Schizophrenia The disorder affects more than 21 million

Schizophrenia is a chronic mental
disorder characterized by disturbances in perception, emotion, or behavior, and
a general loss of touch with reality. The disorder affects more than 21 million
people worldwide, although 50% of people living with schizophrenia do not
receive appropriate care for the condition (). Symptoms frequently include
audio or visual hallucinations, loss of emotional responsiveness, and poor
executive functioning (). The symptoms of schizophrenia fall into three
categories: positive, negative, and cognitive. “Positive” symptoms comprise of
those symptoms that are uncharacteristic of people with healthy cognitive
functioning, such as audiovisual hallucinations, dysfunctional thought
patterns, or involuntary bodily movements. “Negative” symptoms include
behavioral or emotional irregularities such as lack of emotional expression,
reduced feelings of pleasure, or reduced participation in everyday activities.

Cognitive symptoms include loss of working memory, difficulty concentrating,
and reduced decision-making capacity ().


People with schizophrenia often
experience their first psychotic episode between the ages of 16 and 30 (). Although
the causes of schizophrenia are yet unknown, there are several risk factors
that contribute to the development of this disorder. No single gene causes
schizophrenia by itself, but the disorder does run in families (). However,
there are many cases in which schizophrenia manifests itself in people without
a family history of the disorder. Individual environmental factors may also
interact with genetic factors to contribute to the development of the
condition. Examples of these include exposure to viruses, fetal malnutrition,
birth complications, and psychosocial factors (). Severe imbalance in the
neurotransmitters dopamine and glutamate and developmental problems of the
brain may also play a role in schizophrenia ().


Treatment options for schizophrenia
include antipsychotic medications, psychosocial treatments, and coordinated
specialty care (CSC) (). Medications for schizophrenia usually target the
neurotransmitter dopamine, and fall into two categories: first-generation
antipsychotics, and second-generation antipsychotics. These medications can be
taken either as a pill or as a monthly injection, depending on the individual’s
willingness or ability to comply with treatment. First-generation
antipsychotics were developed in the 1950s. The most common of these are
Chloropromazine and Fluphenazine. Although first-generation antipsychotics are
cheaper, an important consideration in the long-term, they tend to have
significant neurological side effects, such as involuntary muscle spasms and
restless movements (). Second-generation antipsychotics were developed later,
are more numerous, and have less severe side effects. The most commonly used second-generation
antipsychotics are Risperidone and Aripiprazole. Although second-generation
antipsychotics have less serious side effects than first-generation
antipsychotics, they can still have severe interactions with other prescription
drugs, and should be used as a last resort after considering other medications
that can be taken with your doctor (everyday Health).


Psychosocial interventions
incorporate therapy and social skills training alongside medical treatment for
schizophrenia. Cognitive-behavioral therapy works on normalizing thought
patterns, developing coping mechanisms for psychotic episodes, and allowing the
individual to identify early warning signs for relapse. Social skills training
focuses on improving the individual’s ability to communicate effectively in
everyday situations, and family therapy provides support and education for
families affected by schizophrenia. In addition to therapy, vocational
rehabilitation is available to help people with schizophrenia function in the
working world. In cases of treatment-resistant schizophrenia, individuals have
the option of electroconvulsive therapy (ECT). This option can be helpful for
an individual who also experiences depression, or for individuals who need rapid
results (mayoclinic).


            The other
health issue relating to this case study is one of intimate partner violence
and verbal abuse. Intimate partner violence (IPV) refers to physical, sexual,
or psychological abuse by a partner or spouse. It can also include controlling
behaviors, including isolating a person, monitoring their movements, and
restricting their access to financial resources or medical care. The
relationship does not require sexual intimacy in order to categorize the
behavior as IPV (cdc). According to findings from the CDC’s National Intimate
Partner and Sexual Violence Survey (NISVS), about 1 in 3 women, and 1 in 6 men
in the United States experience IPV during their lifetime (). In the U.S., over
27% of women and 11% of men have experienced IPV (). According to the World
Health Organization (WHO) multi-country study on women’s health and domestic
violence against women, 13-61% of women from 10 different countries reported
ever having experienced physical violence by a partner (). The impacts of IPV
are widespread, leaving victims feeling fearful, concerned for their safety,
and exhibiting symptoms of post-traumatic stress disorder ().


            There are a
multitude of prevention strategies for intimate partner violence. As outlined
in the CDC’s Technical Manual for Preventing Intimate Partner Violence Across
the Lifetime, techniques include teaching safe and healthy relationship
behaviors, engaging influential peers, disrupting the pathways that lead to
IPV, creating safe environments, strengthening economic support for families,
and providing support to survivors of IPV. These strategies address primary,
secondary, and tertiary prevention of IPV and are based off of the
environmental, social, and economic risk factors contributing to IPV. They also
look at IPV from an ecological perspective, addressing not only the individual skills
that shape healthy relationships, but also the social and environmental
influences that ultimately impact relationship dynamics.


             Overarching societal attitudes and cultural
factors can explain trends in intimate partner violence and how we treat people
with schizophrenia.