Throughout history there have been accounts of schizophrenia-like syndromes that report, irrational, uncontrolled, and incoherent behavior. And since there is no hard historical evidence mentioning schizophrenia it is thought that it is a modern occurrence or that if it is not it was masked in historical, medical writings by being lumped in with related psychotic phenomena such as psychoses, dementia, or melancholia. The very first detailed case report of one James Tilly Matthews in 1797 and other such accounts published by Phillipe Pinel in 1809 are considered to be the very first definite cases of schizophrenia recorded in medical journals. In 1853 Benedict Morel termed this new mental disorder as ‘early dementia’. This was the accepted term for the condition until 1903 when Eugene Bleur renamed it Schizophrenia, or “splitting of the mind”. Bleur realized that unlike dementia some of the patients seemed to be getting better and would even have complete recoveries which is impossible with dementia. For the first hald of the 20th century schizophrenia was thought to be a hereditary disease and so people with the disorder were sterilized in many countries and in Nazi Germany they were outright murdered. Since the new edition of DSM-IV has come out, five different types of
Massey 2
schizophrenia have been confirmed. Paranoid schizophrenia is considered the worst. Its common characteristics are the belief that everyone is out to get you, along with auditory and visual hallucinations and delusions that help to confirm and justify in the patients mind his or her paranoia.
Schizophrenia effects effects over 2.2 million people in the United States alone. In this year over 1.5 million people will be diagnosed with schizophrenia worldwide and over 100,000 in the United States. It is also not a disorder of social classes or of standards of living either, it is a worldwide phenomenon; an estimated 4.3 to 8 million people have schizophrenia in India and 6-12 million in China. However, schizophrenia does seem to discriminate between the sexes to some extent. Males are more likely to be diagnosed with schizophrenia. As well, schizophrenia tends to manifest at an earlier age for males, typically showing itself at around the age 18, whereas in females it typically appears around 25 years old. The onset of schizophrenia is extremely rare in people under 10 or over 40 years of age.
Schizophrenia has physical effects on the patient’s brain. For one thing it affects the hippocampus with something called cellular disarray. In the hippocampus of a person without schizophrenia or any other diseases the cells seem to have an ordered structure about them. However in the hippocampus of a patient with schizophrenia there is no order or structure at all, all the cells are disorganized and scattered. As well, patients with schizophrenia experience excess dopamine which is most likely the cause of the delusions, auditory hallucinations and disturbed thoughts. Although schizophrenia does have some genetic basis it cannot be linked to one gene, otherwise it would show in all monozygotic twins, instead in cases where one monozygotic twin has schizophrenia only 48% will the other twin develop schizophrenia. One hypothesis, called the brain abnormality hypothesis, suggests that schizophrenia comes from biological problems in the brain. These include reduced blood flow in the globus pallidus, problems in the frontal lobe known as hypofrontality, thinning in the medial temporal lobe, reduced size in the anterior hypothalamus, enlargement in the lateral and third ventricles and and in the Sulci which indicates a reduced number of neurons. Any of these problems (which could be among the causes of schizophrenia) could be caused by birth trauma, infections, nutritional issues and/or genetic factors.
There are many kinds of drugs that are used in the treatment of schizophrenia. They are often prescribed on the basis of what symptoms are prevalent and potency of the drug. However the very first succesful drug used in the treatment of schizophrenia is a typical, antipsychotic known generically as chloropromazine and by brand, thorazine. Chloropromazine, first synthesized in December of 1950 is an antipsychotic medication in the group of drugs known as phenothiazines which work by changing what certain chemicals do in the brain. Chloropromazine had clear effects on helping to ease symptoms of schizophrenia. Delusions, hallucinations, and disordered thinking are all relieved to some extent through the use of chloropromazine. Doses varied based on the severity of the schizophrenic symptoms on an individual basis and the patient should never stray from the recommended dosage due to the potential severity of the side effects. However the drug has been outdated by newer more effective atypical, antipsychotic, drugs such as Olanzapine. Olanzapine is an atypical, drug in the class known as thienobenzodiazepines. Like most new atypical antipsychotic drugs, when compared to the older typical ones, olanzapine has a lower affinity for histamine receptors.
Massey 3
Although the mode of action of olanzapines antipsychotic activity is unknown it may involve antagonizing the serotonin receptors. Other typical antipsychotic drugs used in treatment of schizophrenia include quetiapine, and and risperidone.
Schizophrenia is in my mind the most devastating mental disorder or disease that one could possibly endure. It is the most misunderstood disorders as well and research should be greatly increased. Although schizophrenia is not directly responsible for taking a large amount of lives a year as cancer is I would argue that its effects on the human mind are even worse than death in extreme cases. For someone to live in a state of inescapable, extreme paranoia with delusional thoughts for a lifetime all the time is a fate worse than death. Although it effects less than one percent of the world’s population it has affected us all. Living in Richmond city it is hard to walk anywhere without seeing a homeless man or woman occasionally in Monroe Park or sleeping on a bench or behind some bushes and almost as common is being confronted by one. Many of these people have mental illnesses such as paranoid schizophrenia and could potentially be a danger to the people around them since they have no access to medication. I have personally been confronted by homeless people on multiple different occasions and many of them were visibly not of a sound mind. As well I found no medications in my research that prevented or helped to prevent or treat the disease, instead they only treated the symptoms. I think it is vital that more research be put into the development of a preventative or disease treating medication. But of course to do this we must understand what it is that causes schizophrenia.