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Schizophrenia

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D E S C R I P T I O N

Schizophrenia is a complex brain disorder characterized by severe psychotic symptoms. It is the most chronic and disabling of the major mental illnesses. People with schizophrenia often have difficulty differentiating between real and imaginary experiences, thinking logically, expressing normal emotions or behaving normally. Because of the disorder's complexity, few generalizations hold true for all people who have schizophrenia.

Schizophrenia has four subtypes:

1. Paranoid schizophrenia - person feels suspicious, persecuted, grandiose or some combination of the three.

2. Disorganized schizophrenia - person frequently exhibits disorganized speech or behavior, but may not have delusions.

3. Catatonic schizophrenia - person is withdrawn and negative, often assuming unusual postures.

4. Residual schizophrenia - person is no longer hallucinating, delusional, disorganized or catatonic but continues to show signs of disturbance.


R I S K

Approximately 1 percent of the population develops schizophrenia. In a given year, more than 2 million Americans suffer from the illness.

The disorder affects men and women with equal frequency. However, the symptoms often appear earlier in men, usually in the late teens or early 20s; women are typically affected in the 20s to early 30s. Children over age 5 can develop schizophrenia, but it is very rare before adolescence.

Relapse rates for people who are not treated are as high as 50 percent within one year. These relapses often result in hospitalization.

Schizophrenia runs in families. People who have a close relative with schizophrenia are more likely to develop the disorder than other people are.

Suicide is the leading cause of death for people with schizophrenia. People with schizophrenia should be treated throughout life to prevent relapse and suicide.


S Y M P T O M S

Symptoms of schizophrenia vary from person to person. Their onset may be sudden or gradual. Symptoms are often bizarre, disabling and frightening. They include:

1. Hallucinations - perceptions that are not connected to an appropriate source. Hallucinations can occur in any sensory form, but hearing voices is the most common.

2. Delusions - false personal beliefs that are not subject to reason or contradictory evidence and are not explained by a person's cultural concepts.

3. Disordered thinking - inability to focus attention or connect thoughts into logical sequences. The person may be easily distracted and unable to differentiate what is relevant and what isn't; speech can become disorganized and fragmented.

4. Blunted or flat affect - severe reduction in emotional expressiveness.

Symptoms such as hallucinations and delusions are called positive symptoms, whereas emotional withdrawal and reduction in emotional expressiveness are called negative symptoms.


T R E A T M E N T

Because of the complexity of schizophrenia, treatment is usually a combination of medication, psychotherapy and rehabilitation.

1. Medication - Antipsychotic drugs reduce psychotic symptoms and usually let people with schizophrenia function more effectively and appropriately. They do not cure schizophrenia or ensure that there will be no further psychotic episodes.

Antipsychotic drugs introduced in the 1950s and 1960s have been the standard of treatment and have helped many people. These drugs are generally safe and reduce positive symptoms, but they do not reduce negative symptoms well. They may also cause unwanted side effects.

Over the past decade, new antipsychotic medications called "atypical" agents have come into use. These agents are thought to be effective at reducing both positive and negative symptoms, and they may also cause fewer unwanted side effects than the older agents.

2. Psychotherapy - "Talk" therapy may focus on current or past problems, experiences, thoughts, feelings or relationships. Individuals with schizophrenia may gradually come to understand more about themselves and their problems.

3. Rehabilitation - Programs provide training to help people with schizophrenia develop self-care, social and work-related skills.


P R E V E N T I O N

Schizophrenia has no known single cause. Biomedical research is exploring genetic, developmental, behavioral and other factors that may cause or contribute to the disorder. At this time prevention is not possible, but adhering to treatment programs can minimize the probability of relapse.

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