1. Question Three: How have past and present cases influenced changes in treatment and how doctors/psychologists/psychiatrists view schizophrenia?
1.1. Source: "Common Drugs and Medications to Treat Schizophrenia." WebMD. WebMD, n.d. Web. 05 May 2014. http://www.webmd.com/drugs/condition-948-Schizophrenia.aspx?diseaseid=948&diseasename=Schizophrenia
1.1.1. ABCD: People can add comments and rate the drugs based on their own experiences. It offers community review on typical drugs or medications used to treat people who suffer specific diseases. Because the site stays up to date with current medications, it is constantly edited.
1.1.1.1. Notes From Site: Simply a list of some of the most typical medications and drugs used for treated schizophrenia. They vary from modern day to past "most common" medications.
1.2. Source: Lane, Dr. Cheryl, PsyD. "History of Schizophrenia." History of Schizophrenia. N.p., 2014. Web. 05 May 2014. http://www.schizophrenic.com/content/schizophrenia/history-schizophrenia
1.2.1. ABCD: Community can subscribe, but cannot post any actual facts. Informational site where patients can ask questions and professionals answer them to the best of their ability. Information is based on past and present studies.2014.
1.2.1.1. Notes: Schizophrenia was not officially coined or labeled as a complex disorder until 1911 by Dr. Eugen Bleuler. In earlier times, it was often associated with possession resulting in the victim’s exorcism, flogging, starvation, or burning at the stake. Some were even subject to “trephining” in which holes were drilled into the head to “release the dark spirits.” Another method was “bloodletting.” It was not until the latter part of the 1800s that doctors and scientists began to understand schizophrenia, and it was then coined “hebephrenia” by Ewald Hecker in 1871 representing cognitive disorganization. This term is still used today. Throughout these improvements, however, treatment of the disease did not improve, leaving patients who suffered the illness locked or chained away in the dark insane asylums, where flogging was included in the treatment and the public could often pay money to come in and simply watch the patients as if they were at a zoo. As Dr. Bleuler began to understand and study schizophrenia and how the mind “split off” from reality, a definition of the illness was created by Kurt Schneider and conditions in the institutions slowly began to improve.
1.3. Synthesis: Cases in the past have often been associated with possession, witchcraft, and demons--sometimes even seen as punishment from the Heavens for past mistakes in past lives. As science, medicine, and psychology improved, treatment for disorders such as schizophrenia have also improved--quite drastically. Instead of bloodletting, isolation, flogging or trephining, patients now receive real beneficial help in learning to cope and live with their disorder. Slowly, schizophrenia was recognized as an actual disorder and not possession or witchcraft. As doctors began to investigate the symptoms and factors regarding the disorder, they also began to try to treat it better and more successfully. With this also came acceptance from society--and families. It was no longer such a shame on the family and so families have begun to get involved with the treatment. Doctors, psychologists, and psychiatrists have helped create better medication and treatment that has allowed people to be moved to out-patient care or even a simple prescription for an antipsychotic medication that offers sufficient treatment for them. People suffering from schizophrenia are no longer kept like worthless animals and lab rats for people to watch for their own amusement, but are now treated as actual patients suffering from a very real disorder.
2. Other Sources: Used for Wide Research and All Questions
2.1. Source:"The Johns Hopkins Schizophrenia Center." The Johns Hopkins Schizophrenia Center. The Johns Hopkins University, The Johns Hopkins Hospital, Johns Hopkins Health System, n.d. Web. 04 May 2014. http://www.hopkinsmedicine.org/psychiatry/specialty_areas/schizophrenia/
2.1.1. ABCD: Connected to a legit medical center with a schizophrenia center included. All facts are from experiences, cases, research done on cite, and patients involved. Site is edited as new information is found.
2.1.1.1. Notes: This source discusses, patient care at John Hopkins Medical Center, education about the disorder itself, and outreach. Outreach is key in understanding this disorder because within schizophrenia people learn by sharing and cross referencing their findings. It speaks of hospital care offered as well as other treatment plans (outpatient, group homes, etc,) and research being done to aid in the understanding of schizophrenia.
2.2. Source: Smith, Melinda, M.A., and Jeanne Segal, Ph.D. "Schizophrenia: Signs, Types & Causes." Schizophrenia: Signs, Symptoms, Types, Causes, and Effects. N.p., Feb. 2014. Web. 04 May 2014. http://www.helpguide.org/mental/schizophrenia_symptom.htm
2.2.1. ABCD: Non-profit resource, written by doctors themselves, gives numerous facts about family involvement and effects of having schizophrenia. Articles are all written by doctors and psychologists.
2.2.1.1. Notes: Also, looked into "Helping a Person with Schizophrenia." This article talks about how to help a person suffering from schizophrenia cope, set up an emergency plan in case of a psychotic episode. The prior article speaks of more understanding the disorder in general. It explains causes, effects, optional treatments, what kind of treatment is best for you, etc.
2.3. Sort of Synthesis? These sources were used for nearly every question and have been incorporated into the synthesizes accordingly.
3. Question One: How do we know this disorder exists if there is no specific test to accurately diagnose it? How do doctors diagnose accurately if there is no tests to confirm it?
3.1. Source: "Schizophrenia." NIMH RSS. N.p., n.d. Web. 02 May 2014. http://www.nimh.nih.gov/health/topics/schizophrenia/index.shtml
3.1.1. ABCD: .gov. Factual and informational purpose. Little to no biasness. Very up to date on facts.
3.1.1.1. Notes: Doctors use cross referencing, observations made by the family, second opinions, basic science labs, epidemiological data, and brain imaging to help patients suffering from schizophrenia. Family members are often the patient's main caregivers. People with schizophrenia often resist treatment due to their belief that their hallucinations or delusions are real. a mental health professional will assess the patient and determine whether a voluntary or involuntary admission is needed. For a person to be admitted involuntarily, the law states that the professional must witness psychotic behavior and hear the person voice delusional thoughts. Family and friends can provide needed information to help a mental health professional make a decision. Sometimes symptoms become severe for people who stop their medication and treatment. This is dangerous, since they may become unable to care for themselves. Some people end up on the street or in jail, where they rarely receive the kind of help they need (relate to Crazy in America!). The patient will need support during this time. When people with a mental illness are pressured and criticized, they usually do not get well. Often, their symptoms may get worse or they may become violent. It can be difficult to know how to respond to someone with schizophrenia who makes strange or clearly false statements. Remember that these beliefs or hallucinations seem very real to the person. It is not helpful to say they are wrong or imaginary. But going along with the delusions is not helpful, either. This makes it very hard for the family and the person struggling with the disorder because it can become frustrating to deal with and gives little help to either parties. Schizophrenia is a biological illness. Being respectful, supportive, and kind without tolerating dangerous or inappropriate behavior is the best way to approach people with this disorder. 10% of people with schizophrenia die of suicide.
3.2. Source: Braslow, Joel T., and Sarah Linsley Starks. "Psychology and Psychiatry." New Dictionary of the History of Ideas. Ed. Maryanne Cline Horowitz. Vol. 5. Detroit: Charles Scribner's Sons, 2005. 1958-1964. Gale Virtual Reference Library. Web. 5 May 2014. http://go.galegroup.com/ps/i.do?id=GALE%7CCX3424300645&v=2.1&u=huxl28173&it=r&p=GVRL&sw=w&asid=b4874ecd452f1197df06bd11fb7b73ce
3.2.1. ABCD: Little biasness due to most of it being straight up facts. Very credible and has reliable sources from which they received their information. 1958-1964.
3.2.1.1. Notes: The settings in which psychiatrists practice, the range of diseases they seek to treat, their theoretical understandings of these diseases, and the treatments they apply are all radically different from those of their predecessors.Despite enormous changes, researchers have not identified the root cause of a single psychiatric disease or developed a single definitive cure. Throughout the twentieth century, psychiatrists divided psychiatric illness into two main classes: "organic" and "functional." They classified organic illnesses as those in which there was an obvious cause, whereas the functional disorders, those most commonly associated with the practice of psychiatry, had no ascertainable biological cause. These disorders are subdivided into two categories—psychotic disorders and nonpsychotic disorders—that are then further divided into specific diagnoses. State hospitalization and outpatient psychotherapy both largely have been replaced by a proliferation of psychotropic drugs, with considerable implications for how society views mental illness, as well as how people make sense of more everyday aspects of human feelings and behaviors. In the early twentieth century, American psychiatry was almost exclusively institutionally based. Nineteenth-century asylum founders had created these institutions as a means of providing a psychologically therapeutic environment in combination with physical treatment regimens, but by the turn of the century their optimism had worn off, replaced by a biological fatalism regarding the patients' chances of improving. By the early twentieth century, state mental hospitals—a designation that had replaced that of asylum—were vastly overcrowded institutions for the care of severely ill patients, many of whom became permanent residents. In such a setting, where a handful of psychiatrists often cared for thousands of patients, patients were categorized not by diagnosis but by behavior and prognosis, and were housed in wards with labels such as "acutely excited," "chronic quiet," "chronically disturbed," and "convalescing." Disordered behavior was the primary target of psychiatric interventions, which consisted almost exclusively of somatic therapies: hydrotherapy (e.g., continuous baths or wet-sheet body wraps), insulin-induced comas, electroconvulsive therapy, and lobotomy. These treatments were believed to be therapeutic by virtue of their success in subduing out-of-control (diseased) behavior. Psychiatrists began referring to drugs (Thorazine, etc.) as antipsychotics in the mid 1960s. Antipsychotic drugs are in many ways the most important class of psychotropic drugs. Since the mid-twentieth century, psychiatry has undergone revolutionary changes in how psychiatrists diagnose patients, how they treat them, and how they evaluate whether a treatment works. Though psychiatrists are now trained to expertly manipulate a patient's drug regimen, they have become increasingly less able to situate a patient's suffering within a psychological and social context.
3.3. Synthesis: With so many advances that have been made since the days of simply asylums, many diseases have been specified and have become more able to be treated. Diagnosing disorders like schizophrenia requires the doctor to look at more than simply some test results. They must ask several questions, look at the time span and symptoms the patient is experiencing, look at brain imaging, cross referencing, and many other factors that hint at what exactly the patient is suffering from. While families and patients look to doctors to diagnose them, it is really the family and patient themselves who confirm the diagnosis. Since the only actual tests they can do to test for Schizophrenia is brain imaging and looking back through the patient's heredity of mental and psychological disorders, it may seem difficult to diagnose a person with schizophrenia. However, it really is not as difficult as it sounds. The "tests" to confirm it come from the symptoms the patient is showing and how they fit in to a number of disorders that the doctor thinks it could be. Substance abuse is commonly linked to schizophrenia because what a person who is high or drunk sees and hears is sometimes (most of the time) just their imagination and result of the substance. Schizophrenia is where the person sees, hears, and sometimes feels things that they believe to be truly real. It is a fine line of difference, yet simple blood tests can confirm substance abuse, therefore, excluding it from being a possible cause. While there are other disorders that share common symptoms with schizophrenia, the disorder itself is actually starkly different than the others because of the symptoms that they do not share.
4. Question Two: Before people with schizophrenia were diagnosed and treated, what happened to them in the institutions and how did their family treat them? How does that vary from today? Are people still institutionalized for having schizophrenia today?
4.1. Source: "Schizophrenia." Mental Health America. N.p., n.d. Web. 03 May 2014. http://www.mentalhealthamerica.net/conditions/schizophrenia
4.1.1. ABCD: Offers a list of treatment options, symptoms, medications, and types of schizophrenia. Mental Health America Organization (very reliable). Almost no bias. 2000.
4.1.1.1. Notes: Many people suffering from schizophrenia in the past never had their family to rely on due to the shame brought on by having the illness, unlike today where the families of the patient are most of the time very involved and supportive of the patient and their treatment. In fact, it is usually them who notice the first symptoms of schizophrenia.
4.2. Source: Pfeiffer, Mary Beth. Crazy in America: The Hidden Tragedy of Our Criminalized Mentally Ill. New York: Carroll & Graf, 2007. Print.
4.2.1. ABCD: Author shows a lot of research was done in writing the novel. Speaks of cases where mentally ill people are charged and criminalized for behaviors linked to their disorder. Tells of the horrors and consequences of this being done.
4.2.1.1. Notes: This novel dives in to the horrors and consequences of people with mental disorders being criminally charged and left to live out the rest of their lives in a cell due to behaviors caused by the lack of treatment of their disorder. It mentions many horrifying cases where people as young as 18 hung themselves due to not being able to handle or cope with being left in a cell or "dark place" all alone with their thoughts. Left alone, untreated, and without any help or guidance, these people were held victims to their own disorders and offered no solace, comfort, help, or understanding regarding their state of mental health.