The Complexity of Schizophrenia

In 1911 a Swiss psychiatrist who headed a psychiatric hospital at Burgholzli introduced the term schizophrenia. His work, which was known as "Bleuler's four A's" involved disturbances in affect, association, ambivalence and autism.

Today, the American Psychiatric Association has identified criteria which is used in diagnosis for many disorders including schizophrenia. Three specific categories regarding symptoms must be present and three specific things must be absent before a diagnosis is given.

A psychiatrist or mental health professional examines the presence and severity of characteristic symptoms which may include delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behaviour or other negatives. One or more of these is usually apparent for a significant portion of time during a one-month period of time.

Social or occupational dysfunction usually appears in one or more major areas such as work, interpersonal relations or self-care. The performances of children and adolescents may be below expected levels of achievement. Functioning in adults can clearly be compared between those before onset and those afterwards.

Professionals also study the duration of symptoms and minimally examine a six month period of time before making a diagnosis.

A number of other disorders and conditions must be ruled out. These include schizoaffective, mood disorder, substance abuse, general medical conditions or pervasive developmental disorders.

Yes, the process of diagnosis is complex and to complicate it even further, there are five subtypes of schizophrenia including Paranoid, Catatonic, Disorganized, Undifferentiated, and Residual.

Associated features may include learning problems, hypoactivity, psychosis, euphoric mood, depressed mood, somatic or sexual dysfunction, hyperactivity, guilt or obsession, sexually deviant behaviour, odd/eccentric or suspicious personality, anxious or fearful, dependent, dramatic, erratic or antisocial personality.

Once a diagnosis is made, the professionals involved can help design a treatment plan for the individual. Schizophrenia is not a "curable disease". I know individuals, however, who manage the symptoms and live lives of health, productivity and happiness.

If you would like more information please contact Catherine McCulloch who is the Program Director of the Schizophrenia Society in downtown Medicine Hat.