The Difference Between a Fact and a Factoid

QUESTION

What’s the difference between ‘factoid’ and ‘fact’? Is there even a difference?

ANSWER

Yes there’s a difference between the two.

A ‘factoid’ is an insignificant or trivial fact. Something fictitious or unsubstantiated that is passed off as fact. While ‘fact’ is something that actually exists or is known to exist or to have happened.

Due to the confusion surrounding this word, I can absolutely see where they are coming from as “Factoid” has two somewhat distinct definitions, one being more or less a subset of “Fact”, the other not meaning the same thing at all as “Fact”.  Despite the general recommendation against its use by English guides, I still like to use it because it is the only single word that means exactly what I’m trying to say in my “Bonus Factoid” section at the end of some articles.

“Fact” obviously means something that is unquestionably true, or as Webster more eloquently puts it, it is the “quality of being actual”.

“Factoid” however means something slightly different.  The first definition, for which it would seem I’m incorrect in my usage, is the following:  “an invented fact, believed to be true because of its appearance in print”

This was the original definition coined in 1973 by Norman Mailer.  Mailer described a factoid as “facts which have no existence before appearing in a magazine or newspaper”.   He came up with the word, adding the suffix “oid” as an “oid” ending implies “similar but not the same” or more succinctly “like” or “resembling”.

However, thanks in large part to CNN and the BBC in the 1980s/1990s to today including “factoids” in their news casts referring to trivial bits of factual information, there is now a second “official” definition of “factoid” as follows (from Merriam-Webster): “a briefly stated and usually trivial fact”

And it is of course this definition to which I am using this word at the end of some of my articles when I have “Bonus Factoids“, bulleted short trivial facts.

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24. Persistent Depressive Disorder (Dysthymia)

Definition

By Mayo Clinic Staff

Dysthymia (dis-THIE-me-uh) is a mild but long-term (chronic) form of depression. Symptoms usually last for at least two years, and often for much longer than that. Dysthymia interferes with your ability to function and enjoy life.

With dysthymia, you may lose interest in normal daily activities, feel hopeless, lack productivity, and have low self-esteem and an overall feeling of inadequacy. People with dysthymia are often thought of as being overly critical, constantly complaining and incapable of having fun.

Dysthymic Disorder is a type of chronic depression similar to Major Depressive Disorder although much less severe. Like Major depressive disorder, Dysthymic Disorder is characterized by emotional and behavioral symptoms such as feelings of hopelessness, insomnia, inability to concentrate, low energy and irritability. However, those with Dysthymic Disorder often exhibit fewer and less extreme symptoms than those with Major Depressive Disorder for longer periods of time. To be diagnosed with Dysthymic disorder, one must exhibit two or more symptoms of the illness for two years or more in order to be considered for treatment. If left unaddressed, Dysthymic Disorder can disrupt normal functioning in the lives of those suffering from it. Talk to a doctor or mental health practitioner if you believe you or a loved one may have this condition.

Common Symptoms of Dysthymic Disorder

• For the majority of days within a two-year period, the patient reports being depressed or appears depressed to others.
• Typical symptoms of Dysthymic Disorder do not relent for longer than two months in a row.
• Within the first two years of the illness the patient has not suffered a major depressive episode.
• The patient has not had a manic episode or been or been diagnosed with Cyclothymic Disorder.
• Another medical condition or medications or other substances do not cause the illness.

Treatment of Dysthymic Disorder

It should be noted that 75% of people with Dysthymic Disorder have had a chronic physical illness, anxiety disorders or substance abuse problems. Also, people with Dysthymic Disorder often come from families who have exhibited the depressive symptoms of Dysthymic Disorder. Treatment options for this condition include medications, psychotherapy and support groups among others. These treatments are very similar to those used for people with Major Depressive Disorder. Medications include anti-depressants like Zoloft, Prozac and Paxil. These medications, however, can sometimes come with very negative side effects. Suicidal thoughts and aggression have been reported as negative side effects, along with physical side effects such as low blood pressure, nausea, diarrhea, insomnia and short-term memory loss. Psychotherapy includes cognitive behavioral therapy and interpersonal psychotherapy. A doctor or mental health professional may help you or your loved one cope with the symptoms of Dysthymic Disorder. The long-term effects can disrupt the normal everyday functioning of a person with the condition, especially because of the illness’ persistence. Approximately 10% of people who suffer from Dysthymic Disorder later develop Major Depressive Disorder. Do not let your illness get to this point. There are plenty of experts willing to help and people who can relate.

Review Sources

• University of Michigan Depression Center – This page provides information on dysthymic disorder, facts and figures, existing treatment options and possible long-term effects.
• Wikipedia – This page contains information on dysthymic disorder, characteristics of someone suffering from the condition, causes and treatment.

Persistent Depressive Disorder (Dysthymia) Symptoms

By PSYCH CENTRAL STAFF

Persistent Depressive Disorder, formerly known as Dysthymic Disorder (also known as dysthymia), has been recently renamed in the updated DSM-5 (2013). 

The essential feature of persistent depressive disorder (dysthymia) is a depressed mood that occurs for most of the day, for more days than not, for at least 2 years (at least 1 year for children and adolescents). This disorder represents a consolidation of DSM-IV-defined chronic major depressive disorder and dysthymic disorder. Major depression may precede persistent depressive disorder, and major depressive episodes may occur during persistent depressive disorder. Individuals whose symptoms meet major depressive disorder criteria for 2 years should be given a diagnosis of persistent depressive disorder as well as major depressive disorder.

Individuals with persistent depressive disorder describe their mood as sad or “down in the dumps.” During periods of depressed mood, at least two of the following six symptoms from are present.

• Poor appetite or overeating
• Insomnia or hypersomnia
• Low energy or fatigue
• Low self-esteem
• Poor concentration or difficulty making decisions
• Feelings of hopelessness

Because these symptoms have become a part of the individual’s day-to-day experience, particularly in the case of early onset (e.g., “I’ve always been this way”), they may not be reported unless the individual is directly prompted. During the 2-year period (1 year for children or adolescents), any symptom-free intervals last no longer than 2 months.

In children and adolescents, the mood can be irritable and it must have lasted at least one year.
Furthermore, in order to be diagnosed with Persistent Depressive Disorder, there has never been a Manic Episode, aMixed Episode, or a Hypomanic Episode in the first 2 years, and criteria have never been met for Cyclothymic Disorder.
In order to meet the diagnostic criteria for Dysthymic Disorder, the symptoms may not be due to the direct physiological effects of a the use or abuse of a substance (for instance, alcohol, drugs, or medications) or a general medical condition (e.g., cancer or a stroke). The symptoms must also cause significant distress or impairment in social, occupational, educational or other important areas of functioning.

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23. Cyclothymic disorder

Definition

By Mayo Clinic Staff

Cyclothymia (si-klo-THIGH-me-uh), also called cyclothymic disorder, is a mood disorder. Cyclothymia causes emotional ups and downs, but they're not as extreme as in bipolar disorder type I or II.

With cyclothymia, you experience periods when your mood noticeably shifts up and down from your baseline. You may feel on top of the world for a time, followed by a low period when you feel somewhat blue. Between these cyclothymic highs and lows, you may feel stable and fine.

Compared with bipolar disorder I or II, the highs and lows of cyclothymia are less extreme. Still, it's critical to seek help managing these symptoms because they increase your risk of bipolar disorder I or II. Treatment options for cyclothymia include talk therapy (psychotherapy), medications and close, ongoing follow-up with your doctor.

Cyclothymic Disorder

Cyclothymic disorder is very similar to Dipolar Disorder and may be caused by the same factors as Dipolar Disorder and Major Depression. The three conditions often appear together within families. However, the major difference between Cyclothymic Disorder from Dipolar Disorder and Major Depression is that Cyclothymic Disorder does not cause mood swings as extreme as those one might get from Bipolar Disorder and Major Depression. Also, Cyclothymic Disorder is much more persistent with respites from the symptoms lasting no more than two months at a time and overall symptoms lasting more than two years. As with Major Depression and Bipolar Disorder, a doctor will diagnose Cyclothymic Disorder by asking about the patient’s history to ensure that there are no other factors such as medications that could be giving a false indication of the illness. The doctor can conclude this through urine and blood tests.

Common Symptoms of Cyclothymic Disorder:

• Pessimism
• Difficulty concentrating
• Poor memory
• Irritability
• Insomnia
• Lack of motivation

These depressive symptoms contrast with such euphoric symptoms as:

• Extreme optimism
• Exaggerated self-esteem
• Poor judgement
• Inconsiderateness
• Distractibility
• Spending sprees

Causes of Cyclothymic Disorder

Causes of Cyclothymic Disorder have been debated. Biological factors such as heritability, low serotonin levels and high cortisol levels have been blamed, as well as psychological factors including stressful events and social environments often times related to parenting styles.

Treatment of Cyclothymic Disorder

Treatment for Cyclothymic Disorder includes medications, psychotherapy and support groups much like you would find for people suffering from Major Depressive Disorder and Bipolar Disorder. Some of the most commonly prescribed medications for this condition are Lithium, which is often used for people with Bipolar Disorder, as well as anti-seizure drugs such as Valproic acid and Carbamazepine. Psychotherapy usually involves identifying the early signs of the condition and finding a way to moderate them so that a full-blown episode does not occur. This could mean that the patient and his or her loved ones need to work on ways in which they can nurture positive-thinking and carefully master self-control. Don’t hesitate to contact a medical or psychological health professional if you believe you or a loved one may have Cyclothymic Disorder. If left untreated this can be a debilitating condition that affects all facets of life. One thing someone suffering from Cyclothymic Disorder can count on is that there are always people willing to help and there are always others with whom one can relate.

Read the Full Page: Cyclothymic Disorder – Symptoms and Causes of Cyclothymic Disorder – Treatment 
AllAboutCounseling.com 

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22. Mental Health and Delusional Disorder

Delusional disorder, previously called paranoid disorder, is a type of serious mental illness called a "psychosis" in which a person cannot tell what is real from what is imagined. The main feature of this disorder is the presence of delusions, which are unshakable beliefs in something untrue. People with delusional disorder experience non-bizarre delusions, which involve situations that could occur in real life, such as being followed, poisoned, deceived, conspired against, or loved from a distance. These delusions usually involve the misinterpretation of perceptions or experiences. In reality, however, the situations are either not true at all or highly exaggerated.

People with delusional disorder often can continue to socialize and function normally, apart from the subject of their delusion, and generally do not behave in an obviously odd or bizarre manner. This is unlike people with other psychotic disorders, who also might have delusions as a symptom of their disorder. In some cases, however, people with delusional disorder might become so preoccupied with their delusions that their lives are disrupted.

Although delusions might be a symptom of more common disorders, such asschizophrenia, delusional disorder itself is rather rare. Delusional disorder most often occurs in middle to late life and is slightly more common in women than in men.

Types of Delusional Disorder

There are different types of delusional disorder based on the main theme of the delusions experienced. The types of delusional disorder include:

• Erotomanic: Someone with this type of delusional disorder believes that another person, often someone important or famous, is in love with him or her. The person might attempt to contact the object of the delusion, and stalking behavior is not uncommon.
• Grandiose: A person with this type of delusional disorder has an over-inflated sense of worth, power, knowledge, or identity. The person might believe he or she has a great talent or has made an important discovery.
• Jealous: A person with this type of delusional disorder believes that his or her spouse or sexual partner is unfaithful.
• Persecutory: People with this type of delusional disorder believe that they (or someone close to them) are being mistreated, or that someone is spying on them or planning to harm them. It is not uncommon for people with this type of delusional disorder to make repeated complaints to legal authorities.
• Somatic: A person with this type of delusional disorder believes that he or she has a physical defect or medical problem.
• Mixed: People with this type of delusional disorder have two or more of the types of delusions listed above.

What Are the Symptoms of Delusional Disorder?

The presence of non-bizarre delusions is the most obvious symptom of this disorder. Other symptoms that mighty appear include:

• An irritable, angry, or low mood
• Hallucinations (seeing, hearing, or feeling things that are not really there) that are related to the delusion (For example, a person who believes he or she has an odor problem may smell a bad odor.)

What Causes Delusional Disorder?

As with many other psychotic disorders, the exact cause of delusional disorder is not yet known. Researchers are, however, looking at the role of various genetic, biological, environmental or psychological factors.

• Genetic: The fact that delusional disorder is more common in people who have family members with delusional disorder or schizophrenia suggests there might be a genetic factor involved. It is believed that, as with other mental disorders, a tendency to develop delusional disorder might be passed on from parents to their children.
• Biological: Researchers are studying how abnormalities of certain areas of the brain might be involved in the development of delusional disorders. Abnormalities in the functioning of brain regions that control perception and thinking may be linked to the formation of delusional symptoms.
• Environmental/psychological: Evidence suggests that delusional disorder can be triggered by stress. Alcohol and drug abuse also might contribute to the condition. People who tend to be isolated, such as immigrants or those with poor sight and hearing, appear to be more vulnerable to developing delusional disorder.

How Is Delusional Disorder Diagnosed?

If symptoms of delusional disorder are present, your doctor will likely perform a complete medical history and physical exam. Although there are no lab tests to specifically diagnose delusional disorder, the doctor might use various diagnostic tests, such as imaging studies or blood tests, to rule out physical illness as the cause of the symptoms.

If the doctor finds no physical reason for the symptoms, he or she might refer the person to a psychiatrist or psychologist, health care professionals who are specially trained to diagnose and treat mental illnesses. Psychiatrists and psychologists use specially designed interview and assessment tools to evaluate a person for a psychotic disorder. The doctor or therapist bases his or her diagnosis on the person's report of symptoms, and his or her observation of the person's attitude and behavior. The doctor or therapist then determines if the person's symptoms point to a specific disorder. A diagnosis of delusional disorder is made if a person has non-bizarre delusions for at least one month and does not have the characteristic symptoms of other psychotic disorders, such as schizophrenia.

How Is Delusional Disorder Treated?

Treatment for delusional disorder most often includes medication andpsychotherapy (a type of counseling). Delusional disorder can be very difficult to treat in part because its sufferers often have poor insight and do not recognize that a psychiatric problem exists.  Studies show that close to half of patients treated with antipsychotic medications show at least partial improvement.

Antipsychotic medicines are the primary treatment for delusional disorder.  Sometimes, psychotherapy can also be a helpful adjunct to medications as a way to help patients better manage and cope with the stresses related to their delusional beliefs and its impact on their lives. Psychotherapies that may be helpful in delsional disorder include the following:

• Individual psychotherapy: Can help the person recognize and correct the underlying thinking that has become distorted.
• Cognitive-behavioral therapy (CBT): Can help the person learn to recognize and change thought patterns and behaviors that lead to troublesome feelings.
• Family therapy: Can help families deal more effectively with a loved one who has delusional disorder, enabling them to contribute to a better outcome for the person.

How Is Delusional Disorder Treated? continued...

The primary medications used to attempt to treat delusional disorder are called anti-psychotics. Drugs used include:

• Conventional antipsychotics: Also called neuroleptics, these have been used to treat mental disorders since the mid-1950s. They work by blocking dopamine receptors in the brain. Dopamine is a neurotransmitter believed to be involved in the development of delusions. Conventional antipsychotics include Thorazine, Loxapine, Prolixin, Haldol, Navane, Stelazine, Trilafon, and Mellaril.
• Atypical antipsychotics: These newer drugs appear to be effective in treating the symptoms of delusional disorder with fewer movement-related side effects than the older typical antipsychotics. They work by blocking dopamine and serotonin receptors in the brain. Serotonin is another neurotransmitter believed to be involved in delusional disorder. These drugs include Risperdal, Clozaril, Seroquel, Geodon, and Zyprexa.
• Other medications: Tranquilizers and antidepressants might also be used to treat anxiety or mood symptoms if they occur in combination with delusional disorder. Tranquilizers might be used if the person has a very high level of anxiety or problems sleeping. Antidepressants might be used to treat depression, which often occurs in people with delusional disorder

People with severe symptoms or who are at risk of hurting themselves or others might need to be hospitalized until the condition is stabilized.

What Are the Complications of Delusional Disorder?

• People with delusional disorder might become depressed, often as the result of difficulties associated with the delusions.
• Acting on the delusions also can lead to violence or legal problems; for example, a person with an erotomanic delusion who stalks or harasses the object of his or her delusion, could lead to arrest.
• Further, people with this disorder can eventually become alienated from others, especially if their delusions interfere with or damage their relationships.

What Is the Outlook for People With Delusional Disorder?

The outlook for people with delusional disorder varies depending on the person, the type of delusional disorder, and the person's life circumstances, including the availability of support and a willingness to stick with treatment.

Delusional disorder is typically a chronic (ongoing) condition, but when properly treated, many people with this disorder can find relief from their symptoms. Some people recover completely and others experience episodes of delusional beliefs with periods of remission (lack of symptoms).

Unfortunately, many people with this disorder do not seek help. It often is difficult for people with a mental disorder to recognize that they are not well, or they may attribute their symptoms to other factors, such as the environment. They also might be too embarrassed or afraid to seek treatment. Without treatment, delusional disorder can be a life-long illness.

Can Delusional Disorder Be Prevented?

There is no known way to prevent delusional disorder. However, early diagnosis and treatment can help decrease the disruption to the person's life, family, and friendships.

Delusional disorder is characterized by the presence of eitherbizarre or non-bizarre delusions which have persisted for atleast one month. Non-bizarre delusions typically are beliefs of something occurring  in a person’s life which is not out of the realm of possibility. For example, the person may believe their significant other is cheating on them, that someone close to them is about to die, a friend is really a government agent, etc. All of these situations could be true or possible, but the person suffering from this disorder knows them not to be (e.g., through fact-checking, third-person confirmation, etc.). Delusions are deemed bizarre if they are clearly implausible, not understandable, and not derived from ordinary life experiences (e.g., an individual’s belief that a stranger has removed his or her internal organs and replaced them with someone else’s organs without leaving any wounds or scars). Delusions that express a loss of control over mind or body are generally considered to be bizarre and reflect a lower degree of insight and a stronger conviction to hold such belief compared to when they are non-bizarre. Accordingly, if an individual has bizarre delusions, a clinician will specify “with bizarre content” when documenting the delusional disorder.

People who have this disorder generally don’t experience a marked impairment in their daily functioning in a social, occupational or other important setting. Outward behavior is not noticeably bizarre or objectively characterized as out-of-the-ordinary.

The delusions can not be better accounted for by another disorder, such as schizophrenia, which is also characterized by delusions (which are bizarre).  The delusions also cannot be better accounted for by a mood disorder, if the mood disturbances have been relatively brief. The lifetime prevalence of delusional disorder has been estimated at around 0.2% .

Specific Diagnostic Criteria

1. Delusions lasting for at least 1 month’s duration.
2. Criterion A for Schizophrenia has never  been met. Note:Tactile and olfactory hallucinations may be present  in Delusional Disorder if they are related to the delusional theme.Criterion A of Schizophrenia requires two (or more) of the following,  each present for a significant portion of time during a 1-month period  (or less if successfully treated):
   1. delusions
   2. hallucinations
   3. disorganized speech (e.g., frequent derailment or incoherence)
   4. grossly disorganized or catatonic behavior
   5. negative symptoms, i.e., affective flattening, alogia, or avolition
   Note: Criteria A of Schizophrenia requires only one symptom if delusions are bizarre or hallucinations consist of a voice keeping up a running commentary on the person’s behavior or thoughts, or two or more voices conversing with each other.
3. Apart from the impact of the delusion(s) or its ramifications,  functioning is not markedly impaired and behavior is not obviously odd  or bizarre.
4. If mood episodes have occurred concurrently with delusions, their total duration has been brief relative to the duration of the delusional periods.
5. The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition.

Specify type (the following types are assigned based on the predominant delusional theme):

• Erotomanic Type:  delusions that another person, usually of higher status, is in love with the individual
• Grandiose Type:  delusions of inflated worth, power, knowledge, identity, or special relationship to a deity or famous person
• Jealous Type: delusions that the individual’s sexual partner is unfaithful
• Persecutory Type:  delusions that the person (or someone to whom the person is close) is being malevolently treated in some way
• Somatic Type: delusions that the person has some physical defect or general medical condition
• Mixed Type: delusions characteristic of more than one of the above types but no one theme predominates
• Unspecified Type

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21. Schizophrenia

Schizophrenia is a mental disorder that generally appears in late adolescence or early adulthood - however, it can emerge at any time in life. It is one of many brain diseases that may include delusions, loss of personality (flat affect), confusion, agitation, social withdrawal, psychosis, and bizarre behavior.

What is schizophrenia?

Individuals with schizophrenia may hear voices that are not there. Some may be convinced that others are reading their minds, controlling how they think, or plotting against them. This can distress patients severely and persistently, making them withdrawn and frantic.

Others may find it hard to make sense of what a person with schizophrenia is talking about. In some cases, the individual may spend hours completely still, without talking. On other occasions he or she may seem fine, until they start explaining what they are truly thinking.

The effects of schizophrenia reach far beyond the patient - schizophrenia does not only affect the person with the disorder. Families, friends and society are affected too. A sizable proportion of people with schizophrenia have to rely on others, because they are unable to hold a job or care for themselves.

With proper treatment, patients can lead productive lives - according to the National Institute of Mental Health¹(NIMN), treatment can help relieve many of the symptoms of schizophrenia. However, the majority of patients with the disorder have to cope with the symptoms for life. This does not mean that a person with schizophrenia who receives treatment cannot lead a rewarding, productive and meaningful life in his or her community.

Schizophrenia most commonly strikes between the ages of 15 to 25 among men, and about 25 to 35 in women. In many cases the disorder develops so slowly that the sufferer does not know he/she has it for a long time. While, with other people it can strike suddenly and develop fast.

Schizophrenia, possibly many illnesses combined - it is a complex, chronic, severe, and disabling brain disorder and affects approximately 1% of all adults globally. Experts say schizophrenia is probably many illnesses masquerading as one. Research indicates that schizophrenia is likely to be the result of faulty neuronal development in the brain of the fetus, which later in life emerges as a full-blown illness.

According to the University of Maryland Medical Center², schizophrenia affects males and females equally. However, an article in the BMJ⁸ says that schizophrenia affects 1.4 males for every 1 female.

The Schizophrenic Disorders Clinic³ at the Stanford School of Medicine describes schizophrenia as "a thought disorder: a brain disorder that interferes with a person's ability to think clearly, manage emotions, make decisions, and relate to others."

John Forbes Nash Jr. (born June 13, 1928) has lived
with paranoid schizophrenia.

John Nash, an American mathematician who worked at Princeton University, won the Nobel Prize in Economics and lived with paranoid schizophrenia most of his life. He eventually managed to live without medication. A film was made of his life "A Beautiful Mind", which Nash says was "loosely accurate".

A study published in The Lancet⁷ found that schizophrenia with active psychosis is the third most disabling condition after quadriplegia and dementia, and ahead of blindness and paraplegia.

The word schizophrenia comes from the Greek word skhizeinmeaning "to split" and the Greek word Phrenos (phren) meaning "diaphragm, heart, mind". In 1910, the Swiss psychiatrist, Eugen Bleuler (1857-1939) coined the term Schizophrenie in a lecture in Berlin on April 24th, 1908.

The brain

Our brain consists of billions of nerve cells. Each nerve cell has branches that give out and receive messages from other nerve cells.

The ending of these nerve cells release neurotransmitters - types of chemicals. These neurotransmitters carry messages from the endings of one nerve cell to the nerve cell body of another. In the brain of a person who has schizophrenia, this messaging system does not work properly.

Signs and symptoms

Other interesting related articles:

What is Catatonic Schizophrenia?

What is Schizoaffective Disorder?

What is Childhood Schizophrenia?

What is Disorganized Schizophrenia (Hebephrenia)?

What is Paranoid Schizophrenia?

What are the Different Types of Schizophrenia?

There is, to date, no physical or laboratory test that can absolutely diagnose schizophrenia. The doctor, a psychiatrist, will make a diagnosis based on the patient's clinical symptoms. However, physical testing can rule out some other disorders and conditions which sometimes have similar symptoms, such as seizure disorders, thyroid dysfunction, brain tumor, drug use, and metabolic disorders.

Symptoms and signs of schizophrenia will vary, depending on the individual. The symptoms are classified into four categories:

• Positive symptoms - also known as psychotic symptoms. These are symptoms that appear, which people without schizophrenia do not have. For example, delusion.


• Negative symptoms - these refer to elements that are taken away from the individual; loss or absence of normal traits or abilities that people without schizophrenia normally have. For example, blunted emotion.


• Cognitive symptoms - these are symptoms within the person's thought processes. They may be positive or negative symptoms, for example, poor concentration is a negative symptom.


• Emotional symptoms - these are symptoms within the person's feelings. They are usually negative symptoms, such as blunted emotions.

Below is a list of the major symptoms:

• Delusions - The patient has false beliefs of persecution, guilt of grandeur. He/she may feel things are being controlled from outside. It is not uncommon for people with schizophrenia to describe plots against them. They may think they have extraordinary powers and gifts. Some patients with schizophrenia may hide in order to protect themselves from an imagined persecution.


• Hallucinations - hearing voices is much more common than seeing, feeling, tasting, or smelling things which are not there, but seem very real to the patient.


• Thought disorder - the person may jump from one subject to another for no logical reason. The speaker may be hard to follow. The patient's speech might be muddled and incoherent. In some cases the patient may believe that somebody is messing with his/her mind.

Other symptoms schizophrenia patients may experience include:

• Lack of motivation (avolition) - the patient loses his/her drive. Everyday automatic actions, such as washing and cooking are abandoned. It is important that those close to the patient understand that this loss of drive is due to the illness, and has nothing to do with slothfulness.


• Poor expression of emotions - responses to happy or sad occasions may be lacking, or inappropriate.


• Social withdrawal - when a patient with schizophrenia withdraws socially it is often because he/she believes somebody is going to harm them. Other reasons could be a fear of interacting with other humans because of poor social skills.


• Unaware of illness - as the hallucinations and delusions seem so real for the patients, many of them may not believe they are ill. They may refuse to take medications which could help them enormously for fear of side-effects, for example.


• Cognitive difficulties - the patient's ability to concentrate, remember things, plan ahead, and to organize himself/herself are affected. Communication becomes more difficult.

Recent developments on the symptoms of schizophrenia from MNT news

Impaired eye movements linked to schizophrenia - researchers from the University of British Columbia explained in the Journal of Neuroscience that people with schizophrenia find it harder to follow a moving dot on a computer screen.

What causes schizophrenia?

Nobody has been able to pinpoint one single cause. Experts believe several factors are generally involved in contributing to the onset of schizophrenia.

The likely factors do not work in isolation, either. Evidence does suggest that genetic and environmental factors generally act together to bring about schizophrenia. Evidence indicated that the diagnosis of schizophrenia has an inherited element, but it is also significantly influenced by environmental triggers. In other words, imagine your body is full of buttons, and some of those buttons result in schizophrenia if somebody comes and presses them enough times and in the right sequences.

The buttons would be your genetic susceptibility, while the person pressing them would be the environmental factors.

Below is a list of the factors that are thought to contribute towards the onset of schizophrenia:

• Your genes
  
  If there is no history of schizophrenia in your family your chances of developing it are less than 1%. However, that risk rises to 10% if one of your parents was/is a sufferer.
  
  A gene that is probably the most studied "schizophrenia gene" plays a surprising role in the brain: It controls the birth of new neurons in addition to their integration into existing brain circuitry, according to an article published by Cell.
  
  A Swedish study found that schizophrenia and bipolar disorder have the same genetic causes.
  
  Thirteen locations in the human genetic code may help explain the cause of schizophrenia - a study involving 59,000 people, 5,001 of whom had been diagnosed with schizophrenia, identified 22 genome locations, with 13 new ones that are thought to be involved in the development of schizophrenia.
  
  The scientists added that of particular importance to schizophrenia were two genetically-determined processes - the "micro-RNA 137" pathway and the "calcium channel pathway".
  
  Principal investigator, Professor Patrick Sullivan, of the Center for Psychiatric Genomics at the University of North Carolina School of Medicine, said "This study gives us the clearest picture to date of two different pathways that might be going wrong in people with schizophrenia. Now we need to concentrate our research very urgently on these two pathways in our quest to understand what causes this disabling mental illness."


• Chemical imbalance in the brain
  
  Experts believe that an imbalance of dopamine, a neurotransmitter, is involved in the onset of schizophrenia. They also believe that this imbalance is most likely caused by your genes making you susceptible to the illness. Some researchers say other the levels of other neurotransmitters, such as serotonin, may also be involved.
  
  Changes in key brain functions, such as perception, emotion and behavior lead experts to conclude that the brain is the biological site of schizophrenia.
  
  Schizophrenia could be caused by faulty signaling in the brain, according to research published in the journalMolecular Psychiatry.


• Family relationships
  
  Although there is no evidence to prove or even indicate that family relationships might cause schizophrenia, some patients with the illness believe family tension may trigger relapses.


• Environment
  
  Although there is yet no definite proof, many suspect that prenatal or perinatal trauma, and viral infections may contribute to the development of the disease. Perinatal means "occurring about 5 months before and up to one month after birth".
  
  Stressful experiences often precede the emergence of schizophrenia. Before any acute symptoms are apparent, people with schizophrenia habitually become bad-tempered, anxious, and unfocussed. This can trigger relationship problems, divorce and unemployment. These factors are often blamed for the onset of the disease, when really it was the other way round - the disease caused the crisis. Therefore, it is extremely difficult to know whether schizophrenia caused certain stresses or occurred as a result of them.


• Some drugs
  
  Cannabis and LSD are known to cause schizophrenia relapses. According to the State Government of Victoria⁶ in Australia, for people with a predisposition to a psychotic illness such as schizophrenia, usage of cannabis may trigger the first episode in what can be a disabling condition that lasts for the rest of their lives.
  
  The National Library of Medicine⁹ says that some prescription drugs, such as steroids and stimulants, can cause psychosis.

Tests and diagnosis

A schizophrenia diagnosis is carried out by observing the actions of the patient. If the doctor suspects possible schizophrenia, they will need to know about the patient's medical and psychiatric history.

Certain tests will be ordered to rule out other illnesses and conditions that may trigger schizophrenia-like symptoms. Examples of some of the tests may include:

• Blood tests - to determine CBC (complete blood count) as well as some other blood tests.


• Imaging studies - to rule out tumors, problems in the structure of the brain, and other conditions/illnesses


• Psychological evaluation - a specialist will assess the patient's mental state by asking about thoughts, moods, hallucinations, suicidal traits, violent tendencies or potential for violence, as well as observing their demeanor and appearance.

Schizophrenia - Diagnostic Criteria

Patients must meet the criteria laid down in the DSM (Diagnostic and Statistical Manual of Mental Disorders). It is an American Psychiatric Association manual that is used by health care professionals to diagnose mental illnesses and conditions.

The health care professional needs to exclude other possible mental health disorders, such as bipolar disorder orschizoaffective disorder.

It is also important to establish that the signs and symptoms have not been caused by, for example, a prescribed medication, a medical condition, or substance abuse.

Also, the patient must:

• Have at least two of the following typical symptoms of schizophrenia -
  
  - Delusions
  - Disorganized or catatonic behavior
  - Disorganized speech
  - Hallucinations
  - Negative symptoms that are present for much of the time during the last four weeks.


• Experience considerable impairment in the ability to attend school, carry out their work duties, or carry out every day tasks


• Have symptoms which persist for six months or more

Sometimes, the person with schizophrenia may find their symptoms frightening, and conceal them from others. If there is severe paranoia, they may be suspicious of family or friends who try to help. There are many elements in disease that make it difficult to confirm a schizophrenia diagnosis.

Recent developments on schizophrenia from MNT news

Collecting neurons from the nose to diagnose schizophrenia - researchers from Tel Aviv University, Israel, reported in Neurobiology of Disease that collecting neurons from the nose of the patient may be a rapid way to test for schizophrenia.

Noam Shomron of TAU's Sackler Faculty of Medicine, and team describe how they devised a potential way of diagnosing schizophrenia by testing microRNA molecules found in the neurons inside the patient's nose. A sample can be taken via a simple biopsy.

Shomron believes this could become a "more sure-fire" way of diagnosing schizophrenia than ever before. It may also be a way of detecting the devastating disease earlier on. Schizophrenia treatment is usually much more effective if it can start during the early stages.

Are autism and schizophrenia related? - when seen at first glance, autism and schizophrenia appear to be completely different disorders. However, a discovery made by researchers at Tel Aviv University's Sackler Faculty of Medicine and the Sheba Medical Center showed that the two disorders have similar roots, and are linked to other mental conditions, such as bipolar disorder.

Both schizophrenia and autism share come traits, including a limited ability to lead a normal life function in the real world, as well as cognitive and social dysfunction.

The scientists found a genetic link between the two disorders, which causes a higher risk within families. Dr. Mark Weiser and team found that people with a sibling with schizophrenia had a twelve-fold higher chance of having autism than those without schizophrenia in the family.

Schizophrenia genetically linked to four other mental illnesses or disorders - researchers the Cross Disorders Group of the Psychiatric Genomic Consortium reported that schizophrenia, major depressive disorder, bipolar disorder, autism spectrum disorders, and ADHD (attention-deficit hyperactivity disorder) share the same common inherited genetic faults.

Does schizophrenia begin in the womb? Stem cell study says yes - researchers from the Salk Institute in California have demonstrated that neurons from skin cells of patients with schizophrenia behave oddly in early stages of development, supporting the theory that schizophrenia begins in the womb.

The researchers, who published their results in the journal Molecular Psychiatry, say their findings could provide clues for how to detect and treat the disease early.

Researchers identify genetic mutations that may cause schizophrenia - Schizophrenia affects around 2.4 million adults in the US. The exact cause of the condition is unknown, but past research has suggested that genetics may play a part. Now, investigators from the Columbia University Medical Center in New York, NY, have uncovered clues that may build on this concept. The research team published their findings in the journalNeuron.

Schizophrenia and cannabis use may have genetic link - There is growing evidence that cannabis use is a cause of schizophrenia and now a new study led by King's College London, UK, also finds increased cannabis use and schizophrenia may have genes in common.

How a genetic variation 'may increase schizophrenia risk' - The exact causes of schizophrenia are unknown, but past research has suggested that some individuals with the condition possess certain genetic variations. Now, researchers at Johns Hopkins University School of Medicine in Baltimore, MD, say they have begun to understand how one schizophrenia-related genetic variation influences brain cell development.

Researchers identify more than 80 new genes linked to schizophrenia - What causes schizophrenia has long baffled scientists. But in what is deemed the largest ever molecular genetic study of schizophrenia, a team of international researchers has pinpointed 108 genes linked to the condition - 83 of which are newly discovered - that may help identify its causes and pave the way for new treatments.

Schizophrenia 'made up of eight specific genetic disorders' - Past studies have indicated that rather than being a single disease, schizophrenia is a collection of different disorders. Now, a new study by researchers at Washington University in St. Louis, MO, claims the condition consists of eight distinct genetic disorders, all of which present their own specific symptoms.

Treatment options

The UK's National Health Service⁴ says it is important that schizophrenia is diagnosed as early as possible, because the chances of a recovery are much greater the earlier it is treated.

Psychiatrists say the most effective treatment for schizophrenia patients is usually a combination of medication, psychological counseling, and self-help resources.

Anti-psychosis drugs have transformed schizophrenia treatment. Thanks to them, the majority of patients are able to live in the community, rather than stay in hospital. In many parts of the world care is delivered in the community, rather than in hospital.

The primary schizophrenia treatment is medication. Sadly, compliance is a major problem. Compliance, in medicine, means following the medication regimen. People with schizophrenia often go off their medication for long periods during their lives, at huge personal costs to themselves and often to those around them as well.

The Cleveland Clinic⁵ says that the patient must continue taking medication even when symptoms are gone, otherwise they will come back.

The majority of patients go off their medication within the first year of treatment. In order to address this, successful schizophrenia treatment needs to consist of a life-long regimen of both drug and psychosocial, support therapies. The medication can help control the patient's hallucinations and delusions, but it cannot help them learn to communicate with others, get a job, and thrive in society.

Although a significant number of people with schizophrenia live in poverty, this does not have to be the case. A person with schizophrenia who complies with the treatment regimen long-term will be able to lead a happy and productive life.

The first time a person experiences schizophrenia symptoms can be very unpleasant. He/she may take a long time to recover, and that recovery can be a lonely experience. It is crucial that a schizophrenia sufferer receives the full support of his/her family, friends, and community services when onset appears for the first time.

Medications

The medical management of schizophrenia generally involves drugs for psychosis, depression and anxiety. This is because schizophrenia is a combination of thought disorder, mood disorder and anxiety disorder.

The most common antipsychotic drugs are Risperidone (Risperdal), Olanzapine (Zyprexa), Quetiapine (Seroquel), Ziprasidone (Geodon), and Clozapine (Clozaril):

• Risperidone (Risperdal) - introduced in America in 1994. This drug is less sedating than other atypical antipsychotics. There is a higher probability, compared to other atypical antipsychotics, of extrapyramidal symptoms (affecting the extrapyramidal motor system, a neural network located in the brain that is involved in the coordination of movement). Although weight gain and diabetes are possible risks, they are less likely to happen, compared with Clozapine or Olanzapine.


• Olanzapine (Zyprexa) - approved in the USA in 1996. A typical dose is 10 to 20 mg per day. Risk of extrapyramidal symptoms is low, compared to Risperidone. This drug may also improve negative symptoms. However, the risks of serious weight gain and the development of diabetes are significant.


• Quetiapine (Seroquel) - came onto the market in America in 1997. Typical dose is between 400 to 800 mg per day. If the patient is resistant to treatment the dose may be higher. The risk of extrapyramidal symptoms is low, compared to Risperidone. There is a risk of weight gain and diabetes, however the risk is lower than Clozapine or Olanzapine.


• Ziprasidone (Geodon) - became available in the USA in 2001. Typical doses range from 80 to 160 mg per day. This drug can be given orally or by intramuscular administration. The risk of extrapyramidal symptoms is low. The risk of weight gain and diabetes is lower than other atypical antipsychotics. However, it might contribute to cardiacarrhythmia, and must not be taken together with other drugs that also have this side effect.


• Clozapine (Clozaril) - has been available in the USA since 1990. A typical dose ranges from 300 to 700 mg per day. It is very effective for patients who have been resistant to treatment. It is known to lower suicidal behaviors. Patients must have their blood regularly monitored as it can affect the white blood cell count. The risk of weight gain and diabetes is significant.

Recent developments on schizophrenia treatment from MNT news

Researchers at the University of Iowa found that higher dosages of anti-psychotic medications resulted in the loss of more brain tissue. They also found that brain scans after patients' first psychotic episode revealed that they had less brain tissue than healthy people without schizophrenia.

Head investigator, Professor Nancy Andreasen, said "This was a very upsetting finding. We spent a couple of years analyzing the data more or less hoping we had made a mistake. But in the end, it was a solid finding that wasn't going to go away, so we decided to go ahead and publish it. The impact is painful because psychiatrists, patients, and family members don't know how to interpret this finding. 'Should we stop using antipsychotic medication? Should we be using less?'"

How common is schizophrenia?

The prevalence of schizophrenia globally varies slightly, depending on which report you look at, from about 0.7% to 1.2% of the adult population in general. Most of these percentages refer to people suffering from schizophrenia "at some time during their lives".

An Australian study found that schizophrenia is more common in developed nations than developing ones. It also found that the illness is less widespread than previously thought. Estimates of 10 per 1,000 people should be changed to 7 or 8 per 1,000 people, the study concluded.

In the USA about 2.2 million adults, or about 1.1% of the population age 18 and older in a given year have schizophrenia.

Schizophrenia is not a 'very' common disease. Approximately 1% of people throughout the globe suffer from schizophrenia (or perhaps a little less than 1% in developing countries) at some point in their lives. It is estimated that about 1.2% of Americans, a total of 3.2 million people, have the disorder at some point in their lives. Globally, about 1.5 million people each year are diagnosed with schizophrenia. In the UK it is estimated that about 600,000 people have schizophrenia.

Schizophrenia
and Psychosis

Schizophrenia Information & Treatment Introduction

Throughout recorded history, the disorder we now know as schizophrenia has been a source of bewilderment. Those suffering from the illness once were thought to be possessed by demons and were feared, tormented, exiled or locked up forever.

In spite of advances in the understanding of its causes, course and treatment, schizophrenia continues to confound both health professionals and the public. It is easier for the average person to cope with the idea of cancer than it is to understand the odd behavior, hallucinations or strange ideas of the person with schizophrenia.

As with many mental disorders, the causes of schizophrenia are poorly understood. Friends and family commonly are shocked, afraid or angry when they learn of the diagnosis. People often imagine a person with schizophrenia as being more violent or out-of-control than a person who has another kind of serious mental illness. But these kinds of prejudices and misperceptions can be readily corrected.

Expectations become more realistic as schizophrenia is better understood as a disorder that requires ongoing -- often lifetime -- treatment. Demystification of the illness, along with recent insights from neuroscience and neuropsychology, gives new hope for finding more effective treatments for an illness that previously carried a grave prognosis.

Schizophrenia is characterized by a broad range of unusual behaviors that cause profound disruption in the lives of people suffering from the condition, as well as in the lives of the people around them. Schizophrenia strikes without regard to gender, race, social class or culture.

Delusions & Hallucinations Are Common in Schizophrenia

One of the most obvious kinds of impairment caused by schizophrenia involves how a person thinks. The individual can lose much of the ability to rationally evaluate his or her surroundings and interactions with others. They often believe things that are untrue, and may have difficulty accepting what they see as "true" reality.

Schizophrenia most often includes hallucinations and/or delusions, which reflect distortions in the perception and interpretation of reality. The resulting behaviors may seem bizarre to the casual observer, even though they may be consistent with the schizophrenic's abnormal perceptions and beliefs.

For instance, someone with schizophrenia may act in an extremely paranoid manner -- purchasing multiple locks for their doors, always checking behind them as they walk in public, refusing to talk on the phone. Without context, these behaviors may seem irrational or illogical. But to someone with schizophrenia, these behaviors may reflect a reasonable reaction their false beliefs that others are out to get them or lock them up.

Nearly one-third of those diagnosed with schizophrenia will attempt suicide. About 10 percent of those with the diagnosis will commit suicide within 20 years of the beginning of the disorder. Patients with schizophrenia are not likely to share their suicidal intentions with others, making life-saving interventions more difficult. The risk of depression needs special mention due to the high rate of suicide in these patients. The most significant risk of suicide in schizophrenia is among males under 30 who have some symptoms of depression and a relatively recent hospital discharge. Other risks include imagined voices directing the patient toward self-harm (auditory command hallucinations) and intense false beliefs (delusions).

The relationship of schizophrenia to substance abuse is significant. Due to impairments in insight and judgment, people with schizophrenia may be less able to judge and control the temptations and resulting difficulties associated with drug or alcohol abuse.

In addition, it is not uncommon for people suffering from this disorder to try to "self-medicate" their otherwise debilitating symptoms with mind-altering drugs. The abuse of such substances, most commonly nicotine, alcohol, cocaine and marijuana, impedes treatment and recovery.

The Onset of Schizophrenia

The onset of schizophrenia in most people is a gradual deterioration that occurs in early adulthood -- usually in a person's early 20s. Loved ones and friends may spot early warning signs long before the primary symptoms of schizophrenia occur. During this initial pre-onset phase, a person may seem without goals in their life, becoming increasingly eccentric and unmotivated. They may isolate themselves and remove themselves from family situations and friends. They may stop engaging in other activities that they also used to enjoy, such as hobbies or volunteering.

Warning signs that may indicate someone is heading toward an episode of schizophrenia include:

• Social isolation and withdrawal
• Irrational, bizarre or odd statements or beliefs
• Increased paranoia or questioning others' motivations
• Becoming more emotionless
• Hostility or suspiciousness
• Increasing reliance on drugs or alcohol (in an attempt to self-medicate)
• Lack of motivation
• Speaking in a strange manner unlike themselves
• Inappropriate laughter
• Insomnia or oversleeping
• Deterioration in their personal appearance and hygiene

While there is no guarantee that one or more of these symptoms will lead to schizophrenia, a number of them occurring together should be cause for concern, especially if it appears that the individual is getting worse over time. This is the ideal time to act to help the person (even if it turns out not to be schizophrenia)

Schizophrenia is a mental disorder that is characterized by at least 2 of the following  symptoms, for at least one month:

• Delusions
• Hallucinations
• Disorganized speech (e.g., frequent derailment or incoherence)
• Grossly disorganized or catatonic behavior
• A set of three negative symptoms (a “flattening” of one’s emotions, alogia, avolition; see below)

Only one of the above symptoms is required to make the diagnosis of schizophrenia if the person’s delusions are bizarreor if the hallucinations consist of a voice keeping up a running commentary on the person’s behavior or thoughts, or two or more voices conversing with each other.

Positive Symptoms Delusions Hallucinations Disorganized thinking Agitation

Negative Symptoms Affective flattening- The person’s range of emotional expression is clearly diminished; poor eye contract; reduced body language Alogia- A poverty of speech, such as brief, empty replies Avolition – Inability to initiate and persist in goal-directed activities (such as school or work)

Although the above symptoms must be present for at least one (1) month, there also needs to be continuous signs of the disturbance that persist for at least six (6) months.  During this period, the signs of the disorder may be present in a milder form, for instance as just odd beliefs or unusual perceptual experiences. During this 6 month period, at least two of the above criteria must be met, or only the criteria of Negative Symptoms must be present — if even just in milder form.

Onset of schizophrenia prior to adolescence is rare. The peak age at onset for the first psychotic episode is in the early- to mid-20s for males and in the late-20s for females. Though active symptoms typically do not emerge until an individual is in their 20′s, oftentimes prodromal symptoms will precede the first psychotic episode, characterized by milder forms of hallucinations or delusions. For example, individuals may express a variety of unusual or odd beliefs that are not of delusional proportions (e.g., ideas of reference or magical thinking); they may have unusual perceptual experiences (e.g., sensing the presence of an unseen person); their speech may be generally understandable but vague; and their behavior may be unusual but not grossly disorganized (e.g., mumbling in public).

Individuals with schizophrenia evidence large distress and impairments in various life domains. Functioning in areas such as work, interpersonal relations, or self-care must be markedly below the level achieved prior to the onset of the symptoms to receive the diagnosis (or when the onset is in childhood or adolescence, failure to achieve expected level of interpersonal, academic, or occupational achievement).

Schizoaffective Disorder and Mood Disorder With Psychotic Features must be considered as alternative explanations for the symptoms and have been ruled out. The disturbance must also not be due to the direct physiological effects of use or abuse of a substance (e.g., alcohol, drugs, medications) or a general medical condition.

If there is a history of Autistic Disorder or another Pervasive Developmental Disorder, the additional diagnosis of Schizophrenia is made only if prominent delusions or hallucinations are also present for at least a month (or less if successfully treated).

0.3%–0.7% of individuals appear to acquire schizophrenia. although there is reported variation by race/ethnicity, across countries, and by geographic origin for immigrants and children of immigrants. The sex ratio differs across samples and populationHostility and aggression can be associated with schizophrenia, although spontaneous or random assault is uncommon. Aggression is more frequent for younger males and for individuals with a past history of violence, non-adherence with treatment, substance abuse, and impulsivity. It should be noted that the vast majority of persons with schizophrenia are not aggressive and are more frequently victimized than are individuals in the general population.

The old criteria in the DSM-IV divided schizophrenia by different Types. Though we not longer use such specifiers in the updated DSM-5, they remain below for informational/historical purposes.

A brief list of types of schizophrenia, according to DSM-IV:

• Paranoid schizophrenia– a person feels extremely suspicious, persecuted, grandiose, or experiences a combination of these emotions.
• Disorganized schizophrenia  — a person is often incoherent but may not have delusions.
• Catatonic schizophrenia– a person is withdrawn, mute, negative and often assumes very unusual postures.
• Residual schizophrenia — a person is no longer delusion or hallucinating, but has no motivation or interest in life. These symptoms can be most devastating.

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