Schizophrenia: Impact and Disparities in the Black Community

Introduction

The history of schizophrenia and mental health generally are intertwined and have unique contextual repercussions. The English equivalent of the Greek term for schizophrenia is ‘split mind.’ This term, which in Latin translates to ‘premature dementia’ was created in 1908 by Swiss psychiatrist Paul Eugen Bleuler (1857-1939) to describe a range of mental diseases that German psychiatrist Emil Kraepelin (1856-1926) had named “dementia praecox” (Fraguas & Breathnach, 2009). A leading cause of disability globally and a severe psychotic condition is schizophrenia (Bennett & Rosenheck, 2021). The disease often appears in late adolescence or early adulthood. It frequently results in years of incapacity, significant psychological suffering, social isolation, suicidality, drug misuse, unemployment, dependency on government aid, and homelessness.

Schizophrenia is a severe mental condition that impacts a person’s thoughts, feelings, and actions. People living with schizophrenia may appear to have lost all sense of reality, which may upset them and their loved ones. Participating in everyday activities may be challenging for someone with schizophrenia, but effective therapies are available. Many people undergoing therapy can participate in school or the workforce, become independent, and value their connections with others (National Institute of Mental Health (NIMH), 2021). The condition is complex, protracted, and marked by various symptoms, including hallucinations, delusions, abnormal speech or behavior, and cognitive decline. The disease’s early onset and persistence make it a devastating disorder for many individuals and their families. Disability is typically caused by the interaction of negative symptoms (characterized by loss or deficits) with cognitive symptoms, such as impairments in attention, working memory, or executive function. Positive signs, including suspicion, delusions, and hallucinations, may also cause relapse. Due to the disorder’s inherent heterogeneity, its diagnostic criteria, etiology, and pathophysiology have not been established (Pate, 2014).

The most common type of functional psychosis is schizophrenia. Those with the illness may display various symptoms. Schizophrenia does not cause a split personality, despite how the disease is depicted in the media. Instead, it is a chronic psychotic disorder that affects the patient’s ability to think clearly and feel emotionally stable. A patient’s sickness often interferes with their ability to participate in social activities and form meaningful relationships. Although social withdrawal and other abnormal (schizoid) behaviors often precede a person’s first psychotic episode, other persons may not exhibit any symptoms. Indicative of a psychotic episode are patient-specific signs and symptoms (psychotic features) that reflect the false reality the patient has created in their head. As noted, schizophrenia symptoms are divided into positive, negative, and cognitive categories. Therefore, the psychiatrist must carefully consider each sign to differentiate it from other psychotic disorders, such as schizoaffective disorder, a depressive disorder with psychotic symptoms, and bipolar disorder with psychotic characteristics. Positive signs, which may be called “psychotic acts not observed in healthy individuals,” are the most obvious. These symptoms may include hallucinations, delusions, and abnormal motor behavior with varying degrees of severity. According to the NIMH (2021), each sign is defined. For example:

• Hallucinations : When a person perceives sounds, tastes, smells, or sensations that are not truly present. People living with schizophrenia frequently hear voices. Before family or friends become aware of a problem, those who hear voices may continue to do so for some time.

• Delusions : When someone holds firmly to false ideas that may appear unreasonable to others.

• Abnormal Motor Behavior : When a person has strange or irrational thinking methods. Thought disorders can make it difficult for people to organize their words and ideas. For example, a speaker occasionally stops in the middle of a thought, switches topics abruptly, or uses meaningless phrases. Also, when a person displays strange body motions, people with movement disorders may repeatedly perform specific movements.