Literature Review: Medical Research on Schizophrenia

Research is a way of developing a better understanding of a specific chosen area which can help improve further studies within the chosen subject. An interesting subject to research is a mental health condition known as schizophrenia and how it affects people within modern society. This specific mental health topic was chosen due to personal reasons and also as a professional interest. This research paper will help gather more information and knowledge toward the understanding of the illness to help progress further within the mental health care industry.

In an article published by Medical News Today (2014) Nordqvist (2014) it describes schizophrenia as a mental health disorder which affects the brain and causes delusions, confusions, social withdrawal, psychosis, loss of personality and can also cause the patient to portray some unusually bizarre behaviour. MNT (2014) also states that this disease of the brain will normally hit a person during their late adolescent years or early adulthood years, but goes on to stress that it can affect anyone at any given time of their life. According to research gathered by the National Institute of Mental Health (2014) a person suffering with schizophrenia will have to cope with the symptoms for life but, treatment can relieve many of these symptoms. The research information that was published by NIMH (2014) was secondary data founded and collected by medical professionals that study and research schizophrenia as a profession. The study that was conducted is known as an epidemiology study (a study of patterns of disease within the community or population) and was used to collect the primary data through participant observation and surveys (patient 2014).

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In recent research studies it is suggested that one in three people to every 100 in the UK suffer with schizophrenia according to statistics provided by Mind (2014). This works out around 220,000 people living in Wales and England and around 24,000,000 worldwide suffer with this illness (RC Psych 2012). These figures founded for this particular research paper are qualitative (open questionnaires) and quantitative (numerical information collected through closed questions) based as they were done through doing surveys and questionnaires on the population of the UK society having home treatment and therapies to help deal with their mental health condition. They are also only based on people living at home with the condition so it excludes people who are confined to prison or within a mental health hospital so as one could imagine the statistics will be much larger in numbers than this. All these statistics come from reliable sources as the figures come from the amount of patients that are being treated by medical professionals, and they are then reported back to the government so that they are able to collect this information and record the figures accurately through the quantitative data gathered by the researches.

In 2009 Gattaz (2009) did a study examining the link between schizophrenia and the sufferer’s urbanicity. This study was carried out during 20 different studies (known as a systematic review, where more than one case is studied, Saha et al 2005) in Western Europe and at the end of it Gattaz (2009) came to the conclusion that the longer a person living in that kind of environment is exposed to urban residence the higher their risk of developing schizophrenia was. This study was ethical in its research as the subjects were all demographically similar with their age, gender, sex and migrant status being within the same range. However during this investigation one of the major methodological (which is the way the researcher would go about discovering the knowledge in a systematic way) (Killam, 2013) implications of conducting the study into the relationship between the neighbourhood and schizophrenia was the timing of the individuals exposure. This was discovered when March et al (2008) assessed and reviewed the study and looked into the validity and the reliability of the study (the quality and the accuracy of the results). This study then becomes unreliable and inconclusive due to the unethical approach which means the hypothesis to this research can be researched again through a more in-depth approach.

Kelly et al (2009) conducted research in order to find if there is a link between schizophrenia and urbanity. This was a longitude study spanning over several years. The subjects were identified by attending psychiatric services within an urban catchment of Dublin during the period of 1995 – 1998 where subjects from North East Ireland were also identified. The population used was 171 during the period of 1995 – 1998 and 153 subjects during the period of 1995 – 2001. All cases bar one were ethically Irish and all were male. The researchers collected qualitative data by means of face to face interviews.

The research found that males were almost twice as likely to suffer from schizophrenia in urban areas, in comparison to males in rural areas. However, incidences of psychosis were lower in urban areas in comparison to the rural counterparts. This research found that the results suggested that males were 48% more like to suffer from schizophrenia

This research did highlight the risks of schizophrenia when living in urban areas. However, this study gives a biased conclusion as all subjects were male and Irish. This research could not be used to generalise the risk cross culturally. Research involving an even ratio of male and female, also an even ratio of ethnicity would probably give a less biased result.

One website named as Schizophrenia (2010) Dr Ira Glick breaks down the etiologic pathway to explain the way that schizophrenia sets in. Etiologic is a medical research term, it is important as the collected information gathers evidence for the investigation into the causes of such illnesses and diseases (Miettinen 2011). The research described on the website schizophrenia (2010) goes on to suggest that schizophrenia starts with the early environmental insults which is the genetic predisposition where, this will then lead onto the neurodevelopmental abnormalities and target features. The later environmental insults start with the further brain dysfunction and schizophrenia which will then lead to the onset of psychosis which is the neurodegeneration and schizophrenia. The study shows that ever growing research suggests that schizophrenia could possibly be prevented whilst the mother is pregnant with their child or, in the early stages of childhood. This could be a good thing because as many other research studies suggest, schizophrenia runs in the family and that deformed genes are passed down hereditary through the family (NHS 2012).

RC Psych (2014) online research website has recently been looking into research suggesting that schizophrenia is linked with the misuse of the illegal drug known as cannabis. These studies suggested that there is a clear strong link between the two with the early use of cannabis and the later mental health issues in those with a genetic vulnerability. Not only was it found that schizophrenia is linked with cannabis misuse but also another mental health issue known as bipolar disorder. According to RC Psych (2014) there is now sufficient evidence that the younger the person is misusing cannabis the higher the chances are of developing the condition later on in life. So in other words they are stating that the more cannabis smoked by an individual the more susceptible the individual is in developing the illness.

Another research that has been studied between people who suffer with schizophrenia and healthy individuals asks the question ‘Is there a difference between the perception of emotional and non-emotional facial expression affected the same within healthy individuals and those who suffer with the mental health illness?’ The results from this study showed that patients suffering with schizophrenia showed impairments in the recognition of identity compared to the groups of young and old healthy individuals. Similarly though it found that old healthy individuals have the impairment of learning new faces the same as experienced in the ability of patients with schizophrenia recognising the learning of new faces (Silver 2014). The method used in this research was through direct observation where the participant’s behaviour was observed by the person conducting the research.

In one of the largest studies to ever be undertaken, scientists believe they are closer than ever before in understanding the complex interplay between a person’s upbringing and their genes that can result in schizophrenia (independent 2014). Within this study the group of Psychiatrists analysed the DNA of 37,000 schizophrenic patients with completely different backgrounds and found that 128 independent genes located at 108 different locations in the human chromosomes significantly contribute the susceptibility of developing schizophrenia, whereas before 83 of these have never been previously linked to the condition. This research study will hopefully prove to be a breakthrough in understanding and hopefully finding a cure one day for the illness.

Larsson et al (2012) conducted research into the use of counselling for individuals suffering from schizophrenia. The research methodology was analysing how eight psychologists talk about and around the topic of schizophrenia to patients by using semi structured interviews. This allowed the researchers to gather qualitative data. Each participant signed a consent form to and were fully briefed in regards to what date was being collected for research. This ensured that all research methods were completed ethically.

Larsson et al (2012) concluded that the use of psychology in diagnosing schizophrenia is heavily underrated, The diagnosis of schizophrenia is almost unheard of in counselling psychology literature. Researchers stated that “conflicting, theories about the cause and nature of schizophrenia have arisen as outlined by Geekie and Read (2009). These include evolutionary theories, psychodynamic and psychoanalytical, life event theories, sociological and anthropological and philosophical and existential theories.”

The research concluded that counselling along with medication brought something different to the treatment of schizophrenia. However, there was a danger of counselling pathologising the individual further. Counselling has been identified as being underepresented in the treatment of schizophrenia. Counselling was identified as being underrepresented within the NHS in general.

Further research using counselling and medication for individuals with schizophrenia could prove to be very informative in treating an individual. However, with NHS budgets getting cut, this could prove to be a barrier in effectively treating individuals with schizophrenia.

In the conclusion to the researches named above the most important thing is finding the key main factor that causes the illness to help in finding a treatment to try and prevent it, keep it at bay or possibly cure it. As research is put into place to help improve a better quality of life for persons suffering with conditions such as schizophrenia all the individuals taking part need to be treated equally therefore these studies need to be ethical in their research to help get a better understanding. Correct training of staff in hospitals, institutes, and self help groups would be of a beneficial factor but these are not cost effective and will cause the government to be paying out expenses for all aspects of the path that needs to be taken in getting there. On the other hand if a better understanding and knowledge of the condition was available to the sufferers then this could keep the cost down as the patients may not be afraid to seek help which can result in them leading a normal and healthy life the same as the next person, being able to get an education behind them, work, get a social life without feeling out casted due to the ignorance of mental health within society (Kings College London 2009).

There are so many different theories in the causes and implications on schizophrenia there will be researches going on for a very long time in trying to establish the true cause of the condition. From the research gathered above if society and medical professionals were more educated on mental health illnesses such as schizophrenia then there wouldn’t be as many problems and research into the condition would become easier as sufferers won’t feel as though they are being judged because of the condition but will feel more that there is help out there for them.

References:

Cannabis and Mental health (2014) Available online at: http://www.rcpsych.ac.uk/mentalhealthinformation/mentalhealthproblems/alcoholanddrugs/cannabisandmentalhealth.aspx Accessed on 24/11/2014

Causes of schizophrenia (2012) Available online at: http://www.nhs.uk/Conditions/Schizophrenia/Pages/Causes.aspx Accessed on 25/11/2014

Crawford et al (2012) Report of the National Audit of Schizophrenia (NAS), RCP: London

DNA hope on schizophrenia: Research breakthrough points at over 100 genes (20143) http://www.independent.co.uk/life-style/health-and-families/health-news/dna-hope-on-schizophrenia-research-breakthrough-points-at-over-100-genes-9619638.html Accessed on 27/11/2014

Epidemiology (2014) Available online at: http://www.patient.co.uk/doctor/schizophrenia-pro Accessed on 27/11/2014

Kelly, B. O’Callaghan, E. Waddington, J. Feeney, L. Browne, S. Scully, P. and Clarke, M. et al (2010) Schizophrenia and the City: A Review of Literature and Prospective Study of Psychosis and Urbanicity in Ireland: Schizophrenia Research 116(1), pp. 75-89.

Killam, L (2013) Research Terminology simplified: Paradigms, Axiology, Ontology, Epistemology and Methodology, Sudbury: Author

Kings College London (2009) Excellence in Mental Health Care: Putting Evidence into Practice, Achievement of Excellence, London: Kings Health Partners, pp. 1

Larsson, P. Loewenthal, D and Brooks, O. (2012) Counselling psychology and schizophrenia: A critical discursive account. Counselling Psychology Quarterly 25(1), pp. 31-47.

Meittinen, O.S (2011) Epidemiological Research: Terms and Concepts, London: Springer

Mental Health Problems (2014) Available online at: http://www.mind.org.uk/information-support/types-of-mental-health-problems/statistics-and-facts-about-mental-health/how-common-are-mental-health-problems Accessed on 26/11/2014

Nordqvist, C (2014) What is schizophrenia. Available online at: http://www.medicalnewstoday.com/articles/36942.php Accessed on 27/11/2014

Saha, S (2005) Systematic Review of the Prevalence of Schizophrenia. Available online at: http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.0020141 Accessed on 25/11/2014

Silver, H. Bilker, W (2014) Social Cognition in Schizophrenia and Healthy Aging: Differences and Similarities

The path to Schizophrenia (2010) Available online at: http://schizophrenia.com/hypo.php Accessed on 25/11/2014

What is schizophrenia (2014) Available online at: http://www.nimh.nih.gov/health/topics/schizophrenia/index.shtml Accessed on 27/11/2014