The concept of schizophrenia as we know it today was developed by Emil Kraepelin in 1896. He described the prognosis as being of an early onset and having a progressive deterioration, and hence named it dementia praecox.Opponents of Kraepelin’s definition argued that, though early onset was common, it was not the only possibility. Cases of schizophrenic diagnosis have been noted as late as age forty or fifty (Plomin & McClearn, 1993). In addition, many had problems with the idea that the disease was “continuously deteriorating,” because it seemed to undermine the efforts of treatment. Today, recent statistics from studies that have followed schizophrenic patients for more than twenty-five years have actually shown that thirty-five percent of schizophrenic patients recover and another thirty-five percent function independently and are self-supporting with some possible residual symptoms (Modrow, 1995). In response to these criticisms, Eugen Bleuler came up with the term “schizophrenia” as we know it today, which means “split mind” (Cromwell, 1978).
Schizophrenia is a rather obscure disorder, not only in the absence of a great deal of information about it, but also in people’s ignorant about it. According to Warner (2000),
Ask a classroom of American college students – in engineering or English literature – what they know about AIDS or cancer and they will probably have a lot to say. But ask about schizophrenia and the silence will be embarrassing. Although schizophrenia is more common than AIDS/HIV, most people know far less about it. “Isn’t it like multiple personality disorder?” people ask. “Is it caused by child abuse?” “Are they mentally retarded?” The answer to all these questions is “No.” (p. 3)As he defines it, schizophrenia is a psychosis, a “severe mental disorder in which the person’s emotions, thinking, judgment, and grasp of reality are so disturbed that his or her functioning is seriously impaired” (Warner, 2000, p. 3). The general ignorance surrounding this cluster of disorders pervades the medical profession as well sometimes, in the incorrect diagnosis or even missed diagnosis of psychotic individuals. It is oftentimes confused with bipolar disorder, due to the psychotic symptoms sometimes experienced by individuals with severe and sudden alterations of mood, and in individuals experiencing mania. However, unlike bipolar disorder, the mean onset tends to be earlier. Also, the course of schizophrenia tends to be more continuous, and the emotional changes in a schizophrenic tend to lack in spontaneity.
Some characteristics of a schizophrenic patient that clinicians use to properly diagnose him are markedly illogical thinking and auditory hallucinations. As Warner (2000) states, these types of hallucinations are characteristic of both bipolar disorder and schizophrenia, but the hallucinations experienced by schizophrenics more often comment on the person’s actions or converse with each other. Delusions are another characteristic of schizophrenia and also of bipolar disorder. What differentiates these from each other is the sense that he is being controlled by outside forces or his thoughts are being interfered with in schizophrenia.
As Gelber et al. (2004) state in their article concerning the diagnosis of schizophrenia, early diagnosis is important in order to effectively treat the patient, determine the prognosis, and identify research participants. It is noted that this is difficult due to the symptomatic overlap between the various causes of psychoses. In order to facilitate early diagnosis, the researchers followed a group of first-episode psychosis patients with a presumptive diagnosis of schizophrenia for six months at which point they were either diagnosed with schizophrenia or another psychiatric diagnosis. At this point, data from the patients were determined and noted, such as demographic profiles, symptoms, quality of life, premorbid adjustment and lateral dominance. What the researchers found was that patients who exhibited higher levels of anhedonia and hallucinations increased their chances for a later diagnosis of schizophrenia, showing that the baseline emotional response, lack of pleasure in life tasks and hallucinations play a large part in the diagnosis.
A more physiological method for testing schizophrenia is one that Kraepelin mentioned over a century ago. His was a description of a deficit in perceiving a briefly presented stimulus. According to him, it is best to study the deficits related to schizophrenia during the few seconds and fractions of seconds which follow “carefully constructed novel, ambiguous, decision-demanding, or otherwise difficult stimuli” (Cromwell, 1978, p. 31). Of the behaviors affected, and which we can study, are reaction time, size estimation, illusion, heart rate and language.