I have had a booklet from a psychiatric ward I was in(just found it), and I just typed it all up(give me some credit :laugh:, it took me two nights to type all this up and I'm exhausted from it now! :tongue, wondered if it may come in handy, since I've found out my boyfriend has it, so, here it is: There's much disagreement about the psychiatric diagnosis of schizophrenia. This booklet introduces the varies different theories and ideas about its diagnosis, cause and treatment. It also offers practical advice to anyone told they have this problem, and to their family and friends. What is schizophrenia? The term schizophrenia is widely used in the mental health system. Psychiatrists classify it as a psychosis. They mean that, in their view, a person can't distinguish their own intense thoughts, ideas, perceptions and imaginings from reality (the shared perceptions, sets of ideas and values that other people in that culture hold to be real). Amoung other symptoms, a person might be hearing voices, or may believe that other people can read their mind and control their thoughts. Most psychiatrists regard such symptoms as a psychiatric disorder. They would usually prescribe major tranquillisers to treat it. Not everyone shares this view of these psychological episodes, however. An alternative idea is that they are logical or natural reactions to adverse life events, in other words an extreme form of distress. Many people prefer to look at schizophrenia 'holistically'. They stress the need to think about individual experience, and the importance of understanding what the experienes mean to the individual. Hearing voices, for instance, holds a different significance within different cultures and spiritual belief systems. How do psychiatrists make a diagnosis? Problems of this kind often start with confusing, or even drastic changes in behaviour. It's important to rule out other possible causes. These symptoms may be similar to other mental health problems, such as bipolar disorder and schizoaffective disorder, or they could be a result of underlying physical problems. Psychiatrists make a diagnosis of schizophrenia on the grounds of various 'positive' and 'negavetive' symptoms. 'Positive' symptoms include: Disordered thinking Hallucinations, such as hearing voices or other sounds Delusions 'Negative' symptoms may include: Feeling apathetic or emotionally flat Being unable to concentrate Wanting to avoid people Feeling a need to be protected Thought disruption A person is said to be experiencing thought disruption if he or she seems unable to follow a logical sequence of thought, and if their ideas appear jumbled and make little sense to others. This can make conversation very difficult and may contribute to the other person's sense of loneliness and isolation. Hallucinations Some people hear voices that others around don't hear. The voices may be familiar, friendly or critical. They might dicuss the hearer's thoughts or behaviour, or they might tell them what to do. Hearing voices doesn't inevitably mean a label of schizophrenia. Up to four per cent of the population hears voices, according to some research, and for the most, the voices are not a problem. But people who are diagnosied with schizophrenia seem to hear mostly critical or unfriendly voices. They may have heard voices all their lives, but a stressful life event might have made the voices more severe and harder to deal with. People sometimes hear other sounds aswell as, or instead of, voices. Delusions Delusions are defined as beliefs or experiences that are not shared by others. Someone might believe, for instance, that they are being persued by secret agents or controlled by external forces that are putting thoughts into their mind. Negative symptoms Other symptons, such as social withdrawal, apathy, and inability to concentrate, are described as 'negative' rather than 'postive', because they are less clear-cut. It can be very difficult to tell whether they are part of the schizophrenia, or whether the person is reacting to other symptoms they find frightening and distressing. For instance, depending on what kind of experience they are having, someone might be quiet and immobile for hours, or move about constantly. Such symptoms could also be a response to other people's behaviour towards them. It's all too often the case that someone with a mental health problem is discriminated against or ignored, causing them to feel isolated, depressed or hopeless. Are some people more likely to be diagnosed than others? About one in a hundred people is diagnosed with schizophrenia at some point in their life - usually as a young adult. This figure is roughly the same for both sexes, but men tend to be younger when the diagnosis is made. You may be more likely to be told you have schizophrenia if a member of your family has already been given the same diagnosis. It's been estimated that around one third of people diagnosed with schizophrenia only experience one episode. Another third may have occasional episdes, while the last third may have to live with schizophrenia as an ongoing problem. When a psychiatrist has very different cultural, religious or social experiences to their patient's, there is a risk of msitaken diagnosis. For example, there is a considerable concern in Britain about the disproportionately high number of young African-Caribbean men given this diagnosis, which has led some experts to ask whether the entire theory of schizophrenia is based on racist ideas. Some people argue that because psychiatric experts can't agree about the definitions, causes, and suitable treatments for schizophrenia, it shouldn't be used as a diagnostic category at all. Are people diagnosed with schizophrenia dangerous? There is more media misinformation about schizophrenia than about any other psychiatric diagnosis. One popular myth is that schizophrenia means 'split personality' and that someone with schizophrenia swings from being calm to being out of control. There are often sensational stories in the newspapers or on TV about 'schizophrenics' who are depicted as being dangerous unless drugged and kept in institutions. In fact, the number of homicides committed by people with any mental illness diagnosis remained at the same low level for ten years, during which time the total number of homicides committed in Britain considerably increased. Most people diagnosed with schizophrenia don't commit violent crimes, and most violent crimes are not committed by people wit schizophrenia. Research has found that people with drug or alcohol problems are twice as likely to commit a violent crime as someone diagnosed with schizophrenia. Evidence of a relationship between schizophrenia and serious crime is so uncertain that predications about violence are considered virtually impossible. People are often very frightened of those who hear voices. It's important to remember that people who hear voices make choices about whether to act on them, just as anyone else would if told to do something. It seems to be the most common for voices to urge the person to kill themselves rather than to kill somebody else. Many make the conscious choice to stay alive every day, despite their voices. What causes schizophrenia? Because of differences of opinion about schizophrenia, it's not easy to identify what might cause it, but there are various different ideas. Inheritance Researchers looking for a particular 'schizophrenia gene' haven't found one. However, it's thought that particular genes might make some people more vulnerable to the symptoms, although this doesn't necessarily mean they will develop them. People's physical development, their upbringing and the enviourment they grow up in probably all play a part, as well as other psychological factors. Body chemistry Biochemical research has been centred on the neurotrasmitter dopamine, which is one of the chemicals that carry messages between brain cells. The theory is that an excess of dopamine may be involved, but it's still not clear whether it has a role in the development of schizphrenia. Nevertheless, major tranquillisers are designed to work on the dopamine system. Family experiences It's generally accepted that early experiences of family life affect the development of personality. There have been theories put forward about whether there is a particular type of family that might contribute to causing schizophrenia, but this has not been proved. Stressful life events Studies and personal accounts suggest that very stressful events may trigger schizophrenia. This could include such life-changing events as losing someone close to you, or the strain of having to change jobs. Other ongoing pressures, such as homelessness, poverty, and sexual or racial harrasment may also contribute to the problem. Over half the people who heard negative voices said that sexual or physical abuse was a cause of the problem, according to one study. Nearly a quarter felt that guilt at their own actions had triggered the negative voices. Substance abuse No-one has established whether the development of schizophrenia is linked to substance abuse. Most researchers don't believe it is, but there is anecdotal evidence that makes this connection. It's possible that people who are diagnosed with schizphrenia may have particularly bad reactions to certain drugs. Overall, most experts think that schizophrenia is caused by a combination of factors; someone's genetic make-up could make them more vulnerable, but stressful events or particular family or life experiences could trigger the onset of symptoms.