Schizophrenia

Schizophrenia is a type of psychotic disorder that is lifelong, chronic and challenging to manage. It affects neurotransmitters in the brain and makes it difficult for the individual to think well, manage their emotions, function normally, and know what is real versus what is not. It also impacts how they think, behave, and perceive their environment and the world. 

Overview

Schizophrenia may trigger symptoms of delusions, hallucinations, and extremely disturbing behavior and thinking patterns that greatly impair daily functioning. 

The disorder is not very common and affects approximately 0.25% to 0.64% of people in the United States. It greatly impacts the person’s life and those around them. It occurs in both women and men of all ages. Women usually show the symptoms in their late 20s and early 30s.

People with schizophrenia need life-long treatment and support. Early intervention can help to control symptoms before severe complications develop and it may help to improve the long-term outlook.

A man is caught in Exhibitionistic Disorder

Signs and Symptoms of Schizophrenia

Schizophrenia involves a series of problems with thinking, actions, and emotions. Signs and symptoms may differ for individuals, but they often involve hallucinations, delusions, impaired speech, and an inability to function within normal limits. Symptoms may include:

Delusions. These are untrue beliefs that are not reality-based. Delusions occur in most people with schizophrenia.

Hallucinations. These usually involve seeing or hearing things that do not exist. Auditory hallucinations are the most common. 

Disorganized thinking and speech. Effective communication is impaired and answers to questions may be partially or completely unrelated. Speech might include meaningless words that may be difficult to be understood.

Very disorganized or irregular motor behavior. This may appear in numerous ways that range from childlike tantrums to agitation, and it is very difficult for them to complete simple tasks. Behavior involves resistance to directions, odd posture, a lack of response, and unnecessary movements.

Negative symptoms. It includes a lack of ability to function normally. For example, the person may not perform self-care (e.g., hygiene), may lack any emotion, lose interest in any activities, socially withdraw, and cannot experience any pleasure. 

Causes of Schizophrenia

The exact cause of schizophrenia is not known. Researchers have discovered a number of things that seem to make someone prone to develop schizophrenia.

  • Genetics (heredity): Schizophrenia can run in families, it may be passed on from parents to their offspring.
  • Brain chemistry: Individuals with schizophrenia have problems with the neurotransmitters or connections of nerve cells that affect thinking and behavior.
  • Brain abnormality: Research says that abnormal brain structure is seen in some people with schizophrenia.
  • Environment:  Exposure to toxins like marijuana, viral infections, and highly stressful circumstances can trigger schizophrenia. It usually occurs while hormonal and physical changes occur in the body.

Risk factors of Schizophrenia:

Certain factors are seen to increase the risk of developing or triggering schizophrenia, which includes:

  • Family history of schizophrenia
  • Pregnancy and birth complications (i.e. malnutrition or exposure to viruses and toxins that may influence the development of the brain).
  • Taking psychotropic or psychoactive drugs during teen years and young adulthood

Complications of Schizophrenia:

Schizophrenia can result in severe complications that influence every area of life. Complications that schizophrenia can cause include:

  • Suicidal tendency and suicide attempts
  • Obsessive-compulsive disorder (OCD)
  • Anxiety disorders
  • Depression
  • Inability to work or attend school
  • Drugs abuse
  • Financial issues and homelessness
  • Social withdrawal
  • Health and medical issues
  • Being oppressed
  • Violent behavior

Prevention of Schizophrenia:

 There is no way to prevent schizophrenia, but following the treatment, regimen might help to prevent worsening or relapse of symptoms. Additionally, researchers expect that learning further about the risk factors of schizophrenia might help in earlier diagnosis and treatment.

Diagnosis of Schizophrenia:   

To diagnose schizophrenia, a doctor will use DSM-5 criteria. The person must have at least two of the following symptoms for one month:

  1. Hallucinations
  2. Delusion
  3. Disorganized speech
  4. Grossly disorganized or catatonic behavior
  5. Negative symptoms, such as lack of speech, emotional flatness, or lack of motivation.

At least one of these symptoms must be 1, 2, or 3. The individual must also complain about significant impairment in their functioning, interaction with others, inability to carry out self-care tasks, and they must have symptoms that persist for 6 months or more. The symptoms must also not be related to any other health condition, a prescribed medication, or the use of other substances.

Treatment of Schizophrenia:

Treatment of Schizophrenia involves both medications and psychological interventions.

Medications used to treat schizophrenia:

Antipsychotics are usually used to treat the disorder. Although these medicines do not cure schizophrenia they help relieve the most troubling symptoms, including hallucinations, delusions, and thinking problems.

Psychological treatment of schizophrenia:

  • Coordinated specialty care (CSC): This is a team-based approach towards treating schizophrenia when the first symptoms appear. It includes both therapy and medicines with social services, (i.e. educational and employment interventions). The family of individual is also involved.
  • Psychosocial therapy:  Psychosocial treatment makes patients learn to manage their symptoms, recognize early warning signs of relapse, and relapse prevention plan. Types of psychosocial therapies include:
    1. A rehabilitation centers on social skills and job training in order to support the affected people to function well in the community and live independently.
    2. Cognitive remediation involves learning skills to deal with issues concerning the processing of information. It often includes coaching, drills, and mental exercises to build up mental skills which involve planning, attention, organization, and memory.
    3. Individual psychotherapy helps the affected individual to better understand his illness, and learn problem-solving skills.
    4. Family therapy helps the families to deal with loved ones having schizophrenia, facilitating them to better support their loved ones.
    5. Group therapy/support groups that provide continued mutual support.

Hospitalization: Many people having schizophrenia are treated outpatient; however, psychotic episodes or states of mind that provoke self-harming or aggressive behaviors may require temporary inpatient treatment. 

Electroconvulsive therapy (ECT): This procedure involves the attachment of electrodes to the person’s scalp while they are under anesthesia. Small electric shocks are delivered to the brain. The results are usually an improvement in thinking in the mood. It is thought that ECT-induced seizures may have a positive impact on the release of the brain’s neurotransmitters. ECT is used as a last resort for individuals with schizophrenia and is only used in the most severe cases that are not responding to any other form of treatment.