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Psychosis is a condition of the mind that results in difficulties determining what is real and what is not real. Symptoms may include delusions and hallucinations, among other features. Additional symptoms are incoherent speech and behavior that is inappropriate for a given situation. There may also be sleep problems, social withdrawal, lack of motivation, and difficulties carrying out daily activities. Psychosis can have serious adverse outcomes.
Paranoia is an instinct or thought process that is believed to be heavily influenced by anxiety, suspicion, or fear, often to the point of delusion and irrationality. Paranoid thinking typically includes persecutory beliefs, or beliefs of conspiracy concerning a perceived threat towards oneself. Paranoia is distinct from phobias, which also involve irrational fear, but usually no blame.
Schizophrenia is a mental disorder characterized by continuous or relapsing episodes of psychosis. Major symptoms include hallucinations, delusions, and disorganized thinking. Other symptoms include social withdrawal, and flat affect. Symptoms typically develop gradually, begin during young adulthood, and in many cases never become resolved. There is no objective diagnostic test; diagnosis is based on observed behavior, a psychiatric history that includes the person's reported experiences, and reports of others familiar with the person. To be diagnosed with schizophrenia, the described symptoms need to have been present for at least six months or one month. Many people with schizophrenia have other mental disorders, especially substance use disorders, depressive disorders, anxiety disorders, and obsessive–compulsive disorder.
Schizoaffective disorder is a mental disorder characterized by abnormal thought processes and an unstable mood. This diagnosis requires symptoms of both schizophrenia and a mood disorder: either bipolar disorder or depression. The main criterion is the presence of psychotic symptoms for at least two weeks without any mood symptoms. Schizoaffective disorder can often be misdiagnosed when the correct diagnosis may be psychotic depression, bipolar I disorder, schizophreniform disorder, or schizophrenia. This is a problem as treatment and prognosis differ greatly for most of these diagnoses.
Depersonalization can consist of a detachment within the self, regarding one's mind or body, or being a detached observer of oneself. Subjects feel they have changed and that the world has become vague, dreamlike, less real, lacking in significance or being outside reality while looking in. It can be described as feeling like one is on “autopilot” and that the person's sense of individuality or selfhood has been hindered or suppressed.
Schizotypal personality disorder, also known as schizotypal disorder, is a cluster A personality disorder. The Diagnostic and Statistical Manual of Mental Disorders (DSM) classification describes the disorder specifically as a personality disorder characterized by thought disorder, paranoia, a characteristic form of social anxiety, derealization, transient psychosis, and unconventional beliefs. People with this disorder feel pronounced discomfort in forming and maintaining social connections with other people, primarily due to the belief that other people harbor negative thoughts and views about them. Peculiar speech mannerisms and socially unexpected modes of dress are also characteristic. Schizotypal people may react oddly in conversations, not respond, or talk to themselves. They frequently interpret situations as being strange or having unusual meanings for them; paranormal and superstitious beliefs are common. Schizotypal people usually disagree with the suggestion that their thoughts and behaviors are a 'disorder' and seek medical attention for depression or anxiety instead. Schizotypal personality disorder occurs in approximately 3% of the general population and is more commonly diagnosed in males.
In psychology, schizotypy is a theoretical concept that posits a continuum of personality characteristics and experiences, ranging from normal dissociative, imaginative states to extreme states of mind related to psychosis, especially schizophrenia. The continuum of personality proposed in schizotypy is in contrast to a categorical view of psychosis, wherein psychosis is considered a particular state of mind, which the person either has or does not have.
Links between creativity and mental health have been extensively discussed and studied by psychologists and other researchers for centuries. Parallels can be drawn to connect creativity to major mental disorders including bipolar disorder, schizophrenia, major depressive disorder, anxiety disorder, OCD and ADHD. For example, studies have demonstrated correlations between creative occupations and people living with mental illness. There are cases that support the idea that mental illness can aid in creativity, but it is also generally agreed that mental illness does not have to be present for creativity to exist.
Thought broadcasting is a type of delusional condition in which the affected person believes that others can hear their inner thoughts, despite a clear lack of evidence. The person may believe that either those nearby can perceive their thoughts or that they are being transmitted via mediums, such as television, radio or the internet. Different people can experience thought broadcasting in different ways. Thought broadcasting is most commonly found among people that have psychotic disorder, specifically schizophrenia.
Risk factors of schizophrenia include many genetic and environmental phenomena. The prevailing model of schizophrenia is that of a special neurodevelopmental disorder with no precise boundary or single cause. Schizophrenia is thought to develop from very complex gene–environment interactions with vulnerability factors. The interactions of these risk factors are intricate, as numerous and diverse medical insults from conception to adulthood can be involved. The combination of genetic and environmental factors leads to deficits in the neural circuits that affect sensory input and cognitive functions. Historically, this theory has been broadly accepted but impossible to prove given ethical limitations. The first definitive proof that schizophrenia arises from multiple biological changes in the brain was recently established in human tissue grown from patient stem cells, where the complexity of disease was found to be "even more complex than currently accepted" due to cell-by-cell encoding of schizophrenia-related neuropathology.
Sarnoff Andrei Mednick, was a psychologist who pioneered the prospective high-risk, longitudinal study to investigate the etiology (causes) of psychopathology, or mental disorders. His emphasis was on schizophrenia. He made significant contributions to the study of creativity, psychopathy, alcoholism and suicide in schizophrenia. He was a Professor Emeritus at The University of Southern California, where he had been a tenured professor since the early '70s and remained highly active in his eighties. Mednick was the first scientist to revisit the genetic basis of mental disorders, following the era of eugenics. He was the recipient of the Joseph Zubin Award in 1996, with more than 300 peer-reviewed publications on the topic.
Philip Holzman (1922–2004) was the Esther and Sidney R. Rabb Professor of Psychology Emeritus at Harvard University and one of the world’s preeminent scientists in schizophrenia research. His landmark studies of oculomotor function documented the presence of abnormal smooth pursuit eye movements in individuals with schizophrenia and their clinically unaffected biological relatives. He was one of the first to investigate the genetic basis of schizophrenia. Another key contribution to the study of schizophrenia was his work on language and thought disorder in individuals with schizophrenia. He also discovered the presence of an active short-term memory deficit in people with schizophrenia and their biological relatives.
The word schizophrenia was coined by the Swiss psychiatrist Eugen Bleuler in 1908, and was intended to describe the separation of function between personality, thinking, memory, and perception. He introduced the term on 24 April 1908 in a lecture given at a psychiatric conference in Berlin and in a publication that same year. Bleuler later expanded his new disease concept into a monograph in 1911, which was finally translated into English in 1950.
Childhood schizophrenia is similar in characteristics of schizophrenia that develops at a later age, but has an onset before the age of 13 years, and is more difficult to diagnose. Schizophrenia is characterized by positive symptoms that can include hallucinations, delusions, and disorganized speech; negative symptoms, such as blunted affect and avolition and apathy, and a number of cognitive impairments. Differential diagnosis is problematic since several other neurodevelopmental disorders, including autism spectrum disorder, language disorder, and attention deficit hyperactivity disorder, also have signs and symptoms similar to childhood-onset schizophrenia.
The diagnosis of schizophrenia, a psychotic disorder, is based on criteria in either the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, or the World Health Organization's International Classification of Diseases (ICD). Clinical assessment of schizophrenia is carried out by a mental health professional based on observed behavior, reported experiences, and reports of others familiar with the person. Diagnosis is usually made by a psychiatrist. Associated symptoms occur along a continuum in the population and must reach a certain severity and level of impairment before a diagnosis is made. Schizophrenia has a prevalence rate of 0.3-0.7% in the United States
Tangential speech or tangentiality is a communication disorder in which the train of thought of the speaker wanders and shows a lack of focus, never returning to the initial topic of the conversation. It tends to occur in situations where a person is experiencing high anxiety, as a manifestation of the psychosis known as schizophrenia, in dementia or in states of delirium. It is less severe than logorrhea and may be associated with the middle stage in dementia. It is, however, more severe than circumstantial speech in which the speaker wanders, but eventually returns to the topic.
The Center for Subjectivity Research (CFS) is an interdisciplinary research center at the University of Copenhagen, directed by Dan Zahavi. They work on a number of different topics: subjectivity, intentionality, empathy, action, perception, embodiment, naturalism, self-consciousness, self-disorders, schizophrenia, autism, cerebral palsy, normativity, anxiety, and trust, and do scholarly work on classical thinkers such as Kant, Hegel, Kierkegaard, Brentano, Husserl, Heidegger, Wittgenstein, Merleau-Ponty, Levinas, and Ricoeur. They put a variety of philosophical and empirical perspectives on subjectivity into play to obtain mutual enlightenment, and methodological and conceptual pluralism. Hence, they have had collaborations within different disciplines such as phenomenology, analytic philosophy, hermeneutics, psychiatry, neuroscience, philosophy of religion, Asian philosophy, developmental psychology, clinical psychology, and cognitive science.
A self-disorder, also called ipseity disturbance, is a psychological phenomenon of disruption or diminishing of a person's minimal self – the fundamental sense that one's experiences are truly one's own. People with self-disorder feel that their internal experiences are actually external; for example, they may experience their own thoughts as coming from outside themselves, whether in the form of true auditory hallucinations or merely as a vague sense that their thoughts do not belong to them.
Basic symptoms of schizophrenia are subjective symptoms, described as experienced from a person's perspective, which show evidence of underlying psychopathology. Basic symptoms have generally been applied to the assessment of people who may be at risk to develop psychosis. Though basic symptoms are often disturbing for the person, problems generally do not become evident to others until the person is no longer able to cope with their basic symptoms. Basic symptoms are more specific to identifying people who exhibit signs of prodromal psychosis (prodrome) and are more likely to develop schizophrenia over other disorders related to psychosis. Schizophrenia is a psychotic disorder, but is not synonymous with psychosis. In the prodrome to psychosis, uncharacteristic basic symptoms develop first, followed by more characteristic basic symptoms and brief and self-limited psychotic-like symptoms, and finally the onset of psychosis. People who were assessed to be high risk according to the basic symptoms criteria have a 48.5% likelihood of progressing to psychosis. In 2015, the European Psychiatric Association issued guidance recommending the use of a subscale of basic symptoms, called the Cognitive Disturbances scale (COGDIS), in the assessment of psychosis risk in help-seeking psychiatric patients; in a meta-analysis, COGDIS was shown to be as predictive of transition to psychosis as the Ultra High Risk (UHR) criteria up to 2 years after assessment, and significantly more predictive thereafter. The basic symptoms measured by COGDIS, as well as those measured by another subscale, the Cognitive-Perceptive basic symptoms scale (COPER), are predictive of transition to schizophrenia.
Kenneth Francis Schaffner is an emeritus Distinguished University Professor, University Professor of Philosophy and Psychology, and Professor of Psychiatry at the University of Pittsburgh. He specializes in the history and philosophy of science.
References
- ↑ "Parnas, Josef". Library of Congress Name Authority File. Retrieved 2021-03-03.
- ↑ "Josef Parnas". Oxford University Department for Continuing Education. Retrieved 2021-03-03.
- ↑ Parnas, Josef; Zandersen, Maja (2021-01-27). "Talking to Patients and Rediscovering Disordered Selfhood in Schizophrenia". Psychiatric Times. Retrieved 2021-03-03.
- ↑ Bürgy, Martin (2011). "Ego Disturbances in the Sense of Kurt Schneider: Historical and Phenomenological Aspects". Psychopathology. 44 (5): 320–328. doi:10.1159/000325059. ISSN 0254-4962.
