Causes, Symptoms and Treatment of Schizophrenia

Schizophrenia is a chronic, severe, debilitating mental illness characterized by disordered thoughts, abnormal behaviors, and anti-social behaviors. It is a psychotic disorder, meaning the person with schizophrenia does not identify with reality at times.

Schizophrenia affects about 1.1% of the world's population. It is the most commonly diagnosed between the ages of 16 to 25. Schizophrenia has a genetic component. While schizophrenia occurs in only 1% of the general population, it occurs in 10% of people with a first-degree relative (parent, sibling) with the disorder. It is also more common in people with a second-degree relative (aunts, uncles, cousins, grandparents) with the disorder.

It affects men 1.5 times more commonly than women. By the way, Schizophrenia in young children is rare. 

Types of Schizophrenia

By the types of symptoms the person exhibits when they are assessed, there are five types of schizophrenia:

Paranoid schizophrenia

Disorganized schizophrenia

Catatonic schizophrenia

Undifferentiated schizophrenia

Residual schizophrenia

Paranoid Schizophrenia

It is distinguished by paranoid behavior, including delusions and auditory hallucinations. Paranoid behavior is exhibited by feelings of persecution, of being watched, or sometimes this behavior is associated with a famous or noteworthy person a celebrity or politician, or an entity such as a corporation. Affected people may display anger, anxiety, and hostility. The person usually has relatively normal intellectual functioning and expression of affect.

Disorganized Schizophrenia

A person with disorganized-type schizophrenia will exhibit behaviors that are disorganized or speech that may be bizarre or difficult to understand. They may display inappropriate emotions or reactions that do not relate to the situation at-hand. Daily activities such as hygiene, eating, and working may be disrupted or neglected by their disorganized thought patterns.

Catatonic Schizophrenia

Disturbances of movement mark catatonic-type schizophrenia. People with this type of schizophrenia may vary between extremes: they may remain immobile or may move all over the place. They may say nothing for hours, or they may repeat everything you say or do. They are often unable to take care of themselves or complete daily activities.

Undifferentiated Schizophrenia

When a person exhibits a mix of two or more of the other types of schizophrenia, including symptoms such as delusions, hallucinations, disorganized speech or behavior, catatonic behavior is called Undifferentiated schizophrenia.

Residual Schizophrenia

When a person has a past history of at least one episode of schizophrenia, but the currently has no symptoms (delusions, hallucinations, disorganized speech or behavior) they are considered to have residual-type schizophrenia. The person may be in complete remission, or may at some point resume symptoms.

Causes of Schizophrenia

Schizophrenia has multiple, intermingled causes which may differ from person to person, including:

Genetics (runs in families)

Environment

Brain chemistry

History of abuse or neglect

Schizophrenia Symptoms

Symptoms include:

Social withdrawal

Anxiety

Delusions

Hallucinations

Paranoid feelings or feelings of persecution

Loss of appetite or neglecting to eat

Loss of hygiene

Symptoms may also be grouped into categories as follows:

Positive (More Overtly Psychotic) Symptoms

These symptoms are not seen in healthy people, include:

Delusions

Hallucinations

Disorganized speech or behavior

Dysfunctional thinking

Catatonia or other movement disorders

Negative (Deficit) Symptoms

"Negative" symptoms disrupt normal emotions and behaviors and include:

Social withdrawal

"Flat affect," dull or monotonous speech, and lack of facial expression

Difficulty expressing emotions

Lack of self-care

Inability to feel pleasure (anhedonia)

Cognitive Symptoms

Cognitive symptoms may be most difficult to detect and these include:

Inability to process information and make decisions

Difficulty focusing or paying attention

Problems with memory or learning new tasks

Affective (or Mood) Symptoms

Affective symptoms refer to those which affect mood. Patients with schizophrenia often have overlapping depression and may have suicidal thoughts or behaviors.

Diagnosis and Medication of Schizophrenia

The diagnosis of schizophrenia is made both by ruling out other medical disorders that can cause the behavioral symptoms (exclusion), and by observation of the presence of characteristic symptoms of the disorder. The doctor will observe for at least six months.

The doctor may use physical examination, psychological evaluation, blood test, and imaging scans to produce a complete picture of the patient's condition.

Mental health screening and evaluation is an important part of the diagnosis process for schizophrenia. Many other mental illnesses such as bipolar disorder, schizoaffective disorder, anxiety disorders, severe depression, and substance abuse may mimic symptoms of schizophrenia. A doctor will perform an assessment to rule out these other conditions and give the medication according to the types of Schizophrenia. 

Prognosis for Schizophrenia

The prognosis for people with schizophrenia can vary depending on the amount of support and treatment the patients receives. Many people with schizophrenia are able to function well and lead normal lives. However, people with schizophrenia have a higher death rate and higher incidence of substance abuse. When medications are taken regularly and the family is supportive, patients can have better outcomes.