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Chapter I

Introduction

Schizophrenia is a chronic and severe mental disorder characterized by disturbances in

thought, perception, emotions, and behavior. People with schizophrenia may experience

hallucinations (seeing or hearing things that aren't there), delusions (false beliefs), disorganized

thinking, and difficulty in maintaining relationships. The symptoms can vary in severity and may

come and go over time. Schizophrenia typically emerges in late adolescence or early adulthood,

and its exact cause is still not fully understood, though it's believed to involve a combination of

genetic, brain chemistry, and environmental factors. Treatment often involves a combination of

antipsychotic medications, psychotherapy, and support services to help manage symptoms and

improve functioning.

Less than 1% of Americans suffer from schizophrenia, a chronic brain disorder that can

cause delusions, hallucinations, disorganized speech, difficulty thinking, and lack of motivation.

Fortunately, most symptoms of schizophrenia can be greatly improved with treatment, and the

chance of a recurrence can be reduced (What Is Schizophrenia?, n.d.)

Schizophrenia was identified more than a century ago. But we do not know the exact

causes. It remains one of the most stigmatized and misunderstood illnesses even today.

Schizophrenia is considered a syndrome, which means that it may encompass a number of

related disorders That have similar causes and symptoms.

 Schizophrenia has been defined and described by various scholars and researchers over

the years. Emil Kraepelin, a pioneer in psychiatry, was among the early scholars to distinguish

schizophrenia from other mental illnesses. He introduced the term "dementia praecox" to

describe this condition, which he characterized by a gradual decline in cognitive abilities

(Kraepelin, 1919). A peculiar destruction of the psychic personality's internal connections

characterizes the range of states that make up dementia praecox; the emotional and volitional

domains of mental life are the primary sites of injury (KRAEPELIN & University of California

Libraries, 1919).

Anyone can get schizophrenia. It affects people all over the world, from all races and

cultures. While it can happen at any age, schizophrenia typically first appears in the teenage

years or early 20s. The disorder affects men and women equally although symptoms generally

appear earlier in men. The earlier the symptoms start, the more severe the illness tends to be.

Children over the age of 5 can have schizophrenia, but it’s rare before adolescence.Website

(2023)

According to WHO, currently, the vast majority of people with schizophrenia around the

world are not receiving mental health care. Approximately 50% of people in mental hospitals

have a schizophrenia diagnosis (4). Only 31.3% of people with psychosis receive specialist

mental health care (5). Most resources for mental health services are inefficiently spent on care

within mental hospitals.

Chapter II

Historical Background

The term "dementia praecox" (which means "early dementia") was used by Dr. Emile

Kraepelin in 1887 to describe the symptoms that are now known as schizophrenia; by calling his

syndrome "early dementia," he meant to distinguish it from dementias that occur later in life,

such as Alzheimer's disease (senility). Kraepelin believed that dementia praecox was primarily a

disease of the brain . He was wrong, though, to think that this illness was a type of dementia, as

we now know that schizophrenia and dementia (mental decline) are two different conditions

(Lautieri, 2024).

The term "schizophrenia" was first used in 1911 by a Swiss psychiatrist, Eugen Bleuler. It

comes from the Greek roots schizo (split) and phrene (mind). Bleuler used this name to

emphasize the mental confusion and fragmented thinking characteristic of people with the

illness. His term was never intended to imply the concept of an actual split personality or

multiple personalities. Nevertheless, this misunderstanding has led to a widespread and deeply

ingrained myth about schizophrenia that persists to this day.

Mental illness was not well understood in ancient times. Conditions like schizophrenia were

not differentiated from other forms of mental illness or mental retardation, much of which was

thought of as being supernatural in origin, caused by evil spirits, demon possession, punishment

for sin, or similar spiritualist phenomena. Apart from exorcism, an early remedy for such

conditions was found in trepanation, a surgical procedure in which holes were drilled in the skull,
perhaps as a means of letting those evil spirits out, perhaps for other, unknown reasons. Though

the practice of trepanation was ultimately discontinued in developed cultures, the idea that many

mental illnesses and schizophrenia was essentially a spiritual and moral problem appears to have

remained dominant for hundreds, if not thousands of years.

Treatment for mental illness, including what we now recognize as schizophrenia, was often

rudimentary and sometimes harsh. One prevalent approach was to confine individuals with

mental illness in asylums or "madhouses." These institutions were often overcrowded and

provided little in the way of therapeutic treatment. Instead, they focused on containment and

isolation from society.

Individuals with severe mental illness were frequently subjected to physical restraints, such as

chains or straitjackets, to prevent them from harming themselves or others. Seclusion in dark,

solitary cells was also common. Medical treatments often involve purging the body of perceived

toxins through methods such as induced vomiting or the use of laxatives. Bloodletting, the

practice of deliberately removing blood from the body, was also used to rebalance bodily

humors, despite lacking scientific validity. Some treatments involved the use of herbal remedies

or botanical compounds believed to have calming or sedative effects. However, the efficacy of

these treatments was questionable, and they were often administered without proper medical

oversight. Hydrotherapy, the use of water in various forms (such as baths or showers), was

sometimes employed as a therapeutic measure. However, its effectiveness in treating mental

illness was limited and varied widely depending on the specific techniques used.
 Overall, treatments for mental illness in the 18th century were characterized by a lack of

scientific understanding and often relied on methods that were ineffective, if not harmful. It

wasn't until later centuries that more humane and evidence-based approaches to mental health

care began to emerge.

The 19th century witnessed progression in the understanding of psychosis, and the

hospital management of psychotic patients began. While Kraepelin in Europe described the

symptoms of what would later be called schizophrenia, Meyer developed humanistic treatment

for the illness in the United States. The early 20th century treatments for schizophrenia included

insulin coma, metrazol shock, electro-convulsive therapy, and frontal leukotomy Tueth (1995).

The early to mid-20th century saw advancements in the understanding and classification

of schizophrenia. Kurt Schneider proposed the concept of "first-rank symptoms" to aid in

diagnosis. Psychodynamic and psychoanalytic approaches were prominent during this period, but

the advent of antipsychotic medications in the 1950s revolutionized treatment.

The rise of deinstitutionalization in the latter half of the 20th century led to shifts in the

management of schizophrenia, with a greater emphasis on community-based care. The

development of the Diagnostic and Statistical Manual of Mental Disorders (DSM) and the

International Classification of Diseases (ICD) provided standardized criteria for diagnosing

schizophrenia.
 Throughout its history, schizophrenia has been a subject of intense study and debate, with

shifting paradigms reflecting changes in scientific, social, and cultural contexts. Despite

significant progress, much remains to be understood about the complexities of this disorder.

Causes and symptoms of schizophrenia

Causes :

The precise origins of schizophrenia remain unknown. Studies indicate that a blend of

physiological, genetic, psychological, and environmental elements may contribute to an

individual's susceptibility to this disorder. Certain individuals may have a predisposition to

schizophrenia, and a significant life stressor or emotional upheaval could potentially precipitate a

psychotic episode. Nonetheless, the reasons why some individuals manifest symptoms of

schizophrenia while others do not remain uncertain.

Researchers have uncovered several factors that appear to make someone more likely to get the

condition. The causes are:

1. Genetics (heredity). Schizophrenia can run in families, which means there is a greater

likelihood that schizophrenia may be passed on from parents to their children.

2. Brain chemistry and circuits. People with schizophrenia may not be able to regulate brain

chemicals called neurotransmitters that control specific pathways, or "circuits," of nerve

cells that affect thinking and behavior.

 3. Brain abnormality. Research has found abnormal brain structure in people with

schizophrenia. But this doesn’t apply to all people with schizophrenia. It can affect

people without the disease.

4. Environment. Viral infections, marijuana, smoking, childhood trauma, social defeat,

malnutrition, vitamin D deficiency, social cognition, and lower intelligence quotient may

play a part in triggering schizophrenia in people whose genetic makeup puts them at risk.

Schizophrenia more often surfaces when the body is having hormonal and physical

changes, such as during the teen and young adult years.

Symptoms :

Schizophrenia has been referred to as a "youth-led disease" due to its typical onset during

late adolescence or early adulthood. While schizophrenia can manifest at any age, the peak age

of onset is typically between the late teens and mid-30s. This means that a significant proportion

of individuals who develop schizophrenia do so during their youth or young adulthood.

Schizophrenia is considered a syndrome, which means that it may encompass a number

of related disorders That have similar causes and symptoms. Everyone with schizophrenia has

slightly different symptoms. The first signs and symptoms can be easy to be missed or unnoticed,

subtle personality changes, irritation or a gradual encroachment of unusual thoughts. Many

individuals with schizophrenia may not recognize their symptoms, but those around them may

notice changes in their behavior or functioning.

 The five main symptoms of schizophrenia, as can significantly impact an individual's

thoughts, perceptions, emotions, and behaviors. They are :

1. Delusions: These are false beliefs that persist despite evidence to the contrary. Delusions

can take various forms, such as paranoid beliefs (e.g., feeling persecuted or monitored),

grandiose beliefs (e.g., believing one has special powers or importance), or somatic

beliefs (e.g., believing one has a serious illness despite medical reassurance).

2. Hallucinations: These involve perceiving sensations that are not based on external

stimuli. The most common type in schizophrenia is auditory hallucinations, where

individuals hear voices speaking to them or about them. However, hallucinations can also

occur in other sensory modalities, such as visual, tactile, olfactory, or gustatory

hallucinations.

3. Disorganized or incoherent speaking: Individuals with schizophrenia may exhibit

disorganized speech patterns, which can include difficulty organizing thoughts, speaking

in tangents, or using neologisms (made-up words). This can make communication

challenging and may lead to misunderstandings or confusion.

4. Disorganized or unusual movements: Some individuals with schizophrenia may display

unusual or purposeless movements, such as repetitive gestures, grimacing, or catatonia (a

 state of immobility or rigidity). These movements may appear bizarre or out of context

with the individual's surroundings.

5. Negative symptoms: Negative symptoms refer to deficits in normal emotional and

behavioral functioning. These can include a lack of emotional expression (flat affect),

reduced motivation or interest in activities (avolition), social withdrawal, and decreased

speech output (alogia). Negative symptoms can significantly impair social and

occupational functioning and contribute to a decreased quality of life.

Recognizing and understanding these symptoms is crucial for early detection and

intervention in schizophrenia. Prompt diagnosis and appropriate treatment can help individuals

manage their symptoms and improve their overall functioning and quality of life. Additionally,

supportive interventions, such as therapy and social support, can play a vital role in helping

individuals with schizophrenia cope with their symptoms and achieve their goals.

Effects and impacts :

1. Short Lifespan :

According to WHO, People with schizophrenia are 2 to 3 times more likely to die early

than the general population . This is often due to physical illnesses, such as

cardiovascular, metabolic, and infectious diseases.

 The elevated risk of cardiovascular disease in people with schizophrenia may be partly

genetic, but it’s also largely affected by behavioral and lifestyle choices. People with

schizophrenia are more likely to have certain lifestyle habits that increase the risk of

cardiovascular disease, like smoking or a sedentary lifestyle. These conditions may result

from a combination of factors, including side effects of antipsychotic medications,

unhealthy lifestyle choices, and barriers to accessing adequate healthcare.(Bsn, 2022)

2. Suicide Risk :

The Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM–5; American

Psychiatric Association [APA], 2013) states that approximately 5%–6% of individuals

with schizophrenia die by suicide, about 20% attempt suicide on one or more occasions,

and many more have significant suicidal ideation. Suicidal behavior is sometimes in

response to command hallucinations to harm oneself or others. Suicide risk remains high

over the whole lifespan for males and females, although it may be especially high for

younger males with comorbid substance use. Other risk factors include having depressive

symptoms or feelings of hopelessness and being unemployed, and the risk is higher, also,

in the period after a psychotic episode or hospital discharge.(American Psychiatric

Association, 2013)
3. Cognitive Impairment :

As mentioned by Bowie and Harvey (2006) Cognitive dysfunction is a core feature of

schizophrenia. Deficits are moderate to severe across several domains, including

attention, working memory, verbal learning and memory, and executive functions.

Individuals with schizophrenia may experience difficulties in sustaining attention,

shifting attention between tasks, and filtering out irrelevant information. This can lead to

distractibility, reduced concentration, and impaired ability to focus on tasks or

conversations.Memory deficits are common in schizophrenia, particularly in the areas of

working memory and episodic memory. Working memory deficits can affect the ability to

hold and manipulate information in mind, while episodic memory deficits may lead to

difficulties in recalling past events or learning new information.

Executive functions refer to a set of cognitive processes involved in planning, organizing,

problem-solving, and goal-directed behavior. Individuals with schizophrenia may have

impairments in these abilities, leading to difficulties in planning and executing tasks,

managing time effectively, and adapting to changing situations.

Processing speed refers to the rate at which individuals can process and respond to

information. People with schizophrenia often exhibit slower processing speed, which can

impact their ability to comprehend and respond to stimuli in real-time, leading to

difficulties in social interactions, academic or work tasks, and daily activities.

4. Social and occupational dysfunction :

The disorder can profoundly impact individuals' ability to engage in social interactions,

maintain relationships, and fulfill their occupational or educational goals. There may be

social withdrawal , which can manifest as a reluctance or inability to participate in social

activities, gatherings, or relationships. This withdrawal may stem from factors such as

paranoia, fear of judgment or persecution, or difficulty understanding social cues and

norms.

Schizophrenia often interferes with individuals' ability to maintain employment or pursue

educational opportunities. Symptoms such as cognitive deficits, disorganized thinking,

and social impairment can impact job performance or academic success, leading to

unemployment, underemployment, or academic difficulties.

Stigma surrounding schizophrenia can further isolate individuals and impede their ability

to participate fully in society. Discrimination in employment, housing, healthcare, and

other areas may exacerbate social and occupational challenges, limiting opportunities for

recovery and community integration.

5. Side Effects of Antipsychotic Medication :

Antipsychotic medications are a cornerstone of schizophrenia treatment, helping to

alleviate symptoms such as hallucinations and delusions. However, they can also have

significant side effects that affect physical health.

 Possible side-effects of antipsychotics include:

● dry mouth

● dizziness

● weight gain that can lead to diabetes

● blurred vision

● movement effects (for example, tremor, stiffness, agitation)

● sedation (for example causing sleepiness or low energy)

● loss of menstrual periods in women

● fluid retention

● dry mouth

● sexual problems

● headaches.

It is important to remember that the same medication can affect different people in

different ways. (Department of Health & Human Services, n.d.)

6.Stigma and Discrimination:

Stigma and Discrimination: Stigma surrounding mental illness, including schizophrenia, can

have profound effects on individuals' self-esteem, identity, and social interactions.

Discrimination in various domains, including employment, housing, healthcare, and

relationships, can further exacerbate feelings of marginalization and social exclusion.

7. Co-occurring Disorders:

Individuals with schizophrenia are at increased risk for co-occurring mental health disorders,

including depression, anxiety, substance use disorders, and personality disorders. These

comorbid conditions can complicate treatment and exacerbate symptoms, leading to poorer

outcomes and reduced quality of life.

8.Human Rights Violations Against Individuals with Schizophrenia:

People with schizophrenia often experience human rights violations both inside mental health

institutions and in community settings. Stigma against people with this condition is intense and

widespread, causing social exclusion, and impacting their relationships with others, including

family and friends. This contributes to discrimination, which in turn can limit access to general

health care, education, housing, and employment

Intervention :

Interventions for schizophrenia typically involve a combination of medication, therapy, and

support services.

Only 31.3% of people with psychosis receive specialized mental health care, and the majority of

resources for mental health services are inefficiently spent on care within mental hospitals.

Currently, the vast majority of people with schizophrenia worldwide do not receive mental health

care. Approximately 50% of people in mental hospitals have a diagnosis of schizophrenia (World

Health Organization: WHO, 2022).

Macro-level interventions address broad societal factors influencing mental health, while

mezzo-level interventions focus on community or organizational settings, and micro-level

interventions target individual needs and behaviors. Here are intervention methods of each :

Macro-Level Interventions:

1. Mental Health Policy Reform:

Governments can implement policies to improve access to mental health services, ensure

parity between mental and physical health care, and reduce stigma associated with mental

illness. This might include increased funding for mental health programs, improved

insurance coverage for mental health services, and anti-stigma campaigns.

2. Education and Awareness Programs:

Public health campaigns can increase awareness about schizophrenia, its symptoms, and

available treatments. These campaigns aim to reduce stigma, promote early intervention,

and encourage supportive attitudes toward individuals with schizophrenia.

3. Housing and Homelessness Programs:

Providing stable housing for individuals with schizophrenia can improve outcomes and

reduce the risk of homelessness, which is more common among people with severe

mental illnesses. Macro-level interventions might involve funding for supportive housing

programs or policies to prevent housing discrimination based on mental illness.

4. Employment Support:

Policies promoting employment opportunities for individuals with schizophrenia, such as

vocational training programs, job placement services, and incentives for employers to hire people

with disabilities, can improve economic stability and quality of life.

Mezzo-Level Interventions:

1.Community Mental Health Centers:

Establishing and funding community mental health centers can increase access to comprehensive

services for individuals with schizophrenia, including medication management, therapy, case

management, and social support.

2.Peer Support Groups:

Mezzo-level interventions might involve organizing peer support groups for individuals with

schizophrenia and their families. These groups provide opportunities for sharing experiences,

coping strategies, and practical advice in a supportive environment.

3. School-Based Mental Health Programs:

Schools can implement programs to support students with mental health challenges, including

early identification, counseling services, and accommodations to support academic success.

 4. Crisis Intervention Teams (CIT):

Training law enforcement officers and emergency responders in CIT techniques can

improve their ability to de-escalate crisis situations involving individuals with mental

illness, including schizophrenia, and connect them with appropriate mental health

services rather than relying solely on law enforcement responses.

Micro-Level Interventions:

1. Medication Adherence Support:

Healthcare providers can work with individuals with schizophrenia to develop strategies

for adhering to their medication regimen, such as pill organizers, reminders, and

addressing concerns about side effects.

2. Individual Therapy:

One-on-one therapy sessions with a mental health professional can help individuals with

schizophrenia manage symptoms, cope with stress, and address personal goals and

challenges.

3. Family Psychoeducation:

Providing education and support to family members of individuals with schizophrenia

can improve family functioning, communication, and coping skills, ultimately

contributing to better outcomes for the individual with schizophrenia.

These interventions work together at different levels to address the complex needs of individuals

with schizophrenia and promote recovery, community integration, and overall well-being.

Recommendation :

The stigmatization and discrimination faced by individuals with schizophrenia present significant

barriers to their well-being, social inclusion, and access to essential services. Addressing these

issues requires comprehensive strategies that promote awareness, understanding, and respect for

the rights and dignity of people living with schizophrenia. This report aims to provide

recommendations for combating stigma and discrimination and fostering a more inclusive and

supportive society.

Key Recommendations:

● Develop and implement public education campaigns to dispel myths, challenge

stereotypes, and increase understanding of schizophrenia and mental illness. These

campaigns should be targeted at the general public, healthcare providers, educators,

employers, and community leaders to promote empathy, reduce stigma, and encourage

supportive attitudes.

● Provide training and education for healthcare professionals on best practices for working

with individuals with schizophrenia. This training should focus on cultural competence,
 person-centered care, trauma-informed approaches, and the importance of empathy,

respect, and non-discrimination in healthcare delivery.

● Advocate for policy changes at the local, national, and international levels to protect the

rights of individuals with schizophrenia and eliminate discriminatory practices.

● Empower individuals with schizophrenia to advocate for their rights, participate in

decision-making processes, and lead initiatives aimed at combating stigma and

discrimination. Provide opportunities for peer support, leadership development, and skills

training to promote self-advocacy and resilience.

● Invest in research and evaluation efforts to better understand the impact of stigma and

discrimination on individuals with schizophrenia and identify effective interventions and

strategies for combating these issues. This includes conducting studies on the prevalence

of stigma, evaluating the effectiveness of anti-stigma initiatives, and identifying

promising practices for promoting social inclusion and reducing discrimination.

Conclusion :

Combatting stigma and discrimination against individuals with schizophrenia requires

coordinated efforts across multiple sectors, including healthcare, education, employment, and

community services. First and foremost, it's crucial to recognize that combating stigma and

discrimination against individuals with schizophrenia is not just a moral imperative but also a

matter of human rights. Everyone deserves to be treated with dignity, respect, and fairness,
regardless of their mental health status. Upholding the rights of individuals with schizophrenia

requires us to challenge stereotypes, dismantle systemic barriers, and promote social inclusion in

all aspects of life. By implementing the recommendations outlined in this report, we can work

towards creating a more inclusive and supportive society where people living with schizophrenia

are valued, respected, and afforded equal opportunities to thrive.

 References

Association, A. P. (2013). Diagnostic and Statistical Manual of Mental Disorders.

https://doi.org/10.1176/appi.books.9780890425596

Bowie, C. R., & Harvey, P. D. (2006). Cognitive deficits and functional outcome in

schizophrenia. Neuropsychiatric Disease and Treatment, 2(4), 531–536.

https://doi.org/10.2147/nedt.2006.2.4.531

Bsn, R. Z. R. (2022, April 27). Life Expectancy with Schizophrenia. Healthline.

https://www.healthline.com/health/schizophrenia/schizophrenia-life-expectancy#why-is-r

isk-higher

Department of Health & Human Services. (n.d.). Antipsychotic medications. Better Health

Channel.

https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/antipsychotic-medica

tions

Kraepelin, E. (2002). Dementia praecox and paraphrenia.

https://www.semanticscholar.org/paper/Dementia-praecox-and-paraphrenia-Kraepelin/f11

d089c718ada5b81012dc948bfe2079a7e1f07

KRAEPELIN, E. [Professor EMIL KRAEPELIN] & University of California Libraries. (1919).

Dementia praecox and paraphrenia. Chicago : Chicago Medical Book Co.

https://dn790005.ca.archive.org/0/items/dementiapraecoxp00kraeiala/dementiapraecoxp0

0kraeiala.pdf
Lautieri, A. (2024, March 6). Historical and contemporary understandings of schizophrenia.

MentalHelp.net.

https://www.mentalhelp.net/schizophrenia/understanding/#:~:text=The%20term%20%22

schizophrenia%22%20was%20first,of%20people%20with%20the%20illness.

Schizophrenia. (n.d.). National Institute of Mental Health (NIMH).

https://www.nimh.nih.gov/health/topics/schizophrenia#:~:text=What%20is%20schizophr

enia%3F,for%20their%20family%20and%20friends.

Tueth, M. J. (1995). Schizophrenia: Emil kraepelin, Adolph Meyer, and beyond. ˜the œJournal of

Emergency Medicine (Print), 13(6), 805–809.

https://doi.org/10.1016/0736-4679(95)02022-5

Website, N. (2023, April 24). Causes - schizophrenia. nhs.uk.

https://www.nhs.uk/mental-health/conditions/schizophrenia/causes/

What is Schizophrenia? (n.d.).

https://www.psychiatry.org/patients-families/schizophrenia/what-is-schizophrenia

World Health Organization: WHO. (2022, January 10). Schizophrenia.

https://www.who.int/news-room/fact-sheets/detail/schizophrenia?gad_source=1&gclid=C

j0KCQjwlN6wBhCcARIsAKZvD5hl_TeeFHshdrAOp9ul8Fo6DjM901oL-cH7MrEvzFB

kjuFyaYn4u2EaAoVnEALw_wcB