Overview Schizophrenia is a chronic severe and disabling brain disorder. It affects about one per cent of the population striking most often in the 16 to 30 year age group. People with schizophrenia have periods where they seem unaffected by it and other times when they may hear voices that other people don't hear or they may believe that others are reading their minds controlling their thoughts or plotting to harm them. These experiences are terrifying and can cause fearfulness withdrawal or extreme agitation.
Symptoms
Psychotic symptoms as described above 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 only 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. Since most adolescents exhibit these behaviors at one time or another a diagnosis can be difficult to make at this stage.
Symptoms of schizophrenia vary with each person. However a doctor will look for two or more of the following over a period of six months before making a diagnosis: - delusions
- difficulty interacting in social situations
- hallucinations
- inability to maintain personal hygiene
- inappropriate expression of emotions
- incoherence
- lack of emotion
- trouble functioning at work or in life
Causes
The cause of schizophrenia is somewhat unclear. Other health problems heredity drug and alcohol use stress and trauma may all be contributing factors.
A growing body of evidence suggests that toxins or infections may affect certain events during prenatal development and as a result play a role in the development of the disorder. Emotional trauma experienced by the pregnant mother may increase the chances that the child will develop schizophrenia later in life.
Stress is also thought to play a role. Evidence has shown that schizophrenia is more common amongst marginalized groups those who live in poverty experience abuse or racism are more likely to experience s mental illness in general.
Treatment
There is no cure all for schizophrenia. Each person with the disorder may have different needs at any given time. A well rounded approach to treatment that includes medication psychotherapy and rehabilitation is often the most successful. Treatment may include any or all of the following: Anti-psychotic medications
The single most important aspect of therapy is regular and consistent use of antipsychotic medications. There are many different types. Clozapine risperidone olanzapine are examples of some commonly used medications to help control the symptoms of schizophrenia. An older but still commonly used antipsychotic is called haldol.
Psychosocial treatment
A positive relationship with a therapist provides a reliable source of information sympathy encouragement and hope all of which are essential for recovery.
Psychosocial treatments can help patients who are already stabilized on anti-psychotic medication deal with certain aspects of schizophrenia such as difficulty with communication motivation self-care work and establishing and maintaining relationships with others. Learning and using coping mechanisms to address these problems allows people with schizophrenia to attend school work and socialize. Patients who receive regular psychosocial treatment also adhere better to their medication schedule and have fewer relapses and hospitalizations. Cognitive Behavioral Therapy
Cognitive behavioral therapy is useful for patients with symptoms that
persist even when they take their medication. The cognitive therapist teaches people with schizophrenia how to test the reality of their thoughts and perceptions how to "not listen" to their voices and how to shake off the apathy that often immobilizes them. This treatment appears to be effective in reducing the severity of symptoms and the chances of a relapse. Illness Management Skills
People with schizophrenia can take an active role in managing their own illness. Once they learn some basic facts about schizophrenia and its treatment they can make informed decisions about their own care. If they are taught how to monitor the early warning signs of relapse and develop a plan to quickly respond to these signs they can learn how to prevent relapses. They can also be taught coping skills they can use to deal with persistent symptoms.
Rehabilitation
Rehabilitation emphasizes social and vocational training to help people with schizophrenia function more effectively in society. Because people with schizophrenia frequently become ill during the critical career-forming years of life (ages 18-35) and because the disease often interferes with normal cognitive functioning many patients do not receive
the training required for skilled work. Rehabilitation programs can include vocational counseling job training and financial management learning to use public transportation and practicing social and workplace communication
skills.
Family Education
Patients with schizophrenia are often discharged from the hospital into the care of their families so it is important that family members know as much as possible about the disease in order to help their loved one prevent relapses. They should learn to use coping strategies and problem-solving skills to effectively manage their ill relative.
Self-Help Groups
Self-help groups for people with schizophrenia and their families are becoming increasingly common. Group members are a continuing source of mutual support and comfort which can be very therapeutic. People in self-help groups know that others are facing the same problems they face. Consequently they no longer feel isolated by their illness or the illness of their loved one. | 