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SH
Schizophrenia is a chronic and often debilitating mental illness. The condition
can cause you to withdraw from the people and activities in the world around you
and to retreat into a world of delusions or separate reality.
Schizophrenia is a form of psychosis, which is an impairment of thinking in which the
interpretation of reality is abnormal. Psychosis is a symptom of disordered brain
function.
The illness affects approximately 1 percent of the population worldwide. In men,
schizophrenia typically emerges in the teens or 20s. In women, the onset of
schizophrenia typically is in the 20s or early 30s.
There's often no cure for schizophrenia, but by working closely with a psychiatrist
and other mental health professionals, schizophrenia can be managed successfully
- especially with an early diagnosis. Fortunately, newer medications continue to
make this poorly understood disorder more manageable.
Schizophrenia symptoms
Hearing voices. Believing someone or something is controlling your thoughts.
Hallucinations. These are all hallmark symptoms of schizophrenia, a serious and
chronic mental illness. Fortunately new medications and better treatment options
make living with schizophrenia more manageable.
Signs and symptoms
Signs and symptoms of schizophrenia may include:
Delusions - personal beliefs not based in reality, such as paranoia that you're being
persecuted or conspired against
Bizarre delusions - for example, a belief in Martians controlling your thoughts
Hallucinations - sensing things that don't exist, such as imaginary voices
Incoherence
Lack of emotions or inappropriate display of emotions
A persistent feeling of being watched
Trouble functioning at work or in social situations
Social isolation
Difficulty with personal hygiene
Clumsy, uncoordinated movements
Generally, schizophrenia causes a slowly progressive deterioration in the ability to
function in various roles, especially in your job and personal life. The signs and
symptoms of schizophrenia vary greatly. A person may behave differently at
different times. He or she may become extremely agitated and distressed, or fall into
a trance-like, immobile, unresponsive (catatonic) state, or even behave normally
much of the time. Signs and symptoms that occur continuously and progressively
may indicate schizophrenia.
In general, schizophrenia has symptoms that fall into three categories - negative,
positive and cognitive:
Negative signs and symptoms
Negative signs and symptoms may appear early in the disease, and a person may
not think he or she needs treatment. They're referred to as negative because they
indicate a loss of behavior or of a personality trait. Negative signs generally
accompany a slow deterioration of function, leading to your becoming less sociable.
Such signs may include:
Dulled emotions (lack of expression)
Inappropriate emotions (laughing while expressing terrifying images)
A change in speech (speaking in a dull monotone)
Positive signs and symptoms
Positive signs include hallucinations and delusions. They're called positive because
they indicate a trait or behavior that's been added to the personality.
Hallucinations. Hallucinations occur when you sense things that don't exist. The
most common hallucination in schizophrenia is hearing voices. You may carry on a
conversation with voices that no one else can hear. Or you may perceive that voices
are providing you instructions on what to do. Hallucinations may result in injuries to
other people.
Delusions.
Delusions are firmly held personal beliefs that have no basis in reality. The most
common subtype of schizophrenia is paranoid schizophrenia, in which you hold
irrational beliefs that others are persecuting you or conspiring against you. For
example, some people with schizophrenia may believe that the television is directing
their behavior or that outside forces are controlling their thoughts.
Cognitive signs and symptoms
These signs and symptoms tend to be more subtle than positive and negative ones.
Cognitive signs and symptoms may include:
Problems making sense of incoming information
Difficulty paying attention
Memory problems
Misconceptions about schizophrenia
Schizophrenia may exist alone or in combination with other psychiatric or medical
conditions. Misconceptions about schizophrenia and its relation to other mental
illnesses abound. The following truths will help clarify what it is and is not:
Schizophrenia isn't the same as a split or multiple personality. Multiple personality
disorder is a separate, rare condition.
Although some people with schizophrenia develop violent tendencies, most don't.
Many withdraw into themselves rather than interact with others.
Not everyone who acts paranoid or distrustful has schizophrenia. Some people have
a paranoid personality disorder, a tendency to be suspicious or distrustful of others,
without the other features of schizophrenia.
Not everyone who hears voices is schizophrenic. Some people with depression may
hear voices. Hearing voices may also occur as a result of a serious medical illness
or from the effects of medication.
Substance abuse and schizophrenia
While not necessarily a sign of schizophrenia, drug abuse is more common in
people with schizophrenia. Nicotine is a commonly abused drug by people with
schizophrenia; it's estimated that 75 percent to 90 percent of people with
schizophrenia smoke compared with about one-quarter of the general population.
Unfortunately some drugs, such as amphetamines, cocaine and marijuana, can
make schizophrenia symptoms worse. Others, such as nicotine, can interfere with
schizophrenia medications.
Causes
Researchers haven't identified the cause or causes of schizophrenia, although they
believe genetic factors play a role. About 1 percent of the general population
develops schizophrenia compared with 10 percent of those with a close family
relative who has the disease. Chemical or subtle structural abnormalities in the brain
may contribute to causing this illness.
When to seek medical advice
By its nature, schizophrenia often isn't an illness for which someone is likely to
voluntarily seek treatment. To a person with schizophrenia, the delusions and
hallucinations are real, and often he or she may believe there's no need for medical
help. If you're a family member or friend of someone who is exhibiting possible signs
of schizophrenia or another mental disorder, you may need to be the one who takes
him or her to a medical professional for evaluation. Additionally, people with
schizophrenia are more likely to attempt suicide, so if your loved one talks about
suicide, seek medical attention immediately.
Screening and diagnosis
Before making a diagnosis of schizophrenia, your doctor likely will rule out other
possible causes of the signs that may suggest schizophrenia. It's possible that other
mental or physical illnesses may cause signs similar to schizophrenia.
Your doctor will want to discuss your family and medical history and do a physical
examination. Your doctor may ask for blood or urine samples to see if medications,
substance abuse or another physical illness may be a factor in your signs.
Among the other mental illnesses that may at least partly resemble schizophrenia
are depression, bipolar disorder, other psychoses, and abuse of alcohol and other
drugs.
It's also possible that physical illnesses such as certain infections, cancers, nervous
system disorders, thyroid disorders and immune system disorders may produce
some psychotic signs. Psychosis is also a possible side effect of some medications.
If no other underlying cause is found, doctors diagnose schizophrenia based on the
signs and symptoms.
Treatment
Antipsychotic medications, also known as neuroleptics, are the cornerstone of
treatment. Until the 1990s, antipsychotics generally were much more effective in
controlling positive symptoms than negative symptoms. A new generation of
antipsychotics provides more effective management of both positive and negative
symptoms. These antipsychotics include clozapine (Clozaril), risperidone
(Risperdal), olanzapine (Zyprexa), quetiapine (Seroquel), ziprasidone (Geodon) and
aripiprazole (Abilify).
According to the American Diabetes Association, certain antipsychotic drugs may
increase the risk of diabetes, obesity and high blood pressure. For this reason,
people who take Clozaril, Risperdal, Zyprexa, Seroquel, Geodon or Abilify should be
screened and carefully monitored by their doctors.
Smokers may need higher doses of antipsychotic medication because nicotine
interferes with these medications.
Newer antipsychotic medications have fewer side effects. For example, for most
people there's a lower incidence of tardive dyskinesia (TD) with the newer drugs
than with the older medications. TD results in involuntary movements of your mouth,
lips, tongue and other parts of the body. Other possible side effects of the older
medications include interactions with other medications, risk of seizures and
reductions of the white blood count. The new drugs represent a real advance in the
treatment of schizophrenia and have led to greater independence and a higher
quality of life for many people with schizophrenia.
In general, the goal of treatment with antipsychotic medications is to effectively
control signs and symptoms at the lowest possible dosage. The appropriate
medication and dosage vary widely from person to person. Even with good
treatment, you may experience relapses despite ongoing drug treatment, but
medications may reduce the frequency of relapses.
Failing to take medications is a problem
Although the newer-generation medications have fewer side effects and better
adherence rates, nonadherence with medication schedules remains a difficult
problem. Unfortunately, some people with schizophrenia fail to adhere to treatment
recommendations and deny that anything is wrong with them. The nature of the
disorder may prevent them from seeking help or adhering to treatment on their own.
Nondrug therapies
Although medications are the mainstay of treatment to reduce signs and symptoms,
many people with schizophrenia also benefit from nondrug therapies. These may
include:
Individual therapy. Cognitive therapy involves a therapist helping you learn ways of
coping with stressful thoughts and situations to reduce your risk of a relapse. You
may learn to change negative patterns of thought and behavior into ways that put
you in control of your thoughts and feelings. Your illness may have made it more
difficult for you to do things in your daily life that people without schizophrenia may
take for granted. A therapist can also help you comply with your schedule of
medications.
Family therapy. Both you and your family members may benefit from therapy that
provides support and education to families. Your symptoms have a better chance of
improving if your family members understand your illness, can recognize stressful
situations that might trigger a relapse and can help you stick to your schedule of
drug treatment. Conversely, you may not do as well if family members distance
themselves from you and are less understanding and more critical of your illness.
Rehabilitation. Training in social and vocational skills necessary to live
independently is an important part of recovery. With the help of a therapist, you can
learn social skills such as good hygiene, cooking and traveling. People with
schizophrenia who are in programs to train them in social skills or for jobs - and help
them find and keep jobs - seem to experience much greater improvement in
symptoms than do those who don't receive vocational training and job placement.
Today fewer people with schizophrenia require long-term hospitalization because
more people respond positively to medications or other forms of treatment for
schizophrenia.
Provided by the Mayo Clinic
can cause you to withdraw from the people and activities in the world around you
and to retreat into a world of delusions or separate reality.
Schizophrenia is a form of psychosis, which is an impairment of thinking in which the
interpretation of reality is abnormal. Psychosis is a symptom of disordered brain
function.
The illness affects approximately 1 percent of the population worldwide. In men,
schizophrenia typically emerges in the teens or 20s. In women, the onset of
schizophrenia typically is in the 20s or early 30s.
There's often no cure for schizophrenia, but by working closely with a psychiatrist
and other mental health professionals, schizophrenia can be managed successfully
- especially with an early diagnosis. Fortunately, newer medications continue to
make this poorly understood disorder more manageable.
Schizophrenia symptoms
Hearing voices. Believing someone or something is controlling your thoughts.
Hallucinations. These are all hallmark symptoms of schizophrenia, a serious and
chronic mental illness. Fortunately new medications and better treatment options
make living with schizophrenia more manageable.
Signs and symptoms
Signs and symptoms of schizophrenia may include:
Delusions - personal beliefs not based in reality, such as paranoia that you're being
persecuted or conspired against
Bizarre delusions - for example, a belief in Martians controlling your thoughts
Hallucinations - sensing things that don't exist, such as imaginary voices
Incoherence
Lack of emotions or inappropriate display of emotions
A persistent feeling of being watched
Trouble functioning at work or in social situations
Social isolation
Difficulty with personal hygiene
Clumsy, uncoordinated movements
Generally, schizophrenia causes a slowly progressive deterioration in the ability to
function in various roles, especially in your job and personal life. The signs and
symptoms of schizophrenia vary greatly. A person may behave differently at
different times. He or she may become extremely agitated and distressed, or fall into
a trance-like, immobile, unresponsive (catatonic) state, or even behave normally
much of the time. Signs and symptoms that occur continuously and progressively
may indicate schizophrenia.
In general, schizophrenia has symptoms that fall into three categories - negative,
positive and cognitive:
Negative signs and symptoms
Negative signs and symptoms may appear early in the disease, and a person may
not think he or she needs treatment. They're referred to as negative because they
indicate a loss of behavior or of a personality trait. Negative signs generally
accompany a slow deterioration of function, leading to your becoming less sociable.
Such signs may include:
Dulled emotions (lack of expression)
Inappropriate emotions (laughing while expressing terrifying images)
A change in speech (speaking in a dull monotone)
Positive signs and symptoms
Positive signs include hallucinations and delusions. They're called positive because
they indicate a trait or behavior that's been added to the personality.
Hallucinations. Hallucinations occur when you sense things that don't exist. The
most common hallucination in schizophrenia is hearing voices. You may carry on a
conversation with voices that no one else can hear. Or you may perceive that voices
are providing you instructions on what to do. Hallucinations may result in injuries to
other people.
Delusions.
Delusions are firmly held personal beliefs that have no basis in reality. The most
common subtype of schizophrenia is paranoid schizophrenia, in which you hold
irrational beliefs that others are persecuting you or conspiring against you. For
example, some people with schizophrenia may believe that the television is directing
their behavior or that outside forces are controlling their thoughts.
Cognitive signs and symptoms
These signs and symptoms tend to be more subtle than positive and negative ones.
Cognitive signs and symptoms may include:
Problems making sense of incoming information
Difficulty paying attention
Memory problems
Misconceptions about schizophrenia
Schizophrenia may exist alone or in combination with other psychiatric or medical
conditions. Misconceptions about schizophrenia and its relation to other mental
illnesses abound. The following truths will help clarify what it is and is not:
Schizophrenia isn't the same as a split or multiple personality. Multiple personality
disorder is a separate, rare condition.
Although some people with schizophrenia develop violent tendencies, most don't.
Many withdraw into themselves rather than interact with others.
Not everyone who acts paranoid or distrustful has schizophrenia. Some people have
a paranoid personality disorder, a tendency to be suspicious or distrustful of others,
without the other features of schizophrenia.
Not everyone who hears voices is schizophrenic. Some people with depression may
hear voices. Hearing voices may also occur as a result of a serious medical illness
or from the effects of medication.
Substance abuse and schizophrenia
While not necessarily a sign of schizophrenia, drug abuse is more common in
people with schizophrenia. Nicotine is a commonly abused drug by people with
schizophrenia; it's estimated that 75 percent to 90 percent of people with
schizophrenia smoke compared with about one-quarter of the general population.
Unfortunately some drugs, such as amphetamines, cocaine and marijuana, can
make schizophrenia symptoms worse. Others, such as nicotine, can interfere with
schizophrenia medications.
Causes
Researchers haven't identified the cause or causes of schizophrenia, although they
believe genetic factors play a role. About 1 percent of the general population
develops schizophrenia compared with 10 percent of those with a close family
relative who has the disease. Chemical or subtle structural abnormalities in the brain
may contribute to causing this illness.
When to seek medical advice
By its nature, schizophrenia often isn't an illness for which someone is likely to
voluntarily seek treatment. To a person with schizophrenia, the delusions and
hallucinations are real, and often he or she may believe there's no need for medical
help. If you're a family member or friend of someone who is exhibiting possible signs
of schizophrenia or another mental disorder, you may need to be the one who takes
him or her to a medical professional for evaluation. Additionally, people with
schizophrenia are more likely to attempt suicide, so if your loved one talks about
suicide, seek medical attention immediately.
Screening and diagnosis
Before making a diagnosis of schizophrenia, your doctor likely will rule out other
possible causes of the signs that may suggest schizophrenia. It's possible that other
mental or physical illnesses may cause signs similar to schizophrenia.
Your doctor will want to discuss your family and medical history and do a physical
examination. Your doctor may ask for blood or urine samples to see if medications,
substance abuse or another physical illness may be a factor in your signs.
Among the other mental illnesses that may at least partly resemble schizophrenia
are depression, bipolar disorder, other psychoses, and abuse of alcohol and other
drugs.
It's also possible that physical illnesses such as certain infections, cancers, nervous
system disorders, thyroid disorders and immune system disorders may produce
some psychotic signs. Psychosis is also a possible side effect of some medications.
If no other underlying cause is found, doctors diagnose schizophrenia based on the
signs and symptoms.
Treatment
Antipsychotic medications, also known as neuroleptics, are the cornerstone of
treatment. Until the 1990s, antipsychotics generally were much more effective in
controlling positive symptoms than negative symptoms. A new generation of
antipsychotics provides more effective management of both positive and negative
symptoms. These antipsychotics include clozapine (Clozaril), risperidone
(Risperdal), olanzapine (Zyprexa), quetiapine (Seroquel), ziprasidone (Geodon) and
aripiprazole (Abilify).
According to the American Diabetes Association, certain antipsychotic drugs may
increase the risk of diabetes, obesity and high blood pressure. For this reason,
people who take Clozaril, Risperdal, Zyprexa, Seroquel, Geodon or Abilify should be
screened and carefully monitored by their doctors.
Smokers may need higher doses of antipsychotic medication because nicotine
interferes with these medications.
Newer antipsychotic medications have fewer side effects. For example, for most
people there's a lower incidence of tardive dyskinesia (TD) with the newer drugs
than with the older medications. TD results in involuntary movements of your mouth,
lips, tongue and other parts of the body. Other possible side effects of the older
medications include interactions with other medications, risk of seizures and
reductions of the white blood count. The new drugs represent a real advance in the
treatment of schizophrenia and have led to greater independence and a higher
quality of life for many people with schizophrenia.
In general, the goal of treatment with antipsychotic medications is to effectively
control signs and symptoms at the lowest possible dosage. The appropriate
medication and dosage vary widely from person to person. Even with good
treatment, you may experience relapses despite ongoing drug treatment, but
medications may reduce the frequency of relapses.
Failing to take medications is a problem
Although the newer-generation medications have fewer side effects and better
adherence rates, nonadherence with medication schedules remains a difficult
problem. Unfortunately, some people with schizophrenia fail to adhere to treatment
recommendations and deny that anything is wrong with them. The nature of the
disorder may prevent them from seeking help or adhering to treatment on their own.
Nondrug therapies
Although medications are the mainstay of treatment to reduce signs and symptoms,
many people with schizophrenia also benefit from nondrug therapies. These may
include:
Individual therapy. Cognitive therapy involves a therapist helping you learn ways of
coping with stressful thoughts and situations to reduce your risk of a relapse. You
may learn to change negative patterns of thought and behavior into ways that put
you in control of your thoughts and feelings. Your illness may have made it more
difficult for you to do things in your daily life that people without schizophrenia may
take for granted. A therapist can also help you comply with your schedule of
medications.
Family therapy. Both you and your family members may benefit from therapy that
provides support and education to families. Your symptoms have a better chance of
improving if your family members understand your illness, can recognize stressful
situations that might trigger a relapse and can help you stick to your schedule of
drug treatment. Conversely, you may not do as well if family members distance
themselves from you and are less understanding and more critical of your illness.
Rehabilitation. Training in social and vocational skills necessary to live
independently is an important part of recovery. With the help of a therapist, you can
learn social skills such as good hygiene, cooking and traveling. People with
schizophrenia who are in programs to train them in social skills or for jobs - and help
them find and keep jobs - seem to experience much greater improvement in
symptoms than do those who don't receive vocational training and job placement.
Today fewer people with schizophrenia require long-term hospitalization because
more people respond positively to medications or other forms of treatment for
schizophrenia.
Provided by the Mayo Clinic
What is Schizophrenia |
| THE MOST COMMON MENTAL AND EMOTIONAL DISORDERS |
| The information provided on these pages are intended as a educational public service. New studies often change our understanding of how to diagnose and treat these illnesses and direct contact with the appropriate, licensed mental health professional prior to treatment is always reccomended. |