Symptoms of schizoaffective disorder

Background:

In the film Glimmer, protagonist David Helfgott is an authentic exemplory case of someone who suffers from schizoaffective disorder. Right away of the film we are able to see the correctness of this diagnosis through David's childhood upbringing and his romantic relationship with his abusive father. This will further be attended to throughout this paper and adequate samples will be stated to further show the perfection of the identification.

Symptoms:

Symptoms of Schizoaffective Disorder which may be seen in David include that of onset. According to William H. Murray, "the period of time between past due adolescence and early adulthood are the peak years for the onset of the schizoaffective disorder" (21), and that it is very seldom diagnosed in years as a child. David exhibited no signs or symptoms of mental disorder during his young child years and experienced a severe mental break around era 14 or 15. He was later hospitalized at a psychiatric ward during his early adulthood years. Clearly, these periods tend to be the most significant in a person's cultural development and can be seriously disrupted by disease starting point.

Schizoaffective disorder is a mental disorder characterized by recurring episodes of feeling disorder and psychosis (Murray, 8). David will display a few periods of depressive disorder in the film, specially when he allows his daddy down by dropping several piano contests. David's father, Peter, unveils that his dad never allowed him to play any devices and places most of his own personal lifelong dreams on the shoulder blades of his son. Anytime David manages to lose, his father will tell him how displeased he's and hounds him to "Get!" "Win!" "Win!" the next time. Having such continuous pressure from his father, David commences experiencing sadness during childhood.

David's depression continues to nurture itself as he struggles to have out the prodigy son career his dad has at heart for him. Around age 14, David is victorious a competition and gets asked by musician Isaac Stern to study music in the us. David's dad forbids him to visit for personal selfish reasons which becomes the turning point in both the film and the partnership of both father and son characters. David has a mental malfunction that happened from agitation, guilt, anxiety, fatigue, panic, trend, pressured talk, suicidal ideation, trend, among other things. These emotions were stirred up by not only the abusive and tremendous pressure exerted by David's daddy, but also by the lack of love he proved to David. David was constantly striving to please his father and solely concerned himself with Pete's joy and ambitions, overlooking his own. This created a great let down when David gained the competition and the prize, yet still his father had not been satisfied in the manner or level David had predicted. All of those emotions brought on David's breakdown.

David's mania, says of abnormally enhanced or irritable mood, arousal, and/or energy (Murray, 41) further added to the symptoms he possessed for schizoaffective disorder. In his college or university years, David started out having hallucinations about doing before crowds where he'd either faint or practically die. His father had expressed that David play Rachmaninoff which is the hardest piano part to play and very rare that a pianist can play the part well. While thoroughly practicing the piece, David displays extreme paranoia and irrationality as a result of expectation that can be played the piece perfectly. David exhibits symptoms of mania such as increased activity with little need for sleep, race thoughts, rapid speaking and inflated self-esteem at times. David exhibits excessive restlessness when practicing pieces for performances and during the whole film he displays guilt or self-blame by verbally reassuring himself aloud: "We performed well tonight. Perfectly. Very well. "

David gets the symptom of disorganized conversation. He's constantly repeating fragments throughout the film and this exhibits his disordered thinking. David even shows up incoherent at times, when he gets lost and stumbles across strangers at a club. David also posses the grossly disorganized patterns symptom; he cannot dress himself and his family members have to button his shirt and put on his shoes for his big shows. David does weep frequently throughout his battle to confirm himself to his dad and also later on to overcome his own problems with learning music records, being disowned by his daddy, and also defeat his disorder, so that he can marry and re-start his musical profession.

Many guideline outs were encountered in the identification of David. In schizophrenia for example, mood shows have been thought to be absent or less visible than in schizoaffective disorder (Akiskal, 76). David was not controlled by an outside power that drove him to have unnecessary delusions and hallucinations. His mental ranking was caused by the disregard of obtaining his father's love and also by his neurotic and perfectionist drive to be the best and practice too much.

Agoraphobia was eliminated because David didn't avoid the public and could play in front of large crowds and in available spaces. He did not have that personal "safe place" that agoraphobics have a problem escaping from. Autism was also eliminated because David did not have severe impaired communal interaction and there were no indicators of a problem present during his childhood, as is often the circumstance with Autism (Saddock, 54). Clinical depressive disorder was ruled out as the sole source because although David does experience depressive shows, his self-esteem was almost always exceptionally high during the film.

Finally dissociative disorder was eliminated because David didn't struggle with 2 personalities, but more of 2 selves within: one whom wished to give everything to please his father and the other who wished to live his own life independent of his father's opinions. Obsessive compulsive disorder was also ruled out because David did not have any rituals or repeated behaviors (other than verbal) and was not paranoid of his verbal repetitiveness.

Epidemiology:

Estimates of the prevalence of schizoaffective disorder change greatly, but schizoaffective patients appear to consist of 3-5% of psychiatric admissions to typical clinical centers. At one point it was broadly presumed that schizoaffective disorder was associated with an increase of risk of disposition disorders in relatives. This might have been due to range of patients with psychotic ambiance disorders who have been included in schizoaffective review populations. The existing diagnostic criteria identify several people with a mixed hereditary picture. They are more likely to have schizophrenic relatives than individuals with mood disorders, but more likely to have family with ambiance disorders than individuals with schizophrenia. (Saddock, 502).

Co-occurring stress and anxiety disorders are comorbid with schizoaffective disorder. Anxiousness may also play a role in the subjective experience and thus form the individual's delusional thought content (Murray, 23). This is obvious in David's tendencies when he commences to feel troubled in regards to a performance and thinks that another person will win over him. His nervousness is so severe at some items that he is covered in sweating and sweat is almost 'pouring' off him, all over his hands and the piano secrets.

Lifetime prevalence is believed at 0. 5% to 0. 8%. Era of onset is comparable to schizophrenia (later teens to early 20s) and schizoaffective patients are much more likely than schizophrenics, but not as likely than mood-disordered patients to truly have a remission after treatment (Podosyan, 2007).

When David was untreated, he would sleep inadequate because he was struggling to fall asleep and was frantically checking the papers or string smoking. David experienced a difficult paying attention and focusing on what was not his music. At times he showed difficulties with logical reasoning (he would not wear jeans in consumer) and impulse control (he grabbed a woman's breast and kissed her, having only been released to her). These problems with considering are what known as cognitive deficits and offer with our professional functions (Murray, 24).

Without treatment, individuals with the disorder may further aggravate in the delusional thought processes and become further alienated from people and contemporary society (Murray, 24), With extensive treatment, a lot of people with schizoaffective disorder may recover much, most or even all of their functionality (Akiskal, 8).

In the film, it made an appearance that the cultural difference in Europe was that there is more of a stigma associated with David's disorder. This was evident in having less knowledge and understanding people possessed about his disorder and after he came back from treatment, people felt hesitant that he still possessed the same performing abilities and talents from his youthful, pre-treatment times.

Etiology:

It is suspected that the analysis signifies a heterogeneous band of individuals, some with aberrant types of schizophrenia plus some with very serious types of ambiance disorders (Saddock, 502). There may be little evidence that schizoaffective disorder is a distinct variety of psychotic illness. As a result, the disorder appears to exist over a continuum in-between schizophrenia and bipolar disorder and severe recurrent unipolar despair. It follows then that the etiology is probably more similar to that of schizophrenia in some instances and more comparable to severe feeling disorders in other situations (Murray, 213).

In the movie, David's family (specifically daddy) added greatly to the onset of his disorder, although he himself only viewed minor types of neuroses and perfectionism and not schizophrenia or schizoaffective disorder. Many different genes may be adding to the genetic risk of acquiring this illness (Podosyan 2007).

The NOTCH4 gene is situated at 6p21. 3, a niche site which several studies have shown an exceedingly strong connection between this gene polymorphisms and schizophrenia patients (Ujike, 2001). In addition, many different biological and environmental factors are believed to interact with the person's genes in way which can increase or reduce the person's risk for expanding schizoaffective disorder. Schizophrenia spectrum disorders have been marginally linked to advanced paternal time at the time of conception, the reason behind mutations (Dark brown, 159).

Many mental health factors may have enjoyed into David's disorder. His psychological claims were constantly changing from bad to worse and it appeared as though he cannot get an emotional period of time from his father's continuous pressure. David was more often than not anxious about doing flawless on level and he was so motivated to win that when he does lose, it was more of a blow to his esteem because he was not well prepared for a loss.

David's sociocultural factors included the stigma from his peers in college or university. He was socially awkward at times and it was problematic for him to try female before his prognosis and later on he appeared to overcompensate for his shyness by operating inappropriately to stranger by either kissing them or grabbing their breast. David also experienced peer jealousy because his professors adored him and observed the immense probable inside him and this may have influenced the other student's behaviour towards him. Heading away to school to review music have help him experience what it was like to be a young man from his own, from his father. It's possible this might have created more anger and resentment towards his father.

Neuropsychology:

David possessed exceptional memory skills because he was plainly in a position to memorize lengthy pieces of music and play them for large crowds with ease. During his young days, he paid attention to what his daddy wished; his music trainers and professors asked of him and undoubtedly his music. It had been not until after treatment that David started out noticing what he sought and made a decision to get wedded and pick up playing the piano again.

David's level of sensitivity was very high throughout parts of the complete film. He was hypersensitive to his competition and wished them good fortune; he was very sensitive of the particular audience considered his performing and almost all of all he was extremely sensitive of his father's would like on a regular basis. This created an obsession to please him when the truth is that was not possibly.

Treatment:

Treatment for schizoaffective disorder consists of a blend of medication, psychotherapy and psychosocial treatment focused on restoration (Saddock, 97).

A psychiatrist will suggest medicine for the average person. Each individual responds in another way to medication and sometimes a combo of medicines may be prescribed.

For psychotic symptoms, preferably one, but sometimes neuroleptic medications are approved (Brannon). Examples of neuroleptic medications include Olanzapine, Risperidone, Quetiapine, Aripiprazole, and Ziprasidone (Saddock, 143). For manic symptoms, feelings stabilizer medications may be prescribed plus a neuroleptic (lithium salt or carbamazepine) and then for despair, antidepressant medications (SSRI or a ambiance stabilizer like Lamictal) may be prescribed along with a neuroleptic (Saddock, 145).

If patients are suicidal, homicidal, or gravely disabled, say that them to an inpatient psychiatric product. . . patients who've schizoaffective disorder can greatly reap the benefits of psychotherapy as well as psycho educational programs (Brannon). Patients should get therapy which involves their families, produces their interpersonal skills and focuses on cognitive rehabilitation. . . . . psychotherapies will include supportive therapy and assertive community remedy in addition to specific and group types of therapy and treatment programs (Brannon).

Family involvement is necessary and incredibly effective in the treatment of this specific disorder. Treatment includes education about the disorder and its own treatment, family assistance in conformity with medications and meetings, and maintenance of structured day to day activities (i. e. , agenda of daily situations) for the individual (Saddock 147).

Early treatment with medication, along with good premorbid function often boosts outcomes (Brannon). As with every disorder, the earlier the detection, the better chances for reduction. If patients aren't a hazard to themselves or to others, they are encouraged to continue their normal regimens and reinforce their public skills whenever you can (Brannon).

In the film David is not shown taking any medications but is highly likely is on medication during his psychiatric remedy. During psychiatric therapy, his family appointments him regularly for support and he is later permitted to go live along with his sister after he's released. It really is at this point we're able to observe how effective medication and psychotherapy have been for David during the last 20 years or so. Once he gets into real life, his social skills have changed much that his can meet a woman, have a relationship with her and finally marry. He also starts to try out the piano again, and takes on regularly for customers of a local restaurant, and years later profits to experiment with at concerts for the general public. David does discuss at one point of the movie that he received electroshock therapy and was also forbidden to move near any pianos to avoid playing and relapsing most of his hallucinations and stress. David's recovery really shows how successful someone with schizoaffective disorder can be after treatment. It is absolutely amazing to watch this man come back to where it started to where he started out as a kid (playing in concert halls) and become happy with his life.

Works Cited:

  • Akiskal, Maneros. The Overlap of Schizophrenic and Affective Spectra. New York: Cambridge School Press. (2007)
  • Brannon, Person, M. D. Schizoaffective Disorder: Treatment and Medication. http://emedicine. medscape. com/article/294763-treatment (June 3 2009)
  • Hicks, S. (Developer & Director). (1996) Glimmer [Film]. Australia: New Brand Home Cinema.
  • Murray, William. Schizoaffective Disorders: New Research. New York: Nova Knowledge Publishers, Inc. (2006)
  • Podosyan, Gevetg. Schizoaffective Disorder. www. health. am/psy/more/schizoaffective_disorder/ (December. 7, 2007)
  • Saddock, VA. Synopsis of Psychiatry. NY: Lippincott, Williams &Wilkins. (2007).
  • Ujike, Hiroshi, et al. NOTCH 4 Gene Polymorphism and Susceptibility to Schizophrenia and Schizoaffective Disorder. www. Scinecedirect. com (2001)

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