Lesson 18: Schizophrenia

Attention

I found this image on www.schizophrenia.org
The artist is Louis Wain, who was fascinated by cats, who painted these over a course of time as he developed Schizophrenia.

Visit this website for some interesting articles and insight into Schizophrenia

Learning Outcomes

Upon completion of this lesson's material, students will be able to:

• Evaluate personal views on dealing with symptomatology of Schizophrenia

Teaching

Read Chapter 12 in Cohen & Eisdorfer

This chapter starts off with a very interesting statistic. About 25% of older people with Schizophrenia developed it later in life, the other 75% developed it during adolescence or early adulthood. Research on late-onset Schizophrenia is very limited.

Late-onset Schizophrenia can be quite disturbing and frightening to individuals and their families. Others who have had the symptoms since they were young are more familiar with some of the bizarre qualities of the disorder.

As with our discussion on Dementia and Alzheimer's, our approach to working with individuals with Schizophrenia is with empathy and care. Symptoms, which can include delusions and hallucinations are very real to these individuals, and they are not likely "doing it for attention".

Although medical treatments for Schizophrenia can be very effective, there is a tendency for individuals to refuse medicine due to side effects (which can be very powerful) and a lack of insight into the illness itself. Relapses are often severe, very disruptive, and reduce quality of life.

You can expect that you may have to deal with individuals who, after a long period of ups and downs with Schizophrenia, have finally "burned their last bridge" with family and other natural supports, and they are being referred to you for assistance. Case Management is a critical service for individuals with Schizophrenia.

The focus of treatment is often on day-to-day problem solving and simply maintaining health outside of the hospital in-between relapse. If you look at the list of "Goals of Treatment" (on p. 141) you can see the pragmatic goals of simple problem solving, housing, substance use, and keeping them "out of trouble".

Individuals with long-term Schizophrenia are more likely to have "learned their way in the world" and have learned to adapt and deal with their disorder, the reduced life script, and the long-term outcomes of having Schizophrenia. Persons with late-onset of Schizophrenia are less equiped to deal with the severe disabling effect of this disorder.

Assessment

Possible Class Discussion

Read the story of MA on p. 137 of the textbook. Reflect on your own comfort level with this kind of symptomatology. While it may be easy to read about it, it is not as easy when it is happening right in front of you. Reflect on any personal experiences you may have had with this diagnosis.