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In the last post, we saw how:
Kraepelin and Eugene laid the foundation for what we understand about schizophrania today.
If a patient is going to get better it is more likely the patient's relatives have to be knowledgeable.
Hospitalization is important for very the initiation and continuation of therapy in schizophrania
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Welcome to Medic Vibes, where we discuss mental health disorders and make sense of them. Dr Ebingo Kigigha is a medical doctor (aspiring psychiatrist) and creative person (illustration and music). This has been our routine for three consecutive months. This month will be dedicated to Schizophrenia. In the first month, we discussed Depression, and in the subsequent month, anxiety. We just finished with Bipolar affective disorder. We are done looking at research work done in Nigeria on schizophrenia.
In this post, we are looking at this study that talks about Beliefs About the Cause of Schizophrenia Among Caregivers in Midwestern Nigeria. To learn more just keep scrolling down. You can also skip to the key point of the post if you which or go to the conclusion to get the summary.
Other Historian
Ernst Kretschmer- He gathered information that showed that those who were thinner with less muscle were more likely to be schizophrenic. He proposed that those who were bigger-bodied were more likely to be bipolar.
Kurt Schneider- he tried to explain first-rank and second-rank symptoms of schizophrenia. By his standard first rank symptoms were specific for schizophrenia but were important to make a diagnosis.
Karl Kasper- He made major strides in the field of psychoanalysis.
Adolf Meyer described schizophrenia as a reaction to stressful life events. It was seen as a poor adaptation method for the terrible things that may have happened in the patient’s life.
People illustrations by Storyset
The type of study is descriptive on done during a particular point in time (cross-sectional study). The sample was a group of patients who were not admitted to the hospital visiting the clinic. The hospital was located in Benin City, Edo state Mid-western Nigeria.
Participants in the study were caregivers of patients with schizophrenia who were consecutively recruited from the outpatient department of the hospital over a period of four months. A convenient sample size of 200 caregivers of 200 outpatients with schizophrenia was used for this study. The patients were service users who fulfilled the diagnostic criteria of the International Classification of Disease {(ICD-10) (WHO 1993)} for schizophrenia and who had been on treatment for at least two years. The primary caregiver for each patient was enrolled in the study. Such caregivers were unpaid relatives who provided support to the patient from time to time.
In four months the patient’s caregivers who expressed interest in the study were gathered and assembled for the study. These were those who were receiving treatment from outside the hospital. The sample size was 200 caregivers who cared for 200 patients. The criteria used were those of the International Classification of Disease (ICD) for schizophrenia. The patients had to be receiving treatment for 2 years before being put into the study.
A questionnaire was given to people to determine epidemiological data like age, sex, religion and highest education level, occupation, and marital status.
A questionnaire assessing the cause of the condition was also developed. 7 possible causes were given in the questionnaire as options included Supernatural factors
witchcraft/sorcery/evil spirits, God’s will/Satan’s work
And biological factors such as genetic and anatomic components. A likely scale with 4 points was used where the subject was to select if the options were not related to the condition, hardly brought about the condition or were absolute causes. They were asked how sure they were about these causes.
If they chose a cause as likely then it is seen as a belief in that cause. They selected the cause they felt was the most related to the condition.
This involved in the study had to give consent for the study after the reason and goals of the study were explained to them. Ethical considerations were fulfilled.
For Data Analysis
The information was analyzed with the Statistical Package of Social Sciences (SPSS). The variables were put into categories. Statistical variables were deduced. Categorical differences were highlighted with chi-square and t-test. They were deemed statistically significant if P was less than 0.05.
Pharmacotherapy
In 1952 Chlorpromazine was introduced and has been praised to be the most important thing that has happened in psychiatry. It was discovered that this drug was able to reduce anxiety in patients that were being prepared for surgery. The drug was found to also reduce the delusion and hallucination of schizophrenia.
Antipsychotics have been found effective in reducing recurrences of psychotic episodes. Close to 7 out of 10 people on antipsychotics do not have reoccurring symptoms.
Antipsychotics usually blog dopamine receptors as their main method of action while they may vary in another characteristic, they all share this feature. There are two classes of antipsychotics the first generation which is the dopamine antagonist and the second generation is more of a serotonin dopamine antagonist.
Clozapine was the first antipsychotic noted to not have extrapyramidal side effects but was later found to have the side effect of agranulocytosis
The treatment of this complex condition required several years to get to this level. There were many psychiatrists who were instrumental in this march forward.
The study made use of questionnaires to properly examine the views of the caregivers in the study.
Antipsychotics are divided into groups based on how new they are and the receptors they act on.
