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In the last post, we saw how:
- Some electrophysiological studies include those done on patients with complex partial seizures and evoked potential.
- The word association test was progressed by Carl Jung and was used in pscyhciatry and psychology cases.
- Dialectical Behavior Therapy is a combination of cognitive and behavioural therapy.
Depression vector created by pch.vector - www.freepik.com
Welcome to Medic Vibes, where we discuss mental health disorders and make sense of them. Dr Ebingo Kigigha is a medical doctor (aspiring psychiatrist) and creative person (illustration and music). This has been our routine for three consecutive months. This month will be dedicated to Schizophrenia. In the first month, we discussed Depression, and in the subsequent month, anxiety. We just finished with Bipolar affective disorder. We are done looking at research work done in Nigeria on schizophrenia.
In this post, we are looking at a Tik Tok. To learn more just keep scrolling down. You can also skip to the key point of the post if you which or go to the conclusion to get the summary.
The understanding is that schizophrenia is a disease of the brain and just like other diseases that are affected by stress, both psychological and social, there is also the possibility that psychosocial stress may affect those who have schizophrenia.
Schizophrenia affects different people whose psychological makeup is different. Psychodynamic theories as outdated as they are still the best way to understand the changes in a patient's thought processes.
The psychoanalytic theory by Sigmund Freud states that schizophrenia is a result of fixations that take place in early development. This fixed mindset leads to the prevention of ego formation and this is what brings about the clinical features of schizophrenia.
The deformed ego is a result of the time when there was no proper ego formation or the ego just started to be made. The ego controls inner desires like sex and violence and it controls how the real events are understood, the problems start from early stagnation and gaps.
Margaret Mahler explained it as a disorder in the give-and-take relationship between a child and his mother.
This person then is fixated on the closeness of the mother and is dependent. The relationship between the mother and child is in the oral phase. The person never can capture their identity.
Paul Federn hypothesised that this gap in the ego gives rise to uninhabitable relationships between the mother and child. This is what gives rise to personality disorders and susceptibility to stress.
The symptoms seen in adolescence are because a strong ego needed to be developed in the child but never was and an adolescent needs the ego to be independent and achieve for themselves.
Harry Stack Sullivan saw schizophrenia as an abnormality in how the person related to themselves. The patient is struck with anxiety and this leads to a distorted reality which leads to the persecutor nature of the condition. Sullivan felt schizophrenia was an adaptation to fight panic, fright and a breakdown in the self. The anxiety was seen as a build-up trauma in childhood.
The psychoanalytical theory explains that the symptoms seen in schizophrenia have specific meanings for each patient. For example, the thought of aliens eating the patient inside may be because the person may be feeling wrong about things the person has done. The hallucination might be because the patient can not cope with reality. These may also be the wishes of the patient or the thing that cause the patient fear.
He also saw delusion and hallucinations as emanating from the same source. They are trials to see fears and impulses in a new light.
No theory you use to look at it, psychotic features are defined in schizophrenia.
Schizophrenia and Hearing Voices
When a person has a very severe mental illness, they may sometimes hear voices, these voices are termed auditory hallucinations. In 80% of patients with schizophrenia, it affects them. The voices usually are talking about them. This symptom starts in late adolescence and early adulthood.
The voices sound very real and usually tell them to commit suicide or commit acts of violence. There is still no biological cause of this symptom but researchers have made attempts at trying to understand it.
A group of researchers used ultra-high field imaging on the brain areas for hearing in a normal population and those with schizophrenia. They found that the way sound is represented in the cortex of those with schizophrenia was normal. They found that these abnormalities start during fetal development. Therefore these voices may start to develop and become more prominent as the patient ages.
The researchers used very powerfully Tesla 7 magnets to get the images used in this study. The images were taken as the participants listened to tones. The tones ranged from very high to very low.
In normal people, the tones were organized into specific parts of the auditory areas of the brain. This formed a map that was gotten from 16 participants with schizophrenia who had an auditory hallucination and 22 normal participants.
Most frequencies brought about activation of the cortex the maps of the brain were distorted in patients with schizophrenia.
These maps are made when the patients are in infancy and stay there throughout life. These voices may be linked to the susceptibility to vocal hallucinations. It is also known to be seen before the patient starts seeing symptoms of schizophrenia. It helps because now offspring of those who have schizophrenia can be tested to know if they are susceptible to being affected by these hallucinations,
The people who wrote these studies believe that it may be possible to modulate changes in these patients who have symptoms. They hope to redo this study with a larger population.
Treatment
These are training methods used to teach those who have schizophrenia how to use old skills and how to pick up new ones. They are workshops, clubs and part-time jobs. Having them be employed shows that they are getting better and helps them get better. Many of them will be able to do their work at high quality even though they are ill. Some may be very exceptional because of the way the disorder makes them behave.
Questions
- What did you learn about Schizophrenia?
Conclusion
- There are old psychological and psychoanalytical theories that explain schizophrenia that is not out of date.
- Hearing voices has seen as schizophrenia and the changes that take place may date back to fetal life.
- Vocation training can help the patient have and maintain a job.
References
- Kaplan-Sadocks-Comprehensive-Textbook-Psychiatry
- Page demarcations made with Inkscape.org
- Encyclopedia