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Schizophrenia
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Schizophrenia

Overview of schizophrenia

Schizophrenia takes its roots from the Greek word, where schizein means ‘to split’ and phren means ‘mind’. Schizophrenia was previously known as multiple personality disorder or split personality disorder. It is a mental illness, which is characterized by impairments in the perception or expression of reality. It appears most commonly as auditory hallucinations, paranoid or bizarre delusions, or disorganized speech and thinking, leading to social or occupational dysfunction. Symptoms can be observed in young adulthood.1 Patients can be diagnosed based on self-reported experiences and observed behavior. Laboratory test for schizophrenia does not exist. Genetics, environment during early life, neurobiology, and psychological and social processes are important factors, which contribute to this condition.

This disorder primarily affects the psychological behavior. The patient with this disorder experiences lowering of mood, loss of interest in usual activities, diminished ability to experience pleasure and anxiety disorders. Social problems, such as long-term unemployment, poverty and lack of shelter are common causes this disorder. The life expectancy of the affected individual is decreased by 10–12 years due to various reasons with high suicide rate.2 Approximately, 10% of individuals with schizophrenia commit suicide, and 20–40% make at least one suicide attempt.3

Occurence of the Disease in Different Groups)
Schizophrenia affects both males and females with the peak ages of onset being 20–28 years for males and 26–32 years for females. Studies show that schizophrenia can affect all ages (childhood, middle age and old age). Schizophrenia is known to be a major cause of disability.1

Signs and Symptoms of schizophrenia

Symptoms of schizophrenia include disorganized thinking, auditory hallucinations and delusions. The affected individuals show signs of catatonia, a syndrome of psychic and motor disturbances. A schizophrenia-like psychosis of shorter duration is termed a schizophreniform disorder.

Isolation from social gathering is a common factor and occurs due to various reasons. Many people diagnosed with schizophrenia avoid stressful social situations that may increase their mental distress.4

Late adolescence and early adulthood are critical periods for the onset of schizophrenia. Much work has been recently carried out to identify and treat the preonset of the illness.5

Preonset symptoms like social isolation, irritability, depressed mood and transient or self-limiting psychosis are experienced before psychosis becomes apparent in their later life.6

Schizophrenia is described in terms of negative and positive symptoms. The positive (or productive) symptoms include the following:

  • Delusions: False belief.
  • Auditory hallucinations: False perception of sound.
  • Thought disorder: Irregularities in speech reflecting disorganized thinking.

The negative (or deficit) symptoms include the following:

  • Blunted affect and emotion: Lack of emotional reactivity.
  • Poverty of speech: Termed as alogia or lack of speech
  • Anhedonia: Inability to experience pleasure.
  • Lack of motivation: Termed avolition or lack of desire to pursue to meaningful goals.
Diagnosis of schizophrenia

Diagnosis of schizophrenia

Diagnosis is based on the person’s own experiences, observed behavioral changes reported by family members, friends or coworkers, and secondary signs observed by a psychiatrist, a social worker or a clinical   

Causes of schizophrenia

Causes of schizophrenia

Treatment of schizophrenia

Treatment of schizophrenia

Treatment in schizophrenia involves taking the correct medicines with minimum side-effects and personal support. Consulting a doctor should not be delayed. In schizophrenia, it is very important to start with the   

Medications for schizophrenia

Antipsychotic medications are used to treat schizophrenia. These medications take around 7–14 days to show their effect and decrease the positive symptoms.

Following are some of the antipsychotic drugs used in treating schizophrenia

Trifluoperazine: Is used for short-term treatment of anxiety. It helps in stabilizing the symptoms of schizophrenia by improving their mood and making them easier to function in everyday life.

Haloperidol: This medicine helps to think more clearly, feel less nervous, take part in everyday life, and prevent committing suicide. It also reduces aggression and the desire to hurt others.

Ziprasidone: Is used when other medications are not effective and works by maintaining the balance of certain natural chemicals called neurotransmitters in the brain.

Clozapine, Quetiapine, Thiothixene and Olanzapine: These medications work by helping to maintain the balance of neurotransmitters in the brain.

Risperidone: Is a common antipsychotic medication. It also helps to think clearly and makes functioning of daily activities easy. It can decrease negative thoughts and hallucinations.

Response to these medications is varies. The term ‘treatment-resistant schizophrenia’ is used for patients failing to respond satisfactorily to at least two different antipsychotic medications. Patients coming under this category are prescribed with medication of superior effectiveness. Such medication has potentially high lethal side-effects.

Patients who are unwilling or unable to take medications regularly, high-potency antipsychotic medication may be given every 2 weeks to achieve control. Long-term usage of such high-potency antipsychotics is not advised.

Over-the-counter drug (OTC): Haloperidol is the commonly available OTC drug. 

Alternative therpy: This therapy is advised after consulting with a physician. The following are some of them coming under this category.

  • Glycine supplements: Glycine is an amino acid, which helps in reducing the negative symptoms of schizophrenia.
  • Omega-3 fatty acids: Helps in reducing the negative and positive symptoms of schizophrenia.
  • Antioxidants: Antioxidants like vitamin E, vitamin C and alpha-lipoic acid show mild improvement to this condition.
  • Electroconvulsive therapy (ECT): Can be considered and may be prescribed in cases where other treatments have failed.
  • Transcranial magnetic stimulation (TMS): This is and alternative to ECT. This treatment is considered as the last resort for people with severe depression.

Written by: Healthplus24 team
Date last updated: August 13, 2011

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References 
 
  1. Castle E, Wessely S, Der G, Murray RM. "The incidence of operationally defined schizophrenia in Camberwell 1965-84". British Journal of Psychiatry 1991; 159: 790–794.
  2. Brown S, Inskip H, Barraclough B. Causes of the excess mortality of schizophrenia. Br J Psychiatry. 2000; 177: 212–217.
  3. Available at: www.mentalhealth.com/dis/p20-ps01.html. Accessed on 18th Mar, 2008.
  4. Freeman D, Garety PA, Kuipers E, et al. "Acting on persecutory delusions: the importance of safety seeking". Behavior Research and Therapy. 2007; 45 (1): 89–99.
  5. Addington J, Cadenhead KS, Cannon TD, et al. "North American prodrome longitudinal study: a collaborative multisite approach to prodromal schizophrenia research". Schizophrenia Bulletin. 2007; 33 (3): 665–672.
  6. Parnas J, Jorgensen A. "Pre-morbid psychopathology in schizophrenia spectrum". British Journal of Psychiatry. 1989; 115: 623–627.
  7. Brown AS. "Prenatal infection as a risk factor for schizophrenia". Schizophrenia Bulletin. 2006; 32 (2): 200–202.
  8. Laruelle M, Abi-Dargham A, van Dyck CH, et al. "Single photon emission computerized tomography imaging of amphetamine-induced dopamine release in drug-free schizophrenic subjects". Proceedings of the National Academy of Sciences of the USA.1996; 93: 9235–9240.
  9. Becker T, Kilian R. "Psychiatric services for people with severe mental illness across western Europe: what can be generalized from current knowledge about differences in provision, costs and outcomes of mental health care". Acta Psychiatrica Scandinavica Supplement. 2006; 429: 9–16.
 
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