Schizophrenia and the Movie A Beautiful Mind Paper Example

Introduction

Schizophrenia is one of the mental disorders that affect individuals in their late adolescence or as they begin their early childhood (ages between 16 and 30). It is a severe and chronic disorder that affects how an individual feels, thinks and acts (National Institute of Mental Health (US), 2009). Schizophrenia may not be as common as other mental disorders, but when it occurs, it is very disabling. It is estimated that about 7 or 8 individuals out of 1000 will develop the disease in their lifetime (National Institute of Mental Health (US), 2009). Schizophrenia is said to be very disabling because of its unique symptom in which the victim sees or hears things that are not there. This makes them believe that other people are controlling their thoughts or reading their minds. As a result, the victim will see those people around him or her as plotting harm, and it makes that victim extremely agitated or withdrawn. Moreover, there is a high likelihood of co-occurring medical conditions such as diabetes and heart diseases that may lead to premature death to the schizophrenia patients (Psychiatry Online, n.d.). Thus, schizophrenia becomes an important mental disorder to study since although it is not very common, as it occurs it affects not only the patient but also people around him or her. For instance, people with schizophrenia have difficulties holding a job or caring for themselves which renders them reliant on others for help (Psychiatry Online, n.d.). It is, therefore, necessary to establish a clear understanding of this mental disorder regarding its etiology, symptoms, diagnosis, and treatment. John Forbes Nash Junior, a major character in the movie A Beautiful Mind and who suffered from schizophrenia, will be used to illustrate the disease symptoms and treatment.

Etiology

Research has pointed out some risk factors that contribute to developing schizophrenia. They include deficits in innate immunity and genes and environment.

Deficits in Innate Immunity

According to Dickerson et al. (2015), schizophrenia may develop as a result of inherent deficits in innate immunity. The research used a sample of 588 people including 249 individuals with chronic schizophrenia, 79 individuals with recent onset psychosis and 260 controls. Combined inflammation score was computed by principal components factor analysis of the levels of Pwntraxin 3, C-reactive protein, casein, IgG antibodies to gliadin and Saccharomyces cerevisiae measured in blood samples (Dickerson et al., 2015). Significant elevations in the combined inflammation score were recorded among chronic schizophrenia individuals as compared to controls. Recent onset group recorded a reduction in the combined inflammation score. The chronic group had amplified odds of combined inflammation score bigger in the 75th and 90th percentile of the controls whereas the onset group showed increased odds of combined inflammation score less than the 10th and 25th percentile levels as compared to the controls (Dickerson et al., 2015). Therefore, the recent onset of psychosis can be attributed due to deficits in innate immunity. Later in the course of the disease, individuals may have augmented levels of immunity (Dickerson et al., 2015).

Genes and Environment

Schizophrenia has also been linked with genes and the environment. Scientists believe that schizophrenia runs in families. Whereas the disease occurs in less than 1% of the population, it occurs in 10% of individuals who have a first-degree relative (parent, brother or sister) with the disorder (National Institute of Mental Health (US), 2009). Similarly, those individuals who have a second-degree relative (uncle, aunt, cousin or grandparent) with the disease more often develop the disease than the general population (National Institute of Mental Health (US), 2009). The risk is about 45 to 65% for identical twins where one develops the disease (National Institute of Mental Health (US), 2009). Scientists further believe that several genes play a part in the development of the disease and the schizophrenia individuals tend to have higher rates of rare genetic mutations which interfere with brain development in different manners. Interactions between individual's aspects of environment and genes are necessary for the disease to develop (National Institute of Mental Health (US), 2009).

Symptoms

The symptoms of schizophrenia fall into several categories with major ones being positive, negative and cognitive symptoms. Positive psychotic symptoms are behaviors that are generally absent in healthy people. For schizophrenia individuals, these symptoms include hallucinations, delusions, thought and movement disorders (Psychiatry Online, n.d.). Hallucinations are sensory experiences that occur without a real stimulus. For example, the victim may hear voices when there is not any voice in the environment. These voices can be coming from within one's mind. The patient may also be seeing objects or people that are not there or smell odors that are non-existing in the environment.

On the other hand, delusions are false beliefs, perceptions and behaviors strongly held by an individual suffering from schizophrenia and are not consistent with that person's culture. For instance, the schizophrenia individual may believe that a neighbor is controlling his or her behaviors with magnetic waves or certain television messages are directed to him. Thought disorders manifest in difficulties to connect thoughts logically leading to an individual stopping a conversation abruptly or talking in a manner difficult to comprehend. Movement disorders manifest in agitated body movements (Psychiatry Online, n.d.).

Negative symptoms are those associated with disruptions to normal behaviors and emotions. These may include reduced speaking or reduced pleasure in everyday life. For example, the person who has schizophrenia may have difficulty in finding pleasure or expressing an emotion, speaking and even initiating plans (Psychiatry Online, n.d.).

Cognitive symptoms are manifestations in the memory and psychological function of the victim. These symptoms appear by way of problems with concentration and attention, declining educational performance among students and poor memory (Psychiatry Online, n.d.).

These symptoms mostly appear in early adulthood but vary according to gender. Men exhibit the signs in the early 20s or late teens whereas in women first signs may appear in 20s or early 30s. Nonetheless, more clear signs may be present earlier and manifest in poor school performance, troubled relationships and reduced motivation (Psychiatry Online, n.d.).

The symptoms described above were quite evident in John Forbes Nash. First, the disturbances began at around 1948 when he was exactly 20 years. He was arrogant and antisocial which is a sign of withdrawal associated with schizophrenic individuals. Also, hallucinations and delusions were clear. Nash had a close friend and a roommate called Charles who was non-existing in reality (Grazer & Howard, 2001). He even hallucinated of a niece called Marcee who was not there. He also hallucinated seeing Parcher and Soviet agents exchanging fire. He also had delusions. When he believed he was being followed when he delivered results to a secret mailbox. The climax of these symptoms was during his lecture at Harvard University when he hallucinates and tries to flee from people he believed to be Russian agents. He had shown negative signs as he stumbled in his speech and everyone was wondering how? (Grazer & Howard, 2001).Diagnosis

Schizophrenia is diagnosed using the DSM-5 criteria established to serve as a guide for medical practitioners or psychiatrists.

Criterion A: At least two of the following symptoms should be present during a 1-month period (or less if successfully treated):

• Delusions
• Hallucinations
• Disorganized speech
• Catatonic behavior
• Negative symptoms

Criterion B: social/occupational dysfunction The person should show at least one major area(s) of functioning such as interpersonal relations, work or self-care being markedly below the prior since the onset of the disturbance. For example, if the disturbance begins at early teens, the specialist should identify an occupational dysfunction that has occurred but was normal during adolescence.

Criterion C: duration The signs of disturbance should continue persistently for six months or more. Inclusive of this period is at least one month of symptoms in criterion A or less (if treated). If symptoms in criterion A are absent, then negative signs should be present.

Criterion D: Schizoaffective and major mood disorder exclusion Schizoaffective and major mood disorder with psychotic features will have been ruled out because (1) no major manic or depressive episodes have occurred concomitantly with the active phase symptoms; or (2) in case the mood episodes have occurred during the active phase symptoms, their sum duration has been shorter relative to that of the residual and active periods.

Criterion E: general/substance mood condition exclusion The general or substance medical condition will have been excluded if the disturbance is not attributable to the physiological effects of a substance such as a medication or a drug.

Criterion F: relationship to global developmental delay or autism spectrum Additional diagnosis is appropriate if a history of autism spectrum disorder or communication disorder has been established.

Differential Diagnoses

Undeniably, some medical conditions can present as psychosis. For example, untreated hyperthyroidism and hypothyroidism present with delusions, auditory hallucinations and thought disorder (Sie, 2011). There are also medications and drugs that can induce psychosis including levodopa, cannabis among others (Sie, 2011). A range of baseline tests needs to be carried out to exclude the above conditions. Necessary baseline tests, therefore, include thyroid function tests to rule out hyperthyroidism or hypothyroidism, liver function tests to detect whether psychosis is as a result of alcohol use or not, blood sugar tests to assess for diabetes, and urine screening to rule out substance abuse (Sie, 2011).

Treatment

The treatment goals in schizophrenia include targeting symptoms, increasing adaptive functioning and targeting symptoms (Patel, K. R., Cherian, Gohil & Atkinson, 2014). For this reason, both pharmacological and nonpharmacological treatments should be integrated for better results since residual symptoms may persist even after pharmacotherapy and nonpharmacotherapy can aid in achieving long-term outcomes by modifying behaviors and self-control. This can be illustrated by Nash's case where he was given some antipsychotics, and the symptoms improved. However, after sometime when he stopped the medication, schizophrenia relapsed (Grazer & Howard, 2001).

Pharmacological treatments entail the use of antipsychotic agents to reduce positive symptoms of schizophrenia (Altamura, Fagiolini, Galderisi, Rocca & Rossi, 2015). It can be seen in the Nash case that antipsychotic agents (such as chlorpromazine) worked well to reduce hallucinations and delusions. However, antipsychotic agents do not treat the cognitive and negative symptoms of schizophrenia, and the patient may continue to present psychotic symptoms (Almatura et al., 2015). This necessitates the use of nonpharmacological interventions.

Nonpharmacological interventions are the psychological therapies such as cognitive behavior therapy (CBT), cognitive remediation, family psychoeducation, mutual support and self-help strategies, and social skill training among other b...