1
Schizophrenia is a group of severe mental disorders characterized by psychosis -- meaning that the patient has severely lost touch with reality -- and a decreased ability to function in society. Approximately 1 percent of people develop schizophrenia, and it's more common in men than women. The most common age of onset is the late teens and early 20s, although it can also occur later in life. Although the cause of schizophrenia has not been determined, the fact that the rate of the disease is 1 percent worldwide, across all cultures, suggests a strong genetic component.
Symptoms
Although schizophrenia has many subtypes, each with a range of symptoms, most people with schizophrenia display some combination of delusions, hallucinations, disordered thinking and unusual behavior. Delusions are beliefs with no basis in reality, for example, "The CIA is controlling my brain waves through a device they implanted in my head." Hallucinations are perceptions without an outside stimulus. Many people with schizophrenia, for example, experience auditory hallucinations, or "voices in their head," which to them seem very real. Disordered thinking often manifests in the conversational style of these patients. For example, a sentence like "The government took my pillowcase echo chamber in the salad dressing," is very hard for anyone else to understand. Unusual behavior might include poor hygiene, unconventional social interactions or doing something unexpected, such as dragging all your furniture into the street.
Treatment
Treatment for schizophrenia usually depends first and foremost on the patient taking an effective antipsychotic drug. Antipsychotic drugs -- both the older ones such as haloperidol and chlorpromazine and the newer "atypical" antipsychotics such as clozapine or risperidone -- are thought to work on the neurotransmitters dopamine and serotonin. Just like any other class of drugs, some antipsychotic drugs are effective for a particular patient and some aren't. Finding the drug or combination of drugs that works best depends on trial and error, which can be a lengthy process because these medications take weeks before they begin to work.
Once medications have stabilized your condition, your health care provider almost always recommends some kind of therapy to help you manage your schizophrenia, depending on your needs. Such therapy can help provide support for the stress of dealing with a chronic serious illness, or it can help with specific real-life challenges such as finding and keeping a job.
Challenges
Many people with schizophrenia don't want to take their medications. Many incorporate the medication into their delusional belief system, especially if they experience side effects. They might believe the medication is poison, for example, and therefore refuse to take it. Others, because of their difficulties with disorganized thinking, have a hard time remembering to take medication on the appropriate schedule. Even if someone is willing to take medication, the side effects can be serious, and can include diabetes, weight gain, high cholesterol, and a permanent neurological disorder known as tardive dyskinesia, in which the patient experiences involuntary tics and movements.
Prognosis
According to Rashmi Nemade, Ph.D, and Mark Dombeck, Ph.D., clinicians writing for the El Paso Mental Health and Mental Retardation website, ten years after a diagnosis of schizophrenia, about half of the patients are considered "completely recovered" or healthy enough to function independently. Another 25 percent have improved but need support in order to function, and 15 percent have not improved. The remaining 10 percent, tragically, commit suicide. Nemade and Dombeck note that the key to a good prognosis is early diagnosis and treatment.
