Schizophrenia is a severe and debilitating brain and behavior disorder affecting how one thinks, feels and acts. People with schizophrenia can have trouble distinguishing reality from fantasy, expressing and managing normal emotions, and making decisions. Thought processes may also be disorganized and the motivation to engage in life's activities may be blunted. Those with the condition may hear imaginary voices and believe others are reading their minds, controlling their thoughts or plotting to harm them. Most people with schizophrenia suffer from symptoms either continuously or intermittently throughout life and are often severely stigmatized by people who do not understand the disease.
Contrary to popular perception, people with schizophrenia do not have “split” or multiple personalities and most pose no danger to others. However, the symptoms are terrifying to those afflicted and can make them unresponsive, agitated or withdrawn. People with schizophrenia attempt suicide more often than people in the general population. While schizophrenia is a chronic disorder, it can be treated with medication, psychological, and social treatments, substantially improving the lives of people with the condition.
Schizophrenia can have very different symptoms in different people. The way the disease manifests itself and progresses in a person depends on the time of onset, severity, and duration of symptoms. Relapse and remission cycles often occur; a person can get better, worse, and better again repeatedly over time. The symptoms of schizophrenia are categorized as positive, negative and cognitive. All three kinds of symptoms reflect problems in brain function.
Positive symptoms, which can be severe or mild, include delusions, hallucinations, and thought disorders. Some psychiatrists also include psychomotor problems that affect movement in this category.
Delusions, hallucinations and inner voices are collectively called psychosis, which also can be a hallmark of other serious mental illnesses such as bipolar disorder. Delusions lead people to believe others are monitoring or threatening them, or reading their thoughts. Hallucinations cause a patient to hear, see, feel or smell something that is not there.
Thought disorders may involve difficulty putting cohesive thoughts together or making sense of speech. Psychomotor problems may appear as clumsiness, unusual mannerisms or repetitive actions, and in extreme cases, motionless rigidity held for extended periods of time.
Negative symptoms reflect a loss of functioning in areas such as emotion or motivation. Negative symptoms include loss or reduction in the ability to initiate plans, speak, express emotion or find pleasure in life. They include emotional flatness or lack of expression, diminished ability to begin and sustain a planned activity, social withdrawal, and apathy. These symptoms can be mistaken for laziness or depression.
Cognitive symptoms involve problems with attention and memory, especially in planning and organizing to achieve a goal. Cognitive deficits are the most disabling for patients trying to lead a normal life
Schizophrenia affects men and women equally. It occurs at similar rates in all ethnic groups around the world. Symptoms such as hallucinations and delusions usually start between ages 16 and 30. Men tend to experience symptoms earlier than women. Most of the time, people do not get schizophrenia after age 45.
Schizophrenia rarely occurs in children, but awareness of childhood onset schizophrenia is increasing. It can be difficult to diagnose schizophrenia in teens. This is because the first signs can include a change of friends, a drop in grades, sleep problems and irritability — behaviors that are common among teens.
While no cure exists for schizophrenia, it is treatable and manageable with medication and behavioral therapy, especially if diagnosed early and treated continuously. Those with acute symptoms, such as severe delusions or hallucinations, suicidal thoughts, or the inability to care for oneself, may require hospitalization. Antipsychotic drugs are the primary medications to reduce the symptoms of schizophrenia. They relieve the positive symptoms through their impact on the brain's neurotransmitter systems. Cognitive and behavioral therapy can then help “retrain” the brain once symptoms are reduced.
These approaches improve communication, motivation and self-care and teach coping mechanisms so that individuals with schizophrenia may attend school, go to work and socialize. Patients undergoing regular psychosocial treatment comply better with medication, and have fewer relapses and hospitalizations. A positive relationship with a therapist or a case manager gives a patient a reliable source of information about schizophrenia, as well as empathy, encouragement and hope. Social networks and family member support have also been shown to be helpful.
From the Brain and Behavior Research Foundation. Full Article
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