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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 Catatonic schizophrenia - person is withdrawn and negative, often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.
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.
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.
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.
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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