Free Essay Sample «Nursing Aging Library Assignment: Schizophrenia»

«Nursing Aging Library Assignment: Schizophrenia»


Throughout the history, schizophrenia has been a controversial issue. The term used to describe an unambiguously human syndrome of severely disordered conduct. People no longer doubt that the illness truly exists, or whether it is a disease or a life choice. They do not debate whether it is a significant public health concern all around the globe. Nowadays, people argue that schizophrenia is the worst disease that can affect humanity, without the exception of AIDS. In the United States of America alone, the estimated cost of managing this illness is over forty billion dollars annually. However, the price that affected patients and their families is worthless.

For over centuries, scientists had an increasing interest in the prevention of such mental diseases as schizophrenia. The purpose of this research paper is to examine schizophrenia and discuss its symptoms, subtypes, risk factors, and interventions. Although schizophrenia is a fatigue not a curable disorder with disastrous consequences, it still can be treatable and manageable.

Definition of Schizophrenia and Statistics

Schizophrenia is one of the most substantial public health problems in the entire world. A report made by World Health Organization classifies it as one of the top ten diseases that contribute to the global burden of disease (Picchioni & Murray, 2008). Schizophrenia is a mental disorder, which comes within the purview of the psychotic illnesses. The research of the disorder started in the early 1900s (Picchioni & Murray, 2008).

When the symptoms start developing, they may cause the misinterpretation of reality. The definitions of schizophrenia have developed through six editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM) (Picchioni & Murray, 2008). The major characteristics of all definitions are the lack of motivation, lifelong health condition, and adverse outcome.

Schizophrenia is a moderately common disease. Although its rates in the overall population vary, the illness affects from 0.5% to approximately 1% of people around the world (Weinberger & Harrison, 2011). The disease originates in the early adulthood between the ages of fifteen and twenty-five (Weinberger & Harrison, 2011). Males may develop schizophrenia earlier than females. Most women usually get ill slightly later than men. Females after the age of thirty may easily develop symptoms, and the scope of the disease among them is noticeably higher (Weinberger & Harrison, 2011). The average onset age is eighteen in males, and twenty-five in females (Weinberger & Harrison, 2011).

People, who are under ten and over forty years of age, rarely suffer from schizophrenia (Weinberger & Harrison, 2011). The hospitalization is required for people between the age of fifteen and forty (Weinberger & Harrison, 2011). The number of those with schizophrenia around the world is as many as fifty-one million people, whereas, in the USA, approximately 2.2 million of people suffer from this disease (Weinberger & Harrison, 2011).

Signs and Symptoms

Whereas signs may slightly differ from the symptoms, they still reflect an impaired capability to function. They include change of thinking and behavior, but people may experience symptoms in various ways (Weinberger & Harrison, 2011).

There are five distinctive symptoms that allow diagnosing schizophrenia. Two or even more of them may remain for a period of one month (Weinberger & Harrison, 2011). There is a clear distinction between positive and negative symptoms in patients diagnosed with schizophrenia.

For instance, DSM-IV requires only one symptom if it is a bizarre delirium or hallucination (Weinberger & Harrison, 2011). The DSM-V does not determine the treatment for these symptoms as it lacks specific character of diagnosis (Weinberger & Harrison, 2011). Thus, the positive symptom requires the same treatment as any other one regarding diagnostic implication. In case of hallucinations, people may hear abusive voices or instructions of what to do.

The third symptom is disorganized speech or behavior (Weinberger & Harrison, 2011). It is one of the main aspects not only of schizophrenia, but also any other psychotic disorder. A person’s speech may be distorted or not logical, as one fails to use and generate proper language. The next two symptoms include self-negligence and lack of motivation (Weinberger & Harrison, 2011). Patients do not pay close attention to them, but eventually they result in family and career distress.


Psychiatrists have traditionally distinguished various subtypes of schizophrenia according to the balance of the symptoms. The first one is paranoid schizophrenia also known as paranoid dementia, which represents the familiar symptoms, such as delirium and hallucinations sometimes accompanied by the fear of persecution (Weinberger & Harrison, 2011).

The next subtype of schizophrenia is hebephrenic, which expresses modified and irrelevant mood, a lack of goal-seeking behavior, and distinguished psychological disorder (Weinberger & Harrison, 2011). Another subtype is catatonic schizophrenia, also called catatonic dementia praecox, which rarely occurs in the West (Weinberger & Harrison, 2011). The characteristic feature of this subtype is a continual evidence of abnormal motor conduct such as posturing, torpidity, agony, or even stupor. Finally, yet importantly, there is simple schizophrenia, which associates with a substantial loss of personal motivation, progressive extension of negative symptoms, and minimization of social, academic, and employment interaction (Weinberger & Harrison, 2011).

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Risk Factors

Despite the low rates of the disease, its expansion remains relatively high. It starts in early adulthood and becomes chronic. Its incidence varies in different areas, rising in some and falling in others (Messias et. al., 2007).

According to the epidemiology of schizophrenia, there is an enormous number of risk factors. They were present prior to the beginning of the disease. Firstly, the season of childbirth is significant (Messias et. al., 2007). Scientists state that people born in winter will more likely have schizophrenia than those born in summer. They explain that a mother passes her second trimester in the time of the flu season; thus, it raises the risk of the disease in her offspring.

Secondly, the birth complications, including bleeding, congenital defects, and uterine insufficiency may also later lead to the disease in children (Messias et. al., 2007). Thirdly, the parents’ age plays contributes to the risk of schizophrenia development. Another substantial factor is the infections and diseases in the immune system (Messias et. al., 2007). Moreover, ethnic status including race, country of origin, and religion identifies the risk of the disease (Messias et. al., 2007). Finally, studies show that people who were using drugs, especially cannabis, may develop schizophrenia (Messias et. al., 2007).

Diagnostic Criteria

In order to classify the antecedent period of schizophrenia and other psychological disorders and examine the evolution or breakdown that deviate from the previous experience or conduct, researchers have suggested two classifications for people at high risk of developing the disorder.

Firstly, they came up with The International Statistical Classification of Diseases and Related Health Problems (Picchioni & Murray, 2008). It includes delusion of affection, hallucination, and bizarre delusion. One of these characteristics may be present most of the time for the entire month. It also comprises delusions, inconsistent speech, stupor, etc.

The Diagnostic and Statistical Manual Fourth Revision, also known as DSM-IV, includes the second classification of schizophrenia mentioning such characteristic symptoms as delirium, hallucinations, catatonic conduct, and unorganized speech (Picchioni & Murray, 2008). According to the World Health Organization, there is an enormous number of frequently reported symptoms of schizophrenia (Picchioni & Murray, 2008). For instance, 97% of people faced the lack of motivation, whereas 74% of them had hallucination of hearing (Picchioni & Murray, 2008). 

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The average time of untreated schizophrenia is from one to two years. The longer this period is, the worse may be the disease outcome (Larson et. al., 2010). Thus, in order to reduce the suffering, it is important to offer patients a suitable treatment as soon as possible. There are two types of treatments – pharmacological and non-pharmacological (Larson et. al., 2010).

Antipsychotic intervention diagnoses psychotic disorder. Due to this type of medication, the decrease of positive symptoms is evident. Long-term exposure to the first-generation neuroleptic medication can cause enormous number of side effects, including delayed dyskenisia and motor disorder (Larson et. al., 2010). The second-generation antipsychotic medication has such drawbacks as weight gain and disturbance in metabolism (Larson et. al., 2010).

Non-pharamacological interventions may include psychological approaches. In comparison to the pharmacological one, this type is cost-effective and well tolerated (Larson et. al., 2010). Researchers state that social interaction, cognitive ability, and training programs bring results that are more positive and improve health.

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Family Considerations and Management of Behaviors

Schizophrenia is a severe mental disorder that is present in both developed and developing countries. It requires tremendous amount of money that eventually devastates patients, their families, and relatives (Devaramane et al., 2011). In the course of the disease, patients feel the interruption of their thoughts and lives. Their families are grieving and showing emotional endurance (Devaramane et al., 2011). Their obligation is to take care of their affected relatives for a lifetime.

Despite the pharmacological medication, family intervention is the most efficient and durable, but may prevent relapses in patients (Devaramane et al., 2011). However, there are also examples when families became forerunners of their mental disorders. Sometimes, family members criticize each other and become hostile. Even though the majority of families face a substantial burden, they still care for their relatives with the disorder and never give up on them. Thus, it is evident that those family members, who have a good influence on each other, may effectively reduce the symptoms (Devaramane et al., 2011). Moreover, it is the most pragmatic, time-efficient, and cost-effective way to save the relative.

However, sometimes families seek for professional help such as effective psychological treatment. It will minimize symptoms, enhance functioning, and avert relapses (Picchioni & Murray, 2008). Unfortunately, this help is limited due to the lack of trained psychotherapists. The most effective way to manage patients’ behavior is cognitive behavioral therapy also known as CBT (Picchioni & Murray, 2008). Family members together with affected patients should visit no less than ten sessions during three months.

Nursing Theories

Psychiatric nurses provide professional help for patients affected with schizophrenia or other mental health issues. They design individual plans for each patient based on psychiatric nursing theories developed by researchers. There are enormous number of theories, but the most widespread are biopsychosocial ones (Kneisl & Trigoboff, 2008). Approaches to treatment have undergone changes and should be responsive to the needs of individuals.

The biologic theories, including Brain Structure Abnormalities, Genetic, Biochemical ones, state that the disease is merely psychological (Kneisl & Trigoboff, 2008). Scientists suggest that the major role in developing of schizophrenia play biological alterations. For instance, metabolic imbalance, organic diseases, brain tumors, use of drug, and infections may cause hallucinations and delusions (Kneisl & Trigoboff, 2008).

The psychological theories focus on the person’s deficit states. For instance, Information Processing Theory states that affected patients are deficient in information processing (Kneisl & Trigoboff, 2008). Attention and Arousal Theory measures a person’s state by physiologic alterations such as heart rate, blood pressure, and skin temperature (Kneisl & Trigoboff, 2008).

Last but not least, there is a Family Theory that implicates dysfunctional family interactions as a cause of schizophrenia (Kneisl & Trigoboff, 2008). Disordered family communication and emotional tone may influence the course of the disease. Thus, schizophrenia is responsive to the emotional climate in the family.


Schizophrenia is a mental disorder that includes positive and negative symptoms, such as hallucinations, delusions, inconsistent speech, etc. It may also accompany cognitive, functional, and social deficits. Statistical data state that males are more likely to develop the disorder and often do that earlier than women. Moreover, psychiatrists have traditionally divided the disease into the paranoid, hebephrenic, catatonic, and simple subtypes. They also distinguish an enormous number of risk factors, including the season of childbirth, birth complications, parental age, ethnic status, and even drug usage. They have also classified schizophrenia according to the two diagnostic criteria, ISC and DSM-IV. Even though the disease is not curable, there are a lot of ways to treat it. They comprise pharmacological and non-pharmacological types of treatment. However, most people believe that the most effective way to bring people back to the normal life is family interventions. 



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