While psychologists have long decried the outdated blanket diagnosis of schizophrenia, it now appears that the psychiatric community is finally coming around to the same conclusion
Outcomes for patients after a psychiatric diagnosis of schizophrenia are generally poor, despite years of study by the psychiatric community. Consequently, the community is finally coming around to understand that schizophrenia may, in fact, be a spectrum, rather than a stand-alone diagnosis.
Eugen Bleuler, a Swiss psychiatrist, first coined the term Schizophrenia in 1910. He derived the word from modern Latin, and it literally means “a splitting of the mind.” However, before this, Emile Kraepelin, a German doctor evaluated patients exhibiting associated symptoms as what he called dementia praecox. And now, just as experts understand that the disorder clearly has nothing in common with dementia, current thinking is also moving away from the idea of a single diagnosis of schizophrenia.
New understanding vs. Old understanding
According to the DSM-IV, there are five types of schizophrenia. These include paranoid, disorganized, undifferentiated, catatonic and residual. However, new understanding, long suspected already by psychologists, is coming to light. Psychiatrists are finally re-considering the disease as a spectrum. This is similar to the way experts began to understand autism. In fact, Professor of psychiatry at Maastricht Universtiy, Jim van Os, believes that the psychiatric establishment should abolish the word schizophrenia altogether.
The essential symptoms associated with the psychiatric community’s definition of schizophrenia are confusion, delusion and of course hallucinations. And it is only now that the community is acknowledging that these symptoms “exist along a continuum and in degrees,” according to Associate Professor in Clinical Psychology and Neuropsychology Simon McCarthy-Jones, at Trinity College in Dublin.
Sadly, according to McCarthy-Jones, the expert’s historic diagnosis of schizophrenia has seen them portray it as hopeless
Once a psychiatrist diagnoses an individual, sadly, their life expectancy becomes reduced by around two decades. However, the statistics surrounding this are not accurate. When some individuals recover, according to van Os, a doctor will assume that the patient never had schizophrenia. Clearly, their symptoms pointed to the disease? Something is not adding up.
Sir Robin Murray, another prominent psychiatrist, concurs: “I expect to see the end of the concept of schizophrenia soon. The syndrome is already beginning to break down, for example, in those cases caused by copy number (genetic) variations, drug abuse, social diversity, etc. Presumably, this process will accelerate, and the term schizophrenia will be confined to history, like ‘dropsy.’”
In other words, researchers are looking at the disorder from the opposite direction
What are the catalytic factors that can potentially lead to the telltale symptoms? What might cause a person to experience persistent psychosis? Why might they suffer from perpetual hallucinations and disorganized thinking, followed by flatness and apathy? As McCarthy-Jones noted, “one past error has been to mistake a path of the path, or, more commonly, to mistake a back road for a motorway.”
There appear already to be distinct catalysts that lead to what psychiatrists have been diagnosing as schizophrenia. And until now, what experts have assumed was the egg, could very well turn out to be the chicken or vice versa. One stark example is cannabis use. Is it the catalyst for schizophrenia? Or are those prone to develop schizophrenia likely to experience its onset if they smoke pot?
A considerable amount of young people diagnosed with schizophrenia experience the disease’s symptoms after prolonged usage of cannabis, and find themselves locked up in secure mental units. But would they have developed any symptoms had they avoided the drug?
Another well-known catalyst is genetic
In approximately 1% of cases, a small stretch of DNA on chromosome 22 is missing in patients who experience schizophrenic symptoms. What is common, however, among all people living with schizophrenia, is the abnormally high levels of dopamine in their bloodstream. What causes the brain to release more dopamine? In other disorders, such as high anxiety and depression, other hormones are at abnormal levels.
Sadly, until now, psychologists like Mary Boyle have been ignored when they have published evidence that the diagnosis of schizophrenia needs rethinking. Let’s hope that this latest awakening within the psychiatric community enables many individuals to find relief, and potentially a cure, after so much suffering.