What is Schizophrenia?

Schizophrenia

Schizophrenia is a severe and debilitating mental disorder in which an individual seems to have lost touch with reality. The disorder is marked by continuous or relapsing psychotic episodes (psychosis is a collective name for delusions, hallucinations, inner speech, and/or voices). Symptoms of schizophrenia, in fact, may include some combination of disordered thinking, lack of motivation, disorganized speech, hallucinations, hearing imaginary voices, mood swings, and/or bizarre behaviors impairing a person's everyday functioning. A person suffering from schizophrenia may also have persecutory delusions, such as believing other people are controlling their thoughts, reading their minds, or planning to do them harm.

Men are more vulnerable to schizophrenia than women, especially at a young age. According to a study conducted in 2013, men are also men more likely to have more severe negative schizophrenia symptoms and a greater impairment in thinking ability.

If you think you or your loved one might have schizophrenia, you should educate yourself on the disorder. There are many myths and misconceptions about this condition, so you’ll need some trustworthy resources to debunk them. It is through education that people can start to eradicate the negative stigma that shrouds this disorder. For example, contrary to popular belief, individuals with schizophrenia do not have “split” or multiple personalities. It probably comes from the origin of the term schizophrenia (schizo meaning split, and phrene meaning mind in Greek),but in reality of facts, schizophrenia has nothing to do with a split mind.

Taking this reliable Schizophrenia Test might be a good idea if you are looking for a free assessment tool. However, you should remember that a psychological test cannot replace an official diagnosis made by a mental health specialist.

How Is Schizophrenia Diagnosed?

To diagnose someone with schizophrenia, a mental health professional may have to do the following:
  • Physical exam may help rule out other issues that might be causing symptoms and check the patient for any complications.
  • Various tests and screenings usually help rule out other mental health disorders with similar symptoms - for instance, screening for alcohol and drug abuse helps make sure that symptoms are not due to substance abuse; the health professional may also request an MRI or CT scan.
  • Psychiatric evaluation: the doctor observes the patient's appearance and demeanor and asks them about their thoughts, delusions, and substance to evaluate their mental status. The process may also include a discussion of personal and family history.

Symptoms

People are usually diagnosed with the condition between the ages of 16 and 30. Schizophrenia is rare in young children. It is also rare in people older than 45.

Hallucinations

Symptoms of the disorder may vary from individual to individual. They can also vary in severity and type over time, with periods of remission and worsening. Some symptoms may always be present.

Symptoms of schizophrenia are usually divided into two following categories: positive and negative.

Positive Symptoms

Individuals with positive symptoms of schizophrenia typically have a distorted perception of reality. In some cases, these symptoms are intermittent, in other cases, they are continuous.

Some of the psychotic symptoms include:
  • Hallucinations: hearing, seeing, feeling, or smelling things that in actuality are not there;
  • Delusions: unshakable beliefs that have nothing to do with reality and seem highly irrational to others - for example, the patient may believe someone is watching them, that thoughts have been planted in their mind by another person, that their body is being taken over, or that a family member or a friend wants to poison them, etc.;
  • Disorganized thinking: trouble keeping one's thoughts straight; for instance, the individual may stop talking in the middle of a thought or jump from topic to topic.
Negative Symptoms

Negative symptoms of schizophrenia are often mistaken for depression or other mental health conditions symptoms. Friends and family unaware of their loved one having schizophrenia may mistake them for deliberate laziness or rudeness. These symptoms may include:

  • Loss of motivation or interest in daily activities
  • Social withdrawal
  • Limited speech and facial expression
  • Restricted expression of emotions
  • Very low energy
  • Extreme agitation or, on the contrary, slowing of movements and spending a lot of time in passive activities.

In extreme cases, an individual with negative schizophrenia symptoms might stop moving or talking for a while. This subtype of the condition is called catatonic schizophrenia.

Here below are the other subtypes of the disorder:

paranoia

  • Paranoid schizophrenia is marked by extreme feelings of persecution, suspicion, grandiosity, or a combination of these;
  • Disorganized schizophrenia (also referred to as hebephrenia) is characterized by incoherent thoughts, repetition of the same things over and over again, use of made-up words understood only by the speaker;
  • Residual schizophrenia is characterized by a lack of motivation or interest in life, odd beliefs, withdrawal from social life, and trouble paying attention.

Most individuals diagnosed with schizophrenia are not prone to violence. On the contrary, people suffering from the disorder are more likely than healthy individuals to be harmed by someone. However, the risk of self-harm and violence toward others increases if the condition is left untreated.

It is common for individuals suffering from schizophrenia to have suicidal thoughts. Estimates are that up to 10 percent of individuals with schizophrenia will commit suicide, in particular, young males suffering from schizophrenia. If you think your loved one might be in danger of attempting suicide or if you know they have already made a suicide attempt, ensure someone stays with that individual. Also, make sure they get adequate treatment as soon as possible.

Causes of Schizophrenia

There are several things that might be behind this mental illness. While the exact causes of schizophrenia are unknown, numerous research has shown that a combination of genetic, physical, environmental, and psychological factors can make an individual more vulnerable to the condition.

Here is what may increase an individual's risk of developing schizophrenia:
  • Genetics: schizophrenia tends to run in families. No single gene causes the disorder by itself - it is different combinations of genes that are responsible for the development of the disorder. Studies of identical twins have revealed that if one twin suffers from schizophrenia, the other has a 50% chance of developing it too.
  • Brain structure and chemistry: abnormalities in brain structure are an established feature of schizophrenia. People suffering from the disorder have less gray matter volume than healthy individuals. White matter also appears to be altered in people with schizophrenia. It is believed that some of these brain structure differences may develop before birth. A change in the level of two neurotransmitters (chemicals that carry messages between brain cells) - dopamine and serotonin, may also lead to the development of schizophrenia.
  • Pregnancy and birth complications: according to numerous research, some individuals who develop schizophrenia have experienced complications before and during their birth, such as the mother's premature labor, asphyxia (lack of oxygen) during birth, and/or low weight at birth.
  • Environment: multiple studies suggest that some aspects of a person’s environment may also play a role in the development of the disorder. These may include exposure to viruses or nutritional problems before birth, living in extreme poverty, and/or unsafe surroundings.

Stressful life events, such as physical/sexual/emotional abuse, loss of a job or home, or a divorce, might also trigger schizophrenia. Drug abuse may trigger the development of the condition in people already vulnerable to it, too. According to recent research, young adults who use drugs regularly are likely to develop the disorder in their later adulthood.

Researchers believe that learning more about risk factors for schizophrenia will lead to earlier diagnoses, as well as earlier and more successful treatments in the future.

Complications

If untreated, the condition can not only result in serious problems that may affect every area of an individual's life. Some of the complications that schizophrenia may cause include:

  • Depression
  • Anxiety disorders and obsessive-compulsive disorder (OCD)
  • Inability to attend school or work
  • Financial problems
  • Social isolation
  • Being victimized

Only sticking with the correct treatment plan can help prevent relapses or worsening of schizophrenia symptoms.

Treatment

There is no cure for the condition. Besides, the disorder requires lifelong treatment, even if the symptoms get better at some point. However, treatment can effectively help many people with schizophrenia live fairly rewarding and productive lives. Medications help reduce the symptoms of schizophrenia. Psychotherapy and social therapy have been shown to give good results, too. In some cases, the patient has to be hospitalized. In any case, it is essential for an individual living with schizophrenia to have supportive caregivers. It is also crucial for family members to have support themselves.

Related Conditions

Delusional Disorder

When an individual has delusional disorder, they, as the name suggests, experience delusions - false beliefs based on incorrect inferences about external reality. Unlike schizophrenia, delusional disorder does not involve any other symptoms. Individuals suffering from this condition may not seem to have any issues with functioning, behavior, and social interactions, except when they mention their delusions.

These delusions are divided into two types: non-bizarre and bizarre. Non-bizarre delusions are situations that could possibly occur in real life. Examples of non-bizarre delusions may include being followed, monitored, or deceived by someone.

Bizarre delusions are strong beliefs that something that cannot possibly happen in this reality is true - for instance, the patient believing someone has removed an organ from their body without any evidence of it.

If a person with delusional disorder becomes too preoccupied with their delusions, it may lead to relationship issues, problems at work, or legal troubles.

The condition is usually treated with individual psychotherapy.

Brief Psychotic Disorder

Brief psychotic disorder is a sudden and short-term episode of psychotic behavior. It may include such symptoms as delusions, hallucinations, and/or disorganized speech.

This episode usually lasts between one day and one month. Then the symptoms disappear, although future relapses are possible. It differs from schizophrenia by the duration of the psychosis.

The condition is typically triggered by extreme stress, such as the loss of a loved one or a traumatic accident. Although the disturbance is short, people suffering from brief psychotic disorder often experience overwhelming confusion and emotional turmoil. Brief psychotic disorder, most often, affects individuals in their 20s, 30s, and 40s. It is more common in women than in men.

Schizophreniform Disorder

The symptoms of schizophreniform disorder are similar to those of schizophrenia. Just like schizophrenia, schizophreniform disorder affects how an individual thinks, acts, relates to other people, expresses their emotions, and perceives reality. The disorder occurs almost equally in males and females between ages 18 and 24.

The symptoms of schizophreniform disorder, unlike schizophrenia symptoms, have a limited durationt- not less than one month but no more than six months. If delusions, hallucinations, disorganized speech, or catatonic behavior last longer than six months, the diagnosis changes to schizophrenia. Schizophreniform disorder can cause serious difficulties in the patient’s life. Some individuals suffering from the condition may need to be hospitalized.

Schizoaffective Disorder

Schizoaffective disorder is a condition marked by unstable moods and abnormal thought processes. An individual can be diagnosed with schizoaffective disorder when they display symptoms of both a mood disorder (depression or bipolar disorder) and schizophrenia - hallucinations, delusions, disorganized speech, or grossly disorganized behaviors).

Schizoaffective disorder symptoms may vary from individual to individual. Typically, for a person to be diagnosed with the condition, the symptoms of a major mood episode (manic or depressed mood) must be present. There must also be a period lasting at least 2 weeks when schizophrenia symptoms, such as delusions or hallucinations, are present in the absence of a mood episode.

Usually, schizoaffective disorder onsets occur in early adulthood. The condition is relatively rare. It has a lifetime prevalence of only 0.3%. Females and males experience the condition approximately at the same rate. However, males often develop the disorder at an earlier age.

The condition can be managed with medication and psychotherapy.

Schizoaffective disorder can sometimes be misdiagnosed. The correct diagnosis may be bipolar I disorder, schizophreniform disorder, schizophrenia, or psychotic depression. It is important to remember that there are major differences between treatments for each of the above-mentioned conditions. That is why it is imperative for mental health professionals to diagnose their patients accurately.

References

Tandon R. Schizophrenia and other psychotic disorders in DSM-5. Clin Schizophr Relat Psychoses. 2013 Apr;7(1):16-9. DOI: 10.3371/CSRP.TA.032513. PubMed

Maric NP, Jovicic MJ, Mihaljevic M, Miljevic C. Improving Current Treatments for Schizophrenia. Drug Dev Res. 2016 Nov;77(7):357-367. DOI: 10.1002/ddr.21337. PubMed

Thomas P, Alptekin K, Gheorghe M, Mauri M, Olivares JM, Riedel M. Management of patients presenting with acute psychotic episodes of schizophrenia. CNS Drugs. 2009;23(3):193-212 PubMed