Background Magnetic resonance imaging (MRI) has demonstrated abnormalities of brain structure, particularly of the temporal lobes, in schizophrenia. These are thought to be neurodevelopmental in origin, but when they become evident is unknown.
‘The experience of schizophrenia’ explores a condition that is diverse and associated with bizarre, inexplicable, and frightening experiences and with behaviour that is strange and difficult to understand. Before the discovery of antipsychotic drugs (neuroleptics) in the 1950s, there were no effective treatments for schizophrenia. In the 1970s it was widely recognized that patients with schizophrenia would be much better off if they were not kept for decades in large institutions. Where possible, new patients were discharged from hospital promptly, following assessment and treatment. There has been much discussion in the medical and the national press of the success or otherwise of ‘care in the community’.
A masked analysis of videotaped assessments of people at high genetic risk of schizophrenia revealed that those who subsequently went on to develop schizophrenia used significantly more second-person pronouns. This was evident before diagnosis, at two separate assessments approximately 18 months apart. This supports the view that people who go on to develop schizophrenia may have an abnormality in the deictic frame of interpersonal communication - that is, the distinction between concepts being self-generated or from elsewhere may be blurred prior to the onset of a diagnosis of schizophrenia.
Schizophrenia: Manifestations, Incidence and Course in Different Cultures. WHO Ten-Country Study. Psychological Medicine Monograph Supplement 20. By A. Jablensky, N. Sartorius, G. Ernberg, M. Anker, A. Korten, J. E. Cooper, R. Day and A. Bertelsen. (Pp. 97; illustrated; £5.95.) Cambridge University Press: Cambridge. 1991. - Volume 23 Issue 1
Quality of life is often relatively lowered in families of children with additional needs, and this may be particularly the case where additional needs are accompanied by an autism spectrum disorder (ASD). Here we explore the effects of diagnostic status specifically, comparing families with children with an ASD diagnosis with others who a) have additional needs but no signs of ASD; and b) have additional needs and signs of ASD but no diagnosis. Mothers (n = 76) of children with additional needs completed standardised questionnaires about quality of life, stress, service provision, child behaviour and presence and severity of ASD traits. In addition, a group of mothers of typically developing young people (n = 17) completed standardised questionnaires on individual and family quality of life and on the behaviour of their son or daughter. Mothers of typically developing young people had significantly higher individual and family quality of life scores than each of the three other groups. Increased severity of ASD was associated with increased maternal stress, which in turn was associated with decreased family and maternal quality of life. The group reporting the lowest quality of life and the highest stress were the mothers of individuals with signs of ASD but no diagnosis. This pattern did not seem to be explained by lack of access to services, or rates of intellectual disability or challenging behaviour in this sub‐group. The finding that poor quality of life and high stress was most apparent in the sub‐group of mothers with children who had signs of ASD but did not have a diagnosis of ASD suggests that an interesting topic for further investigation is whether receipt of a diagnosis itself can positively influence quality of life and levels of maternal stress.
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