Schizophrenia is a mental disorder that makes ithard to:
- Tell the difference between what is real and not real
- Think clearly
- Have normal emotional responses
- Actnormally in social situations
Schizophrenia is a complex illness. Mental health experts are not sure what causes it. Genes mayplay a role.
Schizophrenia occurs in just as many men as inwomen. It usually begins in the teen years or young adulthood, but it may begin later in life. In women, it tends to begin later and is a milder condition.
Schizophrenia in children usually begins after age 5. Childhood schizophrenia is rare and can behard to tell apart from other developmental problems such as autism.
Schizophrenia symptoms usually develop slowly over months or years. Sometimes the personmay have many symptoms, other times only a few.
People with schizophrenia may have trouble keeping friends and working. They may also have problems with anxiety, depression, and suicidal thoughts or behaviors.
Early symptoms may include:
- Irritable or tense feeling
- Trouble concentrating
As the illness continues, the person may have problems with thinking, emotions, and behavior, including:
- Bizarre behaviors
- Hearing or seeing things that are not there (hallucinations)
- Reduced emotion
- Problems paying attention
- Strongly held beliefs that are not real (delusions)
- Thoughts that"jump" betweendifferent topics (“loose associations”)
Exams and Tests
There are no medical tests to diagnose schizophrenia. A psychiatrist should examinethe person and make the diagnosis. The diagnosis is made based on an interview ofthe personand family members.
Thepsychiatrist will ask about:
- How long the symptoms have lasted
- How ability to function has changed
- Developmental background
- Genetic and family history
- How well medicines have worked
- Substance abuse
- Medical conditions
Brain scans (such as CT or MRI) and blood tests may helprule out otherconditions that have similar symptoms.
During an episode of schizophrenia,the pesonmay need to stay in the hospital for safety reasons.
Antipsychotic medicines are the most effective treatment for schizophrenia. They change the balance of chemicals in the brain and can help control symptoms.
Whilehelpful,these medicines can cause side effects. Many side effects can be managed though. For this reason,they should not preventthe personfromgetting treatedfor this serious condition.
Common side effects from antipsychotics may include:
- Feelings of restlessness or jitteryness
- Sleepiness (sedation)
- Slowed movements
- Weight gain
Long-term use of antipsychotic medicines may increasethe riskof a movement disorder called tardive dyskinesia. This condition causes repeated movements thatthe personcannot control. Callthehealth care providerright away if you think you or your family member may have this condition due to the medicine.
When schizophrenia does not improve with antipsychotics, other medicines may be tried.
Schizophrenia is a life-long illness. Most people with this condition need to stay on antipsychotic medication for life.
SUPPORT PROGRAMS AND THERAPIES
Support therapy may be helpful for many people with schizophrenia. Behavioral techniques, such as social skills training, can help the person function better in social and work situations. Job training and relationship-building classes are also important.
Family members and caregivers are very important in the treatment of schizophrenia. Important skills that may be learned at such programs include:
- Coping with symptoms that are present even while taking medicines
- A healthy lifestyle, including getting enough sleep and staying away from recreational drugs
- Taking medicines correctly and how to manage side effects
- Watching for the return of symptoms, and knowing what to do when they return
- Getting the right support services
The outlook with schizophrenia ishard to predict. Most of the time, symptoms improve with medication. But many peoplemay have sometrouble functioning. They are at riskof repeated episodes, especially during the early stages of the illness.
People with schizophrenia may need housing, job training, and other community support programs. People with the most severe forms of this disorder may not be able to live alone. They may need to live in group homes or other long-term, structured residences.
Symptomsare very likely toreturn when medicationis stopped.
Having schizophrenia increases the risk of:
- Developing a problem with alcohol or drugs (substance abuse). Using alcohol or other drugs increases the chancesthat symptoms will return.
- Physical illness. This is due to an inactive lifestyle and side effectsof medication.
When to Contact a Medical Professional
Call your health care provider if you or a family member experiences:
- Voices telling you to hurt yourself or others.
- The urge to hurt yourself or others.
- Feelings of beingscared or overwhelmed.
- Seeing things that are notreally there.
- Feelings thatyou cannot leave the house.
- Feelings that you arenot able to care for yourself.
Schizophrenia cannot be prevented.
Symptoms may beprevented bytaking medication exactly as instructed by the doctor. Symptomsare likely toreturn if medication is stopped.
Changing or stopping medications should only be done by the doctor who prescribed them.
Freudenreich O, Weiss AP, Goff DC. Psychosis and schizophrenia. In: Stern TA, Rosenbaum JF, Fava M, et al., eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 1st ed. Philadelphia, PA: Elsevier Mosby; 2008:chap 28.
Lyness JM. Psychiatric disorders in medical practice. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 404.
Review Date: 1/31/2013
Reviewed By: David B. Merrill, MD, Assistant Clinical Professor of Psychiatry, Department of Psychiatry, Columbia University Medical Center, New York, NY. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, Bethanne Black, Stephanie Slon, and Nissi Wang.