Schizophrenia

What is Schizophrenia?

Schizophrenia is a brain disorder that affects the way a person acts, thinks, and sees the world. People with schizophrenia have an altered perception of reality, often a significant loss of contact with reality. They may see or hear things that don’t exist, speak in strange or confusing ways, believe that others are trying to harm them, or feel like they’re being constantly watched. With such a blurred line between the real and the imaginary, schizophrenia makes it difficult—even frightening—to negotiate the activities of daily life. In response, people with schizophrenia may withdraw from the outside world or act out in confusion and fear.

Most cases of schizophrenia appear in the late teens or early adulthood. For men, the average age of onset is 25. For women, typical onset is around the age of 30. However, schizophrenia can appear for the first time in middle age or even later. In rare cases, schizophrenia can even affect young children and adolescents, although the symptoms are slightly different. In general, the earlier schizophrenia develops, the more severe it is. Schizophrenia also tends to be more severe in men than in women.

Symptoms

There are several subtypes of schizophrenia, depending on the most prominent symptoms. As with any illness, the severity, duration, and frequency of symptoms can vary; however, in persons with schizophrenia, the incidence of severe psychotic symptoms often decreases during a patient’s lifetime. Not taking medications, use of alcohol or illicit drugs, and stressful situations tend to increase symptoms. The symptoms fall into three categories:

Positive symptoms

Hallucinations, such as hearing voices, paranoid delusions, and exaggerated or distorted perceptions, beliefs, and behaviors.

Negative symptoms

A loss or a decrease in the ability to initiate plans, speak, express emotion, or find pleasure.
Cognitive symptoms

Confused and disordered speech, problems with memory, trouble with logical thinking, and difficulty paying attention and making decisions.

Symptoms usually first appear in early adulthood. Men often experience symptoms in their early 20s and women typically first show signs of the disease in their late 20s and early 30s.

    

Causes

Researchers believe that a number of biological and environmental factors play a role in the disease’s onset and course. However, scientists do not yet know which factors produce the illness. Because of the variations in symptoms, many believe that schizophrenia constitutes a group of disorders, not unlike other chronic illnesses. Although the origin of schizophrenia has not been identified, scientists know that there is some hereditary basis or genetic predisposition for the disease because it runs in families.

Treatment

There is no cure for schizophrenia, but treatments are available to reduce the intensity and frequency of the symptoms. Medication and psychosocial treatments can help some people with schizophrenia lead highly productive and rewarding lives, while for others, the illness continues to cause impairments in function despite treatment and family support.

A variety of antipsychotic medications are effective in reducing the psychotic symptoms present in the acute phase of the illness, and they also help reduce the potential for future acute episodes. Before treatment can begin, however, a psychiatrist should conduct a thorough medical examination to rule out substance abuse or other medical illnesses whose symptoms mimic schizophrenia.

People with schizophrenia abuse drugs more often than the general population. Substance abuse complicates the diagnosis of schizophrenia and also reduces the effectiveness of treatment for schizophrenia. If a patient shows signs of addiction, treatment for substance abuse should be pursued along with other treatments.

Recovery and Rehabilitation

After the symptoms of schizophrenia are controlled, therapy can help people learn social skills, cope with stress, identify early warning signs of relapse, and prolong periods of remission. For many with this disease, recovery from schizophrenia includes those who reach their full potential by managing the illness. Because schizophrenia typically strikes in early adulthood, individuals with the disorder need rehabilitation to help develop life-management skills, complete vocational or educational training, and hold a job. For example, supported-employment programs have been found to help persons with schizophrenia obtain self-sufficiency. These programs provide people with severe mental illness with jobs in competitive, real-world settings.

Many people living with schizophrenia receive emotional and material support from their family. Therefore, it is important that families be provided with education and assistance managing their ill relative’s disease. Such assistance has been shown to help prevent relapses and improve the overall mental health of the family members as well as the person with schizophrenia.