16 Jan 2022

조현병(정신분열병).Schizophrenia

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조현병(정신분열병) Schizophrenia

 

정의
조현병은 만성 경과 정신 병이다..
세계적으로 100명 중 1명이 걸린다.
모든 계층, 남녀발병 빈도는 비슷하다.
원인은 아직 정확히 밝혀지지 않했다.
뇌의 기질적 이상이  원인으로 보고 있다.
원인
세로토닌, 도파민 등  신경전달 과정에 이상이 생기면서 증상이 나타난다.
유전적 영향을 받을 수 있다.
환경적 요인으로 조현병이 발병될 수 있다.
증상
조현병(정신분열병)의 발병은 서서히 진행합니다.
주 증상은
환청,
망상,
이상 행동,
횡설수설 등이다.
감정이 메마르고 말수가 적어지며 흥미나 의욕이 없고 대인관계가 없어지는 등과 같은 증상이 나타나기도 한다.
혼자만의 생각에 사로잡혀 있다.
대화를 나누면서 상황에 적절한 것과 적절치 못한 것을 가려내지 못하고, 타인의 의향을 제대로 파악하지 못하며,
엉뚱한 이야기를 불쑥 꺼내거나 쉽게 산만해지고 집중을 잘하지 못한다.
사고가 조직화되어 있지 않고 모호하며 사고가 적절하게 연결되지 않으므로 이야기의 핵심을 파악하기 어렵다.
대화 중에 주제가 갑자기 다른 것으로 바뀌기도 한다.
슬픈 말, 부적절한 감정 표현, 감정이 메말라 감정 표현이 없거나 기쁘거나 슬프다는 정상적인 감정 표현을 잘하지 못하고 무표정해진다.
진단
진단은 자세한 병력을 듣고 환자의 정신 상태를 검사한다. 정확한 진단을 내리기 위해서는 가족이 그동안 일어난 일을 자세히 설명해 주어야 한다.
첫 발병일 경우 다른 신체 질환, 뇌 질환으로 인해 조현병(정신분열병)과 유사한 증상이 나타날 수 있다.
혈액 검사, 뇌컴퓨터단층촬영(CT), 뇌자기공명영상(MRI), 단일광자방출단층촬영(SPECT), 뇌파 검사 등을 시행한다.
환자의 심리 상태를 파악하기 위하여 심리 검사를 한다.
정신과 전문의와 환자의 면담, 가족으로부터 얻게 되는 병력과 증상에 관한 정보이다.
치료
조현병(정신분열병)의 치료는 크게 약물 치료와 정신 치료로 구분된다.
  • 개인 정신 치료
  • 가족 치료
  • 집단정신 치료
  • 지역 사회의 정신사회 재활 프로그램
  • 입원 치료

Schizophrenia

Overview
Schizophrenia is a serious mental disorder in which people interpret reality abnormally. Schizophrenia may result in some combination of hallucinations, delusions, and extremely disordered thinking and behavior that impairs daily functioning, and can be disabling.
People with schizophrenia require lifelong treatment. Early treatment may help get symptoms under control before serious complications develop and may help improve the long-term outlook.
Symptoms
Schizophrenia involves a range of problems with thinking (cognition), behavior and emotions. Signs and symptoms may vary, but usually involve delusions, hallucinations or disorganized speech, and reflect an impaired ability to function. Symptoms may include:
  1. These are false beliefs that are not based in reality. For example, you think that you’re being harmed or harassed; certain gestures or comments are directed at you; you have exceptional ability or fame; another person is in love with you; or a major catastrophe is about to occur. Delusions occur in most people with schizophrenia.
  2. These usually involve seeing or hearing things that don’t exist. Yet for the person with schizophrenia, they have the full force and impact of a normal experience. Hallucinations can be in any of the senses, but hearing voices is the most common hallucination.
  3. Disorganized thinking (speech). Disorganized thinking is inferred from disorganized speech. Effective communication can be impaired, and answers to questions may be partially or completely unrelated. Rarely, speech may include putting together meaningless words that can’t be understood, sometimes known as word salad.
Extremely disorganized or abnormal motor behavior. This may show in a number of ways, from childlike silliness to unpredictable agitation. Behavior isn’t focused on a goal, so it’s hard to do tasks. Behavior can include resistance to instructions, inappropriate or bizarre posture, a complete lack of response, or useless and excessive movement.
Negative symptoms. This refers to reduced or lack of ability to function normally. For example, the person may neglect personal hygiene or appear to lack emotion (doesn’t make eye contact, doesn’t change facial expressions or speaks in a monotone). Also, the person may lose interest in everyday activities, socially withdraw or lack the ability to experience a pleasure.
Symptoms can vary in type and severity over time, with periods of worsening and remission of symptoms. Some symptoms may always be present.
In men, schizophrenia symptoms typically start in the early to mid-20s. In women, symptoms typically begin in the late 20s. It’s uncommon for children to be diagnosed with schizophrenia and rare for those older than age 45.
Symptoms in teenagers
Schizophrenia symptoms in teenagers are similar to those in adults, but the condition may be more difficult to recognize. This may be in part because some of the early symptoms of schizophrenia in teenagers are common for typical development during teen years, such as:
  • Withdrawal from friends and family
  • A drop in performance at school
  • Trouble sleeping
  • Irritability or depressed mood
  • Lack of motivation
  • Also, recreational substance use, such as marijuana, methamphetamines or LSD, can sometimes cause similar signs and symptoms.
  • Compared with schizophrenia symptoms in adults, teens may be:
  • Less likely to have delusions
  • More likely to have visual hallucinations
When to see a doctor
People with schizophrenia often lack awareness that their difficulties stem from a mental disorder that requires medical attention. So it often falls to family or friends to get them help.
Helping someone who may have schizophrenia
If you think someone you know may have symptoms of schizophrenia, talk to him or her about your concerns. Although you can’t force someone to seek professional help, you can offer encouragement and support and help your loved one find a qualified doctor or mental health professional.
If your loved one poses a danger to self or others or can’t provide his or her own food, clothing, or shelter, you may need to call 911 or other emergency responders for help so that your loved one can be evaluated by a mental health professional.
In some cases, emergency hospitalization may be needed. Laws on involuntary commitment for mental health treatment vary by state. You can contact community mental health agencies or police departments in your area for details.
Suicidal thoughts and behavior
Suicidal thoughts and behavior are common among people with schizophrenia. If you have a loved one who is in danger of attempting suicide or has made a suicide attempt, make sure someone stays with that person. Call 911 or your local emergency number immediately. Or, if you think you can do so safely, take the person to the nearest hospital emergency room.
Causes
It’s not known what causes schizophrenia, but researchers believe that a combination of genetics, brain chemistry and environment contributes to development of the disorder.
Problems with certain naturally occurring brain chemicals, including neurotransmitters called dopamine and glutamate, may contribute to schizophrenia. Neuroimaging studies show differences in the brain structure and central nervous system of people with schizophrenia. While researchers aren’t certain about the significance of these changes, they indicate that schizophrenia is a brain disease.
Risk factors
Although the precise cause of schizophrenia isn’t known, certain factors seem to increase the risk of developing or triggering schizophrenia, including:
  • Having a family history of schizophrenia
  • Some pregnancy and birth complications, such as malnutrition or exposure to toxins or viruses that may impact brain development
  • Taking mind-altering (psychoactive or psychotropic) drugs during teen years and young adulthood
Complications
Left untreated, schizophrenia can result in severe problems that affect every area of life. Complications that schizophrenia may cause or be associated with include:
  • Suicide, suicide attempts and thoughts of suicide
  • Anxiety disorders and obsessive-compulsive disorder (OCD)
  • Depression
  • Abuse of alcohol or other drugs, including nicotine
  • Inability to work or attend school
  • Financial problems and homelessness
  • Social isolation
  • Health and medical problems
  • Being victimized
  • Aggressive behavior, although it’s uncommon
Prevention
There’s no sure way to prevent schizophrenia, but sticking with the treatment plan can help prevent relapses or worsening of symptoms.
In addition, researchers hope that learning more about risk factors for schizophrenia may lead to earlier diagnosis and treatment.
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