schizophrenia Alternative Names
Schizophrenia is a mental disorder in which a person loses contact with reality. It causes a decline in the person's general ability to function, as well as abnormal thinking, speech, and behaviour.
What is going on in the body?
About 180000 Australians are affected by schizophrenia at some point in their lives. One in one hundred people all over the world, from all walks of life, have the illness at some stage in their lives. It usually starts in the teenage years or early adulthood, but it can occur at any age. The first signs are often confusing or even shocking changes in the person's behaviour, thoughts, or manner of speaking. The course of schizophrenia is often unpredictable. Many people are affected for the rest of their lives.
What are the signs and symptoms of the condition?
The exact symptoms vary from person to person. There are five main types of symptoms:
In addition, a person with schizophrenia often has social, work, or relationship problems because of the symptoms.
- delusions, which are firmly held personal beliefs that are false. For example, a person may believe that aliens are trying to control him or her.
- hallucinations, in which a person senses things that don't exist. For example, a person may hear voices that no one else can hear, or see things that aren't there.
- disorganised speech, which can make it hard to understand a person with this condition
- disorganised or bizarre behaviour. This may include violent behaviour, strange movements, or a lack of movement.
- "negative" symptoms, or an absence of things that most people have. For example, a person with schizophrenia may lack energy, emotion, or the ability to feel pleasure.
- inability to concentrate
What are the causes and risks of the condition?
No single cause can account for this condition. It may be caused by a combination of inherited factors and the person's environment. Changes in the chemistry of the brain may also trigger it. A person with an affected relative is more likely to have schizophrenia. It is equally common in males and females.
What can be done to prevent the condition?
There are no known ways to prevent the condition.
How is the condition diagnosed?
There is no single test to diagnose schizophrenia. A psychiatrist makes the diagnosis based on the person's history and symptoms. Before the diagnosis is made, symptoms must be present for at least six months. Drug use or another medical condition must be ruled out as the cause of the symptoms. Blood, urine, and other tests may be done to look for any underlying medical disorders. Special x-ray tests of the brain, such as cranial CT scans, may also be done.
What are the long-term effects of the condition?
Good care and treatment is essential for people with this condition. They often have problems with all aspects of thought, emotion, and expression. The course varies from one person to the next. People may be unable to work, have relationships, or even take care of themselves. Suicide is a serious danger. Roughly 10% of affected people eventually commit suicide.
What are the risks to others?
Most people with schizophrenia are not violent. They are often withdrawn and want to be left alone. Drug abuse increases the risk of violence in affected people. A person who stops taking prescribed medication may be at a higher risk for violent behaviour. When violence does occur, it is most often targeted at family and friends, and most often takes place at home.
What are the treatments for the condition?
The goals of treatment are to:
There are three major components of treatment:
- make symptoms less severe
- prevent a decline in function
- provide support so the person can function at the highest level possible
Hospitalisation may be needed at times if the person poses a danger to self or others.
- anti-psychotic medications to reduce symptoms. They may help the person to be more effective and appropriate in society.
- rehabilitation and community support activities to teach the skills needed to survive in society. These skills help an individual with schizophrenia to work, shop, manage a household, and get along with others.
- psychotherapy, with regularly scheduled talks between the individual and a doctor or psychologist. The sessions may focus on current or past problems, experiences, thoughts, feelings, or relationships. This may help the person understand and manage the illness, take medications, and manage stress.
What are the side effects of the treatments?
Antipsychotic medications have many possible side effects. These include drowsiness, restlessness, muscle spasms, dry mouth, and blurry vision. The long-term side effects may include tardive dyskinesia. This disorder causes uncontrollable, random movements of the mouth, lips, and tongue. It sometimes affects the trunk, arms, and legs.
What happens after treatment for the condition?
Most people with schizophrenia need some form of ongoing treatment for long periods of time, or for life. The outlook for an individual with this condition has improved over the past 25 years. Many people with schizophrenia improve enough with treatment to lead independent, satisfying lives. Group homes or structured living environments may be helpful for some individuals. A few people with severe forms of the disorder may need full time care in a safe and supportive setting.
How is the condition monitored?
Someone with schizophrenia needs ongoing monitoring and treatment. Symptoms may flare up and require hospitalisation. Without treatment and medications, some people become quite psychotic and disorganised. These people may be unable to care for their basic needs, such as food, clothing, and shelter. All too often, a person with schizophrenia ends up on the streets or in jail, where he or she is unable to get effective treatment.
Author: Gail Hendrickson, RN, BS
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Potential conflict of interest information for reviewers available on request