Definition:

Schizophrenia is a chronic, severe, and disabling brain disorder.  It is estimated to affect 2.2 million (1.1%) Americans aged 18 and over.  Schizophrenia affects an individual’s capability to think clearly, differentiate reality from fantasy, to handle emotions, make decisions and interact with others.  Schizophrenia tends to appear in the teenage years or early twenties.  Individuals who have schizophrenia suffer chronically or episodically throughout their lives. Due to a lack of public awareness people with schizophrenia are often stigmatized.  Schizophrenia is not caused by bad parenting or a personal weakness; most individuals with schizophrenia are not dangerous or violent towards others whilst receiving treatment. 

It is still unknown what causes schizophrenia; research has indicated that the brains of people with schizophrenia are different from other individuals.  It is thought that Schizophrenia, like many other diseases, is caused by a mixture of problems such as genetic vulnerability and environmental factors that are present during a person’s development.

Researchers have identified the genes that increase a person’s predisposition to this disease.  The genes do not directly cause schizophrenia; rather they increase the likelihood of developing it.  Schizophrenia is known to run in families, the risk of an identical twin developing this illness is about 40-50%.  The risk of a child of a parent suffering from schizophrenia has a 10% of developing the illness.  The risk in the general population is about 1%. 

Scientists have identified small changes in the brain structure and functioning.  This could mean that this illness maybe a disorder of the brain development.

Symptoms of Schizophrenia:

There is no single symptom that identifies schizophrenia.  The symptoms that characterize schizophrenia can be found in other brain disorders. 

Symptoms of schizophrenia are organized into three categories including positive, negative and cognitive symptoms.

• Positive Symptoms
• These symptoms are very noticeable and usually involve a loss of contact with reality.  Unusual thoughts or perceptions, including hallucinations, delusions, thought disorders, and disorders of movement are present.

• Negative Symptoms
• An individual experience a loss or a decreased ability to initiate and sustain a planned activity, speak, express emotion, or find things enjoyable in daily life. These symptoms are often harder to recognize as they are often mistaken for laziness or depression.

• Cognitive Symptoms (also known as Cognitive Deficits or Disorganized Symptoms)

Problems with working memory (the ability to store recently learned information and use it right away), sustain attention and poor executive functioning (the ability to absorb and interpret information and make decisions based on that information).  These symptoms are often only detected when neuropsychological tests are preformed. 

Types of Schizophrenia:
Symptoms usually appear between the ages of 13 and 25 and usually appear earlier in males than females.  Symptoms of schizophrenia can develop slowly over a period of a few months or years; however symptoms may also appear very suddenly.  If you know of anyone who has experienced the symptoms below for more than two weeks you should seek immediate professional assistance.  There are five types of schizophrenia: paranoid schizophrenia, catatonic schizophrenia, disorganized schizophrenia, residual schizophrenia and schizoaffective disorder. 

• Paranoid Schizophrenia
• The individual feels very suspicious, persecuted, or grandiose, or a combination of these.  The individual tends to be preoccupied with delusions or hallucinations.
   
• Catatonic Schizophrenia
• Individuals are negative, withdrawn or mute and may assume unusual body positions.
   
• Disorganized Schizophrenia
• An individual may have disorganized speech, behavior and seem flat or have an inappropriate affect.  Individuals exhibit no symptoms from the catatonic type of Schizophrenia.
   
• Residual Schizophrenia
• The individual does not experience prominent delusions, hallucinations, disorganized speech, overly disorganized or catatonic behavior.  Individuals do experience negative symptoms and may have no interest in life or no motivation.
   
• Schizoaffective Disorder
• A person has symptoms of schizophrenia and a mood disorder, such as depression.

Treatment for Schizophrenia:

There is no cure for schizophrenia, however it can be treated and managed.  Individuals often cease treatment usually because of the side effect of medications, disorganized thinking or they feel the treatment in not effective.  Individuals who refuse to take and continue with their treatment are at risk of a psychotic episode.  Any form of treatment should be discussed with a medical professional before, during and after the treatment.  There are many different forms of treatment for schizophrenia:

Hospitalization – Individuals who experience severe symptoms of schizophrenia may need thorough treatment.  Hospitalization is needed when an individual experiences severe delusions, hallucinations or the inability to take care of themselves.  It is imperative to protect people from hurting themselves and others.  

Medication - Antipsychotic medications have been used since the 1950’s.  They treat the positive symptoms of schizophrenia.  These medications have help many people improve their lives but do not cure schizophrenia.  Different individuals respond differently to different medications.  It is common for people to try different types of medications before the right one is found.  Doctors and patients should work together to control the symptoms with the least amount of side effects. 

In the 1990’s atypical antipsychotics were introduced.  When comparing the atypical antipsychotics with the ‘conventional antipsychotic’ medication seems to be equally effective in treating the positive symptoms but may be better than the old medication in reducing the negative symptoms.  As with the ‘conventional antipsychotic’ medication, people respond differently to atypical antipsychotics so it is important to consult your doctor before and during the course of any medicinal treatment.  It is important to note that antipsychotic medication should not be discontinued without talking to the doctor who prescribed it.

Psychosocial Treatment – It is believed that individuals who attend structured psychosocial rehabilitation programs and continue with their medication can manage their illness better than those who do not participate in such programs.  A successful approach is the Program for Assertive Community Treatment (PACT).  PACT is an intensive team program that helps people stay out of hospitals and live independently.  Professionals help individuals to manage their problems, ensure that medications are taken properly and offer assistance in coping with daily life.

Cognitive Behavior Therapy (CBT) – CBT can be used with individuals who experience symptoms while they are taking medication.  Individuals are taught how to test their reality, to ignore the voices they hear and to deal with the apathy.

Illness Management Skills – Individuals with schizophrenia can take an active role in managing their disorder.  Learning the facts about schizophrenia and the ideas of treatment allows individuals to make informed decisions about their treatment.  Teaching them to be mindful of early warning signs can prevent a relapse of an episode.  Furthermore individuals can learn new skills to cope with enduring symptoms.

Integrated Treatment for Co-occurring Substance Abuse – As substance abuse is a common condition that occurs with schizophrenia this treatment focuses on treating schizophrenia and treating substance abuse.

Rehabilitation – this form of treatment aims at social and vocational training to help individuals with schizophrenia function successfully in social environments.  Rehabilitation can also consist of vocational counseling, job training, money management and assistance with public transportation and social and workplace skills. 

Family Education – it is important for families to learn different types of treatment programs and have a strong understanding of coping strategies and problem solving skills to manage their family members effectively.  Knowing how and where to find support services for people with schizophrenia and caregivers is beneficial.

Self-Help Groups – This type of support network is beneficial for both individuals with schizophrenia and caregivers.  People tend to overcome feelings of isolation as they no longer feel alienated by the condition.  Professional therapists are not always involved but self-help groups are usually comprised of other individuals with schizophrenia and their families, and are a great source of mutual support which is very therapeutic.