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Schizophrenia

Alternate Names

  • schizophrenic disorder

Definition

Schizophrenia is a mental disorder in which a person loses contact with reality. It causes a decline in the person's general ability to function, as well as abnormal thinking, speech, and behavior.

What is going on in the body?

About 1% of people in the US are affected by schizophrenia at some point in their lives. It usually starts in the teenage years or early adulthood, but it can occur at any age. The first signs are often confusing or even shocking changes in the person's behavior, thoughts, or manner of speaking. The course of schizophrenia is often unpredictable. Many people are affected for the rest of their lives.

Risks

What are the causes and risks of the condition?

No single cause can account for this condition. It may be caused by a combination of inherited factors and the person's environment. Changes in the chemistry of the brain may also trigger it.
A person with an affected relative is more likely to have schizophrenia. It is equally common in males and females.

Prevention

What can be done to prevent the condition?

There are no known ways to prevent the condition.

Diagnosed

How is the condition diagnosed?

There is no single test to diagnose schizophrenia. A psychiatrist makes the diagnosis based on the person's history and symptoms. Before the diagnosis is made, symptoms must be present for at least six months. Drug use or another medical condition must be ruled out as the cause of the symptoms. Blood, urine, and other tests may be done to look for any underlying medical disorders. Special x-ray tests of the brain, such as cranial CT scans, may also be done.

Long Term Effects

What are the long-term effects of the condition?

Good care and treatment is essential for people with this condition. They often have problems with all aspects of thought, emotion, and expression. The course varies from one person to the next. People may be unable to work, have relationships, or even take care of themselves. Suicide is a serious danger. Roughly 10% of affected people eventually commit suicide.

Other Risks

What are the risks to others?

Most people with schizophrenia are not violent. They are often withdrawn and want to be left alone. Drug abuse increases the risk of violence in affected people. A person who stops taking prescribed medication may be at a higher risk for violent behavior. When violence does occur, it is most often targeted at family and friends, and most often takes place at home.

Treatments

What are the treatments for the condition?

The goals of treatment are to:
  • make symptoms less severe
  • prevent a decline in function
  • provide support so the person can function at the highest level possible
There are three major components of treatment:
  • antipsychotic medications to reduce symptoms. They may help the person to be more effective and appropriate in society.
  • rehabilitation and community support activities to teach the skills needed to survive in society. These skills help an individual with schizophrenia to work, shop, manage a household, and get along with others.
  • psychotherapy, with regularly scheduled talks between the individual and a mental health professional. The sessions may focus on current or past problems, experiences, thoughts, feelings, or relationships. This may help the person understand and manage the illness, take medications, and manage stress.
Hospitalization may be needed at times if the person poses a danger to self or others.

Side Effects

What are the side effects of the treatments?

Antipsychotic medications have many possible side effects. These include drowsiness, restlessness, muscle spasms, dry mouth, and blurry vision. The long-term side effects may include tardive dyskinesia. This disorder causes uncontrollable, random movements of the mouth, lips, and tongue. It sometimes affects the trunk, arms, and legs.

After Treatment

What happens after treatment for the condition?

Most people with schizophrenia need some form of ongoing treatment for long periods of time, or for life. The outlook for an individual with this condition has improved over the past 25 years. Many people with schizophrenia improve enough with treatment to lead independent, satisfying lives. Group homes or structured living environments may be helpful for some individuals. A few people with severe forms of the disorder may need full time care in a safe and supportive setting.

Monitor

How is the condition monitored?

Someone with schizophrenia needs ongoing monitoring and treatment. Symptoms may flare up and require hospitalization. Without treatment and medications, some people become quite psychotic and disorganized. These people may be unable to care for their basic needs, such as food, clothing, and shelter. All too often, a person with schizophrenia ends up on the streets or in jail, where he or she is unable to get effective treatment.

Sources

Current Emergency Diagnosis and Treatment, Saunders and Ho, 1992

Textbook of Psychiatry, Hales, 1994

Merck Manual of Medical Information: Home Edition, 1997

Professional Guide to Diseases, Springhouse Publishers, 1998

Current Medical Diagnosis and Treatment, Tierney, 2000

Schizophrenia, National Institute of Mental Health, 1999

[hyperLink url="http://www.nimh.nih.gov/publicat/schizoph.htm" linkTitle="www.nimh.nih.gov/publicat/schizoph.htm"]www.nimh.nih.gov/publicat/schizoph.htm[/hyperLink]

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