Schizophrenia

Schizophrenia can be a devastating conditon

Schizophrenia is one of the most chronic and disabling of the major mental illnesses. It is a highly complex condition, and scientists are not even sure if it is one disorder, or a range of disorders, with different causes.

Approximately one per cent of the population develop schizophrenia during their lives. Men and women are affected equally. Schizophrenia is not, as is commonly thought, split personality.

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What is schizophrenia?

Schizophrenia is such a complex condition that few generalisations hold true for all people diagnosed as schizophrenic.

People with acute schizophrenia may experience psychotic symptoms when they are completely unable to separate reality from unreal experiences. They may view the world as highly distorted, changeable and lacking reliable landmarks.

Some patients may only have one psychotic episode, and others may have many episodes during a lifetime, but lead relatively normal lives during interim periods.

Patients with chronic schizophrenia often do not fully recover normal functioning and may require long-term treatment, generally including medication, to control the symptoms.

Some chronic schizophrenic patients may never be able to function without assistance of one sort or another.

The first psychotic symptoms of schizophrenia are often seen in the teens or twenties in men and in the twenties or early thirties in women.

Schizophrenia can be confused with other mental disorders, such as manic-depression and with physical illnesses.

What are the symptoms?

Schizophrenia can cause a huge variety of symptoms, and a sufferer may exhibit very different behaviour at different times.

A person with schizophrenia may feel anxious and confused. A sufferer may seem distant, detached, or preoccupied. Sometimes they may sit motionless and silent for hours.

Alternatively, a schizophrenic may move about constantly, always occupied, wide awake, vigilant, and alert. Prolonged extremes of depression and elation are not uncommon.

Some people with schizophrenia experience hallucinations. The most common form of hallucination is the hearing of voices.

People with schizophrenia also have delusions - false or irrational beliefs. Some can be quite bizarre, for instance that people on television are broadcasting the sufferer's thoughts aloud to other people.

People with paranoid schizophrenia believe they are being persecuted.

Often a schizophrenic patient's thinking is affected by the disorder. The person may not be able to think straight, or to concentrate.

People with schizophrenia also have trouble expressing their emotions. They may appear inconsistent, manic or emotionally stunted.

Are people with schizophrenia likely to be violent?

Although news and entertainment media tend to link mental illness and criminal violence, studies show that mentally ill people are no more prone to violence than the general public.

Most schizophrenic individuals are not violent; more typically, they prefer to withdraw and be left alone.

Some acutely disturbed patients may become physically violent, but such outbursts have become relatively infrequent following the introduction of more effective treatments.

What causes schizophrenia?

There is no known single cause of schizophrenia. It appears that genetic factors produce a vulnerability to schizophrenia, with environmental factors contributing to different degrees in different individuals.

No specific gene has yet been found; no biochemical defect has been proven responsible; and no specific stressful event seems sufficient, by itself, to produce schizophrenia.

However, it is thought that a chemical imbalance in the neurotransmitters - substances that allow communication between nerve cells - is involved in the development of schizophrenia.

How is schizophrenia treated?

Usually by a combination of medication, such as anti-psychotic drugs, and psychological interventions, such as cognitive behaviour therapy.

There is no cure for the condition, but together these approaches are pretty effective at keeping schizophrenia under control.

Anti-psychotics work by blocking the effect of the chemical dopamine, which regulates mood, has on the brain.

The drugs can usually reduce feelings of anxiety or aggression within a few hours.

However, they may take days or weeks to reduce other symptoms, such as hallucinations or delusional thoughts.

Typical anti-psychotics were first developed in the 1950s, and a second generation of drugs, the atypical anti-psychotics, came on stream in the 1990s.

Atypical anti-psychotics are less likely to cause side effects, but are not suitable for everyone.

Both types of drugs can cause side effects such as weight gain, loss of libido and blurred vision.

However, other side effects, such as drowsiness, shaking, and muscle twitches are usually only associated with the older generation of drugs.

The aim of cognitive behaviour therapy is to identify the thinking patterns that are contributing to unwanted feelings and behaviour, and to replace them with a more sober, rational way of thinking.

Other forms of therapy can include working with family members to address issues or occupational therapy.

What is the outlook?

The outlook for people with schizophrenia has improved over the last 25 years.

Although no totally effective therapy has yet been devised, many schizophrenic patients improve enough to lead independent, satisfying lives.

A review of almost 2,000 patients' life histories suggests that 25% achieve full recovery, 50% recover at least partially, and 25% require long-term care.

This page contains basic information. If you are concerned about your health, you should consult a doctor