We do some unusual things to the English language. One interesting example is the word "schizophrenia."
The American Heritage Dictionary lists two definitions for schizophrenia:
Any of a group of psychotic disorders usually characterized by withdrawal from reality, illogical patterns of thinking, delusions, and hallucinations, and accompanied in varying degrees by other emotional, behavioral, or intellectual disturbances. Schizophrenia, often associated with dopamine imbalances in the brain and defects of the frontal lobe, may have an underlying genetic cause.
A condition that results from the coexistence of disparate or antagonistic qualities, identities, or activities: the schizophrenia of the double espionage agent.
The second definition stems from our confusion between schizophrenia and multiple personality disorder. Schizophrenia has nothing to do with split personalities. The schism in schizophrenia is a split with reality. The person in active schizophrenia has lost touch with reality.
The Merck Manual summarizes the origins of schizophrenia as follows:
The concept of dementia praecox was developed from 1896 on, based on the early onset of the tendency toward a deteriorating course. Soon the idea of underlying disturbances in certain psychologic processes, and the distinction between primary and secondary symptoms, were introduced, with attempts to interpret the latter according to Freudian psychoanalytic theory.
The name "schizophrenia" was coined in 1908, referring to the disconnection or splitting of the psychic functions, believed to be an outstanding symptom of the whole group. It was thought that the illness need not always begin early and could end in various ways, including a so-called social remission; but it was not certain that full recoveries occurred without leaving a scar. No definite pathologic, anatomic, or biologic abnormalities were established. However, the unmistakable disturbances of thought, perception, feeling, and behavior had been recognized.
An alternative hypothesis holds that schizophrenia is a recent disease, which explains why more specific descriptions of the disorder were rarely cited before 1800. Although not necessarily incompatible with the view of its ancient origin, this hypothesis claims that some biologic change occurred about 1800, following which a new type of schizophrenia became more common. (Merck Manual Online, Based on the Merck Manual, 1992)
Recent research has implicated abnormalities with the neurotransmitter dopamine in schizophrenia; but we are far from completely understanding this disorder. Most schizophrenia begins in early adulthood, although it can emerge even later. Childhood schizophrenia is rarer. It shares some characteristics with adult schizophrenia, but it also has unique characteristics. Brain abnormalities have been found in both populations. Evidence of abnormal brain development in schizophrenia has recently emerged. MRI (magnetic resonance imaging) scans showed ventricles (fluid-filled cavities in the brain) enlarging between ages 14 and 16 in teens with a rare severe childhood onset form of schizophrenia according to Judith Rapoport, M.D., and her colleagues at the National Institute of Mental Health.
Patients with schizophrenia sometimes fit the stereotype of "crazy." They may hear voices or believe that people are plotting about them behind their back. They may be grandiose, believing that they are actually royalty. Other patients are extremely withdrawn and private. You might not know of their split with reality unless you worked very hard to draw them into a conversation.
Since the discovery of phenothiazines schizophrenia has been primarily treated by medications. The mainstay phenothiazine derivatives such as Thorazine are gradually being replaced by newer medications which have fewer side effects such as clozapine and risperidone. Blood tests are very important with some of these newer medications, however, since there can rarely be serious side-effects.
The American Heritage Dictionary of the English Language, third edition is copyright 1992 by Houghton Mifflin Company.
