Rethink Schizophrenia: A Mindful Approach

Mental-health

Schizophrenia is a chronic brain disorder that affects about one percent of the population. Although the specific cause of the illness is unknown it is believed to be as a result of several factors including: genetics, biology, environment and lifestyle. A combination of genes is believed to be associated with the development of schizophrenia, which may indicate the link between the increased occurrences in families. Studies have shown that while 1 in 100 people may be effected by a schizophrenia diagnosis in the general public this number drops to 1 in 7 in non-identical twins and a 1 in 2 chance for identical twins, where one sibling has previously been diagnosed.

Low birth weight, premature birth and asphyxia during birth are more likely to have been experienced bypeople who are diagnosed with schizophrenia, indicating a link between birth and pregnancy complications and schizophrenia. Experiences such as stress and grief have been found to be external triggers that may lead to the development of schizophrenia in already vulnerable people. Drug abuse is another trigger, and studies have shown a link between cannabis, cocaine, LSD and amphetamines in the onset of schizophrenia.

There are positive and negative symptoms associated with schizophrenia, which indicates if the symptom is in addition to reality (positive) or if they affect the ability to function (negative). Positive symptoms include: hallucinations, delusions and disorganised thinking. Hallucinations are experiences that are not real or that other people do not experience that can be heard, seen or felt by the individual experiencing schizophrenic symptoms.

Delusions may include believing different things such as being chased, plotted against or poisoned and someone the patient knows, the government or aliens are responsible. They may believe they are a famous or important person, people on television are sending messages to them, or their thoughts are being broadcast aloud. Disorganised Thinking may cause the individual to start talking quickly or slowly. The things they say might not make sense to other people and they may switch topics without any obvious link, further preventing them from being understood.

Negative symptoms include: Lack of motivation, slow movement, change in sleep patterns, poor grooming or hygiene, changes in body language, lack of eye contact and reduced range of emotions. Cognitive impairment may also be experienced resulting in an inability to sustain attention, memory problems, reduced ability to take on information and poor decision making.

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Although approximately 3 in 10 people will experience lasting recovery from schizophrenia there is current no cure, professionals therefore work to manage symptoms via drug and psychosocial interventions. Medications such as antipsychotics are usually prescribed in combination with talk-based therapies, with prescription and dosage reviewed annually once determined.

The use of mindfulness for the treatment of schizophrenia has in some instances been met with some reluctance due to the belief that meditation may be a trigger for psychosis. However in research by Chadwick et al (2005), some additional modifications to mindfulness-based interventions were suggested, such as limiting meditation to 10 minutes, starting sessions with a brief body scan to help ground patients, and offering frequent guidance to limit prolonged periods of silence.

More recent studies by Johnson et al., 2011 and White et al., 2011 found that mindfulness-based treatments may improve the negative symptoms found in schizophrenia, with the effects on negative symptoms found to be much higher than for positive symptoms in a study by Khoury et al 2013.

The 2017 study by Chien, W. T et al. found that mindfulness-based psychoeducation significantly improved psychiatric symptoms, psychosocial functioning, insight into illness/treatment and duration of readmissions to hospital over 24 months when compared with the conventional pychoeducation and routine out patient care.

More research within the field of mindfulness and schizophrenia is required for a definitive link between the successful management of the illness and mindfulness based interventions, but recent studies do seem to indicate a positive link.

References:

  1. https://www.rethink.org/diagnosis-treatment/conditions/schizophrenia
  2. https://www.ncbi.nlm.nih.gov/pubmed/23954146
  3. https://www.nhs.uk/conditions/schizophrenia/causes/
  4. https://www.mind.org.uk/information-support/types-of-mental-health-problems/schizophrenia/causes-of-schizophrenia/#.WkTAwyOZOCQ
  5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4591204/
  6. http://bjp.rcpsych.org/content/204/5/333.full
  7. Chadwick P, Taylor KN, Abba N. Mindfulness groups for people with psychosis. Behav Cogn Psychother. 2005;33:351–359
  8. https://www.ncbi.nlm.nih.gov/pubmed/21975193
  9. https://www.ncbi.nlm.nih.gov/pubmed/21385664
  10. https://www.ncbi.nlm.nih.gov/pubmed/23954146
  11. https://plasticbrainblog.com/2017/01/23/mindfulness-shows-promise-in-the-treatment-of-schizophrenia/
  12. Image https://www.homecaredaily.com/2014/03/26/in-home-care-for-schizophrenics-more-effective-than-institutions-study-indicates/
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