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Schizophrenia

What is schizophrenia?

Schizophrenia is one of the most complex of all mental health disorders. It involves a severe, chronic, and disabling disturbance of the brain. What was once classified as a psychological disease is now classified as a brain disease.

What causes schizophrenia?

There is no known single cause responsible for schizophrenia. It is believed that a chemical imbalance in the brain is an inherited factor which is necessary for schizophrenia to develop. However, it is likely that many factors – genetic, behavioral, and environmental – play a role in the development of this mental health condition.

Schizophrenia is considered to be multifactorially inherited. Multifactorial inheritance means that "many factors" are involved. The factors are usually both genetic and environmental, where a combination of genes from both parents, in addition to unknown environmental factors, produce the trait or condition. Often, one gender (either males or females) is affected more frequently than the other in multifactorial traits. There appears to be a different threshold of expression, which means that one gender is more likely to show the problem, over the other gender. Slightly more males develop schizophrenia in childhood, however, by adolescence schizophrenia affects males and females equally.

Who is affected by schizophrenia?

Although schizophrenia affects men and women equally, symptoms in men generally begin earlier than in women. In most cases, schizophrenia first appears in men during their late teens or early 20s. In women, schizophrenia often first appears during their 20s or early 30s.

Statistics indicate that schizophrenia affects about 1% of Americans. A child born into a family with one or more schizophrenic family member has a greater chance of developing schizophrenia than a child born into a family with no history of schizophrenia.

After a person has been diagnosed with schizophrenia, the chance for a sibling to also be diagnosed with schizophrenia is higher. If a parent has schizophrenia, the chance for a child to have the disorder is 10%. Risks increase with multiple affected family members.

What are the symptoms of schizophrenia?

One of the most disturbing and puzzling characteristics of schizophrenia is the sudden onset of its psychotic symptoms. The following are the most common symptoms of schizophrenia. However, each individual may experience symptoms differently. Symptoms may include:

  • Distorted perception of reality (for example, difficulty telling dreams from reality)

  • Confused thinking (for example, confusing television with reality)

  • Detailed and bizarre thoughts and ideas

  • Suspiciousness and/or paranoia (fearfulness that someone, or something, is going to harm them)

  • Hallucinations (seeing, hearing, or feeling things that are not real such as hearing voices telling them to do something)

  • Delusions (ideas that seem real but are not based in reality)

  • Extreme moodiness

  • Severe anxiety and/or fearfulness

  • Flat affect (lack of emotional expression when speaking) or inability to manage emotions

  • Difficulty in performing functions at work and/or school

  • Exaggerated self-worth and/or unrealistic sense of superiority of one's self

  • Social withdrawal (severe problems in making and keeping friends )

  • Disorganized or catatonic behavior (suddenly becoming agitated and confused, or sitting and staring, as if immobilized)

  • Odd behaviors

The symptoms of schizophrenia are often classified as positive (symptoms including delusions, hallucinations, and bizarre behavior), negative (symptoms including flat affect, withdrawal, and emotional unresponsiveness), disorganized speech (including speech that is incomprehensible), and disorganized or catatonic behavior (including marked mood swings, sudden aggressive, or confusion, followed by sudden motionlessness and staring).

The symptoms of schizophrenia in children are similar to adults, however in 80% of diagnosed cases, children have auditory hallucinations. Children typically do not have delusions or formal thought disorder until mid-adolescence or older.

The symptoms of schizophrenia may resemble other problems or psychiatric conditions. Always consult your health care provider for a diagnosis.

How is schizophrenia diagnosed?

Schizophrenia is usually diagnosed by a psychiatrist. Other mental health professionals usually participate in the completion of a comprehensive mental health evaluation to determine individualized treatment needs.

Treatment for schizophrenia

Specific treatment for schizophrenia will be determined by your health care provider based on:

  • Your age, overall health, and medical history

  • Extent of the disease

  • Your tolerance for specific medications, procedures, or therapies

  • Expectations for the course of the disease

  • Your opinion or preference

Schizophrenia is a major psychiatric illness. Treatment for schizophrenia is complex. A combination of therapies is often necessary to meet the individualized needs of the individual with schizophrenia. Treatment is aimed at reducing the symptoms associated with the disorder. Types of treatment that may be helpful to an individual with schizophrenia may include:

  • Medications (also called psychopharmacological management; to reduce the symptoms of schizophrenia), including the following:

    • Neuroleptics. A specialized class of medications used to treat schizophrenia. Neuroleptics are used primarily to treat the pervasive, intrusive, and disturbing thoughts of a person with schizophrenia. They are designed to help minimize the severity of delusions and hallucinations the individual is experiencing. They can reduce symptoms and relieve suffering, but they do not cure the illness.

    • Anti-anxiety medications.

    • Antidepressants .

  • Individual and family psychotherapy (including cognitive and behavioral therapy)

  • Specialized educational and/or structured activity programs (for example, social skills training, vocational training, speech and language therapy)

  • Self-help and support groups

Prevention of schizophrenia

Preventive measures to reduce the incidence of schizophrenia are not known at this time. However, identification and early intervention can improve the quality of life experienced by persons with schizophrenia. Treatment is most successful when symptoms of the first psychotic episode are addressed properly and promptly. It is crucial for an individual who is prescribed medications for the treatment of schizophrenia to remain compliant. Dosages and types of medications may need to be adjusted periodically to maintain effectiveness. Always consult your health care provider for more information.