Schizophrenia manifests itself differently depending on its type. However, even in severe cases, it is possible to distinguish this pathology from other similar ones. With mixed types of mental disorders, everything is much more complicated. Mosaic schizophrenia is one of them. The patient has signs of several diseases and syndromes, none of which is pivotal. Let’s talk about this in more detail.
Mosaic means “mixture” in French. It is the metaphorical name for disorders that combine signs of various syndromes and pathologies in medicine. At the same time, there are no distinct symptoms, such as hallucinations and delusions in schizophrenia, so it is difficult to establish a diagnosis and differentiate the disease from other diseases.
The International Classification of Diseases, Ninth Revision (ICD-9) listed personality disorders such as mosaic psychopathy and polymorphic psychopathy. ICD-10 no longer has them. The terms “mosaic schizophrenia” and “mosaic psychopathy” themselves, if used, are more in the domestic sense. Today, doctors operate with the categories “mixed schizophrenia” and “mixed personality disorder.”
Such diseases and syndromes do not manifest themselves in a specific way. They do not have features unique to schizoids, paranoids, hysteroids, or other personality types. However, signs of any of them prevent a person from living, adapting, and interacting with society.
For example, the combination of hysterical, dissociative (unstable), and impulsive (excitable) disorders often leads to dependence on drugs, alcohol, and games, which entails antisocial behavior. However, superstitious ideas arise if the psychasthenic and schizoid types are combined. The combination of schizoid and hysterical disorders can testify to the development of schizophrenia.
In other words, such cases require a long diagnosis. The patient does not always have a disease accompanied by brain damage. But he always needs help. Otherwise, he will not be able to socialize thoroughly.
Schizophrenia and mosaic schizophrenia
Schizophrenia is psychopathology in which mental functions, thinking, and the emotional sphere are affected. It can manifest itself in different forms. Both very severe types of this disease develop rapidly, such as hebephrenic schizophrenia, and are less dangerous – latent with a smaller set of symptoms.
But all types of schizophrenia share several standard features. First, while having a seizure, the person may not be aware of his actions. In most cases, he does not consider himself ill. Second, the disease leaves a mark on his psyche. After an exacerbation, the patient may comprehend what he did, but the pathology cannot go away without a trace. One way or another, the personality will change.
Psychopaths and mosaic schizophrenia are more psychopaths than schizophrenia and are aware of their actions. They are fully responsible for their actions, including criminal responsibility. However, this awareness does not help them to live everyday life, interacting with others according to the rules common to all.
In other words, psychopaths are sane since they do not have the lesion of personality or the inner as in schizophrenic disorders. Thus, psychopathy is not included in the list of psychiatric diagnoses.
The prevalence of psychopathy is about 1-2% in the general population and 15-25% in the criminal world. At the same time, psychopathic traits, which do not indicate that a person is a clinical psychopath, are observed in about 10% of the population. They do not have psychopathy, but they harm those around them in one way or another.
It is generally accepted that the majority of such psychopaths are men. They commit crimes more often. And such criminals are characterized by pathological lying, stealthiness, sadism, and other features perceived by the majority as abnormal and dangerous.
The mechanism of psychopathy development and the mechanism of schizophrenic disorders are still unknown.
In a large-scale study conducted in the U.S. in the 1980s, psychopathy is found more often in men – about 80%. However, some experts believe that female psychopath are more common, just that their disorder symptoms are less pronounced. Moreover, they often resort not to physical but psychological violence against others.
There is no specific cause that would lead to psychopathy. Scientists talk about a set of factors that can influence personality traits. Most experts assure that the future disorder is established in early childhood – in the first three years of a child’s life. Any event, especially traumatic, can affect personality traits.
Often in such cases, there is talk of family oppression, violence, alcoholism, etc. It is difficult to precisely say how a child’s brain will process this information. But we do know that it develops very quickly in children. That is why you should not shout at them (or in their presence), talk swear words, smoke, walk around naked, etc. It is not sure that these factors will lead to the development of psychopathy, but the risk increases markedly.
Developments in genetics have also made it possible to look at such disorders in terms of genetic predisposition. Scientists have discovered genes whose carriers are naturally characterized by selfishness, lack of empathy, cruelty, aggressive behavior, etc.
There is a so-called aggression gene (warrior gene) MAO-A, which sure encodes monoamine oxidase A. The latter affects neurotransmitters’ biochemical processes, providing nerve impulses between brain cells. These neurotransmitters include serotonin, adrenaline, dopamine, and other hormones. If their production is disrupted, when their levels are too high or, conversely, low, the likelihood of developing personality disorders increases.
It is worth noting that a carrier of the said gene does not always become a psychopath. Psychopathy can be genetically conditioned, but the trigger for its development can be external factors, in particular, cruelty and violence witnessed by the child. Persons exposed to psychoactive substances may also be included in the risk group.
Congenital and Acquired
Based on the cases described above, there are two types of psychopathy – chronic and acquired. The first is a consequence of “bad” genetics, and signs appear in early childhood. Acquired psychological disorders can be organic and marginal. If symptoms develop from brain trauma but disappear, we are talking about the organic type. This condition is not called psychopathy in the medical sense of the word.
Marginal varieties of the disorder manifest themselves later and are usually associated with an unfavorable environment. Usually, these types of psychopathy are referred to as mosaic, as it is challenging to identify a specific pathology or syndrome in such cases. In addition, the impairment in the marginal form is not as deep as in the clinical type.
Mosaic Schizophrenia Risk factors
A variety of factors can trigger mosaic schizophrenia. The most obvious ones are:
- Genetic predisposition to aggression;
- Abnormal pregnancy;
- Trauma and diseases affecting the CNS;
- Unfavorable upbringing conditions;
- Abuse of psychoactive substances;
- Age crises and hormonal shifts.
A child may become psychotic due to parental indifference, connivance, impunity, etc. In each case, the doctor tries to cover as many factors as possible, studying the patient’s history.
Symptoms of Mosaic Schizophrenia
The problem of symptomatology is no less complex than that of etiology. Although the exact causes are unknown in the latter case, a different problem occurs regarding symptoms. There are many of them, but it is difficult to attribute them to any particular type of disorder. Usually, the psychopath is suspicious, resentful, prone to fantasies, violent, indifferent, etc. But it is impossible to say that one trait predominates. There may be too many combinations.
Nevertheless, scientists offer a list of symptoms, which allows us to suspect a person of psychopathy. These include:
- Total fearlessness. Even courageous people are called fearless not because they are not afraid but because they know how to overcome fear. Psychopaths, on the other hand, may not experience it, in principle.
- Weak immune system, emotionality. A man tries to satisfy his needs instantly, without thinking about the consequences. He is guided mainly by his desires.
- Lack of empathy. Psychopaths are unable to empathize and sympathize. Other people’s suffering arouses a sense of satisfaction or indifference, not pity.
These are not specific traits but traits that are common to almost all psychopaths. They can also be found in ordinary people. But, as a rule, while committing certain acts, the mentally healthy suffer, repent or, at least, understand that he is wrong.
A psychopath, on the other hand, does not repent. Moreover, he may take pleasure in other people’s suffering. He is willing to resort to manipulation, lies, and betrayal to hide his motives. He often takes advantage of other people’s empathy but regards such a trait as a weakness. Such individuals are always sure of their rightness, which they can prove with psychological and physical violence.
Symptoms in a child
In the case of nuclear mosaic schizophrenia, the first symptoms can be observed already in young children. First, parents should not ignore the aggression and cruelty they allow towards their peers, animals, or playthings.
The remarkable fact should be that such children are not afraid of punishment. They do not repent but always find someone to blame. At the same time, their aggression is characterized by an evident persistence. It is almost impossible to change the mind of such a child. He may even calm down but will most likely remain with his opinion.
In adolescence, he will become uncontrollable. Neither threats nor punishments work, including physical (the latter can also aggravate the situation. Therefore, they are highly undesirable). The teenager-psychopath often runs away from home, studies poorly, associates with bad company, and starts to smoke and use alcohol. It is not uncommon for such children to steal, not only out of necessity but also to please their desire to take someone else’s things. They are not interested in the feelings of others, even their peers.
If these signs are detected, upbringing can be corrected, and a socialized psychopath who will function well in society can be raised.
The essential traits of a psychopath – selfishness, fearlessness, and a desire to get their way at any cost – are likely to persist for life. However, he can learn to control himself and live by the established rules. In many respects, the responsibility rests on parents who should seek out the assistance of a psychotherapist in good time. Often adults punish the child or, on the contrary, justify it in everything, connecting their bad behavior to the “bad environment.
Mosaic schizophrenia includes 2-3 personality disorders or signs of several disorders. In one case or another, traits of the following types may be observed:
- Paranoid. Hypochondria and restlessness are their characteristics. A typical example is a pathological jealousy.
- Schizoid. Very withdrawn and inclined to fantasies. No need for other people. He has signs of anhedonia when there is no ability to enjoy himself.
- Dissociative. The three main symptoms listed above are particularly pronounced. The individual is unable to behave as socially accepted. He quickly falls into a rage and is prone to violence.
- Emotionally unstable (excitable). Quickly gets into an excited state, they cannot control their emotions and actions.
- Hysterical. Easily excited, but the behavior is theatrical and superficial. Hysteria is aimed at drawing attention to oneself.
- Anankast. Characterized by meticulousness and lack of self-confidence, but stubbornness. Has obsessions that do not reach the level of mania or delirium as in standard schizophrenia.
- Anxious. He exaggerates dangers, suspects others of conspiracies, and believes others underestimate him.
- Dependent. Cannot live alone, inclined to obedience, does not like making decisions. He usually behaves like his favorite idol.
Other types include eccentrics, infantile, narcissists, psycho-neurasthenics, etc. In the mosaic form, signs typical for 2-3 types of psychopathy are observed.
Experts assure that managers of different levels of 5% of people are psychopaths.
The most dangerous is a combination of dissociative, hysterical, and emotionally unstable types. Such individuals are more likely to become alcoholics, drug addicts, and criminals, including sexual perverts.
If a person combines the traits of a schizoid and a psychasthenic psychopath, he is usually consumed by some supernatural idea.
Some people become nags, while others try to change the world. When polar symptoms like psychasthenia and hyperexcitability are combined, it is easier to identify odd behaviors. However, it is necessary to differentiate psychopathy from schizophrenia in such cases.
Mosaic Schizophrenia Treatment
It is impossible to cure psychopathy. A person will have to live with it forever. The basis of treatment is psychotherapeutic therapy. It is needed both during acute and remission periods. The patient has to realize that he has a problem. Only then will he have a chance to recover.
Medication therapy is rarely used. Only when the patient is severely anxious may medication be prescribed. There are no specific drugs for psychopaths. These or other psychotropic substances are selected based on the symptoms.
With psychopathy, treatment becomes an ongoing process. One will have to follow the doctor’s recommendations. If the person continues to abuse alcohol or take drugs, they will not be able to cope with aggression and other psychopathic features.
The prognosis for such disorders is difficult to give. If the person wants to live everyday life, they will cope, especially with the help of doctors and relatives.
Also, the development of the disorder depends on its type. If it manifested itself early but the parents took no measures, the probability of an unfavorable outcome – alcoholism, drug addiction, violations of the law – is relatively high.