Schizophrenia

Reviewed By Dr. Arun Kunwar, MBBS, MD in Child & Adolescent Psychiatry

    Introduction :

    Schizophrenia is a serious mental disorder. Schizophrenic people often hear voices which aren’t there and may see the scene which isn’t real. They may feel other people are trying to hurt them. Actually, the word schizophrenia is comprised of two Greek words- skhizein meaning to split and phren meaning mind. Though the whole literary meaning of the word directs towards splitted mind, but schizophrenia isn’t considered as split personality or multiple personality. The schizophrenic patient also having the problem of multiple personality is rarely noticed which is known as complicated schizophrenia.

    Schizophrenia most commonly starts at the age of 13-30. Male may develop the symptoms earlier than Female. This type of mental problem rarely occurs after 30 and people usually do not develop the schizophrenia after the age of 45. It is believed that 1 percent of the total population is suffered from this mental disease. Some research shows it is the result of faulty neuronal development in the brain of the fetus.

    A studio shot of a sad young woman holding her head in her hands
    A sad young girl holding her head in her hands

    Symptoms :

    Symptoms of schizophrenia may be classified into three categories:

    1. Pshychotic symptoms : a person is distorted to hallucinations- hearing or seeing things that are not there, delusions- beliefs that are not true and trouble organizing thoughts and movements.
    2. Negative symptoms : a person becomes weak to react normally showing emotions, facial expressions and motivations.
    3. Cognitive symptoms : a person will gradually become withdrawn. The process of thinking will be depressed and unble to concentrate resulting the person in problem to calculate the information to make any decision.

    Factors influencing Schizophrenia :

    Experts believe several factors are responsible to the onset of schizophrenia but no one is sure. They think the genes, the environment and the brain chemistry may play the vital role. Many evidences suggest that genetic and environmental factors act together to bring about schizophrenia. Here, for the convenience, it is listed one by one as below –

    1. Genetic inheritance : If a family member had the problem of schizophrenia then there is more chance to inherit it genetically.
    2. Chemical imbalance in the brain : It is believed that people with schizophrenia has the imbalance of brain chemicals, viz. dopamin, glutamate and serotonin.
    3. Family relationships : If there is not good relationship among family members then it is more likely to develop schizophrenia.
    4. Environmental factors : It may be triggered by environmental viral infection or immune disorder.
    5. Misuse of drugs : Misuse of drugs or use of substance will also trigger the schizophrenia.

    Diagnosis and Tests :

    The present method of differential diagnosis of schizophrenia rely on the symptoms and signs shown by the victims. By ruling out other mental disorders and making sure the symptoms are not due to abuse of drugs, medication or a medical condition, doctors do the following exams :

    • Physical exam – knowing the whole history and behavioral activities of the patient. If it proves the patient has hallucination, delusion, disorganized speech and catatonic behavior, then it is 70% confirmed that he or she has the problem of schizophrenia.
    • Screening tests – doctors may observe MRI or CT scan.
    • Psychiatric evaluation- doctor may check the mental status of the patient by observing appearance and demeanor and asking about suicidal thoughts. This may also include the discussion of family and personal history.

    Treatments and Therapies :

    Since the cause of schizophrenia is still unclear, treatments focus on eliminating the symptoms of the disease. This include :

    • Antipsychotic medication – there are lots of medicines to diminish the symptoms of schizophrenia which is usually given on daily basis in pill or liquid form. Some antipsychotics are given by injections once or twice a month. Side effects may arise in the beginning of medication period which go away after a few days. There are two major types of antipsychotic medication, viz. typical or conventional and atypical or new generation. Chlorpromazine, haloperidol, thioridazine etc belong under typical and clozapine, quetiapine, ziprasidone etc belong under the category of atypical psychotic medication.
    • Recovery and rehabilitation – while there is no any proper medication for schizophrenia it is more emphasized in proper rehabilitation of the patient.
    • Psychosocial treatments – after the patient is recovering nicely the psychosocial treatments are also carried out such as attending school or work. Such treatment strengthens their will power and are less likely to have relapses.
    • Yoga and meditation – now-a-days yoga and meditation are also used side by side to cure psychotic diseases. This helps them to develop concentration.

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