What is schizophrenia?
Schizophrenia, also sometimes called split personality disorder, is a chronic, severe, debilitating that affects about 1% of the population, corresponding to more than 2 million people in the United States alone. Other statistics about schizophrenia include that it affects men about one and a half times more commonly than women. It is one of the psychotic mental disorders and is characterized by symptoms of thought, behavior, and social problems. The thought problems associated with schizophrenia are described as psychosis, in that the person’s thinking is completely out of touch with reality at times. For example, the sufferer may hear voices or see people that are in no way present or feel like bugs are crawling on their skin when there are none. The individual with this disorder may also have disorganized speech, disorganized behavior, physically rigid or lax behavior (catatonia), significantly decreased behaviors or feelings, as well as delusions, which are ideas about themselves or others that have no basis in reality (for example, experience the of thinking others are plotting against them when they are not).
What are the different
types of schizophrenia?
There are five types of schizophrenia, each based on the kind of symptoms the person has at the time of assessment:
- Paranoid schizophrenia: The individual is preoccupied with one or more delusions or many auditory hallucinations but does not have symptoms of disorganized schizophrenia.
- Disorganized schizophrenia: Prominent symptoms are disorganized speech and behavior, as well as flat or inappropriate affect. The person does not have enough symptoms to be characterized as catatonic schizophrenic.
- Catatonic schizophrenia: The person with this type of schizophrenia primarily has at least two of the following symptoms: difficulty moving, resistance to moving, excessive movement, abnormal movements, and/or repeating what others say or do.
- Undifferentiated schizophrenia: This is characterized by episodes of two or more of the following symptoms: delusions, hallucinations, disorganized speech or behavior, catatonic behavior or negative symptoms, but the individual does not qualify for a diagnosis of paranoid, disorganized, or catatonic type of schizophrenia.
- Residual schizophrenia: While the full-blown characteristic positive symptoms of schizophrenia (those that involve an excess of normal behavior, such as delusions, paranoia, or heightened sensitivity) are absent, the sufferer has less severe forms of the disorder or has only negative symptoms (symptoms characterized by a decrease in function, such as withdrawal, disinterest, and not speaking).
How common is
schizophrenia in children?
Although there have been fewer studies on schizophrenia in children compared to adults, researchers are finding that in children as young as 6 years old can be found to have all the symptoms of their adult counterparts and to continue to have those symptoms into adulthood.
What is the history of
schizophrenia?
The term schizophrenia has only been in use since 1911. Soon before that, it was deemed a separate mental illness in 1887 by Emil Kraepelin. Despite that relatively recent history, it has been described throughout written history. Ancient Egyptian, Hindu, Chinese, Greek, and Roman writings described symptoms similar to the positive symptoms of schizophrenia. During medieval times, schizophrenia, like other illnesses, was often viewed as evidence of the sufferer being possessed by spirits or evil powers.
A number of accomplished individuals suffer from schizophrenia. The film A Beautiful Mind depicts the life of John Nash, a noted scientist, and his struggles with paranoid schizophrenia. The film The Soloist explores the challenges faced by Juilliard-trained musician Nathaniel Ayers as a result of schizophrenia.
What are causes of
schizophrenia? Is it hereditary?
One frequently asked question about schizophrenia is if it is hereditary. As with most other mental disorders, schizophrenia is not directly passed from one generation to another genetically, and there is no single cause for this illness. Rather, it is the result of a complex group of genetic, psychological, and environmental factors. Genetically, schizophrenia and have much in common, in that the two disorders share a number of the same risk genes. However, the fact is that both illnesses also have some genetic factors that are unique.
Environmentally, the risks of developing schizophrenia can even occur before birth. For example, the risk of schizophrenia is increased in individuals whose mother had one of certain infections during . Difficult life circumstances during childhood, like the early loss of a parent, parental poverty, bullying, witnessing parental violence; emotional, sexual, or physical abuse; physical or emotional neglect; and insecure attachment have been associated with the development of this illness. Even factors like how well represented an ethnic group is in a neighborhood can be a risk or protective factor for developing schizophrenia. For example, some research indicates that ethnic minorities may be more at risk for developing this disorder if there are fewer members of the ethnic group to which the individual belongs in their neighborhood
What are schizophrenia
symptoms and signs?
Symptoms of schizophrenia include the following:
Positive, more overtly
psychotic symptoms
- Beliefs that have no basis in reality (delusions)
- Hearing, seeing, feeling, smelling, or tasting things that have no basis in reality (hallucinations)
- Disorganized speech
- Disorganized behaviors
- Catatonic behaviors
Negative, potentially less
overtly psychotic symptoms
- Inhibition of facial expressions
- Lack of speech
- Lack of motivation
How is schizophrenia
diagnosed?
As is true with virtually any mental-health diagnosis, there is no one test that definitively indicates that someone has schizophrenia. Therefore, health-care practitioners diagnose this disorder by gathering comprehensive medical, family, and mental-health information. Patients tend to benefit when the professional takes into account their client’s entire life and background. This includes but is not limited to the person’s gender, sexual orientation, cultural, religious and ethnic background, and socioeconomic status. The practitioner will also either perform a physical examination or request that the individual’s primary-care doctor perform one. The medical examination will usually include lab tests to evaluate the person’s general health and to explore whether or not the individual has a medical condition that might produce psychological symptoms.
In asking questions about mental-health symptoms, mental-health professionals are often exploring if the individual suffers from hallucinations or delusions, and/or manic symptoms, , substance abuse, as well as some personality disorders (for example, schizotypal personality disorder) and developmental disorders (for example, spectrum disorders). Since some of the symptoms of schizophrenia can also occur in other mental illnesses, the mental-health screening is to determine if the individual suffers from schizoaffective disorder or other psychotic disorder, bipolar disorder, an anxiety disorder, or a substance abuse or personality disorder. Any disorder that is associated with bizarre behavior, mood, or thinking, like or another psychotic disorder, as well as (DID), formally known as multiple personality disorder (MPD) may be particularly challenging to distinguish from schizophrenia. In order to assess the person‘s current emotional state, health-care providers perform a mental-status examination as well.
In addition to providing treatment that is appropriate to the diagnosis, determining the presence of mental illnesses that may co-occur (be comorbid) with schizophrenia is important in improving the life of individuals with schizophrenia. For example, people with schizophrenia are at increased risk of having a depressive or anxiety disorder and of committing
What are treatments for schizophrenia and the side effects of those treatments? Medications
While there are a number of helpful treatments available, medication remains the cornerstone of treatment for people with schizophrenia. These medications are often referred to as antipsychotics since they help decrease the intensity of psychotic symptoms. Many health-care professionals prescribe one of these medications, sometimes in combination of one or more other psychiatric medications, in order to maximize the benefit for the person with schizophrenia.
Medications that are thought to be particularly effective in treating positive symptoms of schizophrenia include (Zyprexa), (Risperdal), (Seroquel), (Geodon), (Abilify), paliperidone (Invega), and asenapine (Saphis). These medications are the newer group of antipsychotic medications, also called second-generation antipsychotics. They are known for having the ability to work quickly compared to many other psychiatric medications. As a group of medications, side effects that occur most often include sleepiness, , and increased appetite. , which may be associated with higher blood sugar levels, elevated blood lipid levels, and sometimes increased levels of a hormone called prolactin, may also occur. Although older antipsychotic medications in this class like (Haldol), (Trilafon), and (Moban) are more likely to cause muscle stiffness, shakiness, and very rarely uncoordinated muscle twitches (tardive dyskinesia) that can be permanent, health-care practitioners appropriately monitor the people they treat for these potential side effects as well. Also, more recent research regarding all antipsychotic medication seems to demonstrate that the older (first-generation) antipsychotics are just as effective as the newer ones and have no higher rate of people stopping treatment because of any side effect the medications cause. Not all medications that treat schizophrenia in adults have been approved for use in treating childhood schizophrenia.
Mood-stabilizer medications like (Lithobid), (Depakote), and (Lamictal) can be useful in treating mood swings that sometimes occur individuals who have a diagnosable mood disorder in addition to psychotic symptoms (for example, , in addition to schizophrenia). These medications may take a bit longer to work compared to the antipsychotic medications. Some (for example, , divalproex, and carbamazepine) require monitoring of medication blood levels, and some can be associated with when taken by pregnant women.
Antidepressant medications are the primary medical treatment for the depression that can often accompany schizophrenia. Examples of that are commonly prescribed for that purpose include serotonergic (SSRI) medications that affect serotonin levels like (Prozac), (Zoloft), (Paxil), (Celexa), and (Lexapro); combination serotonergic/adrenergic medications (SNRIs) like (Effexor) and (Cymbalta), as well as (Wellbutrin), which is a dopaminergic (affecting dopamine levels) antidepressant.
Despite its stigmatized history, (ECT) can be a viable treatment for people whose schizophrenia has inadequately responded to a number of medication trials and psychosocial interventions.
When treating pregnant individuals with schizophrenia, health-care practitioners take great care to balance the need to maintain the person’s more stable thoughts and behavior while minimizing the risks that medications used to treat this disorder may present. While some medications that treat schizophrenia may carry risks to the fetus in pregnancy and during breastfeeding, careful monitoring of how much medication is administered and the health of the fetus and of the mother can go a long way to protecting the fetus from any such risks, while maximizing the chance that the fetus will grow in the healthier environment afforded by an emotionally healthy mother.
