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Schizophrenia is one of the most debilitating psychological disorders, affecting an individual’s general health as it interferes with the person’s autonomy, quality of life, functioning and the subjective well-being. Schizophrenic disorder closely responds to common concepts of lunacy, madness or insanity. A schizophrenic’s mind is deprived of the close connections of feelings, thoughts and is detachted from normalcy. Its symptoms may range from a variety of psychological disorders such as hallucinations, thought disorders, delusions and psychotic disorders. In the movie Adam, Adam displays several symptoms that closely relate to schizophrenia. After the death of his father, Adam Raki (Hugh Dancy) appears disturbed and detached from reality. At the beginning of the movie, he appears awkward, quirky and seems lost. Adam shies away when Beth Buchwald tries to establish a connection with him. These symptoms closely relate with schizophrenic symptoms because Adam’s condition is more than shyness; he seems detached from reality and feelings. He seems not to even noticed that Beth needed help when she struggled up the stairs with grocery. Adam is not rude; he just seems not to notice his surrounding and cannot look straight at other people. With the progression of the movie, people realize that Adam has a problem. It later becomes clear that Adam has a psychotic disorder. This makes it difficult for him to relate to other people. Simultaneously, Adam draws closer to Beth, and she helps him in connecting with reality and his environment. These two characters need each other equally. As Beth struggles with her family problems, she needs Adam to help her cope and vice versa.
Schizophrenia entails a broad spectrum of symptoms and disorders. In addition to this, its diagnosis is not easy as people from different cultures view it differently. Many approaches have been employed to treat schizophrenic symptoms. This paper looks into several of these treatment measures by analysis of five peer reviewed articles related to schizophrenia treatment.
Phosphodiesterase 5 inhibitor is one of the widely suggested treatment for the negative schizophrenic symptoms (Akhondzadeh et al, 2010). Akhondzadeh carried out a study to explore the effects of an augmentation therapy, where scientists added risperidone to sildenafil in the treatment of chronic schizophrenic symptoms as well as negative symptoms. For this study, they recruited forty participants with chronic schizophrenia. The participants were inpatients, ranging from age eighteen to forty five years, had met the DSM IV-TR schizophrenia criteria and were all in the active phase of the illness. During the study, the researchers allocated patients in a random fashion; they administered risperidone (6mg/day) together with sildenafil (75mg/day) to twenty patients, while the other patients received risperidone (6mg/day) together with placebo. The study’s outcome measure was the scale of Positive and Negative Syndrome (PANSS). Before concluding, the researchers revealed that both the administrations fundamentally reduced the scores of negative, positive and general psychopathological symptoms of schizophrenia. However, there was a superior performance in the combination of risperidone and sildenafil than in the administration of risperidone alone. The research conclusions were that sildenafil was a potential adjunctive treatment of the negative symptoms of schizophrenia. Schizophrenic research suggests that the negative symptoms associated with schizophrenia (social withdrawal, lack of motivation, diminished affective responsiveness, movement and speech problems) have a higher influence on the poor functional outcome of the individual than the positive symptoms. These symptoms include delusions and hallucination. In the movie Adam, it is clear that Adam is socially withdrawn, hence affected in his general daily life as he does not relate well with people, and is unmotivated to perform normal human functions such as displaying effective behaviour. Treating schizophrenia is complex because the obtainable antipsychotic medications are inconsistent and unreliable in controlling the negative schizophrenic symptoms. Some of the major theories into the treatment of schizophrenia include the NMDA and dopamine hypothesis.
In another schizophrenic study, (Ghaleiha A, et al, 2011) investigated the treatment of schizophrenia using monotherapy of risperidone, haloperidol or clozapine, following the proposal of a deficit in adenosinergic activity (ADA) to schizophrenic pathophysiology. The study evaluated the amount of adenosine deaminase (ADA) in schizophrenia patients treated with the monotherapies, as well as the relationship between the treatment response and the level of ADA. The study included fifty-one patients suffering from chronic schizophrenia, within the age range from twenty to forty five years old. All the patients were in the active period of the illness and had met the DSM-IV-TR schizophrenia criteria. During the study, the researchers randomly allocated seventeen patients to risperidone (6mg/day) or clozapine (300mg/day) or haloperidol (15mg/day). The researchers later measured Serum ADA activity after eight weeks. The results indicated that patients who received haloperidol had higher ADA plasma level. Additionally, there was a positive response to treatment, which correlated with ADA plasma levels in the clozapine group. In their conclusion, the researchers found out that there was an increase in activity of the ADA enzyme in the treatment with clozapine, which could be correlated with the superior antipsychotic effectiveness of clozapine. This study followed the suggestion that adenosinergic activity is lacking in schizophrenia. This study sustains a presumed role of the lack of adenosine levels in schizophrenic patients’ brains. Several clinical observations and studies show that allopurinol inhibitor reduces schizophrenic symptoms in patients receiving antipsychotic medication.
Vancampfort et al, (2011) carried out a study to assess randomized controlled trials and evaluate the efficacy of physical therapy for schizophrenic individuals. This study follows the lacking evidence in support of the effectiveness of physical therapy as an equal treatment of schizophrenia. Research suggests that schizophrenia is the fifth leading disability cause worldwide. DSM-IV recognizes that schizophrenia entails positive and negative symptoms that are severe enough to trigger occupational and social dysfunctions. Positive symptoms reveal a distortion or an excess of normal functioning, including hallucinations, delusions and disorganized behavior and speech. Conversely, negative symptoms reveal loss or a reduction of normal functioning. These include social withdrawal, apathy and effective flattening. After the confirmation of schizophrenia, most physicians administer anti-psychotic medication, which blocks dopamine receptors. Frequently, first-generation anti-psychotics, such as haloperidol and fluphenazine, are effective management strategies for psychotic symptoms. However, these drugs cause motor side symptoms. Following this, there has been an introduction of the second-generation drugs such as aripiprazole, amisulpride and risperidone. These drugs less frequently trigger motor side effects. Despite being effective, these drugs’ effectiveness in combating cognitive and negative symptoms is still low. After treatment, most schizophrenic patients continue having persistent symptoms or relapses. This situation facilitated the need for other treatment strategies, especially multimodal care, which includes psychosocial therapies. When used as adjuncts to antipsychotic medications, these therapies eliminate symptoms and augment adherence, life quality and functional outcomes. The psychosocial approaches that are effective in this field include family psycho-education, cognitive behavioral therapy, supported employment, social skill training and assertive community treatment. The study revealed that certain physical therapy interventions, such as continuous muscle strength exercises, yoga, muscle relaxation and aerobics are beneficial in eliminating state anxiety, psychological distress and psychiatric symptoms.
Reddy , et al, (2011) carried out a research to review the structural models that describe the effects of placebo treatment in neuropsychiatric disorders as well as schizophrenia. Past researches suggest that great differences in placebo response among clinical trials may considerably affect conclusions about the efficiency of new treatment in psychiatry. Developing a vigorous placebo model to explain placebo responses is critical in facilitating drug effects quantification as well as guiding the clinical trial designs for psychiatric treatment. Nevertheless, there are high dropout rates in the placebo segment of psychiatric clinical tests (Reddy et al, 2011). Study aimed at reviewing several empirical and semi-mechanistic forms that are useful in quantifying the placebo response in schizophrenic tests. Moreover, the study also reviewed useful placebo models in neuropsychiatric disorders such as Parkinson’s disease, depression and Alzheimer’s disease, to find out that placebo models are useful in clinical treatment of chronic schizophrenia. The study placed considerable importance on understanding dropout patterns and the factors for the dropout, to identify true placebo response. In conclusion, the researchers found that a complete integration of drug response models, disease progression models, covariate models, placebo response models and dropout models facilitates reliable prediction of future model based outcomes in determining the suitable clinical test designs. It is possible to adopt various conceptual, mathematical and statistical approaches to detain different aspects of placebo responses in brain illnesses. The researchers believed that there is a need for placebo response models, disease progression models and dropout models.
Citrome et al, (2011) carried out a study to examine metabolic viable changes and weight gain following bipolar disorder and schizophrenia treatment with olanzapine. Antipsychotic therapy is the foundation treatment for severe mental diseases. Atypical second generation antipsychotics are closely related to lower circumstances of extra pyramidal symptoms if compared to the first generation. Nevertheless, most patients have reported metabolic changes including diabetes mellitus, impaired glucose metabolism, dyslipidaemia and weight gain. Whereas estimating relative risks may be inconsistent, the correlation between increases in levels of glucose and second-generation antipsychotics seems to be in a continuum. In addition to this, olanzapine appears to have higher association than other antipsychotics. The conclusions reveals that there is a considerable correlation between olanzapine and weight gain. However, other life style factors also contribute to the weight gain. These factors include lack of exercises and increased food intake, which are prevalent among individuals suffering from chronic mental disorders.
In conclusion, schizophrenia is a serious illness that affects individual’s general health, including the ability to relate with others. It is diagnosed using the DSM-IV-TR, and once confirmed, the key treatment strategy is a prescription of anti-psychotic medications. Although these drugs eliminate several psychotic symptoms, they have several side effects, especially on motor control. Following this realization, there has been an introduction of psychosocial therapies including psycho-education and cognitive behavioral therapy. This paper has looked into the treatment of schizophrenia examining several studies that relate to the concept. These studies include research from various individuals relating to treatment using antipsychotics, side effects, psychotherapy effectiveness and structural models describing treatment with placebo treatment. The paper’s analysis follows the consequences of schizophrenia from a movie, Adam, where protagonist displays shizophernic symptoms after the death of his father.