Nephew with schizophrenia?
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You did not understand the doctor when he spoke to you about this. There are four active types of Schizophrenia and residual Schizophrenia as well. Symptoms of Schizophrenia fall into two groups, positive and negative symptoms. Your nephew was diagnosed Schizophrenic because he expresses two or more negative symptoms. It is not a passive Schizophrenia as you speak of it. Most Schizophrenics are passive. Violence is not a symptom of Schizophrenia. The psychiatrist probably used the term passive in a way of expressing that the patient is not experiencing florid hallucinations and profound delusions.
Unfortunately, it is better to express more positive symptoms than negative symptoms because only the positive symptoms of Schizophrenia respond to anti-psychotics. Positive symptoms are hallucinations and delusions, with the hallucintations being generally auditory although they can be of any kind and the delusions are generally bizarre, unlike with Bipolar which usually have grandiose delusions.
Most Schizophrenics have major symptoms of difficulty processing information and these symptoms will respond almost completely to anti-psychotics which will give a much improved outcome to the patient whether they experience mostly positive or negative symptoms.
Of particular interest, most anti-psychotics are actually major tranquilizers ( not minor tranquilers as in Valium and Klonopin etc) and they express their theraputic effect through the lowering of Dopamine by specically blocking certain Dopamine receptors, (generally the Dopamine D2 receptor). Unfortunately like minor tranquilers, they can cause serious withdrawal, with will include the patient experiencing auditory hallucinations and sometimes visual for a prolonged period of time of about 8 to 12 weeks. These aren't generally listed by the manufacturer because there is no way to prove the person is experiencing the psychosis because of the medicine or the illness. There are certain medicines to avoid if you have Schizophrenia, in particular benzos and other epilepsy meds. There are a couple medicines which are not tranquilizers (sedatives) an example might be the medicine Abilify, which is particularly effective for Catatonic Schizophrenia.
Having only negative symptoms of Schizophrenia may mean lower doses of medicine, mainly to conrol the inability to process information, which can be done effectively by any Dopamine lowering agent. As far as prognosis, generally worse outcomes in Schizophrenia are reflected by olfactory hallucinations which usually indicates a worsening of the condition over time. People who are diagnosed early in life usually have a more severe disease pattern.
But as a Schizophrenic, I can honestly tell you that you worry too much. Schizphrenia, regardless of type, is one the most treatable mental conditions and with a dedication to medicine, they make a full recovery and are able to work and have a family. Of particular use might be the information to try to keep your nephew off addictive substances such as caffeine and nicotine as most people with Schizophrenia are less able to handle these addictions. Another thing of importance is to restrict the medication to only Dopamine lowering agents as far as medicine goes as other medicines are of no benefit to Schizophrenia and that does include over the counter meds which can make Schizophrenia worse.
they other schizophrenia is exactly what you pointed out, no haullcinations, but losing contact with reality, disorganized, paranoia, aggitation, prone to substance abuse and tobbacco use.. people can be affected by psychotic features to varing degrees, each case can be unique,, he may be functional, but not talkative,, some slip inside themselves so much that they are silent and stop taking care of themselves (such as not bathing).. the more functional ones can just get odd ideas in their heads, scattered speech etc..
Medicine is the number one treatment, as well as having an environment that is relaxing for him...
Abilify, Risperdal, Seroquel, Geodon, as well as some benzodiazapems could be used.. there are several others not listed here that may be considered, but that descion should be left up to a psychiatrist.. if he is only seeing a family doctor, he should see a psychiatrist for continuation of care for schizophrenia, if nothing else for a psychiatric interview to confirm the diagnosis...
Also, check out the link i listed below as well as the DSM-IV, the diagnostic manual for mental illnesses..
Actually your doctor is completely wrong. There are five types of schizophrenia: disorganized, paranoid, residual, undifferentiated, and catatonic types. I also noticed in your post that you stated a couple of times that your nephew is not violent, this can be left unsaid, as most people with schizophrenia are not at all violent and is completely and inaccurately displayed in the media. I wonder if this doctor is actually a psychiatrist, I hope not because he seems very poorly educated on schizophrenia, which I find sad and irritating.
From what you said it sounds like your nephew has the disorganized type of schizophrenia, meaning the main impairment is his thought/cognitive process. Most people with this type of schizophrenia do not experience hallucinations, but can usually be noticed for bizarre mannerisms and at times poor hygiene. I suggest that you get your nephew the proper car by someone who is experienced in treating schizophrenia.
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