How does the schizophrenia change the life cycle?
The interpretation of the literature on aging and schizophrenia requires taking into account the bio- psycho- social perspective. That implies that the changes that come during the life cycle of the people with schizophrenia should be integrated with the normal changes of aging (in the neuro- endocrine system, the cognitive abilities, the psychic health and the adaptation).
Psychopathology
Schizophrenia turns out to be plastic during the life cycle. As a whole the tendency is to reduce the positive symptoms. The researchers, however, do not agree on the rising profile of the negative symptoms. Some think that the negative symptoms dominate
the picture of the disease in the late stages of the life cycle while others believe these symptoms diminish. Often, there is a correlation between the negative symptoms and the cognitive deficiency.
The level of depressiveness is high in the older patients with schizophrenia.
The depression correlates with the positive symptoms, the bad somatic health, low income and weak social support. The men and the women are equally predisposed to developing schizophrenia but onset is earlier in the men. Something more, the schizophrenia in the women is milder in its early stages but its symptoms grow with the advancement of the disorder while in the men the symptoms diminish as a whole. The
difference between men and women in the early stages of the disorder is connected to a number of biological and social factors. For example, with the advancement of age the advantage of women over men’s characteristic for the onset of the disorder diminishes.
However, that is more often connected with loss of family ties and emotional support rather than with changes in the hormonal status of the woman.
Neuropsychological Functioning
The old people with schizophrenia face double risk: the majority of them demonstrate neuropsychological deficiency earlier in the
development of the disorder. Together with that, as a consequence of the aging and other limitations such as insufficient education, unemployment and institutionalisation, their cognitive functioning is impaired even more in the advanced age. That deficiency is not that strong and progressive as it is in the Alzheimer’s disease. However, it has a significant influence on their social functioning and adaptation.
Social Functioning
The research on social functioning shows contradictory results. Some research shows improvement in the social functioning during the lifetime cycle while others find social degradation. However, when the researchers focus on the specific components of the social functioning, the tendency towards improvement is obvious. For example, the coping strategies seem to develop with age and the individual may become a more active participant in the process of his or her treatment and re socialization. Just like it is in the younger people suffering from schizophrenia, the social network of elderly people with the same disorder has a tendency to diminish compared to their peers. Moreover, when the elderly are exposed to situations that evoke strong emotions, their reactions are not in accordance with, or contradict the outer stimuli. The social support which they have is one of the most reliable predictors of a successful
functioning. Quite a lot of researches show that a majority of the elderly suffering from schizophrenia are satisfied with their lives but their satisfaction is lower than the one of their peers . The high subjective well-being correlates to a greater extent with the subjective factors such as social support and subjective estimate of the overall health condition rather than with objective estimates like presence of real health problems and level of income. The dissonance of the social adaptation significantly correlates with a high level of cognitive deficiency, negative symptoms and with disorders of the bone system. Moreover, the age of the elderly
with schizophrenia as well as the elderly as a whole is not considered a process of degradation as a whole but is considered in correlation with the adaptation, compensation and plasticity.
Co – morbidity
The level and the consequences of the medical co- morbidity in the elderly suffering from schizophrenia is underestimated as a whole
. Almost half of the co- morbidity medical conditions are omitted in most of the cases. Some disorders such as cardio- vascular diseases and diabetes are often found in patients with schizophrenia . Jeste and colleagues show that the elderly with schizophrenia do not suffer from the common somatic disorders compared to their peers but the presence of somatic disorders is more severe. They make the conclusion that the patients with schizophrenia rarely receive adequate medical care. Structural barriers in the health system as well as the attitude of the medical doctors may be obstacles to the process. The morbidity of the patients suffering from schizophrenia is estimated at two to four times higher in comparison with the overall population but it is not clear if that high morbidity is connected mainly with the advancement of the age .