sexta-feira, 29 de janeiro de 2016

Schizophrenia



Schizophrenia is a chronic mental illness that manifests itself in adolescence or early adulthood. Its frequency in the general population is the order of 1 for every 100 people, with about 40 new cases per 100,000 inhabitants per year. In Brazil it is estimated that there are approximately 1.6 million schizophrenics; each year about 50,000 people manifest the disease for the first time. It reaches a corresponding proportion of men and women in general starts earlier in men, around 20-25 years of age, and women, around 25-30 years.

What are the symptoms?

Schizophrenia has various manifestations, affecting many areas of psychological functioning. The main symptoms are:

1. delusions: they are false ideas, of which the patient has absolute conviction. For example, he finds himself pursued or observed by hidden cameras, believes the neighbors or people passing in the street want to hurt you.

2. hallucinations: they are false perceptions of the sense organs. The most common hallucinations in schizophrenia are auditory, in the form of voices. The patient hears voices that talk about him, or accompanying their activities with comments. Often these voices give orders on how to act in certain circumstances. Other forms of hallucinations as visual, tactile or olfactory may also occur in schizophrenia.

3. changes of thought: ideas can become confused, disorganized and disjointed, making the patient's speech difficult to understand. Often the patient is convinced that your thoughts can be read by others, or that thoughts are stolen from your mind or entered it.

4. changes of affection: many patients have a loss of the ability to react emotionally to the circumstances, becoming indifferent and no emotional expression. Sometimes the patient has emotional reactions that are incongruent, inadequate in relation to the context in which it is. It is childish and eccentric or behaves indifferently to the environment that surrounds it.

5. decreased motivation: the patient loses the will, is discouraged and apathetic, no longer able to cope with the tasks of everyday life. Barely talk, is isolated and withdrawn socially.

Other symptoms, such as difficulty in concentration, motility alterations, excessive distrust, indifference, may appear in schizophrenia. Depending on how the symptoms are grouped, it is possible to characterize the different subtypes of the disease. Schizophrenia usually develops in acute episodes that shows the various symptoms described above, especially delusions and hallucinations, interspersed with periods of remission, with few obvious symptoms.

What causes schizophrenia?

It is not known what the causes of schizophrenia. Heredity has a relative importance, it is known that first-degree relatives of schizophrenic has a greater chance of developing the disease than people in general. On the other hand, there is known the mode of genetic transmission of schizophrenia. Environmental factors (p. Ex., Complications of pregnancy and childbirth, infections, etc.) that may affect the developing nervous system in the gestation period seem to be important in the disease. Studies of image of modern methods such as CT and MRI show that some patients have small brain changes, with a slight decrease in the size of certain brain areas. Biochemical changes in brain neurotransmitters, particularly dopamine seem to be implicated in disease.

How it is diagnosed schizophrenia?

The diagnosis of schizophrenia is made by the specialist from the onset of the disease. No type of laboratory test (blood test, x-ray, CT scan, EEG etc.) to confirm the diagnosis. Often the clinical examination requests, but these serve only to exclude other conditions that can present manifestations similar to schizophrenia.

How is schizophrenia?

The treatment of schizophrenia is aimed at the control of symptoms and the reintegration of the patient. The treatment of schizophrenia requires two approaches: medication and psychosocial. Drug treatment is done with medicines called antipsychotics or neuroleptics. They are used in the acute phase of the disease to relieve psychotic symptoms, and also in the periods between attacks, to prevent further relapses. Most patients have continuously use the medication to have no further seizures. So the patient should undergo periodic medical evaluations; the doctor tries to keep the medication in the lowest possible dose to avoid relapses and avoid any side effects. Psychosocial approaches are needed to promote the reintegration of the patient to the family and society. Due to the fact that some symptoms (especially apathy, social withdrawal and others) may persist even after the crisis, we need an individualized plan of rehabilitation. Patients usually need psychotherapy, occupational therapy, and other procedures designed to help you cope more easily with the difficulties of everyday life.

How family members can collaborate with the patient?

The family are very important allies in the treatment and reintegration of the patient. it is important to be informed about the disease schizophrenia so that they can understand the symptoms and the patient's attitudes, avoiding misinterpretations. Inadequate attitudes of family members can often contribute to the clinical deterioration of the same. The initial impact of the news that someone in the family has schizophrenia is quite painful. As schizophrenia is a little-known disease and subject to a lot of misinformation people feel perplexed and confused. Often, before the eccentric attitudes of patients, family members also react with inappropriate attitudes, perpetuating a vicious circle difficult to be broken. Hostile attitudes, criticisms and overprotection harm the patient, support and understanding are needed so it can have an independent life and mingle well with the disease.

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