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Definition

Schizophrenia is a chronic psychotic disorder, the person who experienced it can not assess the reality of the good and bad self-understanding (Kaplan and Sadock, 1997).

Symptom

Primary includes changes thought processes, emotional distress, willingness, and otisme. While secondary symptoms include delusions, hallucinations, catatonic symptoms.

Secondary manifestations to adjust to primary disorder. Schizophrenia is divided into several types, namely simplex, hebefrenik, catatonic, paranoid, not detailed, residual (Maslim, 2000). Of the several types of schizophrenia is given for paranoid schizophrenia. This type is characterized by a preoccupation with one or more delusions or hallucinations, and no behavioral disorganization or catatonic type. In classic paranoid type schizophrenia is characterized mainly by the presence of delusions of greatness, or delusions chase, the course of disease rather constant. Thoughts drift (flight of ideas) are more commonly found in mania, more frequent incoherence in schizophrenia (Maramis, 1998). Time criteria based on the theory of Townsend (1998), who said the condition of the client lives unpredictable, because at any time subject to change.

Delusions are beliefs about the contents of a mind that does not correspond to reality or do not match the intelligence and cultural background, firmly maintained that belief and can not be changed. Mayer-Gross in Maramis (1998) divides delusions in 2 groups, namely primary and secondary. Primary delusions arise illogical, without any external cause. Whereas secondary delusions usually sounds logical, can be followed and a way to explain other symptoms of schizophrenia, delusions named after it, one of which is the delusion of greatness

Delusions of greatness is delusional increased capacity, power, knowledge, identity, or special relationship with a deity or famous person (Kaplan and Sadock, 1997). This opinion is also supported by Kusuma (1997) which states that the degree of delusional grandeur can be stretched a mild exaggeration to actual characteristics of the psychotic delusions of greatness. Fill eg delusions patients have an important discovery or has an unknown talent or excellent health.

Etiology

a. Predisposition

1) Biology
Paranoid schizophrenia caused by central nervous system abnormalities, ie diensefalon / by post mortem changes / an artifact at a time to make preparations. Endocrine disruption also affected, this theory associated with the onset of schizophrenia at the time of puberty, pregnancy or puerperium time and time climacterium. Likewise with metabolic disorders, it is because the people who have schizophrenia appear pale and unhealthy, the tip extremity cyanosis, decreased appetite and weight loss. This theory is supported by the Adolf Meyer stating that a constitutional inferior / physical illness can affect the onset of paranoid schizophrenia.

According Schebel (1991) in Townsend (1998) also say that schizophrenia is a disability since birth, the chaos of the pyramidal cells in the brain, which the brain cells in normal neatly.

Neurological disorder that affects the limbic system and the basal ganglia are associated with the incidence of delusions. Suspicion because of a neurological disorder that is not accompanied by disturbances of intelligence, tend to have a complex delusional. While delusions are accompanied by disturbances of intelligence often a simple supposition (kaplan and Sadock, 1997).

2) Psychological
According to Carpenito (1998), clients with a feeling of suspicion projecting essentially the suspect. On the client with delusions of greatness are feeling inadequate and worthless. First time to deny his own feelings, and then projecting his feelings on the environment and end up having to explain to others. What is someone thinking about an event affect your feelings and behavior. Some of the changes in thinking, feeling or behavior will lead to other changes. The impact of the change was one of them was hallucinations, can occur in one's mind as clearly hear, see, feel, or taste of the phenomenon, according to the time, the irrational belief that ironically produced discontent, a character who "must" and "should.

3) Genetic
Heredity also determines the onset of schizophrenia. This is evidenced by studies in families with schizophrenia and especially twins one egg. Morbidity for the stepsister of 0.9 to 1.8%, siblings 7-15% of children with one parent who had schizophrenia 7-16%, if both parents had schizophrenia 40-68%, twins two eggs (heterozygot) 2-15%, one egg twins (monozygot) 61-86% (Maramis, 1998).

b. Precipitation
This factor can be sourced from internal and external.

Sociocultural stressors
Stress that accumulates to support the onset of schizophrenia and other psychotic disorders (Stuart, 1998)

psychological stressors
The intensity of high anxiety, feelings of guilt and sin, punishment of self, a sense of inadequacy, unbridled fantasy and dream-dream or hope that does not go up, is a source of suspicion. Delusions may develop if there is a great passion of wrath, insult and hurt deep.

The symptoms of delusions
Type of paranoid schizophrenia have symptoms of a typical primary delusions, accompanied by delusions and hallucinations-delusions secondary (Maramis, 1998). According to Kaplan and Sadock (1997), the condition of clients who experience delusions are:

a. Mental status
1) On mental status examination, the results showed a very normal, unless there is a clear system of abnormal delusional.
2) Mood wahamnya clients consistent with the content.
3) On suspicion suspicious, suspicious behavior obtained.
4) On the delusions of greatness, found discussion about increasing self-identity, has a special relationship with a famous person.
5) The system wahamnya, checking the possibility to feel the quality of mild depression.
6) Clients with delusions, hallucinations do not have a stand / settle, unless the client with delusions touch or smell. On some clients likely to be found hallucinations hear.

b. Sensory and cognition
1) On the supposition, there is no abnormality in orientation, except that it has specific delusions about the time, place and situation.
2) Memory and cognitive processes client is intact (intact).
3) Clients delusions almost always have insight (power point) not less ugly.
4) Clients trustworthy information unless harm him. The best decision for examiners in determining the condition of the client is to assess the behavior of the past, the present and planned.