Analyzing Psychological Disorders
University of Phoenix

Analyzing Psychological Disorders

Schizophrenia is a mental disorder that makes it hard to tell the difference between what is real and what is not real. Schizophrenia makes it hard to think clearly, and have normal emotional responses. Act normally in social situations is also affected by this disorder.
According to the National Institute of Mental Health, approximately 1 percent of the U.S. population is diagnosed with schizophrenia. Schizophrenia has no exact known cause but is categorized as a brain disorder affecting the balance in neurotransmitter concentration of dopamine, glutamate and serotonin systems. Symptoms present in the disorder are positive, which means psychosis, or negative, which means affecting emotions and behavior. The primary areas of the brain implicated in schizophrenia are the forebrain, hindbrain and limbic system (LIVESTRONG, Aubri, John, 2011).
The forebrain is the topmost and largest portion of the brain and includes the cerebral hemispheres which are divided into four lobes; they are the limbic system, thalamus, hypothalamus and corpus callosum. As a whole, the forebrain serves to control cognition which is the process of thinking, knowing, learning, judging, sensory and motor function, temperature regulation, reproduction, hunger, sleep cycle and emotional expression. It is within the frontal lobe where thought organization occurs, creating the delusional ideas that are a common positive symptom of schizophrenia. It is also in this lobe that overstimulation of dopamine impacts decreased glutamate and neural activity. The temporal lobe regulates hearing, and object and facial recognition. When schizophrenia is present the temporal lobe process is twisted, and a result is auditory and visual hallucinations.
The hindbrain includes the pons, medulla and cerebellum. It serves to manage motor activity, posture, balance, and circulation of blood. It is the undermost portion of the brain, and when schizophrenia is present a result of this portion of the brain being affected is shown in the negative symptoms of not being able to emotionally express one’s self, and inappropriate body language signals. Additionally, in severe schizophrenia catatonic behaviors are present, characterized by rigid posture, aimless motor activity, and decreased reaction to environmental cues.
The limbic system is a collection of brain systems including the hippocampus and amygdala. This system is located in the innermost portion of the brain and serves to regulate emotions, memories, learning, and sexual behavior. A brain affected by schizophrenia causes affective flattening which is considered a negative symptom of the disorder. Additionally, impairment in this portion of the brain creates disorganized behaviors preventing normal social connecting, bizarre actions and preoccupation with inappropriate sexual content.
Although it is not known what causes schizophrenia, researchers believe that a combination of genetics and environment contributes to the development of the disorder. Problems with certain naturally occurring brain chemicals, including neurotransmitters called dopamine and glutamate, may also contribute to schizophrenia. Neuroimaging studies have shown differences in the brain structure and central nervous system of people with schizophrenia. While researchers aren't certain about the significance of these changes, they support evidence that schizophrenia is a brain disease.
In addition to positive, negative, aggressive and cognitive symptoms, patients with schizophrenia often exhibit affective disorders including depression and anxiety. Affective symptoms in schizophrenia can be particularly disturbing for patients with schizophrenia because it increases the risk of suicide and diminishes the quality of life. Schizophrenia is a chronic psychiatric disorder that encompasses several different symptom domains: positive, negative, affective, aggressive and cognitive. Positive symptoms include hallucinations and delusions and are often the most responsive to treatment. Negative symptoms include apathy, anhedonia and flat affect whereas cognitive symptoms include attentional deficits and impaired executive function. There is substantial overlap among these different symptom domains and it can be particularly difficult to distinguish negative symptoms from affective symptoms including depression and anxiety.
Affective symptoms are common in schizophrenia. Depressive symptoms are reported in as many as 80% of patients with schizophrenia while symptoms of mania are reported in as many as 20% of individuals with schizophrenia (Debbi A. Morrissette, Stephen M. Stahl, 2011).
In addition to those who meet criteria for major depression, there are also a significant number of patients with schizophrenia who experience sub-syndromal depressive symptoms. Depressive symptoms in patients with schizophrenia can have devastating consequences including increased risk of psychotic relapse and hospitalization, worse social functioning and poorer quality of life compared to patients with schizophrenia who do not have prominent affective symptoms. Depressive symptoms significantly increase the risk of suicide. The majority (64%) of patients with schizophrenia who commit suicide do so while experiencing depressive symptoms. Similarly, suicide attempts are even more common in individuals with schizoaffective disorder compared to those with either schizophrenia or a mood disorder. The neural basis of schizophrenia may involve an imbalance of neurotransmitters and abnormal brain structures. According to MayoClinic.com, the causes of schizophrenia are not completely understood. Schizophrenia may be caused by a combination of genetic, environmental and neurological factors. Different symptoms of schizophrenia may be caused by different neurological dysfunctions. Neurology is the medical field concerned with the nervous system, which includes the brain, spinal cord and nerves. According to research published in 1999 in the "American Journal of Psychiatry," schizophrenia is characterized by "neurological abnormalities"; however, the significance of neurological abnormalities in schizophrenia patients is unclear. Drugs used to treat schizophrenia, are antipsychotic drugs. Antipsychotic (neuroleptic) drugs are by far the most effective medications for the treatment of schizophrenia. Until the superiority of clozapine in patients who had not responded adequately to other drugs was demonstrated, antipsychotic drugs were generally thought to be interchangeable in terms of efficacy. Among 100 studies comparing the effectiveness of chlorpromazine, thioridazine, and trifluoperazine with that of the other drugs excluding clozapine and risperidone, only 1 study reported a significant difference. Antipsychotic drugs are often described as having "high potency," meaning that the daily dose is a few milligrams, or "low potency," indicating a high daily dose. Low-potency drugs tend to have considerably stronger sedative effects. Many clinicians think that agitated patients respond best to the more sedating drugs and that withdrawn patients respond better to the less sedating drugs, but these views are not supported by the results of controlled trials. High-potency drugs such as haloperidol and fluphenazine, have more extrapyramidal effects and cause less sedation and less postural hypotension, whereas low-potency drugs such as chlorpromazine and thioridazine cause more sedation and hypotension and have fewer extrapyramidal effects. High-potency drugs are better suited for intramuscular injection and rapid dose escalation. As newer drugs are developed, this categorization may prove less meaningful (Wood, Alastair JJ, MD; Kane, John Michael, MD. The New England Journal of Medicine 334.1Jan 4, 1996: 34-42. The two new antipsychotic drugs that have been approved in the United States in recent years deserve specific comment. One of them, risperidone, should be included among the first-line antipsychotic drugs, whereas the other, clozapine, is indicated only for patients who do not respond to or cannot tolerate the first-line drugs. Stress can come from any event or thought that makes you feel frustrated, angry, or nervous. Anxiety is a feeling of fear, unease, and worry. The source of these symptoms however, is not always known. In Tom’s case, all the symptoms of anxiety are there. Tom experiences fear of health issues even though he has recently been to the doctor, and there is nothing wrong with him. Tom’s anxiety may be more related to Hypochondriasis which is an Anxiety Type and Symptom. Hypochondriasis - or as it is now referred to as "illness anxiety disorder" - is a type of anxiety that is often misunderstood. It goes by many casual names, the most common being "hypochondria" or "health anxiety" and in some ways it comes in many different types, in terms of how people think about that health anxiety and the symptoms it causes. Hypochondria -- the conviction that one is ill, despite all evidence to the contrary -- affects as much as 5% of the U.S. population, according to the American Psychological Association. It often starts in a person's 20s and can be triggered by a medical scare or the illness of a friend or relative. It then can wax and wane over a person's life, flaring up during stressful times. It affects men and women equally (R. Morgan Griffin WebMD the Magazine – Feature Reviewed by Brunilda Nazario, MD). Tom seems to living a comfortable and successful life, so I don’t think his symtpoms have much to do with anything in the nurture aspect. Tom’s symptoms can be very well related to his surroundings. He has a good job, he is married, and has three healthy children. Most would call that ideal, and I think with a rough family background, that wouldn’t be the case. I think tom may be too focused on keeping everything okay that the stress gets the best of him. Being an engineer is not an easy job; neither is being a husband and father, so day after day it took a toll on him. Fortunately, there are medications that can help Tom concentrate more, and alleviate some stress he may be feeling. The physical symptoms that Tom is experiencing such as headache and fatigue can all be caused mentally. Hypochondria is hard to treat, but experts have made progress. Several studies show that using antidepressants, such as Prozac and Luvox, can help. Antianxiety medications are also used to treat the disorder. Barsky and other researchers say that cognitive-behavioral therapy also works. Sleep is a vital part of normal health and wellness for everyone. Insomnia is defined as a lack of sleep that occurs when there is adequate and normal opportunity to sleep (differentiating insomnia from sleep deprivation that occurs with circadian rhythm disturbances such as time zone changes or shift work). The type of sleep disturbance and the duration of the problem classify insomnia. The type of sleep disturbance may be because of a problem with sleep onset (getting to sleep), difficulty in maintaining continuous sleep (remaining asleep for the time necessary for renewal and refreshment), or waking up too early (National Institutes of Health [NIH], 2005). The duration of the insomnia determines whether it is considered acute or chronic. Acute insomnia can occur in anyone and lasts for a relatively short time (less than 30 days), and can reoccur for short periods of time when "triggered" by transient events (primarily stress). Chronic insomnia lasts longer than 30 days and has a more extended impact on an individual's daytime function. Women are more prone to insomnia than men (especially during menstruation or menopause when the menstrual cycle causes changes in hormones), and complaints of insomnia increase with age (NIH; Forth, 2006). Treatment options for acute or transient insomnia may include behavioral interventions and short-term use of pharmacotherapeutics or a combination of both. According to some experts, behavioral change is the first step toward breaking maladaptive sleep habits (Smith & Perlis, 2006). When interventions such as keeping a regular sleep schedule, creating a dark, comfortable bedroom environment, and establishing a “pre-bedtime” ritual are effective, insomnia can be resolved without the expense of drugs or side effects of the drug.

References
Journal Article: Orthopaedic nursing / National Association of Orthopaedic Nurses; Turkoski, Beatrice B, 09/2006.
Journal Article: The New England Journal of Medicine; Massachusetts Medical Society; Alastair JJ Wood and John Michael Kane, 01/1996.
Journal Article: Drug Discovery Today: Therapeutic Strategies; Morrissette, Debbi A and Stahl, Stephen M, 06/2011. http://www.mayoclinic.org/diseases-conditions/schizophrenia/basics/causes/con-20021077 http://www.webmd.com/anxiety-panic/features/worried-sick-help-for-hypochondria