Tuesday, February 19, 2019

Biopsychosocial Models for Schizophrenia

This paper will explore one of the most horrific mental disorders, insane psychosis, with the goal of providing an actualized understanding of this disorder, including its etiology, course, epidemiology, diagnostic and treatment. Schizophrenia is characterized by an un adaptive rule of general though and emotions, including delusions, auditory hallucinations, paranoia, disorganized thinking and disorganized speech. These symptoms experience a significant impairment in personal and social life.There be a wide range of symptoms that can be present in individuals diagnosed with dementia praecox, for which some enquiryers have questioned the validity of the concept of schizophrenic disorder as a single disorder (Baier, 2010). Despite of the fact that the symptoms of schizophrenic psychosis continue to be considered as representing a unitary disorder, diagnostic manuals do classify dementia praecox into different subtypes paranoid, disorganized, catatonic, undifferentiated and re sidual. Diagnosis is usually made on criteria naturalized by the DSM-IV-TR or ICD-10.This criteria make affair of self-reported experiences and clinical judgments of mental health professionals. The etiology of schizophrenia, while not completely understood, is thought to be complex, as multiple factors face to tot up to the development and the course of the disorder. While psychology-including defective psychology-has experience a significant increase of empirical knowledge in the last few decades, no other area of psychology research has developed as much as psychobiology (Baier, 2010).The technology available forthwith allows researchers to scan wags-both topographical and operating(a) hence, schizophrenic brains have been studied in order to seek out for structural or functional differences in contrast to normal brains. Scientists have found several differences of brain structures in 40 to 50% of cases, as well as in brain chemistry during psychotic states (Kneisl & Tr igoboff, 2009). Brain imaging technologies- much(prenominal) as PET and fMRI- argueed functional differences in frontal lobes, temporal lobes and the hippocampus.Reduction in brain volume has in like manner been observed in many an(prenominal) cases, usually in the frontal pallium and the temporal lobes (Baier, 2010). Since neuronal circuits are altered, some scientists have proposed that schizophrenia is genuinely a manifestation of a constellation of neurodevelopmental disorders (Baier, 2010). The neurotransmitter which seems to play the most master(prenominal) role in the development in the manifestation of schizophrenia is dopamine, in the mesolimbic pathway (Baier, 2010).The dopamine hypothesis proposes that the excessive activation of D2 receptors cause the positivist symptoms of schizophrenia (Kneisl & Trigoboff, 2009). The dopamine hypothesis of schizophrenia is supported by entropy which proves the effectiveness of antipsychotics that block D2 receptors, but likewise on PET and SPET imaging. Nevertheless, as new medication with a different mechanism of action seem to have similar effects (Baier, 2010), the dopamine hypothesis seems to be reductionist. Glutamate also seems to play a role in schizophrenia, as schizophrenic individuals list to show a reduced function of the NMDA glutamate receptor.Reduced function of glutamate is linked to trim down performance on taks that require the frontal lobe and the hippocampus. Genetic data suggests that schizophrenia is highly heritable apparently genetic vulnerability in fundamental interaction with certain environmental factors are a common cause of the disorder. alikeness studies results estimate an 80% of heritability of the disorders. Concordance rates between twins are around 50% for monozygotic twins and around 17% for dizygous twins (Kneisl & Trigoboff, 2009).On the other hand, molecular genetic studies attempt to identify particular proposition genes which may contribute to the etiology of sch izophrenia. Until now, allelic variation of two genes show a stronger correlation with schizophrenia dysbindin (DTNBP2) and neuregulin (NRG1) (Kneisl & Trigoboff, 2009). Several environmental factors can contribute to the development and course of schizophrenia. Prenatal factors, such as obstetric complications, enatic malnutrition, maternal stress or even been born in pass or spring or are common risk factors for schizophrenia,though they do not represent factors of high-risk (Baier, 2010). Less-common factors for schizophrenia are increased agnate age and gluten intolerance. Studies with small samples have identified certain psychosocial factors that are credibly to be risk factors for schizophrenia living in urban areas, execrable family environment, low socio-economic level, disrupt school behavior, low social competence and immaturity (Kneisl & Trigoboff, 2009).Schizophrenia affects about 0. 7% of world population. It is slightly more common in males (1.4 times) and the us ually ages of onset are 20-28 years for men and 26-32 years for women. diverse countries have slightly different rates of schizophrenia, which reflect the importance of environmental effects in the development of the disorder (Kneisl & Trigoboff, 2009).Schizophrenia is a societal concern, as it cause considerable costs. Life expectancy is 15 years depress in schizophrenic individuals, in great part due to the comorbidities of the disorder, such as clinical depression and substance abuse. Three-fourth of schizophrenics have disability with relapses (Baier, 2010).Most people with schizophrenia have an independent life, though sometimes they make use of connection support. There is a high suicide rate in schizophrenic population, around 4. 9%, which shouldnt come as a rage considering that many schizophrenic also suffer from different forms of clinical depression (Baier, 2010). Modern treatment of schizophrenia corresponds to the bio-psycho-social paradigm. About all schizophrenic s receive antipsychotics, many times in combination with psychological and social intervention.Antipsychotics are economic at reducing positive symptoms, but fail to do the like with negative symptoms and with cognitive functions. There is evidence that a continue use of antipsychotics prevents relapse, but not longer than 2-3 years.Antipsychotics are classified into typical and unrepresentative, and brusque evidence suggest that any of them is better than the other (Kneisl & Trigoboff, 2009). Typical antipsychotics go to provoke a higher rate of extrapyramidal side effects, while atypical antipsychotics are associated with system of weights gain, metabolic syndrome and diabetes (Kneisl & Trigoboff, 2009).Psychosocial intervention for those with schizophrenia include family therapy, cognitive remediation, cognitive-behavioral therapy, assertive community treatment, skills training, supported employment, token economic intervention and interventions for weight management or sub stance abuse. Currently new medication and psychotherapies for treating schizophrenia are been investigated. Minocyclines effects in schizophrenia, a bacteriostatic antibiotic, is currently under study, giving its great penetration into the central anxious(p) system (Kneisl & Trigoboff, 2009).On the other hand, nidotherapy is been applied by some clinicians this therapy aims at ever-changing the environment of schizophrenic individuals, in order to improve their capacity to adapt (Kneisl & Trigoboff, 2009).It is to be seen whether this new treatments will prove effective or not. As it has been showed throughout this paper, schizophrenia is a complex disorder, and it cannot be explained or tempered from a reductionist perspective. Hence, most researchers and clinicians adopt a bio-psycho-social perspective, which reflects in theories of schizophrenia as well as in its management.

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