After the last program, “The Stabbing of a Mother by a College Student in Japan,” aired, many people left blog comments about how they had relatives with similar symptoms and how their families felt helpless and desperate, not knowing how to judge, because they were worried that they would be ostracized and discriminated against if they had schizophrenia, and they were unable to talk to the outside world and ask for help.
During our news investigation, we had produced a program to investigate violent crimes committed by mentally ill people and learned that it is extremely important to detect and treat patients in a timely manner with medication. The relapse rate after stopping medication is over 80%. This matter not only concerns the pain and hope of a family, but if they struggle in silence, then the society is also in the midst of uneasiness at the same time. Yang Zhong, Clinical Psychology Department, Changshu Mental Health Center
Many readers have asked if there can be a forum or a microblogging platform about this disease, so that families can exchange information and support each other in time. The initial search on the Internet has not yet yielded any results. If anyone is willing to make such a platform, they can also contact in the comments or through the mailbox of my blog.
Yesterday, I called Ji XIII of the Squirrel Society of Science to find a more authoritative doctor to spread common knowledge about the diagnosis and treatment of schizophrenia, and he asked the Heart Matters Identification Group of GoShell.com to interview Ms. Nie Jing of Peking University in conjunction with this case. Thanks to them. I’m posting the article below for readers’ reference.
The Shells Heart Matters Identification Group (hereinafter referred to as “Shells”): Is Wang’s case the same as what we usually call mental illness?
Nie Jing: Schizophrenia is different from general mental illnesses. Normal people have the ability to perceive, experience, and respond appropriately to environmental stimuli in an adaptive manner, whereas in psychiatric patients this ability to “engage with reality” is impaired, so that their social functioning is severely impaired. A major characteristic of schizophrenic patients is their lack of self-awareness; they do not perceive themselves as ill and do not actively seek medical attention. They also have no inhibitions about their behavior. Self-knowledge, also known as introspection, refers to the patient’s ability to recognize his or her own mental state, i.e., whether he or she can perceive or recognize that he or she is ill and whether his or her mental state is normal, and can correctly analyze and judge and point out which of his or her past and present manifestations and experiences are pathological. In the CCTV interview with Wang’s family, it was mentioned that some abnormalities were noticed in Japan, but Wang claimed that he was not sick, so his family assumed that he was not sick. For schizophrenic patients, without medication, they lack a basic understanding of their illness and will still insist that they are normal and not sick, even when others clearly point out their problems. Therefore, family members should not give up on diagnosing and treating patients simply by virtue of their own feelings, which is very dangerous.
GoShell: It is said that there are 16 million mentally ill people in China, so do we need to be careful to watch out for people around us who may become ill?
Nie Jing: The incidence of schizophrenia is relatively low, with an average prevalence of 5.8 per 1,000 according to the World Health Organization. And not all people with schizophrenia have violent tendencies or delusions of victimization. Some psychiatrists even believe that some schizophrenics are safer than the general population because they are so afraid of interacting with other people that they generally do not readily engage with others and exhibit a strong withdrawal from social interaction. Patients with simple schizophrenia, for example, may show early symptoms similar to neurasthenia, such as depression, inattention, dizziness, and insomnia, and then gradually develop withdrawnness, laziness, lack of interest, emotional indifference, and erratic behavior to the point of being unable to adapt to social needs, but without the obvious “positive symptoms” such as delusions and hallucinations.
Googling: So how do we identify people with schizophrenia?
Nie Jing: In most cases, schizophrenics tend to start in young adulthood and exhibit symptoms that can be divided into negative and positive symptoms. Negative symptoms are the lack of normal reactions. For example, a lack of thinking, emotional indifference, or reduced volition are all “negative symptoms”. Like seeing his mother in a pool of blood, a normal person would feel grief, but Wang had no emotional reaction, and could only logically reason that he “should be grieving”. Positive symptoms are the appearance of behaviors or thoughts that normal people do not have: hallucinations, delusions, thought breakdowns, emotional inversions, and disorganized speech. Wang’s symptoms are also obvious. From the interview, we can see that he has the typical delusion of being victimized, feeling that someone is watching him or even having a chip implanted in his brain.
Shell: How can you help someone around you who has suspected schizophrenia symptoms?
Nie Jing: Early detection and early treatment. Go to a hospital psychiatric department for diagnosis and medication in a timely manner. However, people around you cannot force anyone to be sent to a psychiatric department for treatment. According to the new Psychiatric Law, no one else (except the public security authorities) has the authority to compel medical treatment unless the guardian takes the initiative to authorize it. Therefore, it is best to contact the guardian or first-degree relatives of a suspected case as soon as it is discovered. If the suspected patient appears to be a nuisance to public safety, the public security department needs to be contacted immediately.
Shell: Given this, what do we need to do to protect ourselves if we encounter a schizophrenic?
Nie Jing: As I said earlier, not all schizophrenics are aggressive and not as dangerous as one might think. Moreover, medication for schizophrenia patients at home and abroad has made great progress and can effectively remove many positive symptoms such as hallucinations and delusions, and many schizophrenia patients can even stop having illnesses for life and maintain normal social functions as long as they adhere to their medication. On the other hand, for those patients with schizophrenia who have a sudden onset of schizophrenia or who, for various reasons, have not yet been able to undergo medication, it is best to remain relatively cautious, not to provoke them, to keep a certain distance from them, and to contact their families or the public security authorities when they exhibit abnormal behavior.