Guest Author - Karen Huber
Schizophrenia is a serious, chronic disorder that affects about 1 percent of people worldwide and is often confused with dissociative identity disorder (split or several personalities. Schizophrenia is characterized by delusions, hallucinations and odd behavior, but the personality itself is intact. People with schizophrenia have odd ideas, hear nonexistent voices, hallucinate, and suffer physical symptoms. There is no cure, but it is often managed successfully by therapy and medication. Schizophrenia has been called the most debilitating mental disorder, the most misdiagnosed, and the most difficult to diagnose. It affects thoughts, perceptions, emotions, and judgment abilities. Familial factors, genetics, and environmental factors are thought to influence the development of schizophrenia.
Positive symptoms of schizophrenia are distorted thoughts or perceptions that include hallucinations, delusions, thought disorders, and lack of insight. Negative symptoms represent a decrease in the ability to initiate plans or movement, speak, express emotion, or find pleasure in everyday life. These include disorganized speech, attention problems, and disorganized motor activity. Cognitive symptoms are problems with attention, certain types of memory, and the functions that enable planning and organization. Writing and speaking normally can become very difficult.
DSM-IV-TR distinguishes five types of schizophrenia. Paranoid schizophrenia is characterized by persecutory delusions or frequent auditory hallucinations. Disorganized schizophrenia is characterized by disorganized speech and behavior, and flat or inappropriate affect. Extreme social impairment and severe regressive behaviors are often seen. Catatonic schizophrenia’s major feature is disturbance of motor activity. Patients show excessive excitement, agitation, hyperactivity, or withdrawn behavior patterns. Undifferentiated schizophrenia includes behavior that cannot be classified as one of the other types. Residual schizophrenia is a category for people who have had at least one episode of schizophrenia but are not now showing prominent symptoms.
Psychotic symptoms, such as hallucinations and delusions, usually emerge in men in their late teens and early twenties and in women in their mid-twenties to early thirties. They seldom occur after age 45 and rarely before puberty; although cases of schizophrenia in children as young as five have been reported. In adolescents, the first signs can include a change of friends, a drop in grades, sleep problems, and irritability. Sometimes there is acting out and violent behavior in schizophrenic patients. There is a better chance of recovery from acute or sudden onset of disease. Sometimes, schizophrenics suffer from an IQ loss of 8-10 points.
The most common medical treatment for schizophrenia is the use of antipsychotic medication. Neuroleptic medications such as Haldol, Prolixin, Navane, Stelazine, Trilafon, and Mellaril, while effective in treating positive symptoms, cause side effects, which can affect the nervous system. . Atypical antipsychotics include Clozaril, Abilify, Geodon, Invega, Risperdal, Saphris, Seroquel, and Zyprexa. Antidepressants can successfully reduce symptoms of depression.
Behavioral psychotherapy of some type is often effective for people suffering from schizophrenia. Cognitive therapy, psychoeducation, and family therapy can all help schizophrenics deal with their symptoms and learn to operate in society. Social skills training is of great importance, in order to teach the patient specific ways to manage themselves in social situations.
Social and cognitive treatments include family and group therapies to learn communication, social skills and an understanding of the illness. Rehabilitation programs can include vocational counseling, job training, money management, learning to use public transportation, and practicing social and workplace communication skills.
Schizophrenia is a chronic disorder that needs constant management. It cannot be cured but the recurrence of psychotic episodes can be decreased significantly by staying on medication. Most people with schizophrenia need to take some type of medication for the rest of their lives in addition to supportive therapy or rehabilitation.
Schizophrenics have a relatively high mortality rate than that of most other psychiatric patient groups. Overall, the lifespan for schizophrenia patients is shortened by approximately 10 years for men and 9 years for women. Medical conditions such as infections and circulatory diseases contribute to the increased mortality of schizophrenia patients. Presently, schizophrenia has a poorer recovery rate overall than other mental disorders.
