Early-onset Schizophrenia Essay Sample

Early-onset Schizophrenia Essay Sample

While it is most common for the onset of schizophrenia to present itself in adult years, there has been a recent desire for scholars to investigate early interventions of early-onset schizophrenia (EOS) amongst adolescent years of life. The adolescent years within this literature review will be defined as the years between 12 to 18. Because adolescent’s is a crucial period in development of brain functioning both physically and psychologically, the cause of concern for early intervention upon the first signs of EOS deserves further research and awareness. The effectiveness of approaching early intervention, specifically psychosocial interventions through a whole-person wellness model is likely to predict positive outcomes for those threatened by psychotic symptoms. To clarify, the review aims to focus and bring attention to the problem of solely based prescriptive methods and address the benefits of psychosocial interventions including: therapeutic, family, and spiritual interventions particularly beneficial to the early detection of schizophrenic symptoms. Early-onset Schizophrenia Essay Sample

As schizophrenia maintains its complexity in its diagnosis, the illness reveals itself in what is known as both positive and negative symptoms. Positive symptoms can be defined as “unusual thought content, suspiciousness/persecutory ideas, hallucinations or abnormality in perceptions, and disorganized communication. While negative symptoms include social withdrawal, avolition, expression of emotion, self-neglect, and interruption in occupational functioning” (Algon et al., 2012). With study’s suggesting further investigation in early interventions (Armando et al., 2015, Claxton et al., 2017), it is essential for the individuals’ support system to be aware of the prodromal period, or in other words, the initial signs of deterioration in personal functioning. The prodromal period is characterized through “nonpsychotic symptoms like early symptoms of depression and anxiety, irritability, insomnia, eccentric behavior, and negative symptoms like apathy, social withdrawal, impaired concentration, and memory related issues” (Kulhara et al., 2008). Amongst adolescents with early-onset schizophrenia, it is common to find that each individual has their own set of symptoms and is presented differently over their period of development. As stated above, the adolescent years are a crucial time for development in which symptoms are often mistaken as a growing phase or an ‘adolescent crisis’, often leading to a misinterpretation of the adolescent expressing signs of mental illness. The further issue contrived by misidentification merely delays interventions needed for the youth and often takes up to two years for the family members to seek guidance after these first signs (Kulhara et al., 2008). In addition, findings suggest the “duration of untreated psychosis may be a predictor of poor outcomes in first-episode psychosis, therefore early and appropriate treatment is crucial (Cullen et al., 2008). These studies suggest the importance of early recognition of symptoms in order to conduct immediate and necessary treatment to either delay or even prevent further deterioration and onset of psychosis. Early-onset Schizophrenia Essay Sample
According to recent study’s, it is necessary for early identification of those who are at risk of developing psychosis or are in fact in the early stages of the illness, whilst maintaining effective treatment options to support them (Claxton, 2017). Learning more through recent evidence-based literature about effective treatment options will aid those involved in making an easier transition into engaging services. It is important to address the family as the primary audience in this review seeking a well-rounded model of treatment in EOS. While it is known that pharmacological means of treatment are highly recommended and have their benefits, research suggests these treatments alone have limited production of functional and long-lasting recovery (Hollis, 2013) Further, a rise in interest of psychosocial intervention is recognized as a key component of a comprehensive plan of approach for schizophrenia (Armando, 2015). In addition, usual treatments are based around the biopsychosocial model similarly to many other mental illnesses. Accompanied with medication and psychosocial interventions addressed in the literature, there is little attention focusing on the benefits of spiritual and religious practices considered to aid patients in prevention and recovery. Studies have evaluated these practices portraying evidence in spirituality as having a significant role in the wellness of many (Grover et al., 2014). Therefore, acknowledgment of spiritual practices derived from recent studies deserves further evaluation in EOS. Becoming aware of these basic interventions outside the bounds of medication will aid families in addressing early detection and break down the stigma wrapped around mental illness.Early-onset Schizophrenia Essay Sample
This literature review will seek to advance early intervention research by helping the family members of adolescent-onset schizophrenia examine and discover effective psychosocial intervention techniques and bring light to the risk factors in solely prescriptive methods. Thus, highlighting the benefits of a whole-person model approach in treatment. In a culture where medication has become a frontline approach to wellness, it is crucial to recognize the growing evidence revealing improved outcomes, reduction of symptoms and increased recovery through psychosocial modes of intervention in EOS and suggestive spiritual integrations.
The Problem
Schizophrenia is known to have a tremendous impact upon an individual’s functioning capabilities whether at the onset in child and adolescents or in adult years. In the targeted population, adolescent years prove to be a crucial period of development. Therefore, structuring goals and a comprehensive treatment plan intended to intervene early enough to reduce the ultimate severity of future outcomes is essential (Kulhara et al., 2008). With suggestive estimates ranging from one in four persons converting into schizophrenia from their prodromal state (Kulhara et al., 2008), there begs the question of what interventions or combinations of which modify behavior in the safest ways? As it remains difficult to predict which patients with premorbid symptoms will go on to develop schizophrenia, pharmacologic strategies in early-intervention continues its path in controversy (Algon et al., 2012). Given the possible risks of false identification and prescribing antipsychotics to those who are at the time not psychotic (Schaffner et al., 2001), may expose such individual’s to long-term susceptibility of further mental deterioration. Through psychosocial interventions, those that do not chemically alter brain functioning resulting in prescriptive methods, may help to breakdown the stigma in this devastating mental illness and give credit to alternative, less intimidating, early interventions.Early-onset Schizophrenia Essay Sample
Psychosocial Interventions
A growing inspiration of studies in psychosocial interventions have made its way into fields of research. Due to a correlation in less adverse effects recognized through these types of interventions, it is suggested for psychosocial means to be taken into consideration first until further clarification of efficacy in pharmacological approaches are identified (Algon et al., 2012). In regard to therapeutic means of intervention, cognitive therapy (CT) and cognitive-behavioral therapy (CBT) has been a key area of focus in the literature. As a technique to challenging distorted cognitive views and empowering individuals to strengthen problem solving skills, CT and CBT have been reviewed through extensive studies. Resulting from these studies, it has been identified that such therapies provide benefits to the suggested population (Algon et al., 2012). Further, “the National Institute for Clinical Excellence guidelines recommend that individual CBT is offered to all people with a diagnosis of schizophrenia” (Haddock et al., 2014).
The overall predictability of positive outcomes through therapeutic interventions can be overwhelming through copious amounts of evidence found in recent literature. Family and wraparound coordinators would benefit greatly to include these techniques in their service engagements for their youth. Addington et al. (2011) conducted a study with youth to analyze CBT interventions. It was found that supportive therapeutic techniques along with CBT would be essential in early treatment in adolescents targeting positive symptoms (Addington et al., 2011). This study is helpful in revealing improvements within the adolescent population overtime with the help of supportive therapy. Although therapeutic interventions have shown to provide positive outcomes and reduction in relapse in EOS youth, further qualifying psychosocial interventions are worthy of acknowledgment.Early-onset Schizophrenia Essay Sample
Not only can the early-onset of schizophrenia negatively impact the adolescent individual. It has often shown to impact the family now taking on the burden of identifying, adapting to, and living in proximity to the individual. The family comes to be a key element of early interventions due to the adolescent most likely living at home during the first signs and symptoms. Family support is particularly relevant in early detection as the heavy burden falls upon the family as the primary care taker. According to Claxton et al. (2017) responses to the condition and symptoms by the family has recognizable influence on the course of illness development. For example, family reactions such as frequent critical comments, hostility, and highly expressed emotions have significantly increased effects of negative outcomes in the patient. In order to achieve the desirable outcomes for the individual suffering with the onset of schizophrenia, a balance of intervention in the family would have a significant appeal.
It is evident through literature that the effectiveness of family intervention along with other forms of intervention and treatment reduces rate of relapse and family burden (Lee & Schebb, 2013). Family interventions seek to address both the individual and family through multiple forms of delivery. These could either be in the form of multiple family settings or individualized family sessions providing a space for evidence-based talk therapy modalities. Claxton et al. (2017) & Onwumere et al. (2011) define the intention of these measures as a desire to establish open communication to improve understanding of the illness at hand and the emotional toll upon family dynamics. While then promoting adaptive coping skills and strengthening relapse resistant measures. Further, participants invest in “information sharing (Psycho-education), problem-solving, emotional processing, stress management and communication” (Claxton et al., 2017). Evidence is provided across the board in relation to efficacy of family interventions. In past review and evaluation, a study conducted by Bird et al. (2010) found a significant decrease in relapse and hospitalizations of the adolescent preceding services in family interventions. In support of these findings, improved carer outcomes and continued indication of decreased relapses were also found in a follow up study most recently (Lee & Schepp, 2013; Claxton et al., 2017). Although further research is needed to identify exact components related to increased positive outcomes often clouded by the individual differences in situations, the given evidence supports the efficiency of family intervention in hopes to aid the individual into long-lasting recovery.
Lastly, an understudied area of intervention and positive influence for those facing the treacherous hardship of schizophrenia lies within spiritual integration. Why spiritual and religious practices remain outside of the biopsychosocial model remains in question and is cause for further evaluation.


In recent studies, these religious and spiritual practices of any origin or design have shown significant positive impacts on the direction of outcomes in schizophrenia (Grover et al., 2014, Revheim et al., 2010, Mohr et al., 2007). Facing life’s challenges in itself can be a difficult task for an individual of all walks of life. Developing coping skills has been an essential piece to overall wellbeing. Assistance through these challenging feats instill desired attention in multiple modalities including spiritual practices.Early-onset Schizophrenia Essay Sample.  According to studies, “Instilling hope and personal empowerment are values shared with those who favor the inclusion of spiritual coping for treatment of serious mental illness” (Kenhoe, 1999). Spiritual coping is a term used frequently within the literature and has been referred to as the “functionally oriented expressions of religion in times of stress” (Grover et al., 2014). Although it is not required in religious and spiritual practices, social groups have shown their benefits in social involvement and inclusion for adolescents with EOS. Evidence shows that religion/religiousness in patients with schizophrenia is associated with increased social integration, withdrawal from use of substances and reduction in the risk of suicide (Grover et al., 2014, Mohr et al., 2006). Recognizing spiritual coping as a valuable asset, submersion into faith-based practices may reflect a need in an under looked intervention.
Recovery often speaks of hope, personal advocation, education and responsibility as a primitive model. Hope has been a widely discussed topic in areas of addiction, medical practice, growth through trauma and so on. Adolescent populations threatened by the scarcity of mental illness need hope to feel recovery from early-onset schizophrenia is an attainable measure. Revheim et al. (2010) examined potential associations in feelings toward coping and spiritual integration in patients with diagnosis in schizophrenia. Participants were significantly more hopeful then those who did not have spirituality as a coping strategy and offered positive findings supporting spirituality as a qualifying system in recovery (Revheim et al., 2010). Limitations within this study did not specify their population in the adolescent range and places demand for further evaluation in a similar testing. Limited existing research proves to show higher rates of positive treatment outcomes with the support of spiritual integration (Grover et al., 2014). Therefore, early interventions of EOS may benefit greatly from growing research in spirituality in order to develop efficacy of future positive outcomes.Early-onset Schizophrenia Essay Sample

Through this review it is evident that adolescent phases of life have a great impact on outcomes of development in personal functioning. Children and adolescents have attracted researchers over the years addressing early signs of mental illness. This study aimed to focus on early interventions of schizophrenia within these early years due to significant personal and social developmental risks correlated to the onset of schizophrenia. The literature evaluated has produced strong evidence furthering effectiveness and efficacy of psychosocial interventions and spiritual integration in EOS. Through extensive research, further acknowledgment and attention of these topics are needed. Other areas of discussion said to have great influence on the topic of early intervention for early-onset schizophrenia such as treatment resistance, sensitivity to the effects of antipsychotic medications, additional cognitive impairment, schizophrenia and schooling, economics and much more were not evaluated within this literature review. However, these factors have a great influence upon the approach to treatment and deserve future study, assessment and attention. Awareness of service users with schizophrenia are on the rise in which it is time for society to be called into action. Whether family, care giver or observer, it is important to understand early signs and symptoms leading to mental illness and have the necessary tools to guide and intervene before further damage can be done for our youth.Early-onset Schizophrenia Essay Sample


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