1534 kumar shivam1, amir riyaz khan1 international vol 8 (1)

Psychosocial symptoms and therapy aspects of Schizophrenia
1

Airo International Research Journals January, 2017
Volume VIII, ISSN:2320-3714
Kumar Shivam1
, Amir Riyaz Khan1
, Narendra Pratap Singh2
, Balwant Kishan Malik1
,
Pankaj Taneja1
*
1
Department of Biotechnology, School of Engineering and Technology
Sharda University, Greater Noida U.P.; India
2
Department of Psychiatry Patna Medical College and Hospital
*
Corresponding and co-first author: Associate Professor, Department of Biotechnology, School
of Engineering and Technology, Sharda University
Email: pankaj.taneja@sharda.ac.in
Abstract
Schizophrenia is a disorder with characteristic feature of diminished hippocampus volume. The
disease exhibits signs of hallucinations, confusion, emotional distress and mental retardation.
Besides medication, Psychotherapy is also suggested for treatment Schizopherinia. This review
discusses psychosocial symptoms and related therapy aspects of Schizophrenia.
Keywords: Schizophernia, Psychosocial, therapy
Introduction
Schizophrenia is a severe issue which influences how a man considers, feels and acts. Somebody
with schizophrenia may experience issues recognizing what is genuine and what is nonexistent;
It might be lethargic or pulled back; and may experience issues communicating ordinary feelings
in social circumstances. Points of view may likewise be complicated and the inspiration to take
part in life's exercises might be blunted. Those with the condition may hear nonexistent voices
and believe others are perusing their brains, controlling their contemplations or plotting to
mischief them [1]. The vast majority with schizophrenia experiences the ill effects of indications
either constantly or discontinuously all through life and are regularly seriously trashed by
individuals who don't comprehend the sickness [2]. Individuals with schizophrenia don't have
"split" or various identities and most represent no risk to others [3, 4]. Individuals with

3
schizophrenia endeavor suicide more frequently than individuals in the all-inclusive community,
and evaluations are that up to 10 percent of individuals with schizophrenia will commit a suicide
in the initial 10 years of the sicknessespecially young fellows with schizophrenia [5]. While
schizophrenia is an incessant issue, it can be treated with prescription, mental and social
medications, generously enhancing the lives of individuals with the condition[6].
Indian scenario
The most initial depictions of this disorder in India was made by the Ayurvedic physician
Charaka more than 3300 years’ prior in the content Charaka samhita. This was consistent with
the depictions in Greek medical writing by Hippocrates[7]. Along these lines, India's
commitment to schizophrenia explore has not been substantive. The Madras longitudinal study is
a historic point about on course and result of schizophrenia [8]. The patients have been followed
up from the primary onset for a long time and the study has created a ton of data on related
factors like mortality, occupations, marriageetc. [9]. The investigation of the principal scene
psychoses at the Schizophrenia Research Foundation (SCARF), Chennai, India, when contrasted
and a Canadian study with a comparative specimen has hurled some intriguing multifaceted
findings [10]. Both the studies have repeated the need to encouragecognizance about which thus
will encourage early discovery and aversion of chronicity and incapacity. The care facility of in
hospitals for mental patients is terribly insufficient to give proper attention. While some non-
government organizations (NGOs) run group based focuses of care and recovery, these are very
few. In a freshly decided randomized control trial in India where the usefulness of a cooperative
community based care in which a community health worker (CHW) stop at the home of the
patient to convey mediations was related with skill centered care for persons having
schizophrenia, it was realized that the involvement of the CHW was satisfactory and actual
specially within patients who were showingsymptoms and had greater disability. The possibility
of an efficacy of conveying psychosocial involvements through CHWs was also
recognized[11].Basic techniques for recovery are laid down by group of volunteers who were
organized in acknowledging, differentiating with there mental issues playing at the level of
restoration. Recovery has additionally been encouraged by systems administration with
legislative and non-legislative associations required in social and formative exercises. The NGOs
additionally set out on group based projects, which albeit viable and financially savvy were

constantly confined by their reliance on time-constrained funding. Joint efforts with NGOs are
viewed as an essential way to deal with contact a wide geographic range, with a common
financial responsibility of the coordinated effort. There have likewise been a few developments
in the conveyance of group care. One of these has been the utilized as portable tele-psychiatry by
the Schizophrenia Research Foundation. A transport fitted with portable gear has been conveying
psychological well-being consideration to the number of inhabitants in a piece of Pudukottai
district and broadly acknowledged by the neighborhood populace [12]. The people group based
projects have experienced poor assignment of assets, cold-heartedness to the necessities of
individuals with emotional sickness with respect to both experts and arrangement organizers, and
impassion to psychological well-being all in all maintainability and progression of projects,
particularly by NGOs are to a great extent restricted as most projects are time-bound activities,
dependent upon the subsidizing assets[13]. The need in our nation is to make the District Mental
Health Program (DMHP) more compelling and productive, advance more group construct
administrations lessening the reliance with respect to enormous clinics and decreasing shame.
Living with schizophrenia is no simple matter for people with the confusion and their families.
Regardless of the presentation of numerous new antipsychotics in the most recent decade, there
still stay a few patients who don't react well to prescriptions. Schizophrenia can likewise create
boundless handicaps and insufficiencies in people [14]. In spite of the fact that the rationally
debilitated are additionally qualified for welfare benefits like different gatherings of
handicapped, this procedure is yet to increase uniform force in all conditions of the nation [15].
Schizophrenia is a serious mental issue influencing numerous human resources and working.
Progresses in research hold a great deal of guarantee, yet until a ponder medication is discovered,
we have to address the social and mental issues in patients and families. Government strategies
and projects should be equipped to upgrading offices in the group for these people and enhance
mindfulness about this condition which thus will encourage early treatment and social
consideration.. Accordingly, India's commitment to schizophrenia inquire about has not been
substantive. The Madras longitudinal study is a historic point concentrate on course and result of
schizophrenia. The patients have been followed up from the primary onset for a long time and
the study has created a considerable measure of data on related factors like mortality,
occupations, marriage etc.

5
Psychological Symptoms
The initial symptoms of schizophrenia generally look like unclear, or even dreadful, deviations
in conduct. Handling with the indications can be speciallypuzzling for family fellows who recall
how vibrant and present a person was before sickness. The signs of schizophrenia are
characterized into three groups: positive, negative, and disorganized. Signs may include the
presence of two or more of the following for no less than one week. [16].Constructive side
effects allude to the nearness of insane practices not seen in sound individuals. Individuals with
positive side effects frequently "lose touch" with reality. These indications can go back and forth.
At times they are serious and at different times scarcely perceptible, contingent upon whether the
individual is getting treatment [17].
Hallucination
Hallucination is anordeal including the evident impression of something not present. "Voices"
are the most widely recognized sort of mind flight in schizophrenia. Numerous individuals with
the turmoil hear voices. The voices may converse with the individual about his or her conduct,
may arrange the individual to do things, or caution the individual of peril. In some cases, the
voices converse with each other. Individuals with schizophrenia may hear voices for quite a
while before family and companions see the issue. Different sorts of mental trips incorporate
seeing individuals or articles that are not there, noticing smells that nobody else distinguishes,
and feeling things like undetectable fingers touching their bodies when nobody is close [18].
Movement disorder
Development issue may show up as fomented body developments [19] A man with a
development issue may rehash certain movements again and again. In the other extraordinary, a
man may get to be mental. Mental shock is a state in which a man does not move and does not
react to others [20]. Mental shock is uncommon today, however it was more regular when
treatment for schizophrenia was not accessible. Voices" are the most widely recognized kind of
mind flight in schizophrenia [21].

Negative Symptoms
Negative manifestations are connected with disturbances to typical feelings and practices these
side effects are harder to perceive as a component of the confusion and can be mixed up for
sadness or different conditions[22]. These manifestations incorporate the accompanying: "Level
effect" (a man's face does not move or he or she talks in a dull or tedious voice) Lack of delight
in regular day to day existence Lack of capacity to start and maintain arranged exercises
Speaking close to nothing, notwithstanding when compelled to associate [23]. Individuals with
negative side effects require help with regular undertakings. They regularly disregard essential
individual cleanliness[24]. This may make them appear to be lethargic or unwilling to help
themselves, yet the issues are manifestations brought on by the schizophrenia [25].
Cognitative symptoms
Psychological side effects are unpretentious [26]like negative indications, intellectual side effects
might be hard to perceive as a major aspect of the turmoil. Frequently, they are identified just
when different tests are performed[27]. Subjective manifestations incorporate the accompanying:
Poor "official working" (the capacity to comprehend data and utilize it to decide). Trouble
centering or focusing. Problems with "working memory" (the capacity to utilize data quickly in
the wake of learning it). Subjective side effects regularly make it difficult to lead an ordinary life
and procure a living. They can bring about extraordinary enthusiastic trouble [28].Symptoms can
be different depending on the type of schizophrenia.Paranoid sorts regularly feel restless, are all
the more frequently furious or pugnacious, and erroneously trust that others are attempting to
mischief them or their friends and family[29].Catatonic sorts have issues thinking and
communicating their thoughts plainly, regularly display virtuous conduct, and habitually indicate
little feeling[30]. Catatonic sorts might be in a steady condition of agitation, or they may not
move or be underactive. Their muscles and stance might be unbending. They may scowl or have
other odd outward appearances, and they might be less receptive to others[31]. Undifferentiated
sorts may have indications of more than one other kind of schizophrenia[32]. Residual sorts
encounter a few side effects, however not the same number of as the individuals who are in an
out and out scene of schizophrenia [33]. Other symptoms may include absence of inspiration
(abolition) the patient loses their drive. Ordinary activities, for example, washing and cooking,

7
are relinquished. Poor articulation of feelings - reactions to glad or tragic events might need, or
unseemly. Social withdrawal - when a patient with schizophrenia pulls back socially, it is
regularly in light of the fact that they trust some individual is going to damage them. Ignorant of
disease - as the fantasies and dreams appear to be so genuine for patients, a hefty portion of them
may not trust they are sick. They may decline to take prescription because of a paranoid fear of
reactions, or for dread that the pharmaceutical might be toxic substance, for instance.
[35]Intellectual challenges - the patient's capacity to think, recollect things, prepare, and to sort
out their life are influenced. Correspondence turns out to be more troublesome [36].
Types of Schizophrenia
Catatonic schizophrenia
Catatonic schizophrenia alludes to an arrangement of side effects that may create in a few
patients with schizophrenia. It can incorporate periods where the individual moves next to no and
does not react to directions. At the flip side of the outrageous, the individual can show
movements that is viewed as "inordinate" and "unconventional, for example, echolalia (imitating
sounds) or Echopraxia (mimicking developments). This is called catatonic excitement[37].
Symptoms of catatonic schizophrenia
Mental schizophrenia is much rarer than it used to be because of enhanced medications. Mental
states are currently more prone to be found in sorts of emotional instability other than
schizophrenia, for example, neurodevelopment (conditions that influence kids amid the
improvement of their sensory system), insane bipolar, or depressive issue. People with mental
shock may flip amongst diminished and over the top movements [38]. With present day
medicines, patients with mental schizophrenia can deal with their indications less demanding,
making the probability of driving a more joyful and more advantageous life much more
prominent [39].The clinical picture of mental shock is commanded by no less than three of the
accompanying side effects: Stupor - no psychomotor movement, no communication with nature ,
Catalepsy - incorporates receiving uncommon stances,Waxy adaptability - if an analyst places
the patient's arm in a position, they will keep up this position until it is moved once more
,Mutism - constrained verbal reactions ,Negativism - next to zero reaction to directions or outside

jolts ,Posturing - effectively holding a stance against gravity ,Mannerism - doing odd,
misrepresented activities,Stereotypy - dull developments without an obvious reason ,Agitation -
for no known reason,Grimacing Echolalia - imitating someone else's discourse. Echopraxia -
imitating someone else's developments [40]Without legitimate treatment, a mental scene can
hold on for quite a long time or even weeks. Cognitive troubles - the patient's capacity to focus,
recollect things, prepare, and to arrange is influenced and correspondence turns out to be more
troublesome. Patients with the side effects of mental schizophrenia are not typically ready to get
restorative help all alone [41]. Frequently, it is a relative or companion who looks for medicinal
offer assistance. [42]. Age of guardians during childbirth - more seasoned guardians have a
higher danger of having kids who create schizophrenia. [43]Drugs - the utilization of
medications that influence the brain amid pre-adulthood may build the danger of creating
schizophrenia [44].
Reason for cationic schizophrenia
No one is certain what the reasons for mental schizophrenia are. Researchers demonstrates that
most types of schizophrenia are brought on by ill functioning of brain, we simply don't know
why that happens. No doubt, it is created by a mix of hereditary qualities and ecological triggers.
Specialists trust that a lopsidedness of dopamine, a neurotransmitter, is included in the onset of
schizophrenia. They trust that this lopsidedness is in all probability brought about by qualities
that make somebody vulnerable to the disease. A few specialists say the levels of different
neurotransmitters, similar to serotonin, may likewise be included [45].
Complication of cationic schizophrenia
Untreated mental schizophrenia can bring about issues of a wellbeing, budgetary, behavioral, and
lawful nature, these issues may influence all aspects of the patient's life. Entanglements can
include: Depression, self-destructive considerations, self-destructive conduct - a noteworthy
number of patients with schizophrenia have times of discouragement, Malnutrition, Hygiene
issues, Substance manhandle - which may incorporate liquor, doctor prescribed medicines, and
illicit medications. Untreated mental schizophrenia can bring about issues of a wellbeing, money
related, behavioral, and legitimate nature - these issues may influence all aspects of the patient's
life. Inconveniences can include: Depression, self-destructive musings, self-destructive conduct -

9
a critical number of patients with schizophrenia have times of misery. Malnutrition, Hygiene
issues, Substance mishandle which may incorporate liquor, professionally prescribed
pharmaceuticals, and unlawful medications. Inability to discover or look after occupation, can
bring about destitution and vagrancy[46].
Childhood schizophrenia
Childhood schizophrenia, also known as very early-onset schizophrenia, is a rare and severe
form of the mental disorder. The condition is defined as schizophrenia that starts in children
younger than 13 years of age (and usually over seven years of age), and apart from age of onset
and severity, it is much the same as adultschizophrenia [47].
Disorganized Schizophrenia (Hebephrenic)
Disorganized schizophrenia, or hebephrenic (hebephrenic schizophrenia) is one of a few
subtypes of schizophrenia, an unending (long haul) dysfunctional behavior - it is thought to be an
extraordinary articulation of complication disorder that has been conjectured to be one element
of a 3-factor model of schizophrenia manifestations [48]. The others variables being
fancies/visualizations (reality twisting) and psychomotor neediness (poor discourse, absence of
unconstrained development, and blunting feeling). Disorganized schizophrenia is described by
unintelligible and strange contemplations and practices; at the end of the day, excluded,
disturbed, and purposeless conduct. Specialists say complicated schizophrenia is a more extreme
schizophrenia sort on the grounds that the patient can't perform day by day exercises, for
example, planning suppers and dealing with individual cleanliness (washing). As indicated by
the analyst and specialist individuals will most likely be unable to comprehend what the
individual with confused schizophrenia is stating [49, 50].
Paranoid schizophrenia
Paranoid schizophrenia is a subtype of schizophrenia in which the patient has hallucinations
(false convictions) that a man or a few people are plotting against them or individuals from their
family [51]. Paranoid schizophrenia is the most well-known schizophrenia sort [52]. The
dominant part of individuals with suspicious schizophrenia, as with most schizophrenia subtypes

may likewise have sound-related fantasies [53]. They hear things that are not genuine [54]. They
may likewise have hallucinations of individual loftiness a false conviction that they are much
more prominent and more effective and persuasive than they truly are [55]. A person with
neurotic schizophrenia may invest an unbalanced measure of energy concocting methods for
shielding themselves from their persecutors [56].
Commonly, a man with paranoid schizophrenia has less issues with memory, dulled feelings and
fixation contrasted with those with different subtypes; which permits them to think and capacity
all the more effectively[57]. All things being equal, disorganized schizophrenia is an incessant
(long haul, deep rooted) condition which may in the long run prompt difficulties, including self-
destructive considerations and conduct [58].
Risk factor
There are a few components that add to the danger of creating schizophrenia. Qualities and
environment. Scientists have long realized that schizophrenia now and then keeps running in
families[59]. Notwithstanding, there are numerous individuals who have schizophrenia who
don't have a relative with the turmoil and alternately, numerous individuals with one or all the
more relatives with the confusion who don't create it themselves [60]. Researchers trust that a
wide range of qualities may build the danger of schizophrenia, yet that no single quality causes
the confusion without anyone else. It is not yet conceivable to utilize hereditary data to foresee
who will create schizophrenia [61].Researchers likewise surmise that collaborations amongst
qualities and parts of the individual's surroundings are fundamental for schizophrenia to create.
Natural variables may include [62] Presentation to infections. Lack of healthy sustenance before
birth, issues amid birth.
Psychosocial elements
Scientists believe that a lopsidedness in the intricate, interrelated compound responses of the
mind including the neurotransmitters like dopamine and glutamate, and perhaps others, has a
significant rolein schizophrenia [63].A few specialists likewise think issues amid mental health
before birth may prompt broken associations. The cerebrum likewise experiences real changes

11
amid pubescence, and these progressions could trigger maniacal side effects in individuals who
are helpless because of hereditary qualities or mind contrasts.
Schizophrenia Statistics
Schizophrenia is the most serious of the maladjustments and can influence all sorts of life,
including observation, thought, judgment, inclination, drive and at last, identity. Around fifteen
individuals in each thousand will be influenced over their lifetime.
Cause for Schizophrenia
The correct reasons for schizophrenia are obscure, yet research recommends that a mix of
physical, hereditary, mental and natural variables can make individuals more inclined to build up
the condition. Current deduction is that a few people might be inclined to schizophrenia, and a
distressing or enthusiastic life occasion may trigger a maniacal scene. Notwithstanding, it's not
known why a few people create indications while others don't. Moreover, various
hazardousagentsmay cause schizophreniathrough hereditarymeans. Schizophrenia tends to keep
running in families, however nobody quality is thought to be dependable. It's more probable that
distinctive blends of qualities make individuals more defenseless against the condition. In any
case, having these qualities doesn't really mean you will create schizophrenia. This is genuine
regardless of the possibility that they are raised independently [64].
Mental health
Investigations of individuals with schizophrenia have appeared there are inconspicuous contrasts
in the structure of their brains. These progressions aren't seen in everybody with schizophrenia
and can happen in individuals who don't have an emotional sickness. In any case, they propose
schizophrenia may incompletely be a confusion of the cerebrum. [65]
Neurotransmitters
These are chemicals that convey messages between cerebrum cells. There is an association
amongst neurotransmitters and schizophrenia since medications that change the levels of
neurotransmitters in the mind is known to calm a portion of the manifestations of schizophrenia.

Research recommends schizophrenia might be brought on by an adjustment in the level of two
neurotransmitters: dopamine and serotonin. A few studies show a lopsidedness between the two
might be the premise of the issue. Others have found an adjustment in the body's affectability to
the neurotransmitters is a piece of the reason for schizophrenia [66].
Pregnancy and birth entanglements
Studies have demonstrated that individuals who suffer from schizophrenia will probably have
encountered inconveniences before and amid their introduction to the world, for example, a low
birth weight, untimely work, or an absence of oxygen (asphyxia) amid birth. It might be that
these things subtly affect mental health [67].
Triggers
Triggers are things that can make schizophrenia create in individuals who are at hazard. The
principle mental triggers of schizophrenia are upsetting life occasions, for example, a loss, losing
your employment or home, a separation or the end of a relationship, or physical, sexual,
passionate or racial mishandle. These sorts of encounters, however upsetting, don't bring about
schizophrenia, yet can trigger its advancement in somebody effectively helpless against it [68,
69]
Medicate mishandle
Medications don't straightforwardly bring about schizophrenia, however studies have indicated
that tranquilize abuse builds the danger of creating schizophrenia or a comparable disease.
Certain medications, especially cannabis, cocaine, LSD or amphetamines, may trigger
manifestations of schizophrenia in individuals who are vulnerable. Utilizing amphetamines or
cocaine can prompt psychosis and can bring about a backslide in individuals recouping from a
prior scene. Three noteworthy studies have demonstrated adolescents under 15 who utilize
cannabis routinely, particularly "skunk" and other more powerful types of the medication, are up
to four times more inclined to create schizophrenia by the age of Schizophrenia is ten times more
regular than AIDS, bed demise and melanoma consolidated. It is assessed that schizophrenia
costs the group in any event $2.5 billion every year in direct costs, which can be increased

13
commonly to represent the circuitous expenses. The larger part of individuals will create
schizophrenia between the ages of 15 and 30 - amid their most developmental years.
Nonetheless, this normal does not prohibit more youthful or more seasoned individuals from
creating schizophrenia. Around 5 - 10% of individuals determined to have schizophrenia will end
their own particular lives. This is around 12 times the national normal and implies that roughly
18,000 Australians alive today will suicide as a consequence of schizophrenia. Schizophrenia
influences both guys and females alike, in any case, onset regularly happens prior in men than in
ladies and marginally a bigger number of men than ladies are influenced [70].
Diagnosis of schizophrenia
Diagnosing schizophrenia is troublesome in light of the fact that there is no single manifestation
which is one of a kind to schizophrenia and there are no conclusive blood tests or sweeps for the
turmoil. Making a determination as of now requires perceiving a heavenly body of
manifestations for no less than 6 months. Seeing weakening in the level of working of the
individual with the indications, and also 'precluding' other conceivable clarifications for the
watched unsettling influence[71].There are two noteworthy frameworks right now utilized for
the finding of schizophrenia, Statistical Manual of Mental Disorders [72] and the International
Classification of Disease[73]. These characterizations have enhanced the unwavering quality of
finding. Symptomatic and Statistical Manual of Mental Disorders (DSM) Criteria for
Schizophrenia [74].Horribly disordered or mental conduct is accompanied as side effect
comprising mind damage and voice keeping low. There is also Social/Occupational Dysfunction,
critical unattendiveness to work and interpersonal relations [75]. Hence there is unsettling
behavior symptoms of odd convictions, uncommon perceptual encounters and hallucinations,
schizoaffective confusion [76,77].Hallucinations of control, impact person involvement by
plainly alluding the body or appendage developments or particular considerations, activities or
sensations, and silly discernment[78,79].Constant mental tips in any methodology, when joined
by either momentary or half-framed fancies lead to tenacious over-esteemed thoughts over time
[80]. Breaks of interjections in the line of reasoning, bringing about incongruity or unessential
discourse or neologisms [81,82]. Negative manifestations create lack of discourse and blunting
of confusion in Schizophernia. Schizophrenia is the most extreme of the emotional sicknesses

and can influence all circles of life, including discernment, thought, judgment, state of mind,
drive and at last, identity [83].
Therapy Aspects
Besides medication, psychotherapy is alsorecommended in Schizopherinia. It includes treatment
modalities, music, craftsmanship and body-arranged psychotherapy[83]. Subjective upgrade
treatment is also recommended . This is done by intellectual remediation. It shows individuals
how to better perceive meaningful gestures, or triggers, and enhance their consideration,
memory, and capacity to arrange their contemplations [83].Moreover Electroconvulsive
treatment (ECT) is used to treat extreme melancholy. Here and there, they additionally utilize it
to regard other emotional instabilities, for example, schizophrenia. ECT is one of the quickest
and best approaches to soothe side effects in seriously discouraged or self-destructive individuals
or the individuals who have craziness or other emotional sicknesses [84]. Doctors may also use
ECT to ease other symptoms of schizophrenia, such as delusions, hallucinations, or disorganized
thinking[85].The creative process, as well as of human development, psychological, and
counseling theories, are widely used in hospitals, psychiatricand rehabilitation facilities,
wellness centers, forensic institutions, schools etc in treating these Schizophernia patients.
Research supports the use of arttherapy within a professional relationship for the benefits gained
through artistic self-expressionand reflection for individuals who experience illness, trauma, and
mental healthproblems and those seeking personal growth[86].The National Alliance on Mental
Illness (NAMI) is an effort association that offers a free peer-to-peer program from time to time
for treating mentally retarded people [87]. They use workmanship treatment using different
methodologies, for example, Person-Centered, Cognitive, Behavior, Gestalt, Narrative, Adlerian
procedures and family discussion thus cultivating mindfulness, and self-improvement
[87].Neuroimaging inspects in patients with schizophrenia have revealed information about
masochist neural circuits that could be used as sensible targets using significant cerebrum
affectationand deep brain stimulation (DBS) therapy[88,89]. In spite of the way that not yet
attempted in patients with schizophrenia, DBS is in early stage clinical trials in other psychiatric
issue[89]. Hence DBS is treatment is given to schizophrenia subjects who have ineffective all
other therapeutic alternatives and have serious severe condition. [90,91].

15
Acknowledgements
The authors are thankful to Sharda University and DBT project funding for publication of this
article. There is no conflict of interest of this article.
References
1 Amering, Michaela, and Margit Schmolke. Recovery in mental health: reshaping
scientific and clinical responsibilities. Vol. 7. John Wiley & Sons, 2009.
2 Moore, Laurie J., and James K. Boehnlein. "Posttraumatic stress disorder, depression,
and somatic symptoms in US Mien patients." The Journal of nervous and mental
disease 179, no. 12 (1991): 728-733.
3 Spiegel, David, and Etzel Cardeña. "Disintegrated experience: the dissociative disorders
revisited." Journal of abnormal psychology 100, no. 3 (1991): 366.
4 McDougle, Christopher J., Janice P. Holmes, Mary R. Bronson, George M. Anderson,
Fred R. Volkmar, Lawrence H. Price, and Donald J. Cohen. "Risperidone treatment of
children and adolescents with pervasive developmental disorders: a prospective, open-
label study." Journal of the American Academy of Child & Adolescent Psychiatry 36, no.
5 (1997): 685-693.
5 Levine, Stephen Z., Shelly Bakst, and Jonathan Rabinowitz. "Suicide attempts at the time
of first admission and during early course schizophrenia: a population based
study." Psychiatry research 177, no. 1 (2010): 55-59.
6 Australian, Royal. "Royal Australian and New Zealand College of Psychiatrists clinical
practice guidelines for the treatment of schizophrenia and related disorders." Australian
and New Zealand Journal of Psychiatry (2009).

7 Thara, R., R. Padmavati, and V. Nagaswami. "Schizophrenia in India. Epidemiology,
phenomenology, course and outcome." International Review of Psychiatry 5, no. 2-3
(1993): 157-164.
8 Thara R. Twenty-five years of schizophrenia: The Madras 10. longitudinal study. Indian J
Psychiatry 2012; 54 : 134-7.
9 Iyer SN, Mangala R, Thara R, Malla AK. 11. Preliminary findings from a study of first-
episode psychosis in Montreal, Canada and Chennai, India: comparison of outcomes.
Schizophr Res 2010; 121 : 227-33.
10 Patel V, Thara R. 12. Meeting the mental health challenges: role of NGO initiatives. New
Delhi: SAG E Publications; 2003.
11 Patel V, Thara R. 12. Meeting the mental health challenges: role of NGO initiatives. New
Delhi: SAG E Publications; 200311 Murthy RS. National mental health programme in
India 13. (1982-1989) mid-point appraisal. Indian J Psychiatry 1989; 31 : 267-70
12 Chatterjee S, Naik S, John S, Dabholkar H, Balaji M, Koschorke 14. M, Varghese M, et
al. Effectiveness of a community-based intervention for people with schizophrenia and
their caregivers in India (COPSI): a randomised controlled trial. Lancet 2014; 383 : 1385-
94.
13 Thara R, Islam A, Padmavati R. Beliefs about mental illness : 15. a study of a rural south-
Indian community. Int J Ment Health 1998; 27 : 70-85.
14 Chatterjee, Sudipto, Aravind Pillai, Sumeet Jain, Alex Cohen, and Vikram Patel.
"Outcomes of people with psychotic disorders in a community-based rehabilitation
programme in rural India." The British Journal of Psychiatry195, no. 5 (2009): 433-439.

17
15 Thara, Rangaswamy, and Ramachandran Padmavati. "Community mental health care in
South Asia." World Psychiatry 12, no. 2 (2013): 176-177.
16 Schultze-Lutter, Frauke. "Subjective symptoms of schizophrenia in research and the
clinic: the basic symptom concept." Schizophrenia bulletin 35, no. 1 (2009): 5-8.
17 Rigg, Robert. ARE THERE NO PRISONS?" MENTAL HEALTH AND THE
CRIMINAL JUSTICE SYSTEM IN THE UNITED STATES." U. Denv. Crim. L. Rev. 4
(2014): 103-131.
18 Cavanna, Andrea Eugenio, Serena Servo, Francesco Monaco, and Mary May Robertson.
"The behavioral spectrum of Gilles de la Tourette syndrome." The Journal of
neuropsychiatry and clinical neurosciences 21, no. 1 (2009): 13-23.
19 Crang, M., Crang, P.and May, J. 1999: Virtual geographies: bodies, space and
relations. London and New York: Routledge. Google Scholar CrossRef
20 Donald W. Goodwin, MD; Randall Rosenthal, MDArch Gen Psychiatry. 1971;24(1):76-
80. doi:10.1001/archpsyc.1971.01750070078011.
21 Green, Michael Foster. Schizophrenia revealed: from neurons to social interactions. WW
Norton & Company, 2001.
22 Nordgaard, Julie, and Josef Parnas. "Self-disorders and the schizophrenia spectrum: a
study of 100 first hospital admissions." Schizophrenia bulletin(2014): sbt239.
23 Lezak, Muriel D. "The problem of assessing executive functions." International journal
of Psychology 17, no. 1-4 (1982): 281-297.
24 Shah, Pritesh G., and Bharti W. Gawali. "Functional Magnetic Resonance Imaging and
Schizophrenia as Disconnection Disorder." International Journal of Advanced Research
in Computer Science 4, no. 4 (2013).

25 Sharma, Tonmoy, and Lena Antonova. "Cognitive function in schizophrenia: deficits,
functional consequences, and future treatment." Psychiatric Clinics of North America 26,
no. 1 (2003): 25-40.
26 A Olley, G Malhi, P Sachdev - Journal of Affective Disorders, 2007
27 Mayer, Richard E. "Multimedia learning: Are we asking the right
questions?." Educational psychologist 32, no. 1 (1997): 1-19.28 SJ Zuchowski, B
28 Zuchowski, Steven J., and Brian Kirkpatrick. "Schizophrenia Spectrum and Other
Psychotic Disorders." In Problem-based Behavioral Science and Psychiatry, pp. 377-402.
Springer International Publishing, 2016.
29 Sass, Louis A. "Self-disturbance and schizophrenia: Structure, specificity, pathogenesis
(Current issues, New directions)." Schizophrenia research 152, no. 1 (2014): 5-11
30 Coch, Donna, and Daniel Ansari. "Thinking about mechanisms is crucial to connecting
neuroscience and education." cortex 45, no. 4 (2009): 546-547.
31 Sass, Louis A. "Self-disturbance and schizophrenia: Structure, specificity, pathogenesis
(Current issues, New directions)." Schizophrenia research 152, no. 1 (2014): 5-11.
32 Garety, Phillip A., Elizabeth Kuipers, David Fowler, Daniel Freeman, and P. E.
Bebbington. "A cognitive model of the positive symptoms of psychosis." Psychological
medicine 31, no. 02 (2001): 189-195.
33 Garety, Phillip A., Elizabeth Kuipers, David Fowler, Daniel Freeman, and P. E.
Bebbington. "A cognitive model of the positive symptoms of psychosis." Psychological
medicine 31, no. 02 (2001): 189-195.
34 Berkowitz, Ruth, Rosemarie Eberlein-Fries, Liz Kuipers, and Julian Leff. "Educating
relatives about schizophrenia." Schizophrenia bulletin 10, no. 3 (1984): 418-429.

19
35 Green, Michael F. "Cognitive impairment and functional outcome in schizophrenia and
bipolar disorder." The Journal of clinical psychiatry 67, no. 10 (2006): 12-18.
36 Friedman, Howard. "Perceptual regression in schizophrenia: an hypothesis suggested by
the use of the Rorschach test." The Pedagogical Seminary and Journal of Genetic
Psychology 81, no. 1 (1952): 63-98.
37 Abrams, Richard, and Michael Alan Taylor. "Catatonia: a prospective clinical
study." Archives of General Psychiatry 33, no. 5 (1976): 579-581.
38 Calagé, Carla, Raphael Dalleo, Luis Duno-Gottberg, Clevis Headley, and David Nicholls.
"Haiti in the Americas Graduate Seminar, Fall 2014 Course description."
39 R Tandon, HA Nasrallah, MS Keshavan - Schizophrenia research, 2009 – Elsevier
40 Hartelius, Lena, Maria Jonsson, Anneli Rickeberg, and Katja Laakso. "Communication
and Huntington's disease: qualitative interviews and focus groups with persons with
Huntington's disease, family members, and carers." International journal of language &
communication disorders 45, no. 3 (2010): 381-393.
41 Del Hierro Gangotena, Andrés. "Estudio de la eficacia de la terapia cognitivo conductual
para el tratamiento de un paciente con ataques de pánico e hipocondríasis." (2013).
42 Jablensky, Assen V., Vera Morgan, Stephen R. Zubrick, Carol Bower, and Li-Anne
Yellachich. "Pregnancy, delivery, and neonatal complications in a population cohort of
women with schizophrenia and major affective disorders." American Journal of
Psychiatry 162, no. 1 (2005): 79-91.
43 Chambers, R. Andrew, Jane R. Taylor, and Marc N. Potenza. "Developmental
neurocircuitry of motivation in adolescence: a critical period of addiction
vulnerability." American Journal of Psychiatry (2003).

44 Taylor, Michael Alan, and Max Fink. "Catatonia in psychiatric classification: a home of
its own." American Journal of Psychiatry 160, no. 7 (2003): 1233-1241.
45 Nsamenang, Sheri A., Jameson K. Hirsch, Raluca Topciu, Andrew D. Goodman, and
Paul R. Duberstein. "The interrelations between spiritual well-being, pain interference
and depressive symptoms in patients with multiple sclerosis." Journal of behavioral
medicine 39, no. 2 (2016): 355-363.
46 Nsamenang, Sheri A., Jameson K. Hirsch, Raluca Topciu, Andrew D. Goodman, and
Paul R. Duberstein. "The interrelations between spiritual well-being, pain interference
and depressive symptoms in patients with multiple sclerosis." Journal of behavioral
medicine 39, no. 2 (2016): 355-363.
47 Jablensky, Assen. "The diagnostic concept of schizophrenia: its history, evolution, and
future prospects." Dialogues Clin Neurosci 12, no. 3 (2010): 271-287.
48 Jablensky, Assen. "The diagnostic concept of schizophrenia: its history, evolution, and
future prospects." Dialogues Clin Neurosci 12, no. 3 (2010): 271-287.
49 PF Liddle - Seminars in general adult psychiatry, 2007 - books.google.com
50 Van Leeuwen, James M., Sara Adkins, Tavia Mirassou-Wolf, Wendi K. Schweiger, and
Ryan Grundy. "An evaluation of the Mental Health Facilitator programme in rural
Uganda: Successes and recommendations for future implementation." Journal of
Psychology in Africa 26, no. 3 (2016): 288-299.
51 Kambeitz-Ilankovic, Lana, Eva M. Meisenzahl, Carlos Cabral, Sebastian von Saldern,
Joseph Kambeitz, Peter Falkai, Hans-Jürgen Möller, Maximilian Reiser, and Nikolaos
Koutsouleris. "Prediction of outcome in the psychosis prodrome using neuroanatomical
pattern classification." Schizophrenia research 173, no. 3 (2016): 159-165.

21
52 Ellett, Lyn, Daniel Freeman, and Philippa A. Garety. "The psychological effect of an
urban environment on individuals with persecutory delusions: the Camberwell walk
study." Schizophrenia research 99, no. 1 (2008): 77-84
53 Navarro, Papuico, and Korina Eiko. "Características estereotípicas que intervienen en el
proceso de evaluación de candidatos electorales." (2015).
54 NA Rector, N Stolar, P Grant - 2011 - books.google.com
55 Hartman, David E. "Wechsler Adult Intelligence Scale IV (WAIS IV): return of the gold
standard." Applied neuropsychology 16, no. 1 (2009): 85-87.
56 Ginzburg, Karni, Cheryl Koopman, Lisa D. Butler, Oxana Palesh, Helena C. Kraemer,
Catherine C. Classen, and David Spiegel. "Evidence for a dissociative subtype of post-
traumatic stress disorder among help-seeking childhood sexual abuse survivors." Journal
of Trauma & Dissociation 7, no. 2 (2006): 7-27.
57 Tandon, Rajiv, Henry A. Nasrallah, and Matcheri S. Keshavan. "Schizophrenia,―just the
facts‖ 4. Clinical features and conceptualization." Schizophrenia research 110, no. 1
(2009): 1-23.
58 Hinduja, Sameer, and Justin W. Patchin. "Bullying, cyberbullying, and suicide." Archives
of suicide research 14, no. 3 (2010): 206-221.
59 Plomin, Robert, John C. DeFries, Valerie S. Knopik, and Jenae Neiderheiser. Behavioral
genetics. Palgrave Macmillan, 2013.
60 Konstantareas, M. Mary, and Terri Hewitt. "Autistic disorder and schizophrenia:
Diagnostic overlaps." Journal of autism and developmental disorders 31, no. 1 (2001):
19-28.

61 Tsuang, Ming T., William S. Stone, and Stephen V. Faraone. "Genes, environment and
schizophrenia." The British Journal of Psychiatry 178, no. 40 (2001): s18-s24.
62 Tsuang, Ming. "Schizophrenia: genes and environment." Biological psychiatry 47, no. 3
(2000): 210-220.
63 Shah, Pritesh G., and Bharti W. Gawali. "Functional Magnetic Resonance Imaging and
Schizophrenia as Disconnection Disorder." International Journal of Advanced Research
in Computer Science 4, no. 4 (2013).
64 Lock, Margaret, Julia Freeman, Rosemary Sharples, and Stephanie Lloyd. "When it runs
in the family: putting susceptibility genes in perspective." Public Understanding of
Science 15, no. 3 (2006): 277-300.
65 Gur, Raquel E., and Samuel Chin. "Laterality in functional brain imaging studies of
schizophrenia." Schizophrenia Bulletin 25, no. 1 (1999): 141-156.
66 Javitt, Daniel C., and Joseph T. Coyle. "Decoding schizophrenia." Scientific
American 290, no. 1 (2004): 48-55.
67 Vorster, D. "An investigation into the part played by organic factors in childhood
schizophrenia." The British Journal of Psychiatry 106, no. 443 (1960): 494-522.
68 Thoits, Peggy A. "Stress and health major findings and policy implications." Journal of
health and social behavior 51, no. 1 suppl (2010): S41-S53.
69 Cheryl Corcoran, MD, Lilianne Mujica-Parodi, PhD, Scott Yale, MSW, David Leitman,
BS, and Dolores Malaspina, Could Stress Cause Psychosis in Individuals Vulnerable to
Schizophrenia?CNS Spectr. 2002 Jan; 7(1): 33–42.
70 Cheryl Corcoran, MD, Lilianne Mujica-Parodi, PhD, Scott Yale, MSW, David Leitman,
BS, and Dolores Malaspina. Schizphernia Report 2010.

23
71 Howes, Oliver D., and Shitij Kapur. "The dopamine hypothesis of schizophrenia: version
III—the final common pathway." Schizophrenia bulletin 35, no. 3 (2009): 549-562.
72 Murray, Robin M., Anton Grech, Peter Phillips, and Sonia Johnson. "What is the
relationship between substance abuse and schizophrenia." The epidemiology of
schizophrenia 9 (2003): 317-342.
73 Hall, Wayne, Louisa Degenhardt, and Maree Teesson. "Cannabis use and psychotic
disorders: an update." Drug and alcohol review 23, no. 4 (2004): 433-443.
74 Greenfield, Patricia M. "The changing psychology of culture from 1800 through
2000." Psychological science 24, no. 9 (2013): 1722-1731.
75 Schultz, Stephen H., Stephen W. North, and Cleveland G. Shields. "Schizophrenia: a
review." Am Fam Physician 75, no. 12 (2007): 1821-9.
76 Schultz, Stephen H., Stephen W. North, and Cleveland G. Shields. "Schizophrenia: a
review." Am Fam Physician 75, no. 12 (2007): 1821-9.
77 Ho, Beng-Choon, DONALD W. Black, and Nancy C. Andreasen. Schizophrenia and
other psychotic disorders. American Psychiatric Publishing: Arlington, 2003.
78 Flaum, Michael, and Susan K. Schultz. "The core symptoms of schizophrenia." Annals of
medicine 28, no. 6 (1996): 525-531.
79 World Health Organization. WHO Expert Consultation on Rabies: second report. No.
982. World Health Organization, (2013).
80 Marneros, Andreas. "Schizoaffective disorder." Korean Journal of Schizophrenia
Research 15, no. 1 (2012): 5-12.
81 Mitchell, Kyle Robert. "Examining the Role of Episodic and Semantic Networks in
Anhedonia: Applying the Accessibility Model of Emotional Self-report to

Psychometrically-defined Schizotypy." PhD diss., faculty of Louisiana State University
Agricultural and Mechanical College in partial fulfillment of the requirements for the
degree of Master of Arts in The Department of Psychology by Kyle Robert Mitchell BS,
The University of Texas, 2015.
82 de Jesus Mari, Jair, Denise Razzouk, Rangaswamy Thara, Julian Eaton, and Graham
Thornicroft. "Packages of care for schizophrenia in low-and middle-income
countries." PLoS Med 6, no. 10 (2009): e1000165.
83 Gelenberg, Alan J., and Michel R. Mandel. "Catatonic reactions to high-potency
neuroleptic drugs." Archives of General Psychiatry 34, no. 8 (1977): 947-950.
84 Flaum, Michael, and Susan K. Schultz. "The core symptoms of schizophrenia." Annals of
medicine 28, no. 6 (1996): 525-531.
85 Kessler, Ronald C., G. Paul Amminger, Sergio Aguilar‐Gaxiola, Jordi Alonso, Sing Lee,
and T. Bedirhan Ustun. "Age of onset of mental disorders: a review of recent literature.J
Consult Clin Psychol. 2013 Oct; 81(5): 761–773.
86 Beck, Aaron T., and Neil A. Rector. "Cognitive approaches to schizophrenia: theory and
therapy." Annu. Rev. Clin. Psychol. 1 (2005): 577-606.
87 Rothman, Kenneth J., Sander Greenland, and Timothy L. Lash, eds. Modern
epidemiology. Lippincott Williams & Wilkins, 2008.101HPB (Oxford). 2008; 10(Suppl
1): 7–222.
88 Mannuzza, Salvatore, Abby J. Fyer, Donald F. Klein, and Jean Endicott. "Schedule for
Affective Disorders and Schizophrenia—Lifetime Version modified for the study of
anxiety disorders (SADS-LA): rationale and conceptual development." Journal of
psychiatric research 20, no. 4 (1986): 317-325.

25
89 Eley, Thalia C., Jennifer L. Hudson, Cathy Creswell, Maria Tropeano, Kathryn J. Lester,
Peter Cooper, Anne Farmer et al. "Therapygenetics: the 5HTTLPR and response to
psychological therapy." Molecular psychiatry 17, no. 3 (2012): 236.
90 112 Synofzik, Matthis, and Thomas E. Schlaepfer. "Stimulating personality: ethical
criteria for deep brain stimulation in psychiatric patients and for enhancement
purposes." Biotechnology Journal 3, no. 12 (2008): 1511-1520.
91 Goodman, Wayne K., Kelly D. Foote, Benjamin D. Greenberg, Nikki Ricciuti, Russell
Bauer, Herbert Ward, Nathan A. Shapira et al. "Deep brain stimulation for intractable
obsessive compulsive disorder: pilot study using a blinded, staggered-onset
design." Biological psychiatry 67, no. 6 (2010): 535-542.

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