ZH 2032 English for Life Sciences

UNIT 3: SCHIZOPHRENIA

Pre reading activity:

Discuss the following questions:

1. What do you know about schizophrenia?

2. Do you know anyone who suffers from this illness? Have you seen any
films, documentary or read any articles about schizophrenia? Discuss with
a partner.

Read the following article and answer the questions that follow.

Schizophrenia
1 Schizophrenia is a chronic, severe, and disabling brain disease. Approximately 1
percent of the population develops schizophrenia during their lifetime – more
than 2 million Americans suffer from the illness in a given year. Although
schizophrenia affects men and women with equal frequency, the disorder often
5 appears earlier in men, usually in the late teens or early twenties, than in
women, who are generally affected in the twenties to early thirties. People with
schizophrenia often suffer terrifying symptoms such as hearing internal voices I
not heard by others, or believing that other people are reading their minds,
controlling their thoughts, or plotting to harm them. These symptoms may leave
10 them fearful and withdrawn. Their speech and behavior can be so disorganized
that they may be incomprehensible or frightening to others. Available
treatments can relieve many symptoms, but most people with schizophrenia
continue to suffer some symptoms throughout their lives; it has been estimated
that no more than one in five individuals recovers completely.

15 Schizophrenia is found all over the world. The severity of the symptoms and
long-lasting, chronic pattern of schizophrenia often cause a high degree of
disability. Medications and other treatments for schizophrenia, when used
regularly and as prescribed, can help reduce and control the distressing II
symptoms of the illness. However, some people are not greatly helped by
20 available treatments or may prematurely discontinue treatment because of
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unpleasant side effects or other reasons. Even when treatment is effective,

persisting consequences of the illness – lost opportunities, stigma, residual
symptoms, and medication side effects – may be very troubling.

The first signs of schizophrenia often appear as confusing, or even shocking,

25 changes in behavior. Coping with the symptoms of schizophrenia can be
especially difficult for family members who remember how involved or
vivacious a person was before they became ill. The sudden onset of severe
psychotic symptoms is referred to as an “acute” phase of schizophrenia.
“Psychosis,” a common condition in schizophrenia, is a state of mental III
30 impairment marked by hallucinations, which are disturbances of sensory
perception, and/or delusions, which are false yet strongly held personal beliefs
that result from an inability to separate real from unreal experiences. Less
obvious symptoms, such as social isolation or withdrawal, or unusual speech,
thinking, or behavior, may precede, be seen along with, or follow the psychotic
35 symptoms.

The World of People with Schizophrenia

• Hallucinations and Illusions

Hallucinations and illusions are disturbances of perception that are common in

people suffering from schizophrenia. Hallucinations are perceptions that occur
40 without connection to an appropriate source. Although hallucinations can occur
in any sensory form – auditory (sound), visual (sight), tactile (touch), gustatory IV
(taste), and olfactory (smell) – hearing voices that other people do not hear is
the most common type of hallucination in schizophrenia. Voices may describe
the patient’s activities, carry on a conversation, warn of impending dangers, or
45 even issue orders to the individual. Illusions, on the other hand, occur when a
sensory stimulus is present but is incorrectly interpreted by the individual.

• Delusions

Delusions are false personal beliefs that are not subject to reason or
contradictory evidence and are not explained by a person’s usual cultural
50 concepts. Delusions may take on different themes. For example, patients
suffering from paranoid-type symptoms – roughly one-third of people with
schizophrenia – often have delusions of persecution, or false and irrational
beliefs that they are being cheated, harassed, poisoned, or conspired against.
These patients may believe that they, or a member of the family or someone V
55 close to them, are the focus of this persecution. In addition, delusions of
grandeur, in which a person may believe he or she is a famous or important
figure, may occur in schizophrenia. Sometimes the delusions experienced by
people with schizophrenia are quite bizarre; for instance, believing that a

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neighbor is controlling their behavior with magnetic waves; that people on

television are directing special messages to them; or that their thoughts are
being broadcast aloud to others.

• Disordered Thinking

Schizophrenia often affects a person’s ability to “think straight.” Thoughts may

come and go rapidly; the person may not be able to concentrate on one thought VI
65 for very long and may be easily distracted, unable to focus attention.

People with schizophrenia may not be able to sort out what is relevant and what
is not relevant to a situation. The person may be unable to connect thoughts into
logical sequences, with thoughts becoming disorganized and fragmented. This VII
lack of logical continuity of thought, termed “thought disorder,” can make
70 conversation very difficult and may contribute to social isolation. If people
cannot make sense of what an individual is saying, they are likely to become
uncomfortable and tend to leave that person alone.

What about Medications?

Antipsychotic medications have been available since the mid-1950s. They have
75 greatly improved the outlook for individual patients. These medications reduce VIII
the psychotic symptoms of schizophrenia and usually allow the patient to
function more effectively and appropriately.

Antipsychotic drugs are the best treatment now available, but they do not “cure”
schizophrenia or ensure that there will be no further psychotic episodes. The
80 choice and dosage of medication can be made only by a qualified physician who IX
is well trained in the medical treatment of mental disorders. The dosage of
medication is individualized for each patient, since people may vary a great deal
in the amount of drug needed to reduce symptoms without producing
troublesome side effects.

85 Antipsychotic drugs are often very effective in treating certain symptoms of

schizophrenia, particularly hallucinations and delusions; unfortunately, the
drugs may not be as helpful with other symptoms, such as reduced motivation
and emotional expressiveness. Indeed, the older antipsychotics (which also went
by the name of “neuroleptics”), medicines like haloperidol (Haldol®) or
90 chlorpromazine (Thorazine®), may even produce side effects that resemble the X
more difficult to treat symptoms. Often, lowering the dose or switching to a
different medicine may reduce these side effects; the newer medicines,
including olanzapine (Zyprexa®), quetiapine (Seroquel®), and risperidone

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(Risperdal®), appear less likely to have this problem. Sometimes when people
with schizophrenia become depressed, other symptoms can appear to worsen.
The symptoms may improve with the addition of an antidepressant medication.

What about Psychosocial Treatments?

Antipsychotic drugs have proven to be crucial in relieving the psychotic

symptoms of schizophrenia – hallucinations, delusions, and incoherence – but
100 are not consistent in relieving the behavioral symptoms of the disorder. Even
when patients with schizophrenia are relatively free of psychotic symptoms,
many still have extraordinary difficulty with communication, motivation, self- XI
care, and establishing and maintaining relationships with others. Moreover,
because patients with schizophrenia frequently become ill during the critical
105 career-forming years of life (e.g., ages 18 to 35), they are less likely to complete
the training required for skilled work. As a result, many with schizophrenia not
only suffer thinking and emotional difficulties, but lack social and work skills
and experience as well.

It is with these psychological, social, and occupational problems that

110 psychosocial treatments may help most. While psychosocial approaches have
limited value for acutely psychotic patients (those who are out of touch with
reality or have prominent hallucinations or delusions), they may be useful for
patients with less severe symptoms or for patients whose psychotic symptoms XII
are under control. Numerous forms of psychosocial therapy are available for
people with schizophrenia, and most focus on improving the patient’s social
functioning – whether in the hospital or community, at home, or on the job.
115 Some of these approaches include rehabilitation, individual psychotherapy,
family education and self help groups. Unfortunately, the availability of
different forms of treatment varies greatly from place to place.

Adapted from schizophrenia.com

http://www.schizophrenia.com
National Institute of Mental Health (NIMH)
By Melissa K. Spearing.

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A. VOCABULARY

Match these words with their correct meaning as used in the text.

0. withdrawn (line 10) ________k__________ a. give

1. stigma (line 22) ___________________ b. edition

c. conflicting
2. vivacious (line 27) ___________________
d. viewpoint
3. disturbances (line 30) ___________________ e. unjust treatment

4. issue (line 45) ___________________ f. methods

g. prejudice
5. contradictory (line 49) ___________________
h. lively
6. persecution (line 52) ___________________ i. divided

7. bizarre (line 58) ___________________ j. contrast

k. reserved / distant
8. fragmented (line 69) ___________________
l. partitioned
9. outlook (line 75) ___________________ m. strange

10. approaches (line 110) ___________________ n. confusions

B. REFERENCE

What do these words or phrases refer to?

1.) Them (line 10) : ___________________________________________

2.) distressing symptoms

(line 18-19) : ___________________________________________

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3.) that person (line 72) : ___________________________________________

4.) the drugs (line 86-87) : ____________________________________________

5.) this problem (line 94) : ___________________________________________

C. Find words in the passage (from line 1 to line 28) that match the definitions below.

1) Recurring / constant :_____________________

2) To feel pain or misery :_____________________

3) Beyond your understanding :_____________________

4) Too early or too soon :_____________________

5) Severe or very strong :_____________________

6) An outward or noticeable
signs of disease :_____________________

D. Reading Comprehension

Answer all the questions based on the text.

1. State two symptoms of schizophrenia.

_____________________________________________________________

_____________________________________________________________

2. Why would people be frightened by schizophrenia sufferers?

_____________________________________________________________

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_____________________________________________________________

3. What are the limitations of the available medications or treatments to some of the
schizophrenia patients?

_____________________________________________________________

_____________________________________________________________

4. Why is it difficult for family members especially to cope with schizophrenia?

______________________________________________________________

______________________________________________________________

5. What is psychosis? Explain in your own words.

______________________________________________________________

______________________________________________________________

6. State the function of antipsychotic medication.

_______________________________________________________________

_______________________________________________________________

7. What are the differences between ‘neuroleptics’ and the newer medicines?

_______________________________________________________________

_______________________________________________________________

8. Other than medications, what forms of treatment are available?

_________________________________________________________________

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_________________________________________________________________

Speaking Task

Read the article “Moving Lives Forward” and discuss in your group:

a.) The problems of treating schizophrenia in Malaysia.

b.) Suggest ways to promote greater awareness of schizophrenia among Malaysians.

MOVING LIVES FORWARD

If they are psycho-doctored early, a third of schizophrenia sufferers regain their sanity.
Another third only betray a few symptoms of their affliction. Unfortunately, Malaysians
continue to believe they are beyond help. Most would rather consult a bomoh than see a
psychiatrist.

“It’s easier for them to accept that the symptoms are due to charms and evil spirits than to
accept that it is due to mental illness,” says consultant psychiatrist Professor Dr
Mohammad Hussain Habil in conjunction with Schizophrenia Awareness Month. “The
Malays are especially reluctant to seek medical advice. Once they have seen a bomoh and
been told that it’s an occult problem, they will continue to go back for more.

“Generally, there is a two to three year delay before they come for medical treatment.
Unfortunately it gets more and more difficult to treat the longer you wait.”

Schizophrenia affects about one percent of the world’s population and affects both
genders. Symptoms include delusions, hallucination, catatonic behaviour and not reacting
to people, and the environment, and keeping to themselves. Dr Salina says diagnosis is
reached when two or more of these symptoms persist for a month or more.

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The older antipsychotic medication for schizophrenia had terrible side effects. For
instance, many patients develop a “robotic” walk while others experience an increase risk
of heart attack. Nowadays, the side effects of the new medication are so minimal, it is
difficult to tell who has schizophrenia and has not, says consultant psychiatrist Dr. Salina
Abdul Aziz.

Some recovered patients are well enough to work but, like our undergraduates, many are
simply too choosy. The illness usually appears among males in their late teens and early
20s. In females, it shows up in their late 20s and early 30s.

Even when they have family backing, many find it hard to go back to school later in life.
They say they find it near impossible to study.

“I wish I could go back to study. I’ve tried to go back to school but I’m too depressed. I
just can’t concentrate,” says Peter Tan, a 30 year old schizophrenia patient. He became ill
during Grade 11, in a boarding school in Connecticut, USA. He takes his medication
faithfully. As a result, he has not had a single relapse.
*For the protection of the patients and their families,
none of the names quoted here are real.

Source: New Sunday Times

August 13, 2006

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Identifying Causes and Effects

It’s often possible to identify causes (reasons) or effects (results) in a reading by paying
attention to cause and effect conjunctions such as because, so, for, since, as, therefore,
thus, as a result, or consequently. However, there is frequently no cause and effect
conjunction used. Then you have to use your own logic and infer – use logic to guess the
cause and effect.

E. Identifying the causes and effects

Read the causes. Then match the causes to the correct effects.

1. People suffering from schizophrenia a. no more than one in five

are usually withdrawn and fearful individuals recovers completely.
because they

2. Most people with schizophrenia continue b. suffer from unpleasant side

to suffer the symptoms all their lives as effects.

3. Some people discontinue taking c. psychosocial treatments are

medications because they employed to help family
members cope with
schizophrenia

4. Schizophrenia sufferers live in d. suffer from terrifying

anxiety since they symptoms such as hearing
internal voices.

5. To help with schizophrenia patients, e. experience hallucinations,

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the family needs to be educated delusions and disordered

too, therefore, thinking.

F. Making Inferences

The inferences below can be made from the article on schizophrenia. Find specific
information to support each inference.

1. Inference : People suffering from schizophrenia do not normally recover from it.

Support : ___________________________________________________________

___________________________________________________________

2. Inference : Anti psychotic treatments are able to help patients live a normal life.

Support : ___________________________________________________________

___________________________________________________________

3. Inference : Schizophrenia manifests in many forms.

Support : ___________________________________________________________

___________________________________________________________

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Read the review and identify the comments that the writer made regarding the film “A
Beautiful Mind”. How many positive and negative comments can you identify?

Film Review: A Beautiful Mind

By Bailey Russell

Who would want to watch a film about the life of a mathematician? One that’s over
two hours long and chronicles his life from college in the 40’s until the present? No
takers? Well, this one will probably change your mind.
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Ron Howard’s A Beautiful Mind is easily is his best achievement to date and features
equal bests by Russell Crowe and Jennifer Connelly, the underexposed young actress last
seen in the twisted Requiem For A Dream.

The depiction of John Nash’s life – from his graduate school days at Princeton University,
through a mental breakdown and the onset of paranoid schizophrenia, to his apparent
recovery and reception of the Nobel Prize a few years ago – is truly amazing. The story is
well put together, the characters fascinating and the writing good, but there’s just one
problem – it’s not 100% true.

While this shouldn’t really affect the enjoyment of the film, it does change how it should
be viewed. Specifically, A Beautiful Mind’s claim to be “based on” Nash’s life (currently
at Princeton) has to be seen as tenuous.

The problem is that everything has, in typical and unavoidable Hollywood fashion, been
simplified, from his relationship with his wife (whom in reality divorced and cheated on
with, among others, men) to the particular nature of his studies (romanticized to almost
unrecognizable levels).

That said, the film is still a gripping one. Beginning with Nash’s enrolment in Princeton’s
ridiculously competitive math graduate school, it works quickly through his life towards
its real focus – Nash was diagnosed with paranoid schizophrenia, at a time when little was
known about the disease.

While he was placed in a hospital and treated, the effect was not as he desired, so Nash
proceeded to come to terms with it and conquer it on his own. This cold, steely
intellectualism is the focus of the film, and it is what Crowe conveys so thoroughly and
sympathetically.

One imagines while watching, that if anyone could be so triumphant and control his own
mind, it must be Nash, and perhaps Crowe himself. Such intense concentration is
excruciating, as Nash acknowledges, saying “People don’t tend to like me.” Crowe’s
performance is reminiscent of fine actors like Al Pacino and Robert De Niro at their best.

Complementing the performance is a solid directing style, at times a little flashy, but
effective when tricks are necessary. Howard seems to recognize throughout that this is not
his movie – it belongs to Crowe, and thus allows the actor as much leeway as needed. The
settings, however, do overwhelm at times, from the oddly futuristic overtones of the CIA
vaults, to the pseudo-gothic arches of the universities involved; but they serve superbly as
backdrops and act as a counter-balance to his life outside of academia.

The domestic world within the film is dominated by Connelly, who, as Nash’s wife,
transcends remarkably above her past performances. As an ever-present force guiding
Nash, she works to stabilize him and in the end, perhaps, save him. While a beautiful idea,

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it is also one of the films few flaws – the standard Hollywood reliance on the idea of love
overcoming all (see Robin Williams’ last 10 flicks).

It’s trite, and in this case, both untrue and unnecessary. The story of Nash saving himself
and reentering the ivory halls of knowledge is so much so interesting than what is implied
here. Nonetheless, through the pure strength of the performances, these remain small
arguments against an otherwise a beautiful film about a beautiful mind.

Source: Klue, 2007

DEVELOPING COHERENT AND COHESIVE PARAGRAPHS.

A piece of writing needs to be coherent and cohesive to be understood without ambiguity.

The whole idea of developing coherent and cohesive paragraphs is to provide the reader
with a clear picture of what the author is trying to convey.

Coherence

The function of coherent in writing is to connect ideas logically.

A coherent paragraph has consistent topic strings. The discussion in the paragraph
concentrates on one main idea. The focus of the discussion does not stray from the
core idea or the topic sentence.

A coherent paragraph introduces the topic sentence in the introductory line. This
helps the reader to understand clearly the subject of the discussion. The rest of the
paragraph – the supporting details – is aimed at explaining the topic sentence.

Cohesion

The function of cohesion in writing is to link and connect sentences in a paragraph. A

cohesive paragraph uses good, strong cohesive devices – transitions and conjunctions. The
length of the paragraph should also be appropriate.

Coherence and cohesive in writing serves important functions.

Preparing the reader for the discussion that follows.

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Guiding the reader through the reasoning.

Providing a map for the author’s ideas.

Keeping the focus on the topic.

Transitions

Transition signals are used in a sentence, a paragraph or a passage to link ideas. By

identifying the transition signals, the reader is able to understand the relationship between
the ideas.

There are two types of transitions: transitional words and transitional phrases. For the
most part, these words and phrases are attached to the beginning of the sentence and are
preceded by a period (.) or semicolon (:). They do not really join two sentences together
but indicate the relationship between the two sentences. Different transitions denote
different relationships.

Chronological order

Transitional expressions such as first, second, next, then, last and finally are used to
indicate chronological order. They can also be used to signal examples, especially when
the examples are in chronological order. Another application is to indicate the progression
of the discussion. For an example;

There are several things that I like about the movie. First, are the main
characters. This is Ron Howard’s best achievement to date and features
equal bests by Russell Crowe and Jennifer Connelly. Second, the amazing
ability of Ron Howard in depicting John Nash’s life – from his graduate
school days at Princeton University, through a mental breakdown and the
onset of paranoid schizophrenia, to his apparent recovery and reception of
the Nobel Prize a few years ago. Next, is Ron Howard’s solid directing
style even though at times a little flashy, but effective when tricks are
necessary. Howard is able to recognize that this is not his movie- it belongs
to Crowe, and thus allows the actor as much leeway as needed. Finally, the
superb backdrop – from the futuristic CIA vaults to the pseudo-gothic
arches of the universities involved. These act as a counter-balance to his
life outside of academia.

Examples

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For example and for instance are the most frequently used transitional phrases for
introducing examples and illustrations. They occur most often at the beginning of a
sentence, but they can be placed in the middle (after the introductory phrases, after the
verb phrase, or after the subject) or at the end of the sentence. Other expressions that are
similar in meaning are like and such as.

For instances, patients suffering from paranoid-type symptoms – roughly one-

third of people with schizophrenia – often have delusions of persecution, or false
and irrational beliefs that they are being cheated, harassed, poisoned, or conspired
against.

In describing patients suffering from schizophrenia, for example, the patients

often have delusions of persecution, or false and irrational beliefs that they are
being cheated, harassed, poisoned, or conspired against.

Take, for example, the patients suffering from paranoid-type symptoms.

You, for instance, may have the symptoms of schizophrenia,

You may have the symptoms of schizophrenia, for example.

Addition

Expressions such as also, furthermore, moreover, in addition, and besides that are used to
include more information about an idea already stated. They can be placed at the
beginning, middle or end of the sentence.

Schizophrenia often affects a person’s ability to “think straight.” Thoughts

may come and go rapidly; the person may not be able to concentrate on one
thought for very long and may be easily distracted, unable to focus
attention. In addition, people with schizophrenia may not be able to sort
out what is relevant and what is not relevant to a situation.

Schizophrenia sufferers’ thoughts may easily be distracted and unable to focus

attention. Moreover, they are not able to sort out what is relevant and what is not
relevant to a situation.

Also, they are not able to sort out what is relevant and what is not relevant to a
situation.

Besides that, they are not able to sort out what is relevant and what is not
relevant to a situation.

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Furthermore, they are not able to sort out what is relevant and what is not
relevant to a situation.

Schizophrenia sufferers’ thoughts may easily be distracted and unable to focus

attention; in addition, they are not able to sort out what is relevant and what is
not relevant to a situation.

It, moreover, affects the patient’s ability to sort out what is relevant and
what is not relevant to a situation.

It also affects the patient’s ability to sort out what is relevant and what is
not relevant to a situation.

Comparison or contrast

Expressions such as likewise, similarly, and in the same way indicate comparison or
similarity between the items stated.

Crowe’s performance is reminiscent of fine actors like Al Pacino and

Robert De Niro at their best. Likewise, Connelly’s performance transcends
remarkably above her past performances.

Crowe’s performance is reminiscent of fine actors like Al Pacino and

Robert De Niro at their best. Similarly, Connelly’s performance transcends
remarkably above her past performances.

Expressions such as conversely, however, on the other hand, and in contrast indicate
contrast or difference between the items stated.

People around Nash dislike him. His wife, on the other hand, loves and
supports him.

People around Nash dislike him. In contrast, his wife loves and supports
him.

As I viewed these once familiar surroundings, images of me as a student

came to mind. However, what I saw and what I remembered were not the
same.

Conclusion

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The expressions finally and in conclusion signal the last example or the conclusion of a
paragraph as passage.

In conclusion, although I realize this film does not reflect Nash’s true story, I know
that at this point I understand more about schizophrenia.

Finally, Nash is able to conquer the mental disorder that he suffers successfully.

Conjunctions

Conjunctions function in the same way as transitions, which is to link ideas in clauses,
sentences or paragraphs.

Conjunctions are divided into three groups. They are coordinating conjunctions,
subordinating conjunctions and correlative conjunctions.

Coordinating conjunctions

There are seven coordinating conjunctions: for, and, nor, but, or, yet, so (combining the
first letters of these words gives FANBOYS).
Example 1:

None of the students knows about schizophrenia.

Some of them have watched the film.

None of the students knows about schizophrenia, for most of them

have never watched the film.

Example 2:

Many schizophrenia patients want to be fully recovered.

There are very few specialists in that area in Malaysia.

Many schizophrenia patients want to be fully recovered, but there

are very few specialists in that area in Malaysia.

Subordinating conjunctions

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Subordinating conjunctions can be placed at the beginning or the middle of a

sentence. The following are words used as subordinating conjunctions.

after so that when

although since whenever

as that where

as if though whereas

because unless whether

before until which

even though what while

how whatever

Example 1:

They suddenly organised the meeting.

The chief executive officer was going to be transferred to another

subsidiary.

They suddenly organised the meeting because the chief executive officer
was going to be transferred to another subsidiary.

Example 2:

He likes it (or not).

He has to stay in the house and consume the pills.

Whether he likes it or not, he has to stay in the house and consume the
pills.

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Example 3:

Antipsychotic drugs are the best treatment now available.

Antipsychotic drugs do not “cure” schizophrenia or ensure

that there will be no further psychotic episodes.

Antipsychotic drugs are the best treatment now available

even though they do not “cure” schizophrenia or ensure that
there will be no further psychotic episodes.

Correlative conjunctions

Correlative conjunctions join two independent clauses. Among the correlative

conjunctions are not only … but also, neither … nor, either … or, both … and.

Example 1:

Many schizophrenia patients have to sacrifice their training

required for skilled work.

They have to stay in the mental hospital to undergo

psychotherapy.

Many schizophrenia patients have to not only sacrifice their

training required for skilled work but also to stay in the mental
hospital to undergo psychotherapy

Example 2:

Haloperidol cannot help the patients’ emotional expressiveness.

It does not avoid the patients to be depressed.

Haloperidol neither helps the patients’ emotional expressiveness

nor prevents them from being depressed.

Example 3:

Haloperidol cannot help the patients’ emotional expressiveness.

Chlorpromazine cannot help the patients’ emotional expressiveness.

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Both Haloperidol and Chlorpromazine cannot help the patients’

emotional expressiveness.

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