The three major psychotic disorders for which no biological (i.e., or— ganic) basis has been scientifically established are schizophrenia, delusional disorders, and affective (mood) disorders. One of the largest categories of institutionalized mental patients consists of schizophrenics, individuals with severe disturbances of thinking and often perception. Symptomatic of schizophrenics are withdrawal from contact with reality, loss of empathy with other people, disturbances of concept formation, regressivity, and bi— zarre behavior; hallucinations (false perceptions) and delusions (false beliefs) may also be present.
Schizophrenia typically begins in adolescence or early adulthood and, if untreated, may persist for the patient's lifetime. Men typically become schizophrenic at an earlier age than women, and the two sexes display different symptom pictures. So—called negative symptoms—mutism, blunted affect, social withdrawal, apathetic behavior, inattentiveness—are more characteristic of men than of women. Female schizophrenics are more likely to manifest positive symptoms such as hallucinations, delusions, bizarre behavior, and disordered thought processes (Lewine, 1981).
Although the symptoms of schizophrenia usually appear before age 40, initial onset in old age is not common. Schizophrenia that has its onset in old age is called paraphrenia and is typically a milder form of the disorder. Late— onset schizophrenics tend to have marked and vivid delusions of persecution or other false beliefs, less disturbed thought processes, and manifest more emotion than other schizophrenics. Hallucinations, when present, are likely to be sensory in nature.
Most chronic schizophrenics are meek and mild individuals who are not dangerous to other people. If permitted, many would spend much of their lives in mental hospitals. However, due to the fact that nondangerous mental patients cannot be legally required to remain institutionalized forever, many schizophrenics are released and end up wandering and living in the streets.
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