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A Study on the Prevalence and Predisposing Factors of Schizophernia Among Youths

A Study on the Prevalence and Predisposing Factors of Schizophernia Among Youths in the State Neuropsychiatric Hospital, Nawfia, from the Year 2009 – 2013

Background of the Study

Schizophrenia is a chronic, severe and disabling brain disorder that has affected people throughout history. The disorder interferes with a person’s ability to think clearly, manage emotions and act rationally. Disordered thought process, delusions and hallucinations are the major characteristics. It has its onset in early adulthood as the individuals are beginning to realize their potential. People with the disorder may hear voices other people don’t hear. They may believe other people are reading their minds, controlling their thoughts or plotting to harm them. This can terrify people with the illness and make them withdrawn and extremely agitated.

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McGrath and Kelly (2000) defined schizophrenia as a disabling group of brain disorders characterized by symptoms such as hallucinations, delusions, disorganized communication and blunted affect. Mary and Getrude Leo (2004) opined that schizophrenia is a condition marked by a severe and often irreversible deterioration in personality, affect and intellectual functions.

This thought process known today as schizophrenia undoubtedly has existed throughout human history, however, the deviant behaviour associated with it was more often than not viewed in terms of divine punishment or demonic possession rather than a mental disorder.

Benedict morel (1809-1873) used the term “demence Precoce” to describe a progressive disorder characterized by social withdrawal, self neglect and bizarre behaviour. The nonspecific concept of madness has been around for many thousands of years and schizophrenia was only classified as a distinct mental disorder in 1887 by a German Psychiatrist- Emil Kraepelin (1856-1926). He called it “dementia Praecox’ (dementia of early life) which emphasized the change in cognition (dementia) and early onset (Praecox). Kraepelin considered it a form of dementia like Alzheimer’s that hit younger people.

The term ‘schizophrenia’ was coined by Eugen Paul Bleuler, a Swiss psychiatrist in 1911. It has its roots in Greek words, “Schizo (Split)) and “Phren” (mind). His term was not meant to covey the idea of split or multiple personality but to describe the fragmented thinking of people with the disorder. Bhugra (2006) defined schizophrenia as a psychiatric diagnosis that is characterized by abnormalities in perception or expression of reality.

Carol (2009), states that it is the most puzzling of psychiatric syndromes and-one of its most debilitating.

Schizophrenia typically begin in early adult hood and persists throughout life. It affects men and women equally. Men tend to have earlier onset than women. Both show different patterns of susceptibility for developing the disorder. Males reach a single peak of vulnerability between the ages of 18 and 25 years, in contrast, females peak twice, first between 25 and 30 years, then again around 40 years of age.

Approximately 3-10% of women present with the illness after age 40. Onset before age 10 or after 60 is extremely rare. 90% of patients on treatment for schizophrenia are between 15 and 55 years (Kaplan and Sadock’s, 2007).

Bleular identified four basic mental processes that are at the core of the disordered cognition present in schizophrenia. They are disturbances of affect, association, ambivalence and autism.

Schizophrenia occurs in all societies regardless of class, colour, religion or culture. However, there are variations in terms of incidence and outcomes for different groups of people (source. Dr. Robin Muray). The incidence of schizophrenia in United States of America is 10-58 new cases per100,000 populations. Richard Wyatt, M.D, Chief of neuropsychiatry, National institutes of mental Health, said schizophrenia affects one percent [1%] of the population, accounts for a fourth of all mental costs and takes up one in every three psychiatric hospital beds and nearly 30 percent [19 billion] of schizophrenia’s cost involves direct treatment.

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About 200,000 individuals with schizophrenia are homeless constituting one third of the approximately 600,000 homeless populations (source Department of the Health and human services).

People with schizophrenia have a 50 times higher risk of attempting suicide than the general population. 10 to 13 percent commit suicide and 40% attempting suicide.

Schizophrenia sufferers are far more likely to harm themselves than be violent toward the public; the violence is usually directed at family members and often takes place at home. Violence is not a symptom of schizophrenia.

About 8 percent of people in jails have schizophrenia and are usually charged with misdemeanours such as trespassing (NIMH).

The researcher believes that when the prevalence of the illness is determined, solution will be sort and appropriate care will be given to the client and at the same time preventive measures will be adopted to combat this problem in our society at large.

STATEMENT OF PROBLEM

In recent times, the number of youths between the ages of 18-45 years being admitted into the state Neuropsychiatric Hospital, Nawfia, with the diagnosis of schizophrenia has been on the increase.

Schizophrenia is regarded as one of the most important mental illnesses because of its high prevalence and the magnitude of disability it produces with consequent increases in disease burden which is measured by personal suffering, disability and increased demand on health services. In line with the above statement, Townsend (2005) opined that of all mental illnesses responsible for suffering in the society, schizophrenia probably causes more lengthy hospitalization, more chaos in family life, more exorbitant cost to individuals and governments, and more fears than any other.

Kaplan and sadock [2003] were of the view that schizophrenia constitutes a great economic burden all over the world. It is among the top ten (10) disabling conditions worldwide for young adults who struggle with many functional impairments including self care skills, social functioning, occupational/educational performance and most patients require some public assistance, only about 10-20% of the patients are able to participate in competitive employments.

There is therefore need to ascertain the prevalence and predisposing factors of this illness for proper control or else the rate at which people are afflicted by the disorder will continue to rise. It is based on the above that the researcher was motivated to find out the prevalence and predisposing factors of schizophrenia among youths between the ages of 18-45 years admitted into the state Neuropsychiatric Hospital, Nawfia, from 2009-2013.

 OBJECTIVES OF THE STUDY

  1. To determine the number of youths within the ages of 18-45 years admitted with the diagnosis of schizophrenia into the state Neuropsychiatry Hospital, Nwafia, from 2009 to 2013.
  2. To find out the predisposing factors of schizophrenia
  3. To find out the socio-demographic variables related to the onset of
  4. To explore ways to eliminate the predisposing factors.

SIGNIFICANCE OF THE STUDY

  • The study will provide information on the prevalence and predisposing factors of schizophrenia among Youths in the state Neuropsychiatric Hospital,Nawfia. It will thus be of great significance to the nurse managers and interdisplinary health team for planning, directing and coordination of nursing/medical services for quality nursing care.
  • A higher prevalence rate means a greater disease burden. Prevalence data provide a snapshot of the burden of disease on the society at a specific time; they can be used by the policy makers to inform planning efforts and to estimate ideal resource allocations.
  • It will aid the society in the identification of the risk factors inherent in the prevalence of the disorder, so that they can be dealt with to stem the occurrence and prevent relapse.
  • Again, to the students, it will serve as a source of reference literature for those who will want to make further enquiries into the prevalence of the
  • It is hoped that the study will be of benefit to all agents of socialization considered to have significant role to play in the prevention/reduction of schizophrenia such as parents/family, schools, churches and the
  • Finally, mental illnesses, unlike other forms of illnesses or disabilities, tend to go more with stigmatization in many cultures. This study will help to convince the society that mental illness can be controlled, thereby eradicating the age-long stigma.
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RESEARCH QUESTIONS

  1. What is the prevalence of schizophrenia among youths (aged 18-45 years) admitted into the state Neuropsychiatric Hospital, Nawfia between 2009 and 2013?
  2. What are the socio-demographic variables related to the onset of schizophrenia?
  3. What are the predisposing factors of schizophrenia?
  4. What measures would be employed to eliminate the predisposing factors?

 SCOPE OF THE STUDY

The study is delimited to the youths (males and females) within the ages of 18-45 years admitted into the state Neuropsychiatric hospital, Nawfia, from 2009-2013. It assesses the prevalence and predisposing factors of schizophrenia among these youths with particular references to the number affected, the socio-demographic variables related to the onset which includes age range mostly affected, gender mostly affected, occupation, levels of education and the marital status of the patients.

 OPERATIONAL DEFINITION OF TERMS

  • Prevalence of schizophrenia: The wide-spread of the mental disorder-schizophrenia during a specific time period.
  • Youths: Youths in this study are people who fall within the ages of 18-45 years (males and female).
  • Incidence of schizophrenia: Refers to number of new cases of schizophrenia that occur during a specific time period.
  • Gender: The sex of the patients.
  • Age Range: The age groups of the patients used in the study.
  • Genetics: the study of how traits such as physical and behavioural characteristics including risk for certain diseases are passed (inherited) from parents to their offspring.
  • Environment: Environment as it relates to schizophrenia is “everything other than genes”. It includes everything from the social, nutritional, hormonal and chemical environment in the womb up to the social dynamics and stress a person experiences. Its basically the same as “nature Vs nurture” i.e. “genes Vs environment”.

LITERATURE REVIEW

This chapter reviewed related literature under the following

  • CONCEPTUAL REVIEW
  • THEORETICAL FRAMEWORK
  • EMPIRICAL REVIEW
  • SUMMARY OF LITERATURE

INTRODUCTION

CONCEPT OF SCHIZOPHRENIA

Schizophrenia is a mental illness in which a person becomes unable to link thoughts, emotions and behaviour leading to withdrawal from reality and personal relationship (Altschul and McGovern, 2009). It has defining features of psychotic symptoms which are produced by a loss of ego boundaries and a gross impairment in reality testing which include, prominent hallucinations, delusions, disorganized speech and grossly disorganized behaviour.

Pre-kraepelin Era: By middle of 19th century, some European Psychiatrists described some mental disorders of unknown causes that typically affect the younger people and often progressing to chronic deterioration.

  • Morel, in France: Demence precoce’
  • Clouston, in Scotland: ‘Adult insanity’
  • Kahlbaum, in Germany: ‘Catatonia’
  • Hecker, in Germany: ‘Hebephrenia’
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Kraepelin Era: Emil kraepelin [1856-1929] formulated the nosological (disease) concept of schizophrenia, considering the disorder a unique disease entity. Eugen bleuler [1857-1939] significantly modified kraepelin’s concept. He termed the condition “Schizophrenia”, he stated that schizophrenia is not a disease in strict sense but a group of syndromes.

Post kraepelinian and Bleulerian Era: This era saw a number of European and American Scholars proposing further insight into schizophrenia -karl Leonhard posited localized cerebral dysfunction in the etiology of schizophrenia.

Today, schizophrenia is considered a polygenic disorder with onset in early adulthood, characterized by irregular psychotic episodes and functional impairment but incident cases occurring at all ages with marked difference in symptoms and social outcome (Heinz H- 2014).

Despite the fact that no single factor has been identified that characterizes all patients with schizophrenia, many investigators have devoted their professional lives to research on schizophrenia. And, although the puzzle have not yet been solved, the persistent efforts of clinical researchers have put many pieces into place (Walker et al. 2014)

ETIOLOGY OF SCHIZOPHRENIA

The cause of schizophrenia is still uncertain. No single factor has been implicated in the etiology of schizophrenia. However, experts now agree that schizophrenia develops as a result of interplay between biological predisposition and the environment a person is exposed to. They believe that genetic predisposition and environmental stressors in early development (during pregnancy or early childhood) lead to alterations in the brain making the individual susceptible to developing the disorder in later years.

PREDISPOSING FACTORS: Include.

  • Biological factors
  • Psychological factors
  • Environmental factors

BIOLOGICAL FACTORS

  1. GENETICS

Schizophrenia is a polygenic disorder, scientists believe several genes are associated with an increased risk of schizophrenia but that no single gene causes the disorder by itself.

The case for genetic basis of schizophrenia have been supported by the Twin and Adoption studies which found a high level of heritability in schizophrenics. The theory of genetic causation also argues that schizophrenia is an illness of complex inheritance (Owen et al. 2005).

Roughly, 10% of people with schizophrenia have first-degree relative

A Study on the Prevalence and Predisposing Factors of Schizophernia Among Youths in the State Neuropsychiatric Hospital, Nawfia, from the Year 2009 – 2013

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