How does schizophrenia develop

Schizophrenia is a term used to refer to a severe form of mental disorder. It is found in all countries and cultures, and much more often than you, perhaps, think. According to a rough estimate, approximately 1 person out of 100 may suffer from this ailment at any period of his life. The risk of this disease is 1% during life, about the same as the risk of developing rheumatoid arthritis. Many of us are familiar with people suffering from this much more noticeable disease. The emotional aspect of schizophrenia buy seroquel online is not only extremely difficult for the patient and his (her) family and friends, but the cost of treating schizophrenia is also very difficult for the family. Care of the patient and treatment of schizophrenia in the UK cost in the early 1990's. 397 million pounds sterling, and indirect expenses in the field of loss of production were restrained during the same period at 1,7 billion pounds.

Since most of us did not suffer from mental disorders, we often draw our knowledge of schizophrenia from the popular press. Articles about mental disorders appear very often, but those who suffer and those who care for them often appear in them in a negative light. The tabloid newspapers are particularly eager to describe individual cases of violent death. These can be suicides in terrible conditions, for example, a man entered a lion cage in a zoo in London and suffered severe injuries, or unmotivated murders such as the case of Christopher Cluny, who scored to the death of a stranger at the station of the Finsbury Park subway .

From the description of this event, we get the impression that schizophrenia is a dangerous form of insanity. Those suffering from this disease act irrationally and behave in an absolutely incomprehensible way. In fact, as we will see, the overwhelming majority of patients are not dangerous, and if we want to help them, we must understand them.

Having said this, we all the same know that it is difficult for those of us who are mentally healthy to understand what the patients with schizophrenia are experiencing. The closest we can come to this understanding is by reading what the patients themselves wrote. A particularly memorable document, cited by Sir Aubrey Lewis in 1967, was written by a boy of 18 years who was sick for at least a year.

"I increasingly lose contact with my environment and with myself. Instead of being interested in what is happening around me and taking care of the course of my illness, I keep losing emotional contact with everyone, including myself ... only the abstract knowledge of what is happening around me and with me remains. Even this disease, which permeates my whole existence, I can only consider objectively. But in rare cases, I suddenly become overwhelmed with the sense of terrible destruction that this creeping strange disease causes, the victim of which I became ... Sometimes I get overwhelmed by despair. But after each such flash, I become even more indifferent. I'm losing myself more and more in sickness, I'm plunging into a lifeless existence. My fate, when I think about it, seems to me the most terrible thing that can ever be. I can not imagine anything more frightening than a well-to-do, cultured human being who realizes his own gradual destruction, constantly fully aware of this. But this is what happens to me. "

This message is particularly shocking, because it reflects the so-called "negative" symptom of schizophrenia - a gradual departure from the world and from itself. Few patients can describe their feelings in this way. It is because of the loss of contact with oneself that most sufferers are deprived of the ability and motivation to talk about their illness in such a lively and unconstrained form. Much more often there are reports of a "positive" symptom of schizophrenia - bright false pictures (hallucinations) and false hopes (illusions), which are so characteristic of this disease. Usually such messages are written not during illness, but after recovery.

This aspect of the disease is illustrated in two famous historical accounts: one written at the end of the XVII century, the other - in the middle of the XIX century. We do not have the necessary information to be sure that George Tross and John Persevale can be considered as persons suffering from schizophrenia in accordance with modern medical diagnostic standards. However, many descriptions of what they felt are very similar to the reports of modern patients. Both men clearly describe hallucinations and illusions (deceptions of feelings). These historical documents give us also an idea of ​​how these patients were treated in the past.

I was often visited in a huge number of horrifying and disturbing Visions and Voices, which (I think) were not real, but they seemed to me so and had the same effect on me as if they were real.

I heard the Voice, and I heard that he was just behind me and said to me: "Be humble, even more humble," stretching out a few words ... After listening to him, I tore off my stockings, jacket and suit. And when I undressed in this way, I had a strong inner conviction that I did everything right, in full accordance with the Voice plan. After a while, standing in front of the window, I again heard the Voice that prompted me or gave me a strong impulse, which excited me so that I could cut my hair, and I answered him: I do not have scissors. After that, I discovered that it can be done with a knife. But I answered: I do not have it either. If he had I, I'm sure, the voice after the hair would have reached my throat and told me to cut it. "

These passages are taken from the life of the Reverend Mr. George Tross, written by himself and published in 1714, shortly after his death. What he experienced and described, occurred many years before the record, when he was about twenty years old. By the time he came to write it all down, he became a priest of the Presbyterian church and a respected member of the Exeter community. At moments when he was experiencing all this, he was considered insane. Since he refused to talk and eat, and leave his bed, it's no surprise that his friends were worried about him.

"I was sure that if I was removed (out of bed), I would go to Hell and I would be immersed in the Great Depression."

He had to be taken by force.

"They brought a very large strong man who rode ahead of me, and when he climbed onto the back of the horse, they forcefully put me in front of him, tied him with linen strips. And because I resisted and did everything I could to get off the horse, they tied my legs under the belly of a horse.

Finally, at the will of the All-Good Lord, we arrived safely to the House of Physicians. There I was handed over to the Person who became my Guardian to watch over me so that I could not destroy myself. And in this room and in this house I stayed for several weeks, no, rather, months. Sometimes they tied my hands and fettered my legs when I behaved aggressively and wrongly (which I often did), because I often fought and fought. "

John Perseval, 1838 A century later, in 1838, John Persevale wrote a long account of his experience of insanity. John Persevale was one of the 12 children of Spencer Perceval, the only English Prime Minister who was killed. When John was 27 years old, he started seeing visions, he began to hear voices that told him strange things. His behavior began to deviate so much from the norm that they called a "doctor for sleepwalkers," who ordered him to tie him to the bed and gave him broth and medicine. A few days later, John's brother came and took him to a private shelter near Bristol, led by Dr. Fox.

John spent at the orphanage for about three years. He gradually began to recover and began to write about his illness, which he did for a year or more. He devoted the rest of his life to attempts to reform the ways of treating the mentally ill.

Before the discovery of antipsychotic drugs (neuroleptics), there were no effective means of treating schizophrenia. Antipsychotic medications were introduced into the practice of psychiatry in 1952 and began to be widely used in the 1960s. (See chapter 4). However, these medicines have not been used everywhere. In the 1970's. David Owens and Eva Johnston observed a large group of patients (1,227 people), patients of the Shenli hospital. It was a large psychiatric hospital, located north of London, which is now closed.

Of these, 510 met the standard criteria for diagnosing schizophrenia and were examined in great detail, including records of all the physical therapies that have ever been applied to them. It was found that 65 of these patients never received antipsychotic medications. The reason for this was that in those days the Shenley Hospital was divided into two parts, corresponding to the two London towns that she served.

One part consultants had orthodox views, and their patients received the entire set of therapies that were commonly used at the time, including insulin coma (Figure 2), electroshock therapy (electrocuted to the brain to trigger seizures), and antipsychotic medications.