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What is Schizophrenia?

Schizophrenia is a serious long-term mental health issue characterised by a profound disconnection from reality, known in medical terms as ‘psychosis’.

Explained simply, it’s when sufferers have difficulty in telling what’s real and what’s not, often blurring the line between what’s real and what’s imagined.

It affects how a person thinks, feels, and acts. Sometimes, they may see or believe things that aren’t there or true, which can be distressing for them – and for their family and friends.

The condition isn’t as common as many other mental disorders. According to the World Health Organization, it affects 1 in 300 people (0.32%) worldwide.

Symptoms of Schizophrenia

Schizophrenia can develop slowly. The first signs may be difficult to spot, especially since they often begin during the teenage years.

Some symptoms, like pulling away from friends or changes in how much a person sleeps, can be mistaken for just being part of growing up.

People with schizophrenia can experience difficult periods, called episodes, when their symptoms worsen. After these episodes, they may have times when they have few or no symptoms at all. This is sometimes called acute schizophrenia.

There are a variety of different symptoms seen with schizophrenia. They’re usually sorted into three groups: positive, negative, and cognitive.

  • Positive symptoms, also known as psychotic symptoms, can include seeing or hearing things that aren’t there (hallucinations), believing things that aren’t true (delusions), and having trouble organizing thoughts.
  • Negative symptoms are about losing or having less of the usual human functions. These could include not showing emotions, not feeling happy or excited, having trouble starting and continuing activities, and speaking less.
  • Cognitive symptoms are about changes in thinking skills. These could be problems with focusing, having trouble making decisions, and difficulties with short-term memory.

Delusions, which are strong beliefs that aren’t based on reality, are common in people with schizophrenia.

Some common types of delusions include:

  • Paranoid delusions: When a person thinks they’re being followed or harmed by others. For example, they might think “Someone is following me” or “My spouse is trying to poison me”.
  • Delusions of reference: When a person thinks ordinary events have special meaning for them.
  • Delusions of grandeur: When a person thinks they’re famous or very important, like a religious figure or a famous leader.
  • Delusions of persecution: When a person thinks that others are out to get them.

In a study, the most common type of delusion in people with schizophrenia was delusions of reference, closely followed by delusions of persecution.

Causes, Risk Factors and Life Expectancy for Schizophrenia

The exact cause of schizophrenia remains unknown, but it’s believed to be a combination of genetics, brain chemistry and structure, and environmental factors.

Having family members with schizophrenia, getting exposed to certain viruses or not having enough nutrition before birth, facing tough situations, and using mind-altering drugs during teenage years may contribute to the onset of the disease.

Schizophrenia can happen to anyone, but it usually starts when people are in their late teens or early twenties. Both men and women can be affected. Typically, however, the condition starts earlier in men.

Even though schizophrenia can pose significant challenges, it doesn’t shorten a person’s life.

Research has clearly shown, however, that people with schizophrenia often have other physical health problems too.

In fact, more than 75% of people diagnosed with schizophrenia have at least one other long-term physical health problem, notably heart disease, stroke, and diabetes, and high blood pressure.

Diagnosis

To find out if someone has schizophrenia, doctors perform a detailed mental health check, look at the person’s medical history, do a physical exam, and run lab tests to make sure nothing else is causing the symptoms.

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), made by the American Psychiatric Association and the the International Classification of Diseases (ICD) published by the World Health Organization (WHO) give guidelines for diagnosing schizophrenia.

These include showing signs of the condition for at least six months, with intense symptoms like seeing or hearing things that aren’t there, believing things that aren’t true, or having trouble organising thoughts for at least a month.

Treatment and Medication for Schizophrenia

Even though there’s no cure for schizophrenia, it can be managed with the right treatment plan designed for each person.

This usually includes medicines that help with symptoms, treatments to improve social skills, and special services for people experiencing their first serious episode of schizophrenia.

The medicines can lessen the severity of symptoms, and make future intense episodes less likely.

Medication has been shown to be effective in treating acute psychotic episodes and to improves symptoms of early schizophrenia in 85% of patients.

This means that most people with schizophrenia can experience symptom relief with medication.

Talking therapies, including cognitive behavioural therapy and family-focused therapy, can also help individuals and their families learn to live with the condition.

Prevention of Schizophrenia

There’s no guaranteed way to prevent schizophrenia. But early recognition and treatment can control symptoms before they become severe or extremely disruptive.

A healthy lifestyle, avoiding psychoactive drug use, and seeking help early can also play a part in managing the onset and progression of the disease.

Scientific Studies on Schizophrenia

Research on schizophrenia has significantly advanced our understanding of this complex condition.

New scientific research is exploring genetics, brain imaging, and early intervention techniques to improve outcomes for individuals with schizophrenia.

For example, studies that look at many genes across the entire genome have found several genes that may make a person more likely to have schizophrenia. When looking at brain images, researchers have noticed differences in the brain’s structure and how it works in people with schizophrenia.

Also, studies show that starting treatment early, especially following a person’s first serious episode of schizophrenia, can help improve long-term outcomes.

Summing Up Schizophrenia

Schizophrenia is a complicated mental health condition that touches the lives of many people and their families around the world.

People with schizophrenia and their healthcare providers both have important parts to play in dealing with this disease.

At the same time, scientific research is always moving forward, helping us understand the condition better and find more effective ways to treat and care for it.

Even though schizophrenia is often difficult to deal with and as yet, not fully understood, progress being made in research and treatment offers increasing hope for those who are affected.

Date of prep: 31st July 2023 Job Number: CNX0001

References

https://www.nimh.nih.gov/health/statistics/schizophrenia
https://www.nhs.uk/mental-health/conditions/schizophrenia/symptoms/
https://www.mayoclinic.org/diseases-conditions/schizophrenia/symptoms-causes/syc-20354443
https://symptommedia.com/delusions-associated-with-schizophrenia-ce-course-preview/
https://www.who.int/news-room/fact-sheets/detail/schizophrenia
Mitchell, A. J., & Malone, D. (2006). Physical health and schizophrenia. Current Opinion in Psychiatry, 19(4), 432-437. DOI: 10.1097/01.yco.0000228767.71473.9e
Smith, D. J., Langan, J., McLean, G., Guthrie, B., & Mercer, S. W. (n.d.). Schizophrenia is associated with excess multiple physical-health comorbidities https://bmjopen.bmj.com/content/bmjopen/3/4/e002808.full.pdf
Fleischhacker, W. W., Arango, C., Arteel, P., Barnes, T. R. E., Carpenter, W., Duckworth, K., Galderisi, S., Halpern, L., Knapp, M., Marder, S. R., Moller, M., Sartorius, N., & Woodruff, P. (2014). Schizophrenia—Time to Commit to Policy Change. Schizophrenia Bulletin, 40(Suppl 3), S165-S194.

https://doi.org/10.1093/schbul/sbu006