Doctors and scientists use case studies as a way to figure out what treatments work the best for people afflicted with schizophrenia. Of course, no two schizophrenics are exactly alike, and it is also true that there are different forms of this mental illness. In fact, the same individual may suffer from different types of schizophrenia during different periods of her life.
Cognitive-Behavioral Schizophrenia Case Study
John F. Nash is certainly the most famous contemporary individual who suffered from repeated and severe bouts of schizophrenia over the course of many years. It is very interesting to note that he eventually might be described as having willed himself cured through what Dr. Richard Warner calls a self-applied course of cognitive-behavioral therapy. If you read John Nash’s biography, you may get the idea that he did not care for psychiatrists much, but it is good to know that psychiatrists hold Mr. Nash in high esteem.
Of course, most afflicted individuals, and most people, do not possess the mental power of a Nobel Laureate. That is why the book that Dr. Warner reviewed, Schizophrenia: Cognitive Theory, Research, and Therapy, presents a schizophrenia case study of how Mr. Nash seemed to figure out how to apply CBT to himself, and then goes on to elaborate on the theoretical and treatment practices so psychiatrists can help their own patients achieve positive outcomes.
Longitudinal Case Study: Schizophrenia in Cannabis Users and Non-Users
The first longitudinal case study of cannabis and schizophrenia follows Swedish conscripts. It draws a strong correlation between episodes of schizophrenia in cannabis users. The case compared people who reported using cannabis more than ten times and those who did not use cannabis. The risk of developing schizophrenia, in this population, was 4.1 times higher among the drug users and the non-users. No other drug was reported in use by the study’s population.
Furthermore, there was no evidence of true mental illness in any of the subjects before the drug was used. The pattern for the onset of this mental illness also seemed to be different and more abrupt for the cannabis users. The researchers said that there did not seem to be much difference in the users and non-users in the number of closely related schizophrenics in their family background, but that the users tended to come from poorer families.
However, another cannabis and schizophrenia case study reviewed a number of case studies on this hypothesis and arrived at different conclusions. This review reported that there was little evidence that schizophrenics were strongly attracted to marijuana. It also reported that there was no good evidence that there was a link between cannabis use and schizophrenia spectrum disorders (SSD) and marijuana use. The study concluded that it might be reasonable to conclude, from the evidence, that cannabis may prompt psychosis in a small minority that happens to be vulnerable to the onset of mental illness.
What Else Has Been Learned From Longitudinal Case Studies of Schizophrenia?
Broad case studies can help doctors and scientists learn more about this mental illness, yet schizophrenia remains mysterious in many ways.
- While 1/2 to 2/3 of schizophrenia sufferers suffer from chronic mental illness, the rest have a varied course.
- At the time of the initial schizophrenia diagnosis, there are no clear course predictors.
- One problem with reviewing historical case studies is that diagnostic methods and standards have changed over time.
- Treatments have also changed, hopefully for the better, so it might be hard to predict the course of a patient today from a similar patient outcome a decade ago.
Still, doctors do use case studies in order to predict patient outcomes, and these predictions are generally more accurate than not. However, they are also so simple that they might also be considered intuitive, and not the result of years of studies.
For example, these factors may predict a more positive outcome:
- Shorter duration of symptoms before treatment
- Shorter loss of normal functional behavior before treatment
- Less functional deterioration
- No family history of symptoms
Smarter people tend to have a better chance of recovery.
It is also interesting to note that higher IQs tended to correlate with a higher probability of positive outcomes. Perhaps smarter people are generally more able to understand and use CBT (cognitive behavioral therapy) to help will away their delusions. Of course, that relates back to the case study of John Nash who seemed to teach himself how to perform CBT on himself. Of course, everybody who enjoys a positive outcome does not have to be a genius, but brighter people may be better able to work with therapists to apply these methods.
Women have a more positive recovery rate too.
Case studies have also demonstrated that women have a higher rate of positive outcomes than men do. In general, men have a higher risk of developing this mental illness in the first place. It is not clearly understood why the female gender offers some protection against schizophrenia, but it clearly appears to. Women, in general, might have better social support systems in place than men do. A good social support system has been demonstrated to be one positive indicator in the course of this disease.
Negative Schizophrenia Case Study Indicators
Through the course of many schizophrenia case studies, some indicators are negative. This means that these indicators may indicate a higher risk of developing this mental illness. Once it has developed, these indicators are less favorable for eventual recovery. However, for reasons that are not clearly understood, some people may have almost all of these negative indicators and never develop any symptoms.
- Males: Men are 1.4 times more likely to develop symptoms than women.
- Family history: A close family member with schizophrenia is one of the strongest indicators.
- Cannabis Use: It is not known if this drug encourages symptoms in a small minority of people who happen to be vulnerable. It might be that people with early symptoms are actually drawn to this drug for its benefits in protecting them from psychosis.
- Early Onset: Individuals who suffer an earlier onset are less likely to enjoy a positive outcome.
- Body Type: There was a large Swedish case study of over a million men that found an inverse correlation between height and BMI and the risk of developing schizophrenia.
This is but an overview of the discussion. As always, there is more to come!