While delusional and schizophrenic persons have their ``own world'' to bother, their families are among the people most likely to be affected by the situation. They are the ``real victims'' in all aspects such as financial, psychological, emotional and social burdens and they are the ones who can feel the sufferings caused by the circumstances. Delusional disorder is characterized by one or more false beliefs that persist for at least 1 month and these false beliefs would involve real life situations such as being followed, poisoned, infected, loved or admired at a distance or believe that a lover or spouse is unfaithful.There are different types of delusional disorders: the erotomanic subtypes wherein the delusion is that another person is in love with the individual and the object of the delusion is being contacted through telephone calls, letters or surveillance.
In grandiose type of delusional disorder, the delusional person is certain that he has this extraordinary talent or he has done a great discovery. In the jealous type, the person is believes that his or her spouse or lover is deceiving him or her by having another lover.This belief is based on uncertain evidences and under circumstances, physical attack may be a significant danger. In persecutory type, the person is convinced that someone is spying or harassing him or her and in somatic type, the delusional person is imagining that he has physical deformity or odor.
Delusional disorder starts with paranoid personality disorder. Among the early symptoms includes feeling of being exploited, bearing grudges all the time and being anxious with the loyalty of friends.This disorder does not generally lead to severe impairment but the person will continue having the delusion. A good and honest relationship between the patient and the doctor would help in managing the delusional disorder and if the person is dangerous, he or she needs hospitalization.
Antipsychotic drugs are effective to suppress the symptoms and the long-term treatment is to divert the attention of the patient away from the delusion to a more constructive area though sometimes this approach is difficult to achieve ( The Merck Manuals Online Medical Library , 2003).Schizophrenia is a combination of many different mental dysfunctions such as psychosis. or the loss of contact with the reality, hallucination, delusions, abnormal thinking, flattened affect, weakened motivation and disturbed socialization. It is one of the major health problems worldwide and can persist throughout life. If the patient can not be able to function well in the society, this can lead to abuse, poverty and homelessness and schizophrenic people left untreated may lose contact with their families and friends, finding them living on the streets of cities.The cause of this disorder is unknown, though some current research suggests a combination of environmental and hereditary factors.
Other cause would be an inflicted infection while the mother is pregnant, lack of oxygen at birth, low birth weight and the blood type of the mother and the infant are not compatible. The severity of mental impairment determines the overall disability of the schizophrenic person. The person is unable to think accordingly, unable to interact with people and cannot take care of oneself.These symptoms could be worsen or triggered by the stress from the environment and drug abuse such as marijuana. There is no definite diagnosis for schizophrenia.
The doctor could assess the patient base only on the history and symptoms. Differential diagnosis is carried out through laboratory tests to rule out drug abuse, neurological disorder and hormonal imbalance for the symptom of psychosis. It can be treated with medication, rehabilitation and psychotherapy but if medication is discontinued, recurrence of this disorder might occur ( The Merck Manuals Online Medical Library , 2003).Financial Aspects Healthcare costs, residential care costs, professional billings, prescription medications, administration costs of income assistance plans, costs of incarceration, and productivity losses due to morbidity or premature mortality associated with schizophrenia were among the financial burden, the family and the government are facing. Especially in poor and developing countries with more people suffering from mental problems as a result of poverty, war and outbreak or emerging diseases, treatment among mentally ill persons have to be addressed.Almost 90 percent of people with mental illness in poor countries and developing countries are ignored and untreated (Press, 2007).
Psychological and emotional aspects Upon discovering that a family member has schizophrenia or delusional disorder, other family member would have negative reactions such as confusion, denial, anger, hostility, misunderstanding or even over-protectiveness. These reactions referred to as ``high expressed emotions''. Though some family would show sympathy, compassion and concern without becoming over protective to their family member who is mentally ill.These kinds of positive reactions is called ``low expressed emotions''.
Schizophrenic person living in a family with a high level of expressed emotion are most likely to experience relapse than those living in low expressed emotion households. Some studies also proposed an ``attribution theory'' wherein, those family members and/or relatives who judge the patient as being responsible for his or her ailment has the tendency to show more negative effect (bother, anger, annoyance) and those who do not blame the responsibility of the ailment to the patient will have the tendency to feel positive effect such as sympathy, concern and compassion.This influences the course of schizophrenia though some tend to disagree about it (Lopez, 2004). When the whole family is taught about the psychiatric ailment of the patient and that would result to lower level of expressed emotions in the household, it is said that the family had undergone ``psychoeducation''.
Some family does have different approach in dealing with a family member's illness. Dan Hanson wrote a book about his family's experience entitled Room for J: A Family Struggles with Schizophrenia. He discussed the religious aspect of his son's illness, such as his belief that he is God and how it has affected their own faith.Social Aspects There are some people who are willing to rehabilitate themselves but the stigma of schizophrenia seems to be the barrier.
This disorder is somehow misunderstood and is greatly feared. People confused schizophrenia with split personality or multiple personality and they believe that people suffering from schizophrenia are violent and dangerous. Media publicity had somehow contributed to the impression that most persons with schizophrenia are committing crimes but this is not true because majority of them are not.Some believe that people with schizophrenia have weak personalities and the state of being madness is the patient's own choice of fate while some would say that it is the result of poor parenting, lack of guidance and childhood trauma from past experiences.
One parent stated that when he took her daughter to the hospital, he was accused of abandoning his daughter while another mother said that the clerk in a store did not pay attention to his son when he asked assistance to make a purchase. Some religious groups believed that those people who are inflicted with this disease are those that are punished by God.Who are those willing to help? Due to this mental illness, there are instances that people were not able to continue or find work. The government has allotted funds to assist the person in obtaining basic needs like food, shelter, clothing, medical expenses, etc. for most private insurance policies do not fully cover these expenses. Persons with schizophrenia will be assessed if they may qualify for medical coverage through Social Security Disability depending on the patient's situation.
T he National Alliance for the Mentally Ill (NAMI) implemented the Family-to-Family Education Program in local chapters throughout the United States.A free, twelve week program for family caregivers of persons with severe mental ailment. Other institutions such as VicHealth and the Victorian Department of Human Services, Children of Parents with a Mental Illness (COPMI) and Paying Attention To Self (PATS) aim to provide assistance for the schizophrenia patient and their family. PATS is a peer support group forA young peopleA ages twelve to eighteen years old, whose parents are mentally challenges which aims to give young people the opportunity to meet other teenagers who have similar situations, to learn more about mental health and illness and to explore ways of coping.
In Australia, the Mental Health and Special Programs Branch of the Federal Department of Health and Aged Care commissioned the Australian Infant, Child, Adult Family Mental Health Association (AICAFMHA) to carry out studies regarding the provisions of services to children with parents affected by mental illness and investigate support programs that will be used for future action. Impact to society Estimates of the incidence and prevalence of schizophrenia vary by geographic area and across time.It has been estimated that approximately 24 million people suffer from schizophrenia worldwide, with annual incidence rates of 1-4 per 10 000 adults aged 15-54 years and an average lifetime prevalence of between 0. 5-1%.
Despite affecting only up to 1% of the population, the financial burden of schizophrenia on patients, friends, family members, and the general healthcare system is substantial.The direct costs of schizophrenia are large, ranging from 0. 5% to as high as 3. 5% of national healthcare expenditures. Even larger are the productivity costs (indirect costs) of schizophrenia, with estimates ranging from equivalent to direct costs to up to five times higher than direct costs.
In Canada, despite significant improvements in the past years of medication and therapy, programs and services available for patients with schizophrenia, the economic burden of schizophrenia is still high.Programs that focus on improving patient symptoms and social functioning to increase the participation of the patient in the labor force or production has the potential to make a significant contribution in lowering the cost of this severe mental illness in Canada(Goeree, 2005). In 1990, through the joint force of the World Health Organization (WHO), the World Bank, and Harvard University, they conducted studies about the economic impact of illnesses around the world. It is said that 15% of the burden of the established market economies is accounted for mental illness, including suicide.
While heart disease is known to be the highest economic burden brought to developed nations such as the United States, mental illness ranked as second place. Dr. Dorothy Rice of UCSF found that in both the private and public sector, the total annual cost of mental illness and addictive disorders cost $205 billion and 92 billion of these were allotted for direct treatment and medication while the remaining would be the $113 billion is due to lost in production, some of it was used for the criminal offense and welfare costs (105 billion and 8 billion respectively).Dr.
Rice pointed out that even if unipolar depression is accountable for the biggest fraction of the combined indirect and direct costs, schizophrenia by far responsible for the most direct costs. In 1990, it totaled 17. 3 billion for the direct cost of treatment for individuals with schizophrenia. this comprises the 53. 2% of the total cost.
This is rather astounding considering that the prevalence rate is way too little as compared to the prevalence of anxiety disorders and affective disorders.These only goes to show that providing effective treatments used at the early stage of schizophrenia would have the possibility to control some of the costs associated with this illness (Rice, 1999). Significance in psychological research With the introduction of new treatments available, the attitudes of patients, family members' dispositions and health providers towards biomedical and psychological research can provide valuable trend towards creation of the solutions and for future interventions.This would suggest that the patients, family and psychiatrists are the most important factors to consider in combating this economic and social problem. if they could just strongly support and participate in research studies for the hope and benefits of eradicating this disease in the society. Schizophrenia researches now paying more attention and undertake better understanding of the illness and eventually would gain full information of its cause or causes.
More effective approach with the treatments for patients and more useful support services in the community are now getting in touch with.In the near future, there is the hope of a cure and the responsibility to both private and public sectors is to provide sufficient financial support to come up with these and become reality. Conclusion Government and non-government organizations and psychiatric researches directly and indirectly provide help for the victims as well as for the family members but the involvement of family members is the most important for the treatment of these two disorders. The financial, psychological, emotional and social impact of schizophrenia can be overcome if the family members of the patient have positive outlooks and dispositions.
