Data from a PET study25 suggests the less the frontal lobes activated (red) during a working memory task, the greater the increase in abnormal dopamine activity in the striatum (green), thought to be related to the neurocognitive deficits in schizophrenia.Actress Clara Bow was diagnosed with schizophrenia in 1949.
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Schizophrenia

Schizophrenia is a severe mental illness characterized by persistent defects in the perception or expression of reality. A person experiencing untreated schizophrenia typically demonstrates grossly disorganized thinking, and may also experience delusions or auditory hallucinations. more...

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Although the illness primarily affects cognition, it can also contribute to chronic problems with behavior or emotions. Due to the many possible combinations of symptoms, it is difficult to say whether it is in fact a single psychiatric disorder; and Eugen Bleuler deliberately called the disease "the schizophrenias" (plural) when he coined the present name.

Diagnosis is based on the self-reported experiences of the patient, in combination with secondary signs observed by a psychiatrist or other competent clinician such as a doctor of psychology. There is no objective biological test for schizophrenia, though studies suggest that genetics and biochemistry are important contributing factors. Current research into the development of the disorder often focuses on the role of neurobiology, although a reliable and identifiable organic cause has not been found. In the absence of objective laboratory tests to confirm the diagnosis, some question the legitimacy of schizophrenia's status as a disease.

The term "schizophrenia" translates roughly as "shattered mind," and comes from the Greek σχίζω (schizo, "to split" or "to divide") and φρήν (phrēn, "mind"). Despite its etymology, schizophrenia is not synonymous with dissociative identity disorder, also known as multiple personality disorder or "split personality"; in popular culture the two are often confused. Although schizophrenia often leads to social or occupational dysfunction, there is little association of the illness with a predisposition toward aggressive behavior.

Overview

Schizophrenia is often described in terms of "positive" and "negative" symptoms. Positive symptoms include delusions, auditory hallucinations and thought disorder and are typically regarded as manifestations of psychosis. Negative symptoms are so named because they are considered to be the loss or absence of normal traits or abilities, and include features such as flat, blunted or constricted affect and emotion, poverty of speech and lack of motivation. Some models of schizophrenia include formal thought disorder and planning difficulties in a third group, a "disorganization syndrome."

Additionally, neurocognitive deficits may be present. These may take the form of reduced or impaired psychological functions such as memory, attention, problem-solving, executive function or social cognition.

Onset of schizophrenia typically occurs in late adolescence or early adulthood, with males tending to show symptoms earlier than females.

Psychiatrist Emil Kraepelin was the first to draw a distinction between what he termed dementia praecox ("premature dementia") and other psychotic illnesses. In 1911, "dementia praecox" was renamed "schizophrenia" by psychiatrist Eugen Bleuler, who found Kraepelin's term to be misleading, as the disorder is not a form of dementia, premature or otherwise.

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A change of character: Japan updates the term for "schizophrenia," but the stigma lingers - Health - Brief Article
From Psychology Today, 9/1/02 by Tiffany Kary

SCHIZOPHRENIA HAS BEEN RENAMED IN JAPAN, BUT IT MAY TAKE more than a new word to improve public perception of this debilitating disease.

The Japanese Society of Psychiatry and Neurology (JSPN) has formally changed seishi buntetsu byo, or "split-mind disorder" to togo schicco sho, or "loss-of-coordination disorder." The change was announced at the World Congress of Psychiatry in Yokohoma in August.

"This term has a softer connotation," says Yoshiharu Kim, M.D., director of Adult Mental Health at Japan's National Institute of Mental Health in Chiba.

In Japan, schizophrenia is written with the ideographs for "split" and "mind." The term was appropriated from the German word schizophrenie in 1937. Although the definition mirrors the Greek roots that make up the English and German word, experts say the term is more negative in Japan. The ideograph clearly denotes "split," (an implication lost on Westerners not familiar with Greek). And the word "split" is especially stigmatizing in Japanese culture, which emphasizes self-control at all costs.

The stigma surrounding schizophrenia is so severe that psychiatrists are reluctant to diagnose the disorder and patients go untreated. In a study of five national hospitals, Kim found that only 17 percent of schizophrenics and 34 percent of their relatives were aware of the actual diagnosis.

It will take more than a new ideograph to alleviate such stigma, especially when the disease's clinical definition remains the same, according to Kim, who is also secretary of the JSPN committee in charge of renaming the disorder.

"The new term is a retranslation of `schizophrenia' into the Japanese language and does not make any substantial change in the original concept of the illness," says Kim. After a nine-year battle, a change in the clinical definition of schizophrenia was deemed too difficult; JSPN decided only to rename the condition. Thus, schizophrenia still goes by the 1937 definition that accompanied the term's translation into Japanese: "untreatable, progressive, poor prognosis with disrupted personality."

Kim suggests that schizophrenia be renamed worldwide, though stigmatization is most prevalent in cultures using ideographs. In China and Korea, the term literally means "catastrophe of mind."

COPYRIGHT 2002 Sussex Publishers, Inc.
COPYRIGHT 2002 Gale Group

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