Schizophrenia

Schizophrenia is a chronic, severe, disabling brain disease. It does not mean a split or multiple personality.

Causes

The cause of Schizophrenia is unknown. Problems with brain structure and chemistry are thought to play a role. There also appears to be a genetic component. People with a parent or sibling with Schizophrenia have a 10% chance of developing the disease. This compares to a 1% chance if no relatives have Schizophrenia. Some researchers believe that environmental factors may contribute. They theorize that a viral infection in infancy and/or extreme stress may trigger Schizophrenia in people who are predisposed.

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.
  • Having a parent or sibling with schizophrenia
  • Abnormal brain structure
  • In the northern hemisphere: being born during winter months; being born in the city
  • Oxygen deprivation during pregnancy
  • Issues at your birth such as:
    • Long labor
    • Bleeding during pregnancy
    • Prematurity
    • Low birth weight
    • Maternal malnutrition
    • Infections during pregnancy
  • Loss of a parent during childhood

Symptoms

Symptoms usually start in adolescence or early adulthood. They often appear slowly and become more disturbing and bizarre over time.
Symptoms include:
  • Hallucinations – seeing or hearing things/voices that are not there
  • Delusions – strong but false personal beliefs that are not based in reality
  • Disorganized thinking
  • Disorganized speech – lack of ability to speak in a way that makes sense or carry on a conversation
  • Catatonic behavior – slow movement, repeating rhythmic gestures, pacing walking in circles
  • Emotional flatness – flat speech, lack of facial expression, and general disinterest and withdrawal
  • Inappropriate laughter
  • Poor hygiene and self-care
Associated conditions include:
  • Obsessive-compulsive disorder
  • Substance abuse (of drugs, caffeine, nicotine)
  • Self injury, including suicide

Diagnosis

Early diagnosis is extremely important. People who are diagnosed early are able to:
  • Stabilize their symptoms
  • Decrease the risk of suicide
  • Decrease alcohol and substance abuse
  • Reduce the chance of relapse and/or hospitalization
A person must have active symptoms for at least two weeks, and other symptoms for at least six months before a diagnosis can be made. The doctor will rule out other causes such as drug use, medical illness, or a different mental condition.

Treatment

Schizophrenia is not curable but it is highly treatable. Hospitalization may be required during acute episodes. Symptoms are usually controlled with antipsychotic medications.
Antipsychotic Medications
Antipsychotic medications work by blocking certain chemicals in the brain. This helps to control the abnormal thinking that occurs in people with schizophrenia. Working out a medication plan can be a complicated process. Often medications or dosages need to be changed until the right balance is found. This can take months or even years.
Relapse is common. People often stop taking their medication when they are feeling better. The side effects also can cause people to discontinue treatment. The most common are physical side effects such as:
  • Slow and stiff movements
  • Restlessness
  • Facial tics
  • Protruding tongue
New medications, called atypical antipsychotics, have fewer side effects. Medications for Co-Existing Conditions
Conditions often associated with schizophrenia include depression and anxiety.They may be treated with:
  • Antidepressants
  • Anxiolytic drugs
  • Lithium
  • Anticonvulsants
Electroconvulsive Therapy
Electroconvulsive therapy may be used to treat severe depression. Supportive Therapy
Schizophrenia is a lifelong condition. It can be confusing and frightening for the person with the disease and for family members. Counseling addresses:
  • Social skills
  • Vocational guidance
  • Community resources
  • Coping with family
  • Living arrangements
  • General emotional support
  • Working with the family to help them deal with the patient

Prevention

There are no guidelines for preventing Schizophrenia because the cause is unknown. However, studies show that early, aggressive treatment leads to better outcomes.