion and exclusion criteria and made decisions jointly whether to include or exclude studies. At this stage (2015–6), more than 700 papers were under review. Warner's untimely death occurred before the process could be completed. Searches were undertaken again in 2017–18 and updated in 2020.

• • Search terms : terms schizo* OR psychos*s OR psychotic AND recovery OR outcome* OR remission OR longitudinal OR course OR follow‐up in a title search.
• •Period: 1 Jan 2000‐30 June 2020
• •Science Direct
• •Proquest (Social Sciences Collection)
• •PsycArticles
• •Cinahl (Ebscohost)
• •Medline (Ebscohost)
• •Web of Science (Biosis, Core, Scielo)

Decisions on study inclusion were undertaken in pairs between PH, AK, SA, and LP. In all cases where it was possible, the decisions were confirmed by reference to Warner's own notes shared with PH in 2016. In the event of disagreement, a third opinion was sought from one of the other authors of this paper.

To explore any impact of the financial crash, we divided the studies into those where data collection was entirely completed before 2008, and those whose data were collected entirely after 2008. Remaining studies where data collection included 2008 were assigned to the period in which the majority of data were gathered.

We also divided the studies depending upon their definition of outcome and recovery. We contrasted studies using the RSWG definition of clinical remission (Andreasen et al.,  2005 ) and those that did not. The location of the study was examined categorizing data collection areas into Europe, North America, and the rest of the world (a catch‐all necessitated by low numbers of studies). We further compared outcomes in first episode psychosis (FEP) or early intervention study samples with all outcomes in non‐FEP/Early Intervention studies, labeled various or multiple episodes of psychosis (MEP) (called “mixed duration” by Warner). Length of follow‐up was divided into 6 months (our minimum) or longer than 6 months. Where follow‐up was repeated at more than one time point, the final assessment was used. This enabled us to include the longest available outcomes while avoiding double counting.

3.1. Statistical procedures

Recovery estimates are presented as pooled averages or as medians. For change over time, we used the same year categories as Warner. For economic comparisons, we used the per capita income statistics as recommended by Cohen et al. (Cohen et al.,  2008 ) based on the latest figures provided by the World Bank ( World Bank ). Analysis by regions compared studies conducted in the USA, Europe, and the rest of the world. For comparisons by definition of recovery, we used the Andreasen et al. criteria (2005) (Andreasen et al.,  2005 ) (RSWG) versus studies using other definitions. Warner did not include an explicit persistence criterion in his definition of recovery but others have done, and so we examine all the outcomes by the persistence criterion used in the included studies, using analysis of variance. In relation to study quality, we followed the MOOSE criteria for meta‐analysis in observational studies (Stroup et al.,  2000 ) and consulted subsequent relevant guidance (Aromataris and Munn, 2020 ; Briggs,  2017 ; Deeks et al.,  2008 ; Huedo‐Medina et al.,  2006 ).

Variable distributions were checked. Skewed variables were transformed appropriately, for example, the social/functional outcome variable. Annualized recovery rate was calculated by dividing the remission rate by the length of follow‐up (see Jääskeläinen et al. 2013) (Jääskeläinen et al.,  2013 ). Means of the independent continuous outcome variables were analyzed in relation to the dependent variables using t tests or one‐way ANOVA, and relationships between continuous variables by correlational analysis. Heterogeneity was tested using the I 2 statistic.

A total of 47 studies (Addington et al.,  2012 ; Addington & Addington,  2008 ; Addington, Leriger, et al.,  2003 ; Addington, Young, et al.,  2003 ; Alem et al.,  2009 ; Arceo & Ulloa, 2019 ; Bachmann et al.,  2007 ; Bodén et al.,  2014 ; Carter et al.,  2011 ; Češková et al., 2007 , 2011 ; Chan et al., 2015 , 2019 ; Chang et al.,  2014 ; Chua et al.,  2019 ; Economou et al.,  2011 ; Giraud‐Baro et al.,  2016 ; Hassan & Taha,  2011 ; Heering et al.,  2015 ; Hegelstad et al.,  2012 ; Jaracz et al.,  2015 ; Johansson et al.,  2018 ; Johnson et al.,  2012 ; Kebede et al.,  2005 ; Kurihara et al.,  2011 ; Lauronen et al.,  2007 ; Malla et al.,  2002 , 2006 ; Mattsson et al.,  2008 ; Norman et al., 2014 , 2018 ; Revier et al.,  2015 ; Ritsner et al.,  2014 ; Ruggeri et al.,  2004 ; Saravanan et al.,  2010 ; Schennach et al.,  2020 ; Segarra et al.,  2012 ; Shibre et al.,  2015 ; Singh et al.,  2007 ; Spellmann et al.,  2012 ; Strålin et al., October 2018 ; Suresh et al.,  2012 ; Torgalsbøen et al.,  2014 ; Üçok et al.,  2011 ; Verdoux et al.,  2010 ; Verma et al.,  2012 ; Whitty et al.,  2008 ; Wolter et al.,  2010 ) (full details are given in Supplementary Material B ) met the inclusion criteria and provided data for year of study, definition of outcome, stage of illness, length of follow‐up (in all but one instance follow‐up was 12 months or more), and region (Figure ​ (Figure1 1 ).

Search strategy

Some of these gave only functional or employment outcomes. In three instances, the study reported separate data for two outcomes. Accordingly, 50 data sets were entered into the analysis. The number of studies that followed the Warner criteria for clinical remission was 43. The clinical results below are based on these 43 studies unless otherwise specified. In some other studies, data were presented in a format that could not be interpreted for our present purposes. Such studies usually involved the use of predictive regression models, and raw outcome data were not reported. In all instances, we attempted to, but were unable to, access the raw data. Examples of the types of studies excluded are given in the Supplementary Material C .

The total number of (unduplicated) participants is 13,430 (FEP: 6,049; MEP: 7,381). Clinical outcome was reported in 43 papers (11,048 participants), functional or social outcomes in 20 papers (5,602 participants), and employment outcomes in 23 papers (9,990 participants). Since we are interested in changes in the recent past, our outcomes are reported in table  1 alongside Warner's (2004) results from the latter part of the 20th century, that is, 1945–2000 (derived from Warner 2004; Table 3.1 pages 64–76).

Complete and social recovery: comparison of 20th and 21st century studies

Abbreviations: FEP, First episode psychosis; MEP, Multi Episode Psychosis.

4.1. Study quality

There was no relationship between the quality rating and any of the outcome measures, including clinical outcomes (t = 1.379 df 41 p  =.175; mean difference =8.817; SE diff=6.394 95% CI −4.095 to 21.730). The Jääskeläinen review (Jääskeläinen et al.,  2013 ) found considerable heterogeneity in the recovery rate (I 2 statistic =99.8%), and we too found high heterogeneity in the clinical outcome variable in our included studies (I 2 statistic =97.1%).

4.2. Definition used

Most of the studies used the RSWG criteria, but a very few added the duration requirement, some at 6 months, (Heering et al.,  2015 ; Kurihara et al.,  2011 ) some one year, (Wolter et al.,  2010 ) and others required two years. (Schennach et al.,  2020 ) A comparison between groups of studies that had no duration criterion (36%), or a criterion of six months (42%), or a criterion of twelve months or more (22%) showed no significant differences in any outcome. The outcomes for those studies that used RSWG criteria compared to those using “other” criteria also showed no differences. In all outcomes, the “other” definitions had better outcomes by a few percentage points, with the exception of ARR which was higher in the RSWG studies (ARR 2.2 cf 1.9) but was not significant.

4.3. Clinical and social outcomes and stage of illness

Table  1 shows the mean (pooled average) outcomes in the original Warner work (from post‐World War Two to the end of the century) together with the 21st century results from the present review. Complete recovery improves significantly in the MEP group, but social recovery is not significantly improved in either MEP or FEP. The most striking feature is the significantly higher complete recovery rate (57%) in FEP studies in the present review.

Warner presented the recovery data by decade, and Jääskeläinen et al. (Jääskeläinen et al.,  2013 ) did the same. By their own account, the latter authors used a stricter definition of recovery. We reanalyzed Warner's data to obtain the median recovery rates of FEP and ME by decade, and these are presented in Table  2 .

Comparison of median (%) recovery rate by decades

Data derived from Warner 2004 (Warner,  2004 ); Table 3.1 pages 64–76

Our figures for the first two decades of the 21st century continue trend of improvement previously reported by Warner. Our median is 54.0%. This is consistent with the mean figures given in Table  1 . Similarly, our median for MEP is also considerably improved at 33.45 and is a return to the median levels Warner observed between 1941 and 1955. Possible reasons for these changes are considered in the discussion.

4.4. Annualized recovery rate (ARR)

Using the ARR as defined by Jääskeläinen and colleagues(Jääskeläinen et al.,  2013 ), (who found a median ARR of 1.4%) we found a median ARR of 2.2%. Warner's median ARR for the last period in his review (1980 to 2000) was 2.9. In our data, the ARR shows a trend toward significant reduction over time, reducing to 1.6 after the financial crash of 2008 from 2.2 before (t = 1.85 df 40 p  =.07). The reduction is statistically significant for the MEP group (t = 2.32 df 18 p  =.03).

Table  3 compares all the outcomes for the MEP and FEP groups in our review. Because ARR and social outcome were both skewed, we used log‐transformed variables. Clinical remission, the annualized recovery rate, and employment are all significantly superior for the FEP group, but social outcome is not.

Multiple episode compared to first episode outcomes

4.5. Location

While there is a trend for employment outcome rate to be better in the rest of the world (45% sd 19.9; 8 papers) than in Europe (38.6% sd 18.9; 19 papers) and North America (35.4% sd 24.6; 5 papers), there is no statistically significant relationship between any of the outcomes and region. There was no difference in the regional annualized recovery rate. This result holds for both FEP and MEP studies. Using RSWG studies only, there are still no significant differences by region.

Comparing the 5 LMIC countries with the HICs showed that only employment was significantly different (better in LMIC t = 2.18 df 30 p  =.037).

4.6. Sample characteristics (Sample size, % male, % follow‐up, and length follow‐up)

There are no significant associations between these variable (sample size, gender distribution, percentage followed up, and length of follow‐up) and any outcome measure. The results are the same in both the MEP and FEP groups.

4.7. Measures used

PANSS was the most commonly used clinical outcome measure (62.5% of studies). GAF was the most commonly used functional outcome measure (39.3% of studies). There are no differences in clinical, social, employment, or ARR outcomes in either MEP or FEP cases when PANSS and GAF are used compared to the other measures used.

4.8. Year of data collection

In studies conducted after 2008, good clinical and employment outcomes both decline. Functional outcome improves, but the functional data are highly skewed. Although positive clinical outcome is reduced from a pooled average of 49% before 2008 to 45.6% after, this change is not significant. Employment outcome is markedly worse after the crash (employed 34.9%) than before (employed 42.3%) (as one would expect), but this is not statistically significant. These findings apply to both the FEP and MEP groups.

5. DISCUSSION

Our review has some limitations. The most significant of these is heterogeneity of methods and outcome criteria between studies. This is a limitation which is intrinsic to reviews of naturalistic outcome studies, and it has affected all of the previous reviews. It precludes overconfident conclusions or a claim of definitive findings, especially in those subanalyses where the number of studies is small. While most of our results are indicative only, they do shed light on the multifaceted nature of recovery and on important temporal trends.

This review of 21st century studies tends to confirm one of Warner's key assertions that a significant proportion of people who receive a schizophrenia diagnosis make a good recovery. There are some significant new findings. Generally speaking, these do not reach statistical significance owing to wide confidence intervals, but they resonate with many other findings on the impact of poverty, employment, and other social factors (Wolter et al.,  2010 ).

While we have found that rates of complete recovery have increased substantially for people experiencing a first episode of psychosis in the 21st century, not all of our findings are positive. Findings by both Warner and Jääskeläinen showed decreasing annualized rates of recovery over time, and we have found a continuing decline in ARR since Warner's review. Differences in method and criteria almost certainly account for differences in their figures, particularly the use of a persistence criterion by Jääskeläinen. Nonetheless, the trend is the same in all three reviews.

People with multiple episodes fare much worse than people who respond well to intervention for FEP (Table  1 ). While it has long been recognized that relapse increases the risk of subsequent relapse, something appears to have changed. It is reasonable to speculate that this might be due to changed priorities in mental health policy since the end of the era of deinstitutionalization (roughly 1955–1995). High‐income countries (HICs) have made huge efforts to improve outcomes from FEPs. There has been substantial investment in specialist FEP/early intervention services, which contrasts starkly with disinvestment, loss of research interest and, some would say, neglect of rehabilitation and other services for people with MEP. (Poole et al.,  2013 ).

There is an apparent paradox that an improved rate of complete recovery has been accompanied by a deteriorating ARR. The same clinical and research focus on FEP in the UK and USA might account for this. It is possible that better early intervention on first presentation of psychosis results in an increasingly high proportion of those who will achieve recovery experiencing this immediately, with a consequent reduction in recovery rates for those who relapse, who predominate in the annualized sample. A similar explanation is unrelated to treatment. Overtime, changes in social attitudes may mean that a history of a single episode of psychosis may have become less marginalizing, say with respect to employment, but that recurrent episodes, with attendant disruption to employment and housing, have a much more marginalizing effect, a poor social outcome then contributing to poor clinical outcome.

A further temporal change is a trend toward better outcomes prior to the 2008 crash, and for this to decline somewhat afterward. Both findings are compatible with Warner's emphasis on the political economy as a key factor influencing people's ability to recover. Warner notes (pp38‐40) that when the business cycle goes into recovery, patients in the low income groups disproportionately pay the psychological price of adapting to new jobs, in new locations, with new colleagues, all of which result in new illnesses or the exacerbation of existing ones.

There is a trend to better outcomes in the non‐UK non‐US studies, but this is hard to interpret. The category includes data from LMICs and some HICs, and the number is very small. The finding is of interest, but cannot be taken to show that recovery rates are better in LMICs. More importance can be attached to the fact that, overall, participants in the non‐UK non‐US group probably had poorer access to treatment. If treatment accounted for improved outcomes, you would expect the trend in this group to be in the opposite direction to one we have found.

The same caveats must attach to the finding of a trend toward better employment outcomes in non‐UK non‐US studies, but there may be an important factor relating to better but less formal employment opportunities in LMIC settings. Although we cannot say that outcomes in LMICs are better, our review lends no credence to the idea that LMIC outcomes are worse. Warner took the view that outcomes were better in the developing world, and our limited findings are congruent with other recent findings (Jääskeläinen et al.,  2013 ; Killaspy & Priebe,  2020 ; Miettunen, 2015 ).

Our findings of changes in outcomes over time, with possible attenuation of improvements in HICs after 2008 and outcomes probably no worse in LMICs (possible better), tend to suggest that Warner was right and that social factors are key determinants of recovery. It may be argued that a definition of recovery that includes employment will inevitably become less common in hard times, but this misses the point. Recovery and context cannot be separated. As suggested above, sustained employment is a measure of recovery, but employment is also known to improve clinical outcomes.

There must be some caution about the impact of the 2008 crash. Doubtless, its effects took time to work through. The collapse of the Lehman Brothers Bank (the first sign of problems) was in 2006. Arguably, studies conducted shortly after 2008 were less affected by the crash than those reporting later. It is, of course, possible to make other assumptions and take other cutoff points and the data are available for those who wish to do that. Also, it can be argued that the period since 2008 is too short to reveal significant differences in all of the outcomes.

Comparison of our findings and Warner's original findings shows significant improvements in rates of recovery FEP, with more disappointing results for MEP, especially post‐2008. There appears to have been no real improvement in social outcomes for either FEP or MEP. Rates of recovery are lower when a length of recovery criterion is applied, but trends are unaffected. Taken with Warner's, Miettunen's ( Miettunen, 2015 ) and Jääskeläinen's (Jääskeläinen et al.,  2013 ) findings, there may be a consistent decline in annualized recovery rates decade by decade. The research synthesis literature has found no consistent increases in recovery when defined solely by changes in clinical symptoms. As the published data do not permit robust analysis of social or employment outcomes, there is a pressing need, noted by other authors, for improvements in the capture and reporting of clinical and social outcomes. A reduction in methodological heterogeneity of studies would be a major step forward, with adoption of standard definitions of functional recovery and social outcomes. Having said that, we were unable to show that the greater homogeneity produced by using the RSWG standard definition of recovery led to any differences in reported outcomes compared to other definitions.

Our understanding of functional outcomes would be improved if employment outcomes were disaggregated into meaningful categories of type, length, security of employment, and remuneration rates. This is important for the evaluation of social interventions and system‐wide service improvements. Warner would strongly approve of such a development. One could argue on the basis of this and other reviews that a more profitable way forward might be to think in terms of outcome profiles based on several functional and clinical measures rather than conflating them as many definitions of “recovery” do.

To conclude, there is growing recognition that “outcome” is most meaningfully understood in terms of social parameters. A new approach is needed that does not ignore the biological and psychological aspects of psychosis but does place both causation and intervention firmly in their social context. Psychosis is a disorder where onset, course, and outcomes are profoundly affected by social factors. Recovery can only meaningfully be understood as a social phenomenon.

CONFLICT OF INTEREST

None declared

• During the 21st century, the trend of improvement in rates of recovery appears to have continued, irrespective of how recovery is defined.
• Outcomes for first episode psychosis appear to be far better than for multi‐episode psychosis, which may be due to improvements in intervention, social attitudes, both, or neither. The predominance of multi‐episode individuals in annualized recovery rate data may account for the paradoxical deterioration in this parameter.
• Changes in the political economy appear to have an immediate impact in slow improvements in recovery rates, emphasizing the central importance of social factors.

LIMITATIONS

• The studies included are highly heterogenous with respect to definitions of recovery and reporting of outcome parameters. Measures of social recovery tend to be crude or omitted altogether.
• The degree of heterogeneity in the literature precludes meta‐analysis
• All studies included are naturalistic, which improves relevance to clinical practice, but makes interpretation of impact of specific factors more difficult.

PEER REVIEW

The peer review history for this article is available at https://publons.com/publon/10.1002/brb3.2172 .

Supporting information

Supplementary Material A

Supplementary Material B

Supplementary Material C

Huxley P, Krayer A, Poole R, Prendergast L, Aryal S, Warner R. Schizophrenia outcomes in the 21st century: A systematic review . Brain Behav . 2021; 11 :e02172. 10.1002/brb3.2172 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]

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Schizophrenia - Essay Samples And Topic Ideas For Free

Argumentative essays can be prepared on different subjects and reveal different issues of the science branch. Medicine is among the most popular sciences that medical college or university students choose. They can be asked to describe different types of illnesses: a symptom, conditions of progression, and methods to handle them. If you are given to craft an essay about Schizophrenia, we recommend you get familiar with our list of argumentative essay topics to opt for the unique one. Then, you can find some essay examples on Schizophrenia to understand how to accurately provide your research and content.

Schizophrenia is a disease that leads to a psychological disorder. Such diseases affect a person’s health, and they can experience hallucinations. To be able to uncover the entire topic, you should explore many sources and use writing samples. You can also find a documentary movie that reflects the life of people diagnosed with Schizophrenia. We understand how difficult it can be to keep all information in your head. That’s why it is advisable to draw an outline and fix there all your ideas about your topic. It is important to organize your content through an introduction, main body, and conclusion. When determining thesis statements, mention them in the introductory part and conclude them. You can find a research paper example about Schizophrenia on our platform.

Two Different Approaches Used to Explain the Psychological Phenomenon of Schizophrenia

Schizophrenia is a very rare psychological disorder or brain condition that a significantly small number of people. This disorders most common symptoms include hallucinations or hearing voices, and having a hard time with concentrating or thinking. When most people think of someone having Schizophrenia, they think of a person who is crazy or not in their ""right mind,"" which is not really the case. Sometimes, Schizophrenia is also often mistaken for Dissociative Identity Disorder, which can be similar in a […]

Schizophrenia – the Beautiful Mind of John Forbes Nash Jr.

Patient's Information John Forbes Nash, Jr. was born in 1928 in Bluefield, West Virginia to John Forbes Nash Senior, an electrical engineer, and Margaret Virginia Nash, a school teacher. According to his biographer Sylvia Nasar, Nash's upbringing was stable and he benefited from his parents' middle-upper class status. Although socially awkward, Nash excelled in mathematics and was described as a mathematical genius by his professors. After attending the Carnegie Institute of Technology, Nash began graduate school at Princeton University in […]

A Psychological Diagnosis of John Wayne Gacy

In 1942, a baby was born in a Chicago hospital, named John Wayne Gacy. He came from what seemed like a normal family. He grew up with his two sisters, his mother, and his father. However, no one knew that Gacy's father was both verbally and physically abusing him. This would ultimately affect Gacy for the rest of his life. In 1968, Gacy was indicted by a grand jury for allegedly committing the act of sodomy with a young teenage […]

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Cognitive Behavioral Therapy for Schizophrenia

Schizophrenia is a major psychiatric disorder, or cluster of disorders, characterized by psychotic symptoms that alter a person's perception, thoughts, affect and behavior (NICE, 2009). Tai and Turkington (2009) define Cognitive Behavior Therapy (CBT) as an evidence-based talking therapy that attempts cognitive and behavioral change, based on an individualized formulation of a client's personal history, problems and world views. CBT was built on behavioral principles that emphasized clear relationships between cognition, physiology and emotion (Beck, 1952). This essay will look […]

Schizophrenia: Mind and Mental Health

Psychological clarity is something that everyone strives for. A mind that is free from abundant clutter and jumbled thoughts that bring on stress and negativity. Everyone wants a mind that is able to recognize what is presented to it. A reliable psyche that is free from hallucinations and unwanted paranoia. Even though clarity can be achieved, certain illnesses can hinder individuals from reaching it. There are a multitude of disorders that affect the mind in more ways than one. The […]

The Wrongful Conviction of Charles Milles Manson

The first: Charles Manson as the ringleader, the main man, the cult king. He ordered his followers to do everything. The other, a group of middle aged "hippies" caught up in heavy drug use committed all the murders. They later accused a mentally ill man who was a delusional schizophrenic that they took in as a mascot, of orchestrating all the murders. Carrie Leonetti provides a wonderful argument and presents many facts and statistics as to how Charles Manson could […]

The Causes Effects and Treatments of Schizophrenia

Schizophrenia is a very complex, chronic mental health disorder. It is often characterized by displaying multiple symptoms which may include, but are not limited to, delusions, hallucinations, disorganized behavior and/or speech, and impaired cognitive ability. Schizophrenia affects about 1% of the population at some point in their lifetime (Patel, Cherian, Gohil, & Atkinson, 2014). The current Diagnostic and Statistical Manual of Mental Disorders (DSM-V) describes schizophrenia as an illness that displays psychotic symptoms and significant interpersonal or occupational dysfunction that […]

Schizophrenia – a Genetic and Environmental Review

Introduction Schizophrenia is defined as "a severe brain disorder characterized by disturbances of thoughts, perceptions, volition, and cognition, which affects about 1% of the world population today" (Ozawa et al., 2006, p. 546). The disorder can be incapacitating to those who live with it, preventing normal societal function. Despite its frequency in the population, scientists and medical professionals still struggle to find a conclusive explanation for why some people develop schizophrenia. This may be, in part, due to its ties […]

Schizophrenia: Definition, Symptoms, Causes

Schizophrenia alters how a person thinks, feels, and acts, making it hard for them to differentiate between reality and imagination. Individuals with schizophrenia can often become unresponsive or withdrawn, making it difficult to establish personal and professional relationships (Haycoco, 2009). Contrary to popular misconception, schizophrenia is not a split or multiple personality disorder. Most people with schizophrenia are non-violent and do not pose a danger to others (Mental Health America, 2013). People with schizophrenia may conjure up details about people […]

Schizophrenia in the United States

In the United States, schizophrenia is one of the most prevalent mental health disorders that Americans suffer from daily. Those who deal with such a debilitating disorder go through a variety of different symptoms that can be classified in three categories, positive, negative and cognitive. Initial symptoms of schizophrenia-like irritability and the inability to sleep may cause alarm before a diagnosis is made. Positive symptoms of schizophrenia, those symptoms that are not usually present, can include hallucinations and delusions ("How […]

Schizophrenia and Substance Abuse

Up to 60 percent of chronic schizophrenic patients have been reported to be substance abusers (Hambrecht 1). The comorbidity of drugs and alcohol asks the question if one disorder causes another disorder. From a collected sample of 232 schizophrenic patients, alcohol abuse prior to admission was found in 24 percent (Hambrecht 2). Whereas, drug abuse was found in 14 percent. These rates are two times higher than the rates in the general population (Hambrecht 2). Both alcohol and drug abused […]

Emotions and Schizophrenia

Do you know anyone with a mental disorder? Have you ever felt nervous around them? Do you feel it is hard to understand their feelings? Let me tell you about schizophrenia. I decided to further research schizophrenia when one of my brothers was diagnosed with it a couple of years ago. It was weird at first because I didn't feel comfortable around him due to the way he was acting. Even though it wasn't in a harmful way, I never […]

What is Schizophrenia?

Schizophrenia is a chronic mental disease that drastically affects how a person thinks, feels, and behaves. People with schizophrenia often seem disconnected from reality, with a long list of symptoms that significantly change the lives of those it affects. Throughout history, society has held resentment for the mentally ill and discriminated against them in terrible ways. Following the classification of schizophrenia, the disease became gravely misunderstood by the public. Society harshly stigmatized people with schizophrenia because of the extensive list […]

Schizophrenia: Chronic and Severe Mental Disorders

As we know, schizophrenia and its spectrum disorders are chronic and severe mental disorders that affect an individual in many aspects of life. These disorders impact the ability to think and feel and also affect behavior. This means that people with schizophrenia may seem as if they have lost touch with reality. Sometimes, diagnoses can be difficult as there are no specific tests and the only way to identify it is to recognize symptoms that negatively impact an individual's social […]

Portrayals of Schizophrenia by Media

In media portrayal of schizophrenia, such as A Beautiful Mind, schizophrenic characters are depicted as dangerous, violent, distrusting, paranoid, awkward, and unstable people that need to be hospitalized due to exaggerated delusions and hallucinations. Not only does this stigmatize the diagnosis, but it also inflates the reality of knowing someone with the diagnosis. In actuality, schizophrenia shares many of the same characteristics as other disorders such as OCD, depression, anxiety, and ADD, yet none of these disorders have a more […]

Bipolar Disorder and Schizophrenia

Bipolar disorder and schizophrenia affect many people. According to Mahoney (2017), over 2.5 million Americans over the age of 18 are believed to be living with bipolar I or bipolar II disorder. This does not include those who have not been diagnosed properly due to misinformation about symptoms. Schizophrenia affects approximately one percent of people worldwide, impacting men and women equally. Schizophrenia can strike anyone and usually occurs between the late teenage years and thirty years of age. Males typically […]

Living with Schizophrenia

In today's modern world, research has found and diagnosed multiple mental illnesses. Through this spread of information, psychologists generated Schizophrenia. According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Schizophrenia involves a range of cognitive, behavioral, and emotional symptoms, and can be difficult to diagnose. There is no test for it, resulting in the diagnoses involving the recognition of negative symptoms that impact social functioning. These symptoms include diminished emotional expression, delusions, and hallucinations, etc. all for […]

Mental Disorder: Schizophrenia

Schizophrenia is a mental disorder that affects many adults all around the world. It is usually diagnosed between the late teenage years and early 20s. Even though Schizophrenia is a mental disorder, it affects the entire body as well. It also has many symptoms that are usually misinterpreted and portrayed incorrectly in movies and everyday life. Schizophrenia is described as a mental disorder that makes the person suffering it seem like they are detached from reality. They usually experience delusions, […]

Schizophrenia and Problems in Everyday Lives

People with schizophrenia have a lot of struggles in their everyday lives. Their minds work differently than the average, mentally sound individual. Schizophrenia is defined as a long-term mental disorder of a type involving a breakdown in the relation between thought, emotion, and behavior, leading to faulty perception, inappropriate actions and feelings, withdrawal from reality and personal relationships into fantasy and delusion, and a sense of mental fragmentation (Oxford English Dictionary). Some examples of schizophrenia symptoms consist of delusion, hallucinations, […]

Modern Plague Vs Schizophrenia

Although the cause is unknown, this mental illness can be developed through factors such as genetics, brain chemistry, brain abnormality and environmental factors."" Schizophrenia affects more than 21 million people worldwide. Scientists are still unable to locate the cause of this disorder. Symptoms of this disorder include hallucinations, abnormal behavior, inability to complete activities, lack of pleasure, and emotional flatness. Although a cure has not yet been discovered, treatments may help. Even though the cause is unknown and the disease […]

Negative Symptoms of Schizophrenia

Mental health illnesses affect many people worldwide, among them is schizophrenia which is a chronic mental health disorder that affects a person's brain. Patients with schizophrenia can experience various symptoms as well as functional impairments. Symptoms include delusions, trouble concentrating, and hallucinations (Parekha, 2017). Schizophrenia also interferes with activities of daily living, social interactions, and occupational performance. Most patients will require financial assistance to help support themselves, because only a very low percentage of people are able to work full […]

Schizophrenia: Mental Illness that Controls how a Person Thinks, Behaves and Feels

When you have schizophrenia you lose touch with reality. You make things up and start to hallucinate and began to get violent. You can start feeling irritated and get mad easily at the person near or by you. It can be hard to handle a person with schizophrenia they can sometimes be intolerable, when dealing with someone with schizophrenia you need to keep an eye on them at all times. Schizophrenia normally starts between the ages of 16 and 30, […]

Growth Patterns and Risk of Schizophrenia

In the introduction of this article called Growth Patterns and Risk of Schizophrenia, it mentions how the growth and nutrition of a fetus can play a part that leads to schizophrenia. It includes, that during the fetal development stage if there is malnutrition can lead a higher risk of the baby developing schizophrenia The studies involve with adult height, weight, or growth patterns. In continuation it mentions that birth weight has an effect when it comes to disorders later in […]

Schizophrenia Symptoms and Treatment in a Beautiful Mind

The film A Beautiful Mind chronicles the adult life of John Nash Jr., a Nobel Prize recipient widely regarded as a brilliant mathematician who greatly influenced modern economic theory. The film focuses on Nash's decades long struggle with paranoid schizophrenia after he receives a diagnosis in 1958. Although it is well known that Nash was diagnosed with schizophrenia in real life, I will use this paper to discuss specific symptoms portrayed in the film, and consider how his treatment and […]

Age of Onset of Schizophrenia

Schizophrenia, which occurs in late adulthood, is characterized as a mental health disorder marked by psychotic features, disrupted relationships, and thought processes that disturb a person's mood, thoughts, and behavior. It affects approximately 1.1% of the world's population, or about three and a half million Americans (About Schizophrenia, 2018). Schizophrenia, a disease that impairs neurocognitive functioning (Snyder, 2013), requires long-term treatment given the varying severity of symptoms across different age groups. Affected individuals may suffer from delusions, false beliefs such […]

Schizophrenia and Stigma

While there are a variety of feasible and effective programs to reduce stigmatization among health professionals in mental health related areas, there are several other strategies that can be put in place by health professionals to counter stigmatization within the population. Thornicroft (2006) identifies some of them. First, health professionals would benefit from getting more involved in the media to properly inform the public about mental health issues. The media, often overly sensational, convey negative images of violence, weakness, and […]

A Beautiful Mind Summary: John Nash’s Struggle with Schizophrenia

A Beautiful Mind Summary: Hallucinations In the movie A Beautiful Mind, they bring forth multiple symptoms of schizophrenia. One of the most apparent symptoms shown is Johns's hallucinations. Hallucinations are "the experiencing of sights, sounds, or other perceptions in the absence of external stimuli." In Johns's case, in the movie, he heard as well as saw things that weren't real. The voices that he heard would talk directly to him, giving him commands and tasks to accomplish as well as […]

Decoding the Enigma: a Journey through the DSM-5 Labyrinth of Schizophrenia

Schizophrenia, a labyrinthine puzzle of the mind, has captured the intrigue of both scholars and practitioners for generations. Within the intricate tapestry of psychiatric literature, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), stands as a guiding compass for understanding this enigmatic condition. Yet, delving into its depths requires more than mere academic prowess; it demands a voyage through the complexities of human experience and perception. At the heart of the DSM-5 criteria for schizophrenia lies the […]

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How To Write an Essay About Schizophrenia

Understanding schizophrenia.

Before starting an essay about schizophrenia, it's important to have a comprehensive understanding of this mental disorder. Schizophrenia is a chronic and severe mental disorder that affects how a person thinks, feels, and behaves. It's characterized by distortions in thinking, perception, emotions, language, sense of self, and behavior. Begin your essay by explaining the symptoms of schizophrenia, which can include hallucinations, delusions, disorganized thinking and speech, and impaired cognitive ability. Discuss the known causes of schizophrenia, such as genetic factors, brain chemistry, and environmental influences. Also, explore the impact of schizophrenia on individuals' daily lives, including social interactions, employment, and self-care challenges.

Developing a Thesis Statement

A strong essay on schizophrenia should be centered around a clear, concise thesis statement. This statement should present a specific viewpoint or argument about schizophrenia. For example, you might discuss the challenges in diagnosing and treating schizophrenia, analyze the social stigma associated with the disorder, or explore the latest research in understanding its underlying causes. Your thesis will guide the direction of your essay and provide a structured approach to your analysis.

Gathering Supporting Evidence

To support your thesis, gather evidence from credible sources, such as medical journals, research studies, and healthcare professionals. This might include data on the prevalence of schizophrenia, treatment success rates, or personal narratives from individuals living with schizophrenia. Use this evidence to support your thesis and build a persuasive argument. Remember to consider different perspectives and address potential counterarguments to your thesis.

Analyzing Treatments and Challenges

Dedicate a section of your essay to analyzing the treatments available for schizophrenia and the challenges associated with them. Discuss various treatment methods, such as antipsychotic medications, psychotherapy, and community support. Explore the benefits and limitations of these treatments and the challenges patients face, such as medication side effects and the ongoing need for support and care. Additionally, consider the impact of societal attitudes and healthcare policies on the treatment and management of schizophrenia.

Concluding the Essay

Conclude your essay by summarizing the main points of your discussion and restating your thesis in light of the evidence provided. Your conclusion should tie together your analysis and emphasize the importance of understanding and effectively addressing schizophrenia in society. You might also want to suggest areas for future research or policy improvements that could benefit individuals with schizophrenia.

Reviewing and Refining Your Essay

After completing your essay, review and refine it for clarity and coherence. Ensure that your arguments are well-structured and supported by evidence. Check for grammatical accuracy and ensure that your essay flows logically from one point to the next. Consider seeking feedback from peers or mental health professionals to further improve your essay. A well-crafted essay on schizophrenia will not only demonstrate your understanding of the disorder but also your ability to engage with complex medical and social issues.

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Home — Essay Samples — Nursing & Health — Psychiatry & Mental Health — Schizophrenia

Essays About Schizophrenia

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The History of Schizophrenia

Analysis of the symptoms of schizophrenia, biopsychosocial influences on schizophrenia, an examination of the six mental illnesses and its impact on human life, let us write you an essay from scratch.

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A Case Study on The Mental Illness of Mr. Nash and The Treatment Plan for His Schizophrenia

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Schizoaffective Disorder: The Bridge Between Schizophrenia and Bipolar

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Schizophrenia is a chronic and severe mental disorder characterized by a profound disruption in thinking, perception, emotions, and behavior. It affects approximately 1% of the global population and typically emerges in late adolescence or early adulthood. Individuals with schizophrenia often experience a range of symptoms that can significantly impair their ability to function in various aspects of life.

Delusions: People with schizophrenia often experience delusions, which are fixed false beliefs that are not based in reality. These delusions can be paranoid, grandiose, or related to persecution. Hallucinations: Another common characteristic of schizophrenia is hallucinations, particularly auditory hallucinations. These involve hearing voices or sounds that are not actually present. Disorganized thinking: Schizophrenia can lead to disorganized thinking, making it difficult for individuals to maintain a logical thought process or communicate coherently. They may jump between unrelated topics or exhibit incoherent speech. Negative symptoms: Negative symptoms refer to a decrease or loss of normal functions. These may include a lack of motivation, decreased emotional expression, social withdrawal, and reduced ability to carry out everyday tasks. Cognitive impairments: Schizophrenia can also impact cognitive abilities such as attention, memory, and problem-solving. This can make it challenging for individuals to focus, learn, and make decisions. Impact on daily functioning: Schizophrenia can significantly interfere with an individual's ability to function in daily life. It can disrupt relationships, work or educational performance, and self-care.

Genetics: There is a strong genetic component to schizophrenia, as individuals with a family history of the disorder have a higher risk of developing it. Certain genes and gene variations are associated with an increased susceptibility to schizophrenia. Brain chemistry and structure: Imbalances in brain chemicals, specifically dopamine and glutamate, have been implicated in schizophrenia. Structural abnormalities in the brain, such as enlarged ventricles and reduced gray matter volume, have also been observed in individuals with the disorder. Environmental factors: Prenatal and early life factors can contribute to the development of schizophrenia. Maternal stress, infections during pregnancy, and birth complications have been linked to an increased risk. Additionally, exposure to certain environmental stressors and substance abuse during adolescence and adulthood may also play a role. Neurodevelopmental abnormalities: Schizophrenia is thought to involve disruptions in brain development during early life stages. Factors such as abnormal neural migration, synaptic pruning, and connectivity between brain regions may contribute to the manifestation of symptoms. Psychological and social factors: Stressful life events, trauma, and dysfunctional family environments may increase the risk of developing schizophrenia or trigger its onset in susceptible individuals.

1. Paranoid Schizophrenia 2. Disorganized Schizophrenia 3. Catatonic Schizophrenia 4. Undifferentiated Schizophrenia 5. Residual Schizophrenia

1. Antipsychotic medications 2. Psychotherapy (i.e. cognitive-behavioral therapy (CBT)) 3. Social support (vocational rehabilitation, housing assistance, and community programs) 4. Self-care (practicing good sleep hygiene, engaging in regular physical activity, maintaining a balanced diet, and avoiding alcohol and drugs) 5. Ongoing management.

"A Beautiful Mind" (Film, 2001): This biographical drama portrays the life of mathematician John Nash, who was diagnosed with schizophrenia. The film depicts his struggle with the illness, showcasing both the challenges and the triumphs he experiences. "One Flew Over the Cuckoo's Nest" (Novel, 1962): This classic novel by Ken Kesey takes place in a psychiatric hospital and features a character named Chief Bromden, who is believed to have schizophrenia. The story explores the institutional treatment of mental illness and challenges the notions of sanity and insanity. "Silver Linings Playbook" (Film, 2012): This romantic comedy-drama revolves around a man named Pat Solitano, who has bipolar disorder but also exhibits symptoms of psychosis, including delusions. While the film primarily focuses on bipolar disorder, it sheds light on the complexities of mental health and the impact it has on relationships. "The Soloist" (Book, 2008; Film, 2009): Based on a true story, "The Soloist" follows the life of Nathaniel Ayers, a gifted musician who becomes homeless and is diagnosed with schizophrenia. The narrative explores the challenges faced by Ayers as he navigates his mental health condition while pursuing his passion for music.

1. Schizophrenia affects approximately 1% of the global population, with no significant variation across different cultures or ethnicities. 2. Schizophrenia typically emerges in late adolescence or early adulthood, although it can occur at any age. 3. Men often experience the onset of schizophrenia earlier than women. Additionally, men tend to have more severe symptoms, while women generally have a better overall prognosis. 4. Research suggests that an imbalance of certain neurotransmitters, such as dopamine and glutamate, may contribute to the development of schizophrenia. 5. Schizophrenia is often stigmatized, leading to discrimination and social isolation for those affected. Education and awareness campaigns aim to combat the stigma and promote understanding.

The topic of schizophrenia is important to write an essay about due to its significant impact on individuals, families, and society as a whole. Understanding schizophrenia is crucial for several reasons. Firstly, it is a complex mental health disorder that affects a considerable portion of the population worldwide, leading to significant personal and societal burdens. Exploring the causes, symptoms, and treatment options for schizophrenia can contribute to advancing knowledge in the field of mental health.

Secondly, addressing the misconceptions and stigma associated with schizophrenia is paramount. By writing an essay on this topic, one can raise awareness and promote empathy, fostering a more inclusive and supportive environment for individuals living with schizophrenia.

Additionally, studying schizophrenia can provide insights into the intricate workings of the human mind and the intricate interplay between genetics, neurobiology, and environment. This knowledge can lead to advancements in early detection, intervention, and treatment strategies.

Lastly, exploring the lived experiences of individuals with schizophrenia and their journeys towards recovery can provide valuable perspectives on resilience, hope, and the human capacity for growth and adaptation.

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90 Schizophrenia Essay Topics

🏆 best essay topics on schizophrenia, 🔎 easy schizophrenia research paper topics, 👍 good schizophrenia research topics & essay examples, 🎓 most interesting schizophrenia research titles, 💡 simple schizophrenia essay ideas.

• Nash’s Schizophrenia in “A Beautiful Mind” Film
• Schizophrenia in “A Beautiful Mind” Film by Howard
• Schizophrenia of John Nash in “A Beautiful Mind”
• A Mental Health Nursing Social Interventions for Patients With Schizophrenia
• Schizophrenia: A Comprehensive Explanation
• Factors That Caused Schizophrenia
• Gerontology Nursing: Schizophrenia
• The Portrayal of Schizophrenia in a Beautiful Mind A Beautiful Mind by Ron Howard managed to portray the schizophrenia diagnosis accurately but not without a shred of Hollywood exaggeration.
• Deleuze’s “A Thousand Plateaus” and Guattari’s “Capitalism and Schizophrenia” The book “A Thousand Plateaus” written by the French philosopher Gilles Deleuze and the psychoanalyst Felix Guattari is the second part of the project “Capitalism and Schizophrenia”.
• Neuroscience of Schizophrenia: The Thinking Patterns The journey to understanding the neuroscience of schizophrenia continues, and firsthand stories like that of John Nash and Lewis continue to play a central role in this process.
• Schizophrenia: Definition and Symptomps Schizophrenia is one of the most prolific mental disorders that is characterized by people having an abnormal interpretation of reality.
• Influence of Sexual Dysfunction and Schizophrenia on Human The paper examines the causes, problems and manifestations of mental problems that affect the physical condition of a person.
• Case Presentation: Schizophrenia The client’s name for this case presentation is Clara Hunters. She is a thirty-three-year-old woman. She is white and has been married for five years.
• Case Study of Schizophrenia: Symptoms, Misconceptions and Diagnosis The case study describes the appointment with Jasmine Mack, an African American 18-years old college student who has experienced several symptoms associated with schizophrenia.
• Schizophrenia Treatment: Biopsychological Approaches This paper is aimed at discussing schizophrenia as a mental illness from the perspective of various biopsychological approaches.
• Schizophrenia: Chapters 15-16 of Psychology by Spielman et al. This research will focus on schizophrenia, a psychological disorder discussed in chapters 15 and 16 of the book Psychology by Spielman, Jenkins, and Lovett.
• Advancements in Schizophrenia Research The article’s primary goal is to review the dopamine hypothesis and study and analyze new targets invented in recent years.
• A Cognitive-Behavioural Therapy Utility of Schizophrenia The paper describes how cognitive-behavioral therapies may be utilized in mental health settings to aid schizophrenic patients in overcoming mental health problems.
• Consciousness and Psychedelic Sciences in Managing Schizophrenia Behavioral management is emerging as a significant intervention in psychiatric treatment, focusing mainly on preserving order for those with clinical mental illness.
• Gender Differences in Schizophrenia The study sheds light on the gender differences in schizophrenia onset. Schizophrenia in women and men manifests itself at different ages.
• Schizophrenia Disorder Diagnosis The main reason for the patient’s visit entails experiences and behavior out of touch with reality. It is the duty of a practitioner to enhance optimal Medicare for a patient.
• Schizophrenia Diagnosis, Treatment, and Prognosis This study evaluates the diagnosis of schizophrenia in a high school teenager, focusing on their background history to assert the prevalence of a different disorder.
• Variables Impacting a Patient With Schizophrenia The mother brought Demetri, her 39-year-old son previously diagnosed with schizophrenia, because of his deteriorating mental well-being.
• Medical Terminology of Treating Schizophrenia The article Clinical relevance of paliperidone palmitate 3-monthly in treating schizophrenia discusses how the mentioned injectable antipsychotic (PP3M) improves non-adherence.
• Gender Differences in Development of Schizophrenia Schizophrenia has varied effects on men’s and women’s sexual life. These effects could be due to variances in the start of schizophrenia at different ages.
• Aspects of Schizophrenia Schizophrenia is a severe mental disorder that demands a specific response. It is vital to diagnose it by using available criteria.
• Schizophrenia in Young Women and Men Schizophrenia, according to several researches, affects both men and women. However, men show high vulnerability as the development of this disorder is concerned.
• Schizophrenia Treatment With Fluphenazine Decanoate The present paper suggests Fluphenazine Decanoate as a medicine useful for decreasing the patient’s paranoid behavior.
• Schizophrenia: Fundamentals and Possible Causes The medicinal approach involves taking drugs based on histone deacetylases, as they improve the condition of certain parts of histones’ acetylation.
• Evaluation of the Symptoms of Schizophrenia in “A Beautiful Mind” In this study, the “Diagnostic and Statistical Manual of Mental Disorder” was used to evaluate the symptoms of the main character of the movie called “A Beautiful Mind”.
• Schizophrenia: Diagnosis and Treatment The presence of signs such as hallucinations, delusions, cognitive issues, and negative symptoms is a marker of developing schizophrenia.
• Schizophrenia: Myths, Causes, and Impacts Schizophrenia is a major mental condition characterized by a combination of unusual behaviors such as hallucinations, delusion, and abnormal thinking.
• Schizophrenia. Abnormal Psychology The implications of the analysis include the unmet need for schizophrenia stigma reduction strategies for both general audiences and mental health communities.
• Schizophrenia: Causes and Symptoms The leading causes of the development of schizophrenia include heredity, an unfavorable environment, and negative social conditions.
• Schizophrenia and Dopamine Level It is essential to examine the role of dopamine to understand whether the level of this neurotransmitter is high or low in schizophrenia.
• Schizophrenia Depicted in “A Beautiful Mind” Film Schizophrenia affects millions of people worldwide, and one of them is John Nash, a mathematician played by Russell Crowe in the film “A Beautiful Mind” by Ron Howard.
• Schizophrenia: Diagnosis, Prevention, and Treatment Articles included in the annotated bibliography describe the causes, diagnosis, prevention, and treatment of schizophrenia.
• Schizophrenia Symptoms and Diagnosis: Patient Interview This article proposes an interview with a patient with schizophrenia, gives his reactions to the questions of the interviewer and describes the symptoms of the disease.
• Biological Strategies for Studying Schizophrenia This paper analyzes several major current approaches to studying schizophrenia. It specifically focuses on several streams of research.
• Schizophrenia as Dangerous Mental Disease Schizophrenia is a very dangerous mental disease, which affects a human mind in numerous ways. It warps a person’s perception of reality.
• Schizophrenia as the Most Challenging Psychological Disorder Despite its relatively low prevalence, schizophrenia ranks among the most impairing and debilitating psychological conditions in people
• Features of Schizophrenia as Neurodegenerative Disorder This paper describes schizophrenia as a neurodegenerative disorder and tries to understand the key underlying elements linked with the clinical aspect of schizophrenia.
• Schizophrenia Treatment With Approved Drug Schizophrenia is one of the most common mental disorders in the US. Treatment of schizophrenia is critical since patients stand as dangers to themselves and society.
• Schizophrenia and Folate Status Correlation The research is designed to clarify the relationship between folate status and schizophrenia with an effort to avoid methodological pitfalls during the investigation.
• The Concept of Symptoms in Schizophrenia The essay will delve into the concept of symptoms in schizophrenia and underline the implications for the patient’s treatment.
• Drugs for Treating Schizophrenia and Mood Disorders Schizophrenia and mood disorders are serious mental illnesses, which are challenging to treat. Millions of people suffer from adverse effects on all aspects of life.
• Schizophrenia Versus Schizoaffective Disorders Schizophrenia and schizoaffective are two distinct disorders, each having its way of diagnosis and treatment. However, they share almost similar psychotic characteristics.
• Schizophrenia: Causes, Symptoms, Treatments, and Myths This paper will discuss the causes and symptoms of schizophrenia, the ways of its treatment, and the myths that surround this mental illness.
• Connection Between Schizophrenia and Neurotransmitters Neurotransmitters do the visible impact on the development of schizophrenia, although it manifests when they are inflamed.
• Schizophrenia Disorder: Causes and Treatment Schizophrenia is a mental disease, which affects the thinking capacity of an individual. A considerable number of populations around the globe are affected by this disease.
• An Accurate Portrayal of Schizophrenia This paper will analyze the Schizophrenia along with its symptoms. It will also analyze an important scene in the movie “a beautiful mind” which was directed by Ron Howard.
• Schizophrenia: Non- and Pharmacological Treatment There are effective pharmacological approaches to treating Schizophrenia, such as Clozapine, and non-medical methods, such as psychoeducation.
• Understanding Mental Illness: Aspects of Schizophrenia There is a significant social stigma surrounding severe mental illness such as schizophrenia which leads to discrimination of not just the patient, but the whole family.
• Family Psychoeducation for Schizophrenia Patients This work reviews a meta-analysis on FPE conducted, focusing on the effectiveness of the educational approach in treating patients with schizophrenia and supporting their families.
• Schizophrenia in a First-Year College Student The paper studies a case of schizophrenia, which manifested in a 39-year-old woman during her first year at college in the form of prodromal symptoms, which caused her to drop out.
• Schizophrenia Features Among African American Men Schizophrenia is a serious mental disorder that may occur at any age. African Americans usually have severe psychotic symptoms regarding the scope and quality of hallucinations.
• Schizophrenia and QT Prolongation The paper considers the case of a 62-year-old woman with a history of psychiatric diagnoses, which indicates her predisposition to delusions.
• Schizophrenia: Approaches and Behavior It is hypothesized the symptoms of schizophrenia can be attributed to the increased dopaminergic activities in such brain areas as striatum and thalamus.
• Schizophrenia: Physiological Basis of a Mental Illness Schizophrenia is mental illness with a genetic basis and its complexity is presents in form of chronic psychosis and the cognitive ability of the individual becomes impaired.
• Psychiatry: The Multi-Dimensional Nature of Schizophrenia Schizophrenia is a psychological condition in which patients suffer from disabling chronic mental disorders that adversely affect the normal functioning of the brain.
• Difficulties That the Person With Schizophrenia Goes Through
• Altered Cerebral Blood Flow Covariance Network in Schizophrenia
• Broader Visual Orientation Tuning in Patients With Schizophrenia
• Imaging Schizophrenia With Voxel-Based Morphometry
• Antipsychotics, Metabolic Adverse Effects, and Cognitive Function in Schizophrenia
• Chronicity and Sex Affect Genetic Risk Prediction in Schizophrenia
• Correlation Between Child Abuse and Schizophrenia
• Genetic and Environmental Factors of Schizophrenia
• Complex Gastrointestinal and Endocrine Sources of Inflammation in Schizophrenia
• Environmental and Genetic Effects and Schizophrenia
• Current Controversial Issues During Treatment of Schizophrenia
• Environmental Factors and the Development of Schizophrenia
• Cognitive Behavioral Therapy for Schizophrenia
• Biological and Cognitive Approaches for the Treatment of Schizophrenia
• Antigliadin Antibodies Relation to Neurochemistry in Schizophrenia
• Considering Brexpiprazole and Its Role in Managing Schizophrenia
• Disrupted Thalamic Resting-State Functional Networks in Schizophrenia
• Demystifying Common Misconceptions About Schizophrenia
• Implementing Evidence-Based Practice With Schizophrenia
• Altered Volume and Functional Connectivity of the Habenula in Schizophrenia
• Causes and Key Symptoms of Paranoid Schizophrenia
• Definitions and Social Perceptions of Schizophrenia
• Decreasing Social Interaction Anxiety for Schizophrenia
• Identifying Modifiable Risk Factors for Relapse in Patients With Schizophrenia in China
• Family Education and Management of Schizophrenia
• Creativity and Schizophrenia Spectrum Disorders Across the Arts and Sciences
• Diagnosing and Treating Schizophrenia
• Drug Abuse and Schizophrenia
• Critical Diagnostic Review of Schizophrenia
• Disorganized Schizophrenia and Its Effects on Children

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Schizophrenia Research Paper

This sample schizophrenia research paper features: 6600 words (approx. 22 pages), an outline, and a bibliography with 6 sources. Browse other research paper examples for more inspiration. If you need a thorough research paper written according to all the academic standards, you can always turn to our experienced writers for help. This is how your paper can get an A! Feel free to contact our writing service for professional assistance. We offer high-quality assignments for reasonable rates.

Schizophrenia is a psychotic disorder characterized by disturbances in thought, emotion, and behavior. This research paper discusses the symptoms, etiology, treatment, and other pertinent issues concerning this mental illness.

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Get 10% off with 24start discount code, i. description and classification, a. symptoms, 1. delusions, 2. hallucinations, 3. disorganized speech, 4. disorganized or catatonic behavior, 5. negative symptoms, b. variability of symptoms among patients, c. subtypes of schizophrenia, ii. history, iii. demographic characteristics of schizophrenia, a. sex differences, b. social class differences, iv. life functioning and prognosis, a. long-term course, b. premorbid characteristics of schizophrenia, v. etiology: theories and research findings, a. brain abnormalities in schizophrenia, b. biochemical factors, c. genetics, d. obstetrical complications, e. viral infection, f. diathesis-stress model, vi. treatment and therapy, a. antipsychotic medication, b. psychological treatment, vii. summary.

Delusions are the primary example of abnormal thought content in schizophrenia. Delusional beliefs conflict with reality and are tenaciously held, despite evidence to the contrary. There are several types of delusions. Delusions of control is the belief that one is being manipulated by an external force, often a powerful individual or organization (e.g., the FBI) that has malevolent intent. Delusions of grancleur refers to patients’ beliefs that they are especially important and have unique qualities or powers (e.g., the capacity to influence weather conditions). In contrast, some patients express the conviction that they are victims of persecution or an organized plot, and these beliefs are referred to as delusions of persecution. Examples of more specific delusions include thought broadcasting, the patient’s belief that his or her thoughts are transmitted so that others know them, and thought withdrawal, the belief that an external force has stolen one’s thoughts.

Hallucinations are among the most subjectively distressing symptoms experienced by schizophrenia patients. These perceptual distortions vary among patients and can be auditory, visual, olfactory, gustatory, or tactile. The majority of hallucinations are auditory in nature and typically involve voices. Examples include the patient hearing someone threatening or chastising him or her, a voice repeating the patient’s own thoughts, two or more voices arguing, and voices commenting. The second most common form of hallucination is visual. Visual hallucinations often entail the perception of distortions in the physical environment, especially in the faces and bodies of other people.

Other perceptual distortions that are commonly reported by schizophrenia patients include feeling as if parts of the body are distorted in size or shape, feeling as if an object is closer or farther away than it actually is, feeling numbness, tingling, or burning, being hypersensitive to sensory stimuli, and perceiving objects as flat and colorless. In addition to these distinctive perceptual abnormalities, persons suffering from schizophrenia often report difficulties in focusing their attention or sustaining concentration on a task.

It is important to note that in order for an unsubstantiated belief or sensory experience to quality as a delusion or hallucination, the individual must experience it within a clear sensorium (e.g., unsubstantiated sensory experiences that occur only upon awaking from sleep or when falling asleep would not qualify as delusions). Thus, for example, if a patient reports hearing something that sounds like voices when alone, but adds that he or she is certain that this is a misinterpretation of a sound, such as the wind blowing leaves, this would not constitute an auditory hallucination.

The DSM uses the term disorganized speech to refer to abnormalities in the form or content of the individual’s verbalizations. It is assumed that these abnormalities reflect underlying distortions in the patient’s thought processes. Thus the term thought disorder is frequently used by researchers and practitioners to refer to the disorganized speech that often occurs in schizophrenia.

Problems in the form of speech are reflected in abnormalities in the organization and coherent expression of ideas to others. One common abnormality of form, incoherent speech, is characterized by seemingly unrelated images or fragments of thoughts that are incomprehensible to the listener. The term loose association refers to the tendency to abruptly shift to a topic that has no apparent association with the previous topic. In general, the overall content of loosely associated speech may be easier to comprehend than incoherent speech. In perseverative speech, words, ideas, or both are continuously repeated, as if the patient is unable to shift to another idea. Clang association is the utterance of rhyming words that follow each other (e.g., “a right, bright kite”). Patients choose words for their similarity in sound rather than their syntax, often producing a string of rhyming words.

The overt behavioral symptoms of schizophrenia fall in two general areas: motor functions and interpersonal behavior. Motor abnormalities, including mannerisms, stereotyped movements, and unusual posture, are common among schizophrenia patients. Other common signs include bizarre facial expressions, such as repeated grimacing or staring, and repeated peculiar gestures that often involve complex behavioral sequences. As with other symptoms of the psychosis, the manifestation of motor abnormalities varies among individuals. Schizophrenia patients sometimes mimic the behavior of others, known as echopraxia, or repeat their own movements, known as stereotyped behaviors. Although a subgroup of patients demonstrate heightened levels of activity, including motoric excitement (e.g., agitation or flailing of the limbs), others suffer from a reduction of movement. At the latter extreme, some exhibit catatonic immobility and assume unusual postures that are maintained for extended periods of time. Some may also demonstrate waxy flexibility, a condition in which patients do not resist being placed into strange positions that they then maintain. Catatonia has decreased dramatically in recent decades, so that it is now rare. Several researchers have attributed this decline to the introduction of antipsychotic medication (described later).

In the domain of interpersonal interactions, schizophrenia patients frequently demonstrate behaviors that are perceived as bizarre or inappropriate by others. For example, it is not uncommon for patients to use socially unacceptable language and unusual tones of voice, or to show overly dependent or intrusive behavior. Another common symptom, inappropriate affect, involves unusual emotional reactions to events and experiences. For example, patients may laugh at a sad or somber occasion, or be enraged by insignificant events. Finally, many patients manifest increasingly poor hygiene as their illness progresses. Their appearance may also be marked by disheveled clothing or inappropriate clothing, such as gloves and coats in the summer.

The symptoms of schizophrenia can be classified into the general categories of positive and negative. Positive symptoms involve behavioral excesses and most of the symptoms described earlier fall in to this category (e.g., delusions, hallucinations, and bizarre behaviors). In contrast, negative symptoms involve behavioral deficits. Examples include fiat affect (blunted expressions of emotion), apathy, and social withdrawal. In the domain of verbal expression, schizophrenia patients who manifest a very low rate of verbal output are described as showing poverty of speech. Patients whose speech is normal in quantity, but lacks meaning, suffer from poverty of content. Recently, some researchers have suggested that positive and negative symptoms may be caused by different neural mechanisms.

It is important to mention that a reduction in overt displays of emotion does not necessarily imply that patients have less intense subjective emotional experiences than the average person. In fact, recent findings indicate that blunted emotional expressions can coexist with intense subjective feelings of emotion.

According to DSM-IV, patients must show two or more of the preceding five symptoms to meet the diagnostic criteria for schizophrenia. Thus, no one of these symptoms is required for the diagnosis. Furthermore, the following four criteria must also be met: (1) the patient shows marked deterioration in occupational, interpersonal, or domestic functioning; (2) the patient manifests continuous signs of symptoms or dysfunction for at least 6 months; (3) the patient does not manifest predominant signs of mood disturbance (e.g., depression or mania); and (4) the symptoms are not caused by substance abuse or a primary medical condition.

Because the diagnostic criteria for schizophrenia are relatively broad, with no one essential symptom, there is a great deal of variability among patients in their symptom profiles. It has therefore been proposed that schizophrenia is a heterogeneous disorder with multiple causes. It is also the case, however, that patients must show a marked and persistent impairment to meet the diagnostic criteria for schizophrenia. Thus, those who meet criteria for the diagnosis are significantly impaired in everyday functioning. For many individuals who are diagnosed with schizophrenia, independent functioning is never achieved.

The DSM lists five subtypes of schizophrenia. In schizophrenia of the paranoid type, delusional concerns about persecution and/or preoccupation with threat dominate the clinical presentation, although delusions of grandeur are also often present. Disorganized schizophrenia is distinguished by extremely incoherent speech and behavior, as well as blunted or inappropriate affect. In catatonic schizophrenia, the clinical picture is dominated by abnormalities in movement and posture, such as those described earlier. Patients classified as having undifferentiated schizophrenia do not meet criteria for any of the previous subtypes. Finally, the diagnosis of residual schizophrenia is applied to patients who have had at least one episode of schizophrenia and who continue to show functional impairment, but who do not currently manifest any positive symptoms.

During the late 1800s and early 1900s, Emil Kraepelin and Eugen Bleuler provided the first conceptualizations of schizophrenia. Kraepelin defined “dementia praecox,” the original term for schizophrenia, as an endogenous psychosis characterized by intellectual deterioration (dementia) and early onset (praecox). Kraepelin included negativism, hallucinations, delusions, stereotyped behaviors, attentional difficulties, and emotional dysfunction as major symptoms of the disorder. Kraepelin’s work focused on description and phenomenology, leaving subsequent researchers to investigate the cause or causes of the disorder.

In contrast to Kraepelin, Eugen Bleuler, a Swiss psychiatrist, proposed a broader view of dementia praecox, with a more theoretical emphasis. Bleuler contested two of Kraepelin’s defining assumptions: specifically, that the psychosis was typically characterized by early onset and intellectual deterioration. Bleuler attempted to identify an underlying commonality among the diverse variations of what Kraepelin referred to as dementia praecox and concluded that all of the patients suffered from a “breaking of associative threads,” causing a disharmony among communicative and thought processes. He believed this abnormality accounted for the problems of thought, emotional expression, decision making, and social interaction associated with schizophrenia. Guided by the defining principle of disharmonious mental structures, Bleuler renamed the disorder “schizophrenia,” meaning “split mind.”

In the early to mid-1900s, American psychiatrists continued to use a broad definition of schizophrenia. The distinction between process and reactive schizophrenia was considered important, however, because it was assumed to distinguish between cases characterized by gradual deterioration (process) and cases that were precipitated by acute stress (reactive).

During this time, some clinicians and researchers viewed the specific diagnostic criteria for the major mental illnesses (schizophrenia, bipolar disorder, major depression) as artificial and discretionary, and used instead flexible and inconsistent standards for diagnoses. Studies that compared the rates of disorder across nations revealed that schizophrenia was diagnosed at a much higher rate in the United States than in Great Britain and some other countries. This national difference resulted from the use of broader criteria for diagnosing schizophrenia in the United States. Many patients who were diagnosed as having depression or bipolar disorder in Britain were diagnosed with schizophrenia in the United States. Because subsequent revisions in the DSM have included more restrictive criteria for schizophrenia, U.S. diagnostic rates are now comparable with other countries.

In addition to a more restrictive definition of schizophrenia, subsequent editions of the DSM have included additional diagnostic categories that contain similar symptoms. Thus the range of “schizophrenia spectrum disorders” continue to broaden with the description of variants of schizophrenia, such as schizoaffective disorder, which is characterized by a mix of affective and psychotic symptoms. The diagnostic category of schizophreniform disorder was also added. This diagnosis is given when the patient shows the typical symptoms of schizophrenia, but does not meet the criterion of 6 months of continuous illness.

Estimates of the prevalence of schizophrenia converge at around 1% of the population. Although there is evidence of cross-national differences in the rate of schizophrenia, the differences are not large (i.e., 1 to 2% difference). It is, in fact, striking that the rate of occurrence is so consistent across cultures.

The modal age at onset of schizophrenia is in early adulthood, usually before 25 years of age. Thus most patients have not had the opportunity to marry or establish a stable work history before the onset of the illness. As a result of this, and the often chronic nature of the illness, many patients never attain financial independence. It is relatively rare for preadolescent children to receive a diagnosis of schizophrenia. Similarly, it is rare for individuals beyond the age of 40 to experience a first episode of the illness.

Although it has traditionally been assumed that there is no sex difference in the rates of schizophrenia, some recent research findings indicate that a somewhat larger proportion of males than females meet the DSM-IV criteria for the disorder. Nonetheless, the overall rates do not differ dramatically for men and women. It is well established, however, that women are more likely to have a later onset of illness, as well as a better prognosis. Women also show a higher level of interpersonal and occupational functioning during the period prior to illness onset. The reasons for this sex difference are not known, but it has been proposed by several theorists that the female sex hormone, estrogen, may function in attenuating the severity of the illness.

Compared with the general population averages, schizophrenia patients tend to have significantly lower incomes and educational levels. Poor urban inner city districts, inhabited by the lowest socioeconomic class, contain the largest proportion of schizophrenia patients. There is a sharp contrast between the rates of schizophrenia in the lowest socioeconomic class and all other levels, including the next higher level. Findings from various cultures suggest that rates of schizophrenia are almost two times higher in the lowest social class group compared with the next lowest.

These social class differences appear to be a partial consequence of the debilitating nature of the illness. The social-drift theory suggests that during the development of schizophrenia, people drift into poverty. When the incomes and educational levels of the parents of patients are compared with those of the general population, the differences are not as striking.

There is, nonetheless, evidence that patients do come from families where the incomes and educational backgrounds of the parents are slightly below the average. These findings have led researchers to conclude that there may be a causal link between social class and risk for the illness. The sociogenic hypothesis posits that situational factors associated with low social class, such as degrading treatment from society, low levels of education, and few opportunities for achievement and reward, produce stress that contributes to the risk for schizophrenia.

Before the introduction of antipsychotic medications in 1950, the majority of patients spent most of their lives in institutional settings. There was little in the way of programs for rehabilitation. But contemporary, multifaceted treatment approaches have made it possible for most patients to live in community settings.

Of course, during active episodes of the illness, schizophrenia patients are usually seriously functionally impaired. They are typically unable to work or maintain a social network, and often require hospitalization. Even when in remission, some patients find it challenging to hold a job or to be self-sufficient. This is partially due to residual symptoms, as well as to the interruptions in educational attainment and occupational progress that result from the illness. However, there are many patients who are able to lead productive lives, hold stable jobs, and raise families. With the development of greater community awareness of mental illness, some of the stigma that kept patients from pursuing work or an education has diminished.

For about one third of patients, the illness is chronic and is characterized by episodes of severe symptoms with intermittent periods when the symptoms subside but do not disappear. For others, there are multiple episodes with periods of substantial symptom remission. About one third of those who receive the diagnosis eventually show a partial or complete recovery after one or two episodes.

Several factors have been linked with a more favorable prognosis for schizophrenia. Early treatment seems to be important in that the shorter the period between the onset of the patient’s symptoms and the first prescribed medication, the better the clinical outcome. Another indicator of better prognosis is a high level of occupational and interpersonal functioning in the premorbid period. Also, as noted earlier, women and patients who have a later onset of symptoms have a better long-term outcome.

Some of the difficulties experienced by individuals with schizophrenia can be observed before the onset of the clinical symptoms. Deficits in social skills, concentration, emotional expression, motivation, and occupational or academic performance often precede the first clinical symptoms. This period of gradual decline in functioning before the first illness episode is referred to as the prodromal phase.

However, there are often more subtle signs of dysfunction long before the onset of the prodromal period. Controlled studies using archival data sources, such as medical and school records or childhood home-movies, indicate that subtle differences are discernible as early as infancy in some patients. Individuals who succumb to schizophrenia in adulthood sometimes have abnormal motor development and show deficits in emotional expression and interpersonal relationships in early childhood. Cognitive impairment and difficult temperament have also been observed. During middle childhood and adolescence, researchers have found evidence of neurological abnormality, poor emotional control, social immaturity, and academic performance deficits. Premorbid behavioral problems often become marked through the adolescent years, and many exhibit behavioral disturbances and cognitive abnormalities that resemble the clinical symptoms of schizophrenia.

The causes of schizophrenia are unknown, but it is now widely accepted by both researchers and clinicians that schizophrenia is biologically determined. This is in striking contrast to the early and mid-1900s, when many subscribed to the theory that faulty parenting, especially cold and rejecting mothers, caused schizophrenia in offspring.

There are several sources of evidence for the assumption that schizophrenia involves an abnormality in brain function. First, studies of schizophrenia patients have revealed a variety of behavioral signs of central nervous system impairment, including motor and cognitive dysfunctions. Second, when the brains of patients are examined with in vivo imaging techniques, such as magnetic resonance imaging (MRI), many show abnormalities in brain structure. Similarly, postmortem studies of brain tissue have revealed irregularities in nerve cell formation and interconnections.

Laboratory studies of schizophrenia patients have revealed a variety of abnormalities, including irregularities in smooth pursuit eye movements, psychophysiological responses to sensory stimuli, and concentration. Research on the neuropsychological performance of schizophrenia patients was first conducted in the 1950s and continues to the present time. Individual neuropsychological tests are designed to measure functions subserved by specific regions or systems of the brain. An early finding in this area was that schizophrenia patients were the one psychiatric group whose performance on neuropsychological tests was indistinguishable from people with known brain damage. The findings suggested a generalized cerebral dysfunction in schizophrenia. However, patients show the most consistent deficits on tests of attention and memory, indicating dysfunction of the frontal and temporal lobes and the hippocampus. Further evidence of dysfunction in these brain regions is derived from poor performance on tests of executive functions: the ability to formulate, maintain, and adapt appropriate responses to the environment.

Brain-imaging studies of schizophrenia have yielded results that mirror those obtained from neuropsychological research. Some relatively consistent findings are that the brains of schizophrenia patients have abnormal frontal lobes and enlarged ventricles. Enlarged ventricles suggest decreased brain mass, particularly in the limbic regions, which are intimately involved in emotional processing. Furthermore, ventricular size correlates with negative symptoms, performance deficits on neuropsychological tests, poor response to medication, and poor premorbid adjustment. These associations between ventricular enlargement and both premorbid and postmorbid characteristics suggest that the brain abnormalities are long-standing, perhaps congenital.

In addition to brain structure, investigators have examined biological indices of brain function in schizophrenia. Functional brain-imaging studies, with procedures such as positron emission tomography (PET) and measurement of regional cerebral blood flow, reveal that schizophrenia patients have decreased levels of blood flow to the frontal lobes, especially while performing cognitive tasks.

Researchers are now pursuing the question of what causes the brain abnormalities observed in schizophrenia. Although as yet there are no definitive answers, investigators have made continuous progress in identifying factors that are associated with risk for the disorder.

The structural brain abnormalities that have been observed in schizophrenia support the assumption that it is a disorder of the central nervous system. But it has also been shown that similar structural abnormalities (i.e., ventricular enlargement and volume reductions) are present in other disorders, both neurological and psychiatric. It is therefore assumed that specific abnormalities in brain biochemistry may play a role in schizophrenia.

The functioning of the central nervous system is dependent on a host of chemicals that serve as the “messenger substances” among neurons. These chemicals or neurotransmitters have been the subject of intense investigation. Among the various neurotransmitters that have been implicated in the neuropathophysiology of schizophrenia is dopamine. Dopamine is viewed as a likely candidate for two main reasons: (1) drugs that act to enhance the release or activity of dopamine can produce psychotic symptoms, and (2) drugs that have been established to have antipsychotic properties (i.e., reduce psychotic symptoms) reduce the activity of dopamine in the brain. Current theories of the role of dopamine in schizophrenia have focused on dopamine receptors. There is evidence that there may be an abnormality in the number or sensitivity of certain dopamine receptors in the brains of schizophrenia patients. To date, however, this evidence remains inconclusive.

Several other neurotransmitters have also been hypothesized to play a role in schizophrenia. Current theories under investigation include a malfunction of the receptors for a neurotransmitter called glutamate and an abnormality in the balance between dopamine and serotonin (another neurotransmitter which, like dopamine, has been implicated in the pathogenesis of schizophrenia). As research findings on the biochemical aspects of schizophrenia accumulate, it increasingly appears that the illness may involve multiple neurotransmitters, with different biochemical profiles for different patients.

A convincing body of research supports the notion of a genetic predisposition to schizophrenia. Behavioral genetic studies of families, twins, and adopted offspring of schizophrenia patients indicate that an inherited vulnerability is involved in at least some cases of the disorder.

There is an elevated risk of schizophrenia for individuals with a biological relative who suffers from the disorder, and the risk rates increase as a function of the genetic closeness of the relationship. For example, it has been estimated that children of schizophrenia patients have a 9 to 15 % likelihood of developing the illness, siblings of patients have an 8 to 14% likelihood, and cousins have a 2 to 6% likelihood of being diagnosed with schizophrenia. Given the general population rate of approximately 1%, relatives of patients are at statistically increased risk. It must be noted, however, that relatives share common experiences as well as common genes. Therefore, examinations of the prevalence of schizophrenia in the relatives of patients cannot elucidate the relative contributions of environmental and genetic factors.

Some investigators have studied the development of adopted children whose biological mothers had schizophrenia. This approach has the potential to provide more conclusive information than family studies. The results of these investigations show that when biological offspring of schizophrenic mothers are reared from infancy in adoptive homes they are more likely to develop schizophrenia than are adopted children from healthy mothers. Furthermore, these children also exhibit a higher rate of other adjustment problems when compared with controls. Studies of this type have clearly illustrated that vulnerability to schizophrenia can be inherited.

Research on twins examines differences in concordance rates between identical (monozygotic or MZ) and fraternal (dizygotic or DZ) twins. Twin studies rely on the fact that MZ twins essentially share 100% of their genes. Thus, environmental influences account for any behavioral differences between MZ twins. In contrast, DZ twins are no more genetically similar than regular siblings; DZ twins do, however, share more similar environmental factors than do nontwin siblings. To date, the results of twin studies have consistently shown that MZ twins are significantly more likely to be concordant for schizophrenia than are DZ twins.

At the same time, it is important to note that in at least 50% of the cases in which one member of an MZ twin pair has schizophrenia, the other does not. Such “discordant” pairs have been the subject of a recent, comprehensive investigation in the United States. Among the most important findings from this research project are those from the MRI scans conducted on the twins. The ill twins in the pairs showed significantly more brain abnormalities than the healthy twins. Most notable were reductions in the volume of certain brain regions, especially the hippocampus, and increases in the size of the ventricles. These results clearly indicate the importance of environmental factors in the etiology of schizophrenia.

As is the case with many other disorders that involve brain dysfunction, there is evidence that schizophrenia is associated with exposure to prenatal and delivery complications. Obstetrical complications (OCs) are defined as physical deviations from the normal course of events during pregnancy, labor, or the neonatal period. Estimates of OCs in schizophrenics have been as high as 67%, significantly higher than the rate of OCs found in normal controls.

Among the prenatal factors that have been found to be associated with increased risk for schizophrenia are prenatal maternal nutritional deficiency, viral infection, bleeding, and toxemia. Complications of delivery that can result in hypoxia have also been linked with heightened risk for the disorder. Hypoxia, a deficiency in the amount of oxygen available to the fetus, can affect the development of various parts of the brain. Some researchers argue that hypoxia results in hippocampal damage, thus contributing to vulnerability for schizophrenia. Low birth weight, a neonatal complication, is another potential early factor contributing to schizophrenia. There is evidence that low birth weight is related to increased ventricular size, which is a common characteristic of schizophrenia patients.

The findings on prenatal complications support the notion that fetal brain development may be disrupted in individuals who later manifest schizophrenia. A central question raised by these findings concerns the nature of the etiologic role of OCs. Some hypothesize that OCs produce the neural predisposition to schizophrenia, whereas others posit that OCs exacerbate or interact with an existing genetic predisposition.

Findings from prospective, high-risk research projects lend support to the hypothesis that OCs interact with genetic vulnerabilities in the etiology of schizophrenia. High-risk studies involve the repeated assessment of children of schizophrenia patients, based on the expectation that a larger percentage of these children will eventually develop the illness than individuals in the general population. The high-risk method offers some advantages when compared with retrospective studies of the precursors of schizophrenia. One advantage is that it allows for the direct assessment of subjects in the premorbid period, as well as the selection and study of variables that are thought to have prognostic relevance. Furthermore, because a significant portion of the data collection takes place during the premorbid period, this reduces confounds that often occur in the study of diagnosed patients (e.g., medication and institutionalization).

Studies using the high-risk method have shown an interactive effect of genetic risk and exposure to OCs in predicting adult psychiatric outcome. In other words, the correlation between OCs and adult psychiatric symptoms was greater for offspring of schizophrenia parents than for children of healthy parents. The same pattern was apparent for the relation between OCs and adult brain morphology, suggesting that pre- and perinatal factors contribute to brain abnormalities.

As noted earlier, prenatal exposure to maternal viral infection has also been linked with schizophrenia. Specifically, the rate of schizophrenia is increased for cohorts who were in the second trimester during flu epidemics. Another source of evidence for the viral hypothesis is the finding that the births of schizophrenia patients do not seem to be randomly distributed throughout the course of the year. Instead, the births of schizophrenia patients occur more frequently in winter months.

Some researchers have suggested that postnatal viral infection may also be relevant to schizophrenia, and that the illness may be caused by a long-acting virus. This hypothesis claims that “slow viruses,” which are active over a long period of time, interact with a genetic predisposition to produce schizophrenia. Various findings are cited in support of this hypothesis. Some researchers have identified a viral infection in fatal catatonia, a disorder characterized by schizophrenia-like symptoms, suggesting that a similar viral infection may be found for schizophrenia. Other researchers have found signs of viral activity in the cerebrospinal fluid of patients with schizophrenia.

The diathesis-stress model has dominated theories about the etiology of schizophrenia for several decades. This model assumes that certain individuals inherit or acquire a vulnerability to schizophrenia (the diathesis), and that the behavioral expression of this vulnerability is determined or triggered by environmental stressors. Although “stress” was originally conceptualized as psychosocial in origin, contemporary versions of this model broaden the definition of stress to include prenatal and postnatal insults to the central nervous system. Thus the diathesis, combined with exposure to environmental stressors, can produce schizophrenia.

Exposure to stress within the context of the family has been the focus of researchers in the field. Families in which there is a schizophrenia patient show more conflict and abnormalities in communication than do other families. However, it has also been shown that there is greater conflict and more abnormalities of communication in families in which any member has a severe debilitating illness. Thus, family communication styles are unlikely to play a unique causal role in schizophrenia.

There is good evidence, however, that exposure to high levels of criticism from family members can increase the likelihood of relapse in schizophrenia patients. The number of critical comments, expressions of hostility, and emotional overinvolvement comprise a construct referred to as expressed emotion (EE). Recovering schizophrenia patients in families high in EE are much more likely to have a relapse compared with patients in families low in EE. There is also evidence from studies of the adopted offspring of schizophrenia patients suggesting that familial stress can hasten the onset of symptoms.

Before 1900, knowledge of the nature and causes of mental disorders was limited. Individuals with psychiatric symptoms, particularly psychotic symptoms, were typically viewed by others with disdain or amusement. However, social trends and advances in medical knowledge converged to produce greater sympathy for those with mental illness. This led, especially during the early part of the century, to the construction of public and private hospitals devoted to the care of the mentally ill.

Today, most schizophrenia patients experience at least one period of inpatient treatment. This is typically precipitated by the first psychotic episode. During this initial hospitalization, an extensive assessment is usually conducted to determine the most appropriate diagnosis. Treatment is then initiated to reduce symptoms and stabilize patients so that they can return to the community as soon as possible.

In the past, periods of hospitalization were longer in duration than they are today. This is due, in part, to the availability today of better medical treatments. Another factor that has contributed to shorter hospital stays is the deinstitutionalization movement. Initially spurred by concerns that too many of the mentally ill were becoming “institutionalized” and were losing their ability to function in the community, financial support for state psychiatric hospitals was gradually cut. But community support services and transitional living arrangements were not readily available to many patients. As a result, former psychiatric inpatients now constitute a substantial proportion of the homeless found in U.S. cities.

Introduced in the 1950s, antipsychotic medication has since become the most effective and widely used treatment for schizophrenia. Research indicated that the “typical” antipsychotics, such as haloperidol, decreased the symptoms of schizophrenia, especially positive symptoms, and reduced the risk of relapse. However, they were not as effective in reducing the negative symptoms. Furthermore, some patients showed no response to antipsychotic drugs.

Chlorpromazine (Thorazine) was among the first antipsychotic commonly used to treat schizophrenia. Since the 1950s, many other antipsychotic drugs have been introduced. Like chlorpromazine, these drugs reduce hallucinations, delusions, and thought disorder, and engender more calm, manageable, and socially appropriate behavior. As mentioned, all currently used antipsychotic drugs block dopamine neurotransmission. Thus it has been assumed that their efficacy is due to their capacity to reduce the overactivation of dopamine pathways in the brain.

Unfortunately, the benefits of standard or typical antipsychotic drugs are often mitigated by side effects. Minor side effects include sensitivity to light, dryness of mouth, and drowsiness. The more severe effects are psychomotor dysfunction, skin discoloration, visual impairment, and tardive dyskinesia (an involuntary movement disorder that can appear after prolonged use of antipsychotics). It is especially unfortunate that tardive dyskinesia is sometimes irreversible when patients are withdrawn from neuroleptics. Many of these physical signs are known to be caused by chronic blockade of dopamine pathways. Although additional medications can counter some of the negative effects of the typical antipsychotics, schizophrenia patients often resist taking them because of an aversion to the side effects.

Within the past decade, some new, “atypical” antipsychotic drugs have been introduced. It was hoped that these drugs would be effective in treating patients who had not responded to standard antipsychotics. Also, researchers hoped to identify medications that had fewer side effects. One example is Clozapine, released in 1990, which seems to reduce negative symptoms more effectively than typical antipsychotic drugs. Clozapine not only offers hope for patients who are nonresponsive to other medications, but it also has fewer side effects than typical antipsychotics. However, clozapine can produce one rare, but potentially fatal, side effect, agranulocytosis, a blood disorder. Consequently, patients who are on this medication must be monitored on a regular basis. It is fortunate that several other new antipsychotic medications have recently become available, and some of these appear to have no serious side effects.

It appears that it is important to begin pharmacological treatment of schizophrenia as soon as possible after the symptoms are recognized. The longer patients go without treatment of illness episodes, the worse the long-term prognosis. Medication also has the benefit of lowering the rate of mortality, particularly suicide, among schizophrenia patients. Patients who are treated with antipsychotic medication generally require maintenance of the medication to obtain continued relief from symptoms. Medication withdrawal often results in relapse. At the same time, the associated long- and short-term side effects of antipsychotics, especially the typical antipsychotics, are of continuing concern to patients, their families, and physicians. It is possible that future research on the neural mechanisms involved in schizophrenia will lead to the development of novel treatments that eliminate the need for maintenance medication.

Many schizophrenia patients also suffer from depression and, as noted, are at elevated risk for suicide. The reason or reasons for the high rate of co-occurance of depression with schizophrenia is not known. Given the debilitating and potentially chronic nature of schizophrenia, however, it is likely that some patients experience depressive symptoms in response to their condition. For others, depressive symptoms may be medication side effects or a manifestation of a biologically based vulnerability to depression.

Clinicians have used various forms of psychological therapy in an effort to treat schizophrenia patients. Early attempts to provide therapy for schizophrenia patients relied on insight-oriented or psychodynamic techniques. The chief goal was to foster introspection and self-understanding in patients. Research findings provided no support for the efficacy of these therapies in the treatment of schizophrenia.

It has been shown, however, that supportive therapy can be a useful adjunct to medication in the treatment of patients. Similarly, psychoeducational approaches that emphasize providing information about symptom management have proven effective in reducing relapse. Among the most beneficial forms of psychological treatment is behavioral therapy. Some psychiatric hospitals have established programs in which patients earn credits or “tokens” for appropriate behavior and then redeem these items for privileges or tangible rewards. These programs can increase punctuality, hygiene, and other socially acceptable behaviors in patients.

In recent years, family therapy has become a standard component of the treatment of schizophrenia. These family therapy sessions are psychoeducational in nature and are intended to provide the family with support, information about schizophrenia, and constructive guidance in dealing with the illness in a family member. In this way, family members become a part of the treatment process and learn new ways to help their loved one cope with schizophrenia.

Another critical component of effective treatment is the provision of rehabilitative services. These services take the form of structured residential settings, independent life-skills training, and vocational programs. Such programs often play a major role in helping patients recover from their illness.

It is now firmly established that schizophrenia is caused by an abnormality of brain function that in most cases has its origin in early brain insults, inherited vulnerabilities, or both. But the identification of the causal agents and the specific neural substrates responsible for schizophrenia must await the findings of future research. There is reason to be optimistic about future research progress. New technologies are available for examining brain structure and function. In addition, dramatic advances in neuroscience have expanded our understanding of the brain and the impact of brain abnormalities on behavior. We are likely to witness great strides in our understanding of the causes of all mental illnesses within the coming decades.

It is hoped that advances will also be made in the treatment of schizophrenia. New drugs are being developed at a rapid pace, and more effective medications are likely to result. At the same time, advocacy efforts on the part of patients and their families have resulted in improvements in services. But a further expansion of services is greatly needed to provide patients with the structured living situations and work environments they need to make the transition into independent community living.

Bibliography:

• Breier, A. (Ed.). (1996). The new pharmacotherapy of schizophrenia. Washington DC: American Psychiatric Press.
• Keefe, R. S., & Harvey, P. (1994). Understanding schizophrenia: A guide to the new research on causes and treatment. New York: Free Press.
• Miller, G. A. (Ed.). (1995). The behavioral high-risk paradigm in psychopathology. New York: Springer.
• Shriqui, C. L., & Nasrallah, H. A. (Eds.). (1995). Contemporary issues in the treatment of schizophrenia. Washington DC: American Psychiatric Press.
• Torrey, E. F. (1994). Schizophrenia and manic-depressive disorder: The biological roots of mental illness as revealed by the landmark study of identical twins. New York: Basic Books.
• Walker, E. F. (1991). Schizophrenia: A life-course developmental perspective. New York: Academic Press.

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Schizophrenia research papers: tips and topics.

Schizophrenia is regarded as one of the most serious psychiatric disorders that exist. It is also one of the most common psychiatric disorders. Symptoms of the disease include disorganized speech behavior, hallucinations, and delusional thoughts. Schizophrenia research as with other research under psychiatric medicine areas of today is tailored towards the industry demand.

Over the years, there has been a massive increase in educational programs, however with little or no increase in schizophrenia research topics. As a result, current research on schizophrenia deals more with the prescribing of newer antipsychotic agents. The implication is that there is a vast array of grey in schizophrenia studies. This article will provide some tips that you might need to write schizophrenia research papers on your own, and to standard.

Writing a Good Research Paper on Schizophrenia

In writing a good schizophrenia paper, here are some steps that you can follow, that would be very helpful.

In some cases, you might be lucky enough to be assigned a topic that makes this step relatively irrelevant. Otherwise, if you are to choose a topic on your own, of all the steps involved in writing your research paper on schizophrenia, this might be the toughest. First, you would have to research schizophrenia to understand what you are going into. After this, you would have to decide if your schizophrenia paper would be on areas of research that have previously been touched. You could also decide to dive into totally new research on schizophrenia.

Whichever topic you choose, a good research topic should not be too broad. A relatively broad topic might capture a general view of the research rather than capture a more specific view. For instance, a topic like “Hard drug dependence in Schizophrenia” can easily be narrowed down to “Nicotine dependence in Schizophrenia patients.”

After you might have selected an article that suits you, the next phase is proper research on your chosen topic. You can use the internet to get yourself a lot of schizophrenia research articles. In achieving this aim, you can make good use of Google Scholar.

A simple search with the words “latest research on schizophrenia” or “new research on schizophrenia” would bring you journals that might be helpful in your research study. After you might have found the schizophrenia research article that you need, do well to write down your sources in a way that you can write your references properly in the end.

Developing an outline will help you come up with ideas as well as order your thoughts appropriately. Without a proper outline, your work might like focus and direction. In creating your schizophrenia research paper outline, you create subheadings that have central themes with the topic you have chosen.

Look at these subheadings as key points that you need to discuss your topic for proper understanding. You’ll need to develop the points using what you have found in your schizophrenia research and in the research articles on schizophrenia that you have read.

In writing your research paper on schizophrenia, you could go through two ways. You could start typing your work directly or you could first have a draft. Having a draft will allow you to create a more error-free schizophrenia research paper. However, making a draft could see you extend the time you have in coming up with your schizophrenia paper.

Schizophrenia Research Journals

To come up with a research article on schizophrenia that is of standard, you’ll need to cite some journals. From these journals, you will find research papers on schizophrenia. From these papers, you’ll find the results of a series of schizophrenia research studies that might be helpful. You can also contact professional writers who are experts in this field. Here is a list of journals that are available at your disposal.

• Schizophrenia Research . The schizophrenia research journal is a journal that contributes to the dissemination of information associated with research on schizophrenia. The schizophrenia research impact factor as of 2018 by Clarivative Analysis is 4.569.
• Schizophrenia Bulletin . In this journal, you will find reviews on recent development in the world of research in schizophrenia. It looks into areas of schizophrenia research study bordering around the etiology and treatment of schizophrenia. The Schizophrenia bulletin impact factor is 7.289.
• World Psychiatry . this journal is published by the world’s Psychiatric association. The Journal deals widely with psychiatric medicine as a whole. However, it could as well provide readers with answers to schizophrenia research questions about significant clinical, service and research developments.
• Proceedings from Conferences . In addition to journals, you can make use of proceedings from conferences. For instance, proceedings from the international congress on schizophrenia research that takes place once in two years.

Sample Schizophrenia Research Paper Topics

Just in case you need a topic to write on for your research paper on Schizophrenia, here are a few topics you can work with:

• The role of alkaloid in schizophrenic psychosis.
• Relationship between schizophrenic psychosis and animate thing Pathogens
• Medical Marijuana and its impact on people with Schizophrenia
• “Schizophrenia and also the psychological state shopper Movement
• Incidence of schizophrenic psychosis Among tending Professionals
• Genetic Links Between schizophrenic psychosis and Associated Co-morbid Conditions”
• Longitudinal Studies on Schizophrenic psychosis
• Schizophrenic psychosis and Aging
• New Treatments for schizophrenic psychosis presently in Clinical Trials
• Schizophrenic psychosis and PET Scan Findings”
• Schizophrenia, Schizophrenic psychosis and Neuroplasticity
• Schizophrenia, Schizophrenic psychosis and Homelessness
• The impact on people with schizophrenic psychosis in states that opted out of health care Expansion/The State tending Exchanges underneath the Affordable Care Act

Having all the necessary information relating to your topic would not necessarily make your schizophrenia research paper a good one. A good research paper in addition to having all the necessary information is one that is free of errors. Amongst other things, make sure to review your work properly for grammatical errors. Finally, look out for the flow, use of logic, sentence structure, the order of paragraphs, and avoid plagiarism.