Mental Health

Schizophrenia

Healthpind Staff
Reviewed by Dr Singh, J.P. MBBS, MD, DNB

Overview

Schizophrenia is a severe mental health disorder that changes the way of thinking, feeling, and behavior of the person. Its main characters include psychotic events consisting of delusions and hearing of unspoken voices. It can impair the ability to retain learned skills or learn new ones. As a result, they can adversely affect a person’s livelihood.

According to the WHO, about 21 million people have schizophrenia globally. Schizophrenia generally affects the last phases of adolescence or early adulthood. Symptoms of schizophrenia are treatable. You can lead a fulfilling and wholesome life with treatment, well-integrated in society.

Signs and symptoms of Schizophrenia

Schizophrenia symptoms can be classified into three categories – positive, negative, and cognition-related. The symptoms, however, differ significantly from one person to another and may also change in severity and pattern over time.

Positive symptoms

These are psychotic episodes, and the person eliciting these types of behavior seems to lose touch with reality. These include:

● Delusions

A delusion is a firm and false belief so hard that it is tough to break, even if evidence to the contrary is presented. These delusions occur in more than 90% of patients with schizophrenia. Different types of delusion are –

Delusion of reference – It refers to a false belief that some normal event has hidden and special meaning for a person. For, e.g., you may believe that a newspaper report has a special message for you.
Delusion of persecution refers to a false belief that others will harm you.
Delusion of grandeur – It refers to the false belief that you are as great as some famous personality, Eg – Queen Elizabeth.
Delusion of control is a false belief that outside forces control your thinking and behavior.

● Hallucinations

It is to see, feel,l taste, hear or smell something that doesn’t exist in reality. Auditory hallucinations involving unreal voices are the most common. These hallucinations generally have some meaning for the person

● Disorganized speech

Schizophrenia affects the way a person thinks and concentrates; therefore, it can disorganize your train of thought. As a result, it will change the style of your speaking. You may start with one topic, shift to another, and end with entirely different subjects. You may say completely illogical and incoherent things. The most noteworthy features of disorganized speech include the following: –

Loose association – Quick shifting from one topic to another, the different topics having no connection.
Preservation – Repeat the same words and sentences while you speak.
Neologism – using new words that are not part of the language and have meaning only to you.

Negative symptoms

These are symptoms that decrease your ability to live a well-integrated life. These refer to:

Lack of motivation to do daily activities.
Social withdrawal and loss of interest in the surroundings.
Absence of emotional expression and inability to start plans, express feelings, or enjoy pleasure.

Cognitive symptoms

These include changes in thinking, memory, and other aspects of cognition, problems with concentration or focus, and problems with decision-making.

Scientists think that a combination of genetic and environmental factors causes schizophrenia. It is a polygenic disorder. Many genes seem to be involved in its development. The environmental factor that may be involved includes infection with some viruses, malnutrition, and other psychosocial problems.

Diagnosis

The diagnosis of schizophrenia is arrived at by ruling out other medical conditions having similar symptoms. It includes: –

Medical history to know about symptoms.
Physical examination – This is done to rule out other medical problems.
Medical tests may include blood tests and imaging studies such as a CT scan or MRI.

The doctor may use the diagnostic and statistical manual of mental disorders criteria to arrive at the diagnosis.

Treatment

Schizophrenia requires treatment, which is often lifelong. Treatment comprises a combination of medication and psychotherapy. Psychotherapy is tailor-made for each person.

Medical therapy

It includes the drug given on a doctor’s prescription. Some of the medicines may cause various side effects. The medication is given at a dose that can control symptoms while causing minimal side effects. Different drugs prescribed include second-generation antipsychotics. These medicines pose less risk of side effects than those caused by first-generation. These include medications such as clozapine, olanzapine, risperidone, and aripiprazole.

Psychotherapy

Psychological therapy helps to control symptoms of schizophrenia. Some of the common psychological interventions include:

Cognitive behavior therapy (CBT).
Family therapy.
Art therapy.

Hospitalization

If the symptoms increase in severity, hospitalization will be required.

Electroconvulsive therapy.

If medication and psychotherapy fail to help, electroconvulsive therapy may help.

Self-help and coping

Be relaxed. Control your levels of stress, as it can trigger an attack of schizophrenia. Meditate, do yoga, or follow some relaxation techniques to stay relaxed.
Get optimum sleep. It will rejuvenate your mind and body and keep you energized.
Do Not drink alcohol and avoid recreational drugs. Alcohol and drugs will worsen the symptoms of schizophrenia and may result in complications.
Have a balanced and nutritious diet. It will keep your body healthy and thus help you fight schizophrenia.
Social support from friends and family members will help.
Have at least 30 minutes of physical exercise daily.
Last but not least, maintain strong willpower.