Schizophrenia

“ Based on the above considerations, the normal definition of schizophrenia will be given:
Schizophrenia is a technological problem of the brain. The brain cannot build complex models that fit the external reality, and integrate them in a harmonic/logic way in its general structure of models. The function of building and operating short-range models is maintained.
Many times, schizophrenics on the first level (XS1) can be brilliant in the construction of short-range models.
In short, for humans, schizophrenia is short-range thinking. ”

“ Finally, although people with schizophrenia were nearly 20 times more likely to have committed murder than people in the general population, only one in 300 people with schizophrenia had killed someone, a similar risk to that seen in people with substance abuse. ”

“ Ten demographic and clinical variables were extracted from each study to test for any observed heterogeneity in the risk estimates. We identified 20 individual studies reporting data from 18,423 individuals with schizophrenia and other psychoses. In men, ORs for the comparison of violence in those with schizophrenia and other psychoses with those without mental disorders varied from 1 to 7 with substantial heterogeneity (I2 = 86%) . ”

“ Some people believe that schizophrenia and other psychoses are associated with violence, a perception that is often reinforced by news reports and that contributes to the stigma associated with mental illness. ”

“ They then used a “random effects model” (a statistical technique that allows for heterogeneity between studies) to investigate the association between schizophrenia and violence. For men with schizophrenia or other psychoses, the pooled odds ratio (OR) from the relevant studies (which showed moderate heterogeneity) was 4.7, which was reduced to 3.8 once adjustment was made for socio-economic factors. That is, a man with schizophrenia was four to five times as likely to commit a violent act as a man in the general population. ”

“ The ancients of the 20th Century actually looked upon schizophrenia as a disease! Everyone felt it was very shameful to have a schizophrenic person in the family, and, since children lived right with the same parents who had borne them, it was very bad. If you were a schizophrenic child in the 20th Century, you would be locked up behind bars and people would call you—"
Mary blushed and stumbled over the daring word—"crazy." "The ancients locked up strong ego groups right along with weak ones. Today we would lock up those ancient people." ”

“ When one of these life styles is followed for a long time, the person is going to be affected by schizophrenia induced by the environment, which in time can become pathological. This negative phenomenon can be attenuated to a certain extent, because of the permanent changes in society. ”

“ It's not a simple case of schizophrenia that our men get. It's a schizophrenic dream. The system blocks all sensory contacts and speeds up the mind. You know how a person dreams only a few seconds before he wakes up and that dream seems days or weeks long? Can you imagine how much a dream can be speeded up and clarified by drugs, how much a dream can be controlled by hypnotic suggestion, how much experience can be—"
Murphy saw that they were on a street, the tall, angular shadows of strange buildings all around them. He heard a shuffling noise and turned to see Antarians crawling toward them. ”

“ Further and wider experience has taught me that the laws of the Freudian psychology of dreams and the [204] theory of the neuroses must be turned towards the obscurities of schizophrenic thinking. The painfulness of the elaborated complex necessitates a censorship of its expression. [171] This principle has to be applied to schizophrenic disturbance in thinking; and until it has been proved that this principle is not applicable to schizophrenia, there is no justification for setting up a new principle; i.e. to postulate that schizophrenic disturbance of ideas is something primary. ”

“ This symptom is very unusual in true psychosis, but is used by a number of simulators. In schizophrenia, the onset tends to be gradual, delusions do not spring up full-blown over night; in simulated disorders, the onset is usually fast and delusions may be readily available. ”

“ The condition can be treated with a combination of antipsychotic drugs and supportive therapy; hospitalization may be necessary in very serious cases to prevent self harm. Many people with schizophrenia improve sufficiently after treatment to lead satisfying lives although some patients need lifelong support and supervision. ”

“ The studies of Meyer, Hoch, Kraepelin, Freud, Jung, Bleuler and many others have shown that in manic-depressive insanity, dementia praecox and various other psychoses we are dealing with very definite constitutional conditions, morbid temperaments, personality defects, etc., which are responsible for the maladjustments leading to the development of psychoses. Financial reverses, domestic difficulties, the death of near relatives, the ordinary hardships and disappointments of life, even ill health, do not as a rule mean the development of a psychosis in the normal, properly balanced individual. ”

“ In the first place, we must remember that the mental disorder, if it belongs to the group we are discussing here, is the result of a criminal act, and following in its wake, and that therefore the plea of insanity as an excuse for the deed must manifestly be excluded. But may not this type of reaction furnish us an index to the original personality of the culprit? In other words, should we consider an individual absolutely normal, if, in reaction to some stressful situation, he breaks down mentally and develops a psychosis? ”

“ In other types of psychopathic affections the patient is entirely unaware of the whole situation, he is engrossed by the symptoms which he regards as the sum and substance of his trouble; the fear is entirely subconscious. Frights, scares, dread of sickness, instructions associated with fear of the mysterious and unseen, injunctions with fear of punishment or failure in moral standards, enforcement of social customs with dread of failure and degradation,—all go to the cultivation of the fear instinct which in later life becomes manifested as functional psychosis or neurosis. ”

“ The older psychiatry regarded such a complete breakdown, which it labelled acute mania, as the expression of a mere disorderly jumble of disintegrated mental process, but if we look on the whole situation as a means of reacting to the conflict between suppressed instinctive tendencies and controlling forces, it becomes a question whether the acute psychosis, with all its apparent disorder, is not merely the expression of a victory of the instinctive forces running riot after their escape from a lifelong period of suppression and control. ”

“ The events of the last hundred years include more particularly the delimitation and complete differentiation of general paresis, the rise and fall of the paranoia concept, the description of the traumatic psychoses, the establishment of the alcoholic insanities as clinical entities, a study of the mental diseases due to endogenous and exogenous toxins, the recognition of the neuroses and psychoneuroses in their modern sense, the addition of the psychopathic personalities to our classification and the definition of manic-depressive insanity, dementia praecox and involutional melancholia. ”

“ The disease picture, even when it appears, has a certain duration and independence. The whole course of the disease is quite narrowly limited in time, and goes on either to recovery or dementia. 6. No tendency to periodicity of the attacks or the grouping of symptoms. 7. Sanity and insanity are sharply defined, and in striking contrast." In this group he includes mania, melancholia, acute curable dementia and primary [492] hallucinatory delirium. He describes hysteria, neurasthenia, etc., under the psychic degenerations with paranoia and speaks of them as constitutional neuroses. ”

“ We shall be able from the very outset to recognize that a disorder, in all appearance slight and which is not deeply set, presents a bad prognosis, and we shall be able to foresee a serious and deep psychosis in the future. ”

“ Hallucinations frequently met in the infection-exhaustion psychoses, in dementia, in paranoia, in acute hallucinosis of alcoholism. Disorders of Ideation Hypochondriasis found in many of the hypersuggestible, frequent in the mild depressions and in all victims of self-attention. Retardation found in most depressions. Deficiency as in idiocy—the inability to form new concepts. Acceleration as in hypo-mania. Poverty as in the abnormally self-centered; as in melancholia. Rambling ideas as in chronic insanity. Flight of ideas as in manias, hysterias, and acute deliriums. ”

“ How many times has it fallen to my share to soothe and counteract the fear instinct of panic-stricken psychopathic patients! A psychogenetic examination of every case of functional psychosis brings one invariably to the fundamental fear instinct.
Conflicts, repressions, imperfections, sex-complexes, sex-aberrations, and others do not produce psychopathic symptoms or neurotic states. It is only when mental states become associated with an exaggerated impulse of self-preservation and an intensified fear instinct that neurosis arises. ”

“ Each psychosis repeats in itself, in tendency form at least, the essential stages in the evolution of consciousness. Every psychosis rises from the pure pleasure-pain as the lowest level of mentality like a wave, and like a wave falls back into it again. Every wave of consciousness, whether it rises slowly or rapidly, whether it subsides gradually or violently, rises from pure subjectivity and comes back to it again. ”

“ The principal psychoses represented by 12,252 admissions of that class were as follows: alcoholic psychoses, 9.25 per cent; dementia praecox, 25.0 per cent; senile psychoses, 3.16 per cent; general paresis, 6.06 per cent; manic-depressive psychoses, 10.14 per cent; arteriosclerosis, 3.23 per cent; epilepsy, 1.85 per cent; and without psychoses, 20.63 per cent.
This latter class (without psychosis) is looked upon by some as constituting the most important field of a psychopathic hospital. It is exceedingly interesting to note the conditions which bring such individuals to the institution. ”

“ Then fear, with its physiological manifestations, is always an obtrusive element. Individuals who suffer from this psychosis sometimes cannot even come into the presence of strangers or any public situation without experiencing an attack of symptoms such as I have somewhat schematically described. The phenomena may be summarized as bashfulness, emotion of fear, inhibition, dissociation, limitation of the field of consciousness, ideas of self, confusion of thought and speech, inappropriate and delayed response, delusions of suspicion, tremor, palpitation, etc. ”

“ However, you are not unknown to me. I have heard you well-spoken of; and I remember that, when you were a student in Paris, you were mentioned with honor by the college, for an able paper read before the open section upon the very subject to [13] which I now propose to direct your attention,—mental disease," he added, after a moment's hesitation.
"A case of insanity?" bluntly asked the doctor.
"Heaven forbid! And yet I must not conceal from you that I fear it."
"Give me some of the symptoms. Insanity in strong development, or aberration of faculties, or hallucination?" ”

“ From a medical point of view the existence of a psychosis, if associated with a consequent judgment defect, emotional instability, disturbance of volition, intellectual deterioration, delusional and particularly persecutory control, hallucinatory trends, ideas of reference, etc., is of itself quite sufficient to explain criminal acts in the insane. ”

“ Now, too, though the intellect is not frequently judged insane, so that pubescent insanity is comparatively rare, the feelings, which are yet more fundamental to mental sanity, are most often perverted, and lack of emotional steadiness, violent and dangerous impulses, unreasonable conduct, lack of enthusiasm and sympathy, are very commonly caused by abnormalities here. Neurotic disturbances, such as hysteria, chorea, and, in the opinion of some physicians, sick-headache and early dementia are peculiarly liable to appear and become seated during this period. ”

“ A well defined type of psychosis which as a rule develops gradually and is characterized by the following symptoms: Impairment of retention (forgetfulness) and general failure of memory more marked for recent experiences; defects in orientation and a general reduction of mental capacity; the attention, concentration and thinking processes are interfered with; there is self-centering of interests, often irritability and stubborn opposition; a tendency to reminiscences and fabrications. Accompanying this deterioration there may occur paranoid trends, depressions, confused states, etc. ”

“ Though there is no unanimity about this among health care professionals, we will distinguish between these two kinds of problems by calling a psychosis a mental illness, as opposed to an emotional disorder. It is a matter not only of degree but of kind. A person who is severely depressed or extremely anxious is usually still able to communicate rationally, and distinguish what is real from what is fantasy or delusion. ”

“ According to materialism, psychosis is a product of neurosis; but according to monism, neither is psychosis a product of neurosis, nor is neurosis a product of psychosis, but neurosis is psychosis. They are identical. What an external observer might perceive as a neurosis of my brain, I should at the same moment be feeling as a [466] psychosis. The neurosis is the outer or objective aspect; the psychosis is the inner or subjective aspect.
It is almost impossible to illustrate this assumption by any physical analogies. ”