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Schizophrenia

Definition

Schizophrenia is a chronic, severe, disabling brain disorder. It interferes with the way a person interprets reality. People with schizophrenia may:

Hear voices or see things that others do not
Become paranoid that people are plotting against them
Experience cognitive deficits
Withdraw socially

These and other symptoms make it difficult for people with schizophrenia to have positive relationships with others.

Regions of the Brain

Schizophrenia affects many different areas of the brain causing a wide range of behavioral, emotional, and intellectual symptoms.

Causes

The cause of schizophrenia is unknown but it is associated with problems in brain structure and chemistry. There may be some genetic role.

Schizophrenia does not develop because of one factor. You may have a gene that increases your chance of schizophrenia, but you may not develop the disease based on your environment. Environment means any outside factor like stress or infection.

Risk Factors

Factors that increase your risk of schizophrenia include:

Having a parent or sibling with schizophrenia
Marijuana use or other drug use
Father being of older age
Other factors, like problems during pregnancy or birth such as infection

Symptoms

Men typically develop symptoms in their late teens or early twenties. Schizophrenia in women tends to occur in their twenties or thirties. In rare cases, it is seen in childhood.

Symptoms often appear slowly. They may become more disturbing and bizarre over time or occur in a matter of weeks or months.

Symptoms may 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
Catatonic behavior—slow movement, repeating rhythmic gestures, pacing, walking in circles, refusal to do things, repetitive speech
Emotional flatness—flat speech, lack of facial expression, and general disinterest and withdrawal
Paranoia
Inappropriate laughter
Poor hygiene and self-care

Diagnosis

Your doctor will ask you about your symptoms and medical history. A physical exam will be done.

Schizophrenia is diagnosed by certain symptoms that:

Exist most of the time during a period of one month
Cause a decreased level of functioning
Continue for at least six months (certain symptoms)

The doctor will rule out other causes, such as drug use, physical illness, or other mental health conditions.

Treatment

Schizophrenia is not curable, but it is highly treatable. Hospitalization may be required during acute episodes. Symptoms are usually controlled with antipsychotic medicine.

Talk to your doctor about the best treatment plan for you. Options may include one or more of the following:

Antipsychotic Medications

Antipsychotic medicines work by blocking certain chemicals in the brain. This helps control the abnormal thinking that occurs in people with schizophrenia. Determining a medicine plan can be a complicated process. Often medicines or dosages need to be changed until the right balance is found. This can take months or even years. The right balance of medication will have the least amount of side effects possible with the greatest benefit.

It is important to continue taking the medication even if you are feeling better. Symptoms will return once the medication has been stopped. A long-acting injection instead of daily pills may be used if you have difficulty taking regular medication.

Antipsychotic medication also have side effects that may make it difficult to stick to a medication routine. Common side effects include:

Slow and stiff movements
Restlessness
Facial tics
Protruding tongue

Medicines called atypical antipsychotics have fewer side effects and are better tolerated over long periods of time. However, these medication may cause weight gain, high blood sugar levels, and high cholesterol levels.

Medications for Coexisting Conditions

Depression and anxiety can often occur with schizophrenia. They may be treated with:

Antidepressants
Anti-anxiety medicine
Mood stabilizers
Anticonvulsants

Supportive Therapy

Schizophrenia is a lifelong condition. It can be confusing and frightening for the person with the disease and for family members. Individual and family therapy can address:

Social skills
Vocational guidance
Community resources
Family issues
Living arrangements
Emotional support

If you are diagnosed with schizophrenia, follow your doctor's instructions.

Prevention

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

RESOURCES

National Institute of Mental Health http://www.nimh.nih.gov

World Fellowship for Schizophrenia and Allied Disorders http://world-schizophrenia.org

CANADIAN RESOURCES

Canadian Psychiatric Association http://www.cpa-apc.org

Mental Health Canada http://www.mentalhealthcanada.com

References

Early onset schizophrenia. National Alliance on Mental Illness website. Available at: http://www.nami.org/Template.cfm?Section=By%5FIllness&template=/ContentManagement/ContentDisplay.cfm&ContentID=103175. Updated July 2010. Accessed August 28, 2012.

Schizophrenia. American Psychiatric Association website. Available at: http://www.psychiatry.org/schizophrenia. Accessed April 3, 2013.

Schizophrenia. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated March 13, 2013. Accessed April 3, 2013.

Schizophrenia. National Institute of Mental Health website. Available at: http://www.nimh.nih.gov/health/topics/schizophrenia/index.shtml. Updated April 2, 2013. Accessed April 3, 2013.

Revision Information

Reviewer: Brian Randall, MD
Review Date: 02/2013 -
Update Date: 04/03/2013 -

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.