First of all, schizophrenia is a clinical disease that occurs when more than one symptom comes together in the brain. Schizophrenia; We can call it a clinical disease that is usually severe and has a long course, indicating chronic symptoms that negatively affect areas such as certain thought changes, behavioral disorders, interpersonal communication, and social environment in the person, causing the normal life to gradually deteriorate. (Köroğlu, Güleç 2007). Schizophrenia disease affects a person's quality of life quite negatively. It causes the person to disrupt their daily activities and, as a result, decrease their quality of life and life satisfaction. (Kaplan, Sadock 2005; Köroğlu, Güleç 2007; Öztürk, Uluşahin 2015). In addition to what happens in the brain in schizophrenia, as in many psychological diseases, the person's history is also of great importance. Genetic predisposition, environmental and social factors play a major role in the course of this disease. (Köroğlu, Güleç. 2007). Schizophrenia is recognized all over the world and is considered the most severe mental illness. The probability of developing schizophrenia does not differ around the world. (Buchanan and Carpenter, 2005). As with every disease, the incidence of schizophrenia varies between men and women. It is approximately 1.5 times more common in men than in women. (Lauriello et al., 2005). Alptekin, Ulaş, Akdede et al. (2009), 'The lifetime prevalence of schizophrenia in Turkey was stated as 8.9 per 1000 people'.
Overall, it reveals a big picture that complicates life-long activities. In this emerging picture, there are some problems that complicate the brain. In patients with schizophrenia, the interaction of genetics and social life creates a neurodevelopmental disorder in the neural networks and certain regions of the brain. (Alptekin et al. 2005). Many studies have been conducted on the brain disorder of schizophrenia. To briefly touch upon these researches; decreased gray matter in the prefrontal and temporal cortices as a result of MRI studies of schizophrenia; Findings showing a decrease in the volume in the structures of the amygdala, hippocampus, and limbic system, which are composed of various neurons, and an increase in the volume in the basal ganglia nuclei. has been obtained. (Yavuz, 2008). When we look at another study; It has been found that there are changes in the medial temporal structures, which are closely related to the memory part, in schizophrenia patients. (Aksaray et al., 2001).
Microscopic examinations were performed on some patients, and as a result, disorders related to their density were found in the nerve cells we call neurons. However, consistent results were not obtained. What we call neurotransmitters in the frontal lobe; There are studies reporting disorders of axon endings containing serotonin, GABA and glutamate receptors. (Goldman, Rakic and Selemon 1997). Many different studies have been conducted on the subject and one of them is; He has focused on the dopamine hypothesis for years. According to their hypothesis, certain irregularities in the dopamine neurotransmitter are one of the primary foundations of schizophrenia. As a result, dopaminergic increases the psychotic symptoms in the person, and secondly, there is no relationship between these symptoms and D2 dopamine receptors. Although many studies focus on dopamine, the dopamine hypothesis alone is not sufficient to explain the symptoms seen in schizophrenia. (Gargiula and Landa De Gargiulo 2014, Frohlich and Van Horn 2014, Howes et al. 2015).
As a result of these changes, the pathological changes that occur in the brain in schizophrenia have caused a number of symptoms and findings in the person. The most important of these are the disorders that occur in the language and the person's thoughts. (Liddle et al., 2002). It also shows some appearance and behavioral symptoms. The mind is in a complex state. The complexity of the mind creates behavioral problems in the person. They may make a sudden unexpected move or suddenly appear in an unexpected place. The results observed in behavior also differ in emotional states. Feelings of malaise, reluctance, dullness, resentment and doubt are among the emotions he feels. Concrete thinking, not abstract thinking, is dominant in patients.
Connections between thoughts are completely broken and reflected in the way of speaking. In the early stages of illness, there may be difficulties with speech. Over time, his speech will return to normal. But this conversation is not like the communication of healthy people. Since there are disruptions in the flow, it is also reflected in his speech. He stops suddenly while speaking and may list too many words in a row. Delusions are the most important symptoms of this disease. Imaginary voices claim to see things that another person does not see. They talk to imaginary beings. And with this, patients' beliefs weaken and they have inaccurate beliefs. The symptoms of schizophrenia appear gradually and have reached a certain point until you catch this process.
The last thing I want to mention is the impairment of insight that occurs in schizophrenia patients. This situation creates an obstacle for the schizophrenia patient receiving treatment. It is stated that, as with most diseases, people are unaware of and cannot accept this disease and its symptoms. Lack of insight negatively affects the treatment process and it has been stated that the patient's ignorance about his disease is high. (Beck et. al. , 2011). There are also insight studies in schizophrenia patients. According to a study, 40% of patients were found to have poor insight. (Mhala et. al. , 2014). Other studies have shown that patients with low insight also have low compliance with treatment. (Dilbaz et al., 2006).
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