Schizophrenia (1)

It is a chronic mental disorder that alters the way an individual expresses, thinks and perceives reality. It influences the person’s normal functioning in society, at school, at work, and in relationships. People with schizophrenia seem like they have been disconnected from society. Schizophrenia is a lifelong disease that can’t be cured completely but can be controlled with appropriate treatment.

What happens in schizophrenia?

It involves a type of mental illness known as “psychosis” in which a person cannot differentiate between reality and imagination. A person with schizophrenia thinks the world a jumble of images, confused thoughts, and sounds. A sudden change in the behavior and personality of an affected person is called a “psychotic episode”.The severity of schizophrenia depends upon the person’s psychotic episode.

Causes

The exact cause of schizophrenia is still mysterious. Like diabetes and cancer, it also has a biological basis. Some of them are:

  • Genetics

Schizophrenia is inheritable. A child is at a higher risk of getting schizophrenia if one of the parents had had this.

  • Disrupted nerve cell pathway

Neurotransmitters are chemicals that control the pathways of nerve cells. These neurotransmitters are not well regulated in schizophrenia thus affecting the behavior an individual.

  • Abnormal brain structure

Abnormality in brain structure has been seen in many people dealing with schizophrenia. But this is not the exact cause because abnormal brain structures are seen in some other disorders as well.

  • Environment

If a person has the genetic risk of getting schizophrenia, onset of it becomes highly possible when a person is exposed to some viral infections, toxins such as marijuana. Highly stressful conditions also trigger schizophrenia.

Symptoms (2)

The period of onset of symptoms before psychosis is known as “Prodormal period”. In this period, it is difficult to spot schizophrenia. Only sudden changes in behavior can be seen, including

  • Social cut off
  • Temper flare
  • Difficulty in concentration
  • Trouble sleeping
  • Positive symptoms of schizophrenia

In these symptoms, the word “positive” means added actions or thoughts that are not reality-based. They are also called psychotic symptoms. These include

  • Delusions

These are mixed, false, and weird beliefs that are not reality-based. In schizophrenia, delusions involved bizarre, impossible, and fantastical beliefs. For example, a person feels that the government is handling us via some radiations.

  • Hallucinations

These are sensations that seem real to a person but are self-created. The most common symptoms are hearing voices. The person feels that some strange voices are commenting or insulting him. Seeing things is a less common type of hallucinations. Hallucinations also include skin sensations, weird taste in the mouth, strange orders, etc.

  • Catatonia

In this condition, a person remains in the same position for a long time and suddenly stops while speaking.

  • Disorganized symptoms of schizophrenia

These symptoms show that person is not perceiving well and not responding as expected. Examples are:

  • A person makes poor communication by using nonsense words or talking in a way that is not understandable.
  • Switching off thoughts that are not relevant
  • Walking slowly
  • Poor decision-making abilities
  • Writes more without any meaning
  • Repeating gestures or movements
  • Cognitive symptoms

The person faces difficulty in

  • Paying attention
  • Working memory (use of information just after learning it)
  • Understanding facts
  • Decision-making
  • Negative symptoms

The word “negative” refers to the absence of normal functioning and behavior in affected people. Negative symptoms include

  • Lack of feelings
  • withdrawal from friends, families, and social activities
  • speaking less
  • lack of energy
  • lack of motivation
  • loss of interest in life
  • Poor grooming and hygiene habits

Diagnosis of schizophrenia

Upon the appearance of symptoms, the doctor considers medical history and examines the physical symptoms of a patient. There are no specific tests to diagnose schizophrenia. But doctors perform some other tests, possibly brain imaging and blood test to check any other cause of schizophrenia. If a doctor does not find any symptom then he refers a patient to a psychologist or psychiatrist.

A person is said to be diagnosed with schizophrenia if he shows any of the following two symptoms in the last six months.

  • Delusions
  • Hallucinations
  • Catatonic behavior
  • Disorganized speech
  • Negative symptoms

Among those two symptoms, one of them has to be,

  • Hallucinations
  • Delusions
  • Disorganized speech

Treatment of Schizophrenia

Treatment of schizophrenia does not cure it completely but reduces the symptoms and helps the person to deal with it more actively.

There are several treatment approaches for schizophrenia

  1. Medications

Medicines used to treat schizophrenia are called antipsychotics. These medications do not eradicate schizophrenia but reduce the most troubling symptoms such as hallucinations, delusions, and poor thinking abilities. These medications have been grouped into two categories.

  1. First-generation antipsychotics
  • Chlorpromazine
  • Fluphenazine
  • Haloperidol
  • Thiothixene
  • Perphenazine
    1. Second-generation antipsychotics
  • Aripiprazole
  • Clozapine
  • Iloperidone
  • Olanzapine
  • Lurasidone
  1. Coordinated specialty care (CSC)

CSC is a team approach for schizophrenia. It combines psychological therapy and medicines with educational interventions, employment, and social services, and motivates a patient to live a normal life.

  1. Psychosocial therapy

While medications relieve the symptoms, psychosocial therapy helps with social, psychological, behavioral, and occupational problems. It also helps the patient in managing his symptoms. This therapy includes

  • Rehabilitation; focuses on the job training and social skills to help the patient work in society and live independently.
  • Cognitive remediation; involves learning strategies to resolve information processing problems. It uses computer-based exercises and coaching to build up mental skills that involve memory attention organization and planning.
  • Family therapy

Family’s affection and handling with care help the patient to manage schizophrenia symptoms.

  • Individual psychotherapy

Aids the person in understanding his disorder, and learning problem-solving skills.

  1. Hospitalization

Many affected people are treated as outpatients but hospitalization is the best option in case of;

  • Severe symptoms
  • Possibility of a patient to harm himself
  • Non-compliant patient

References

  1. https://www.mayoclinic.org/diseases-conditions/schizophrenia/symptoms-causes/syc-20354443#:~:text=Schizophrenia%20is%20a%20serious%20mental,functioning%2C%20and%20can%20be%20disabling.
  2. https://www.webmd.com/schizophrenia/schizophrenia-symptoms#1