A BEAUTIFUL MIND

It is a biopic of the famed mathematician John Nash and his lifelong struggles with his
mental health. Nash enrolled as a graduate student at Princeton in 1948 and almost
immediately stood out as an odd duck. He devoted himself to finding something unique, a
mathematical theorem that would be completely original. He kept to himself for the most
part and while he went out for drinks with other students, he spends a lot of time with his
roommate, Charles, who eventually becomes his best friend. John is soon a professor at MIT
where he meets and eventually married a graduate student, Alicia. When confronted with
evidence, Nash is finally convinced that he has been hallucinating. The Department of Defense
agent William Parcher and Nash's secret assignment to decode Soviet messages was in fact all a
delusion. Even more surprisingly, Nash's "prodigal roommate" Charles and his niece Marcee are
also products of his mind. Over time however John begins to lose his grip on reality,
eventually being institutionalized diagnosed with schizophrenia. After a series of insulin shock
therapy sessions, Nash is released on the condition that he agrees to take antipsychotic
medication; however, the drugs create negative side-effects that affect his intellectual capacity.
As the depths of his imaginary world are revealed, Nash withdraws from society and it's not
until the 1970s that he makes his first foray back into the world of academics, gradually
returning to research and teaching. In 1994, John Nash was awarded the Nobel prize in
Economics.

SCHIZOPHRENIA

Schizophre is a mental disorder characterized by a disintegration of the process of thinking and of

emotional responsiveness. It most commonly manifests as auditory hallucinations, paranoid or bizarre
delusions, or disorganized speech and thinking, and it is accompanied by significant social or
occupational dysfunction. The onset of symptoms typically occurs in young adulthood. Diagnosis is
based on the patient's self-reported experiences and observed behavior.

Genetics, early environment, neurobiology, psychological and social processes appear to be important
contributory factors; some recreational and prescription drugs appear to cause or worsen symptoms.
Current psychiatric research is focused on the role of neurobiology, but this inquiry has not isolated a
single organic cause. As a result of the many possible combinations of symptoms, there is debate about
whether the diagnosis represents a single disorder or a number of discrete syndromes.

Complications

Individuals with this disorder may develop significant loss of interest or pleasure. Likewise,
some may develop mood abnormalities (e.g., inappropriate smiling, laughing, or silly facial
expressions; depression, anxiety or anger). Often there is day-night reversal (i.e., staying up
late at night and then sleeping late into the day). The individual may show a lack of interest in
eating or may refuse food as a consequence of delusional beliefs. Often movement is abnormal
(e.g., pacing, rocking, or apathetic immobility). Frequently there are significant cognitive
impairments (e.g., poor concentratiion, poor memory, and impaired problem-solving ability).
The majority of individuals with Schizophrenia are unaware that they have a psychotic illness.
This poor insight is neurologically caused by illness, rather than simply being a coping
behavior. This is comparable to the lack of awareness of neurological deficits seen in stroke.
This poor insight predisposes the individual to noncompliance with treatment and has been
found to be predictive of higher relapse rates, increased number of involuntary hospitalizations,
poorer functioning, and a poorer course of illness. Depersonalization, derealization, and
somatic concerns may occur and sometimes reach delusional proportions. Motor abnormalities
(e.g., grimacing, posturing, odd mannerisms, ritualistic or stereotyped behavior) are sometimes
present.
The life expectancy of individual with Schizophrenia is shorter than that of the general
population for a variety of reasons. Suicide is an important factor, because approximately 10%
of individuals with Schizophrenia commit suicide - and between 20% and 40% make at least
one suicide attempt. There is an increased risk of assaultive and violent behavior. The major
predictors of violent behavior are male gender, younger age, past history of violence,
noncompliance with antipsychotic medication, and excessive substance use. However, it should
be noted that most individuals with Schizophrenia are not more dangerous to others than those
in the general population.

Subtypes

The DSM-IV-TR contains five sub-classifications of schizophrenia, although the developers of

DSM-5 are recommending they be dropped from the new classification:[23]

 Paranoid type: Where delusions and hallucinations are present but thought disorder,
disorganized behavior, and affective flattening are absent. (DSM code 295.3/ICD code F20.0)
 Disorganized type: Named hebephrenic schizophrenia in the ICD. Where thought disorder and
flat affect are present together. (DSM code 295.1/ICD code F20.1)
 Catatonic type: The subject may be almost immobile or exhibit agitated, purposeless
movement. Symptoms can include catatonic stupor and waxy flexibility. (DSM code 295.2/ICD
code F20.2)
 Undifferentiated type: Psychotic symptoms are present but the criteria for paranoid,
disorganized, or catatonic types have not been met. (DSM code 295.9/ICD code F20.3)
 Residual type: Where positive symptoms are present at a low intensity only. (DSM code
295.6/ICD code F20.5)
 Post-schizophrenic depression: A depressive episode arising in the aftermath of a schizophrenic
illness where some low-level schizophrenic symptoms may still be present. (ICD code F20.4)
 Simple schizophrenia: Insidious and progressive development of prominent negative symptoms
with no history of psychotic episodes. (ICD code F20.6)

Paranoid schizophrenia is a sub-type of schizophrenia as defined in the Diagnostic and

Statistical Manual of Mental Disorders, DSM-IV code 295.30

It is the most common type of schizophrenia. The clinical picture is dominated by

relatively stable, often paranoid, delusions, usually accompanied by hallucinations,
particularly of the auditory variety (hearing voices), and perceptual disturbances.
Disturbances of affect, volition, and speech, and catatonic symptoms, are not prominent.
DIAGNOSIS

The most widely used standardized criteria for diagnosing schizophrenia come from the
American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders,
version DSM-IV-TR, and the World Health Organization's International Statistical Classification
of Diseases and Related Health Problems, the ICD-10. The latter criteria are typically used in
European countries, while the DSM criteria are used in the United States and the rest of the
world, as well as prevailing in research studies. The ICD-10 criteria put more emphasis on
Schneiderian first-rank symptoms, although, in practice, agreement between the two systems is
high.

According to the revised fourth edition of the Diagnostic and Statistical Manual of Mental
Disorders (DSM-IV-TR), to be diagnosed with schizophrenia, three diagnostic criteria must be
met:

1. Characteristic symptoms: Two or more of the following, each present for much of the time
during a one-month period (or less, if symptoms remitted with treatment).
o Delusions
o Hallucinations
o Disorganized speech, which is a manifestation of formal thought disorder
o Grossly disorganized behavior (e.g. dressing inappropriately, crying frequently) or
catatonic behavior
o Negative symptoms: Blunted affect (lack or decline in emotional response), alogia (lack
or decline in speech), or avolition (lack or decline in motivation)

If the delusions are judged to be bizarre, or hallucinations consist of hearing one voice
participating in a running commentary of the patient's actions or of hearing two or more voices
conversing with each other, only that symptom is required above. The speech disorganization
criterion is only met if it is severe enough to substantially impair communication.

2. Social/occupational dysfunction: For a significant portion of the time since the onset of the
disturbance, one or more major areas of functioning such as work, interpersonal relations, or
self-care, are markedly below the level achieved prior to the onset.
3. Duration: Continuous signs of the disturbance persist for at least six months. This six-month
period must include at least one month of symptoms (or less, if symptoms remitted with
treatment).

If signs of disturbance are present for more than a month but less than six months, the diagnosis
of schizophreniform disorder is applied. Psychotic symptoms lasting less than a month may be
diagnosed as brief psychotic disorder, and various conditions may be classed as psychotic
disorder not otherwise specified. Schizophrenia cannot be diagnosed if symptoms of mood
disorder are substantially present (although schizoaffective disorder could be diagnosed), or if
symptoms of pervasive developmental disorder are present unless prominent delusions or
hallucinations are also present, or if the symptoms are the direct physiological result of a general
medical condition or a substance, such as abuse of a drug or medication.
The words of Nash himself best describe the unraveling of his brilliant mind:

...the staff at my university, the Massachusetts Institute of Technology [where he was

teaching], and later all of Boston were behaving strangely towards me...I started to see crypto-
communists everywhere...I started to think I was a man of great religious importance, and to
hear voices all the time. I began to hear something like telephone calls in my head, from
people opposed to my ideas...The delirium was like a dream, from which I seemed never to
awake.

At 30 years of age, John Nash had schizophrenia - a condition from which most afflicted people
never recover.

After being chased by Soviet agents and an exchange of gunfire, Nash becomes increasingly paranoid
and begins to behave erratically.

http://www.medicinenet.com/schizophrenia/article.html

http://www.mentalhealth.com/dis/p20-ps01.html

http://en.wikipedia.org/wiki/Schizophrenia