What is schizophrenia?

Schizophrenia is a chronic and severe mental disorder that affects how a person thinks, feels, and behaves. People with schizophrenia may seem like they have lost touch with reality. Although schizophrenia is not as common as other mental disorders, the symptoms can be very disabling.

What are the risk factors of schizophrenia?

Risk Factors:

Genes and environment: Scientists have long known that schizophrenia sometimes runs in families. However, there are many people who have schizophrenia who don’t have a family member with the disorder and conversely, many people with one or more family members with the disorder who do not develop it themselves.

Scientists believe that many different genes may increase the risk of schizophrenia, but that no single gene causes the disorder by itself. It is not yet possible to use genetic information to predict who will develop schizophrenia.

Scientists also think that interactions between genes and aspects of the individual’s environment are necessary for schizophrenia to develop. Environmental factors may involve:

  • Exposure to viruses
  • Malnutrition before birth
  • Problems during birth
  • Psychosocial factors

Different brain chemistry and structure: Scientists think that an imbalance in the complex, interrelated chemical reactions of the brain involving the neurotransmitters (substances that brain cells use to communicate with each other) dopamine and glutamate, and possibly others, plays a role in schizophrenia.

Some experts also think problems during brain development before birth may lead to faulty connections. The brain also undergoes major changes during puberty, and these changes could trigger psychotic symptoms in people who are vulnerable due to genetics or brain differences.

The risk of development of schizophrenia in the general population for someone with no family history of mental illness is estimated at approximately 1%. This risk increases to approximately 3% if a person in the extended family, for instance an aunt or uncle, has been diagnosed with schizophrenia.

When one parent has schizophrenia the risk is estimated at 13% for a child. The risk is highest among identical twins when one is diagnosed with schizophrenia the other has 50% chance of developing schizophrenia. It is important to note that even in identical twins there is still 50% chance that the other twin does not develop the condition. This proves that importance of the environmental factors in developing schizophrenia.

What other conditions could present with symptoms of schizophrenia?

Symptoms of schizophrenia can be similar to conditions that could cause hallucination or paranoid thinking. Stimulant drugs such as cocaine and amphetamines are among the most common drugs that could present with symptoms of schizophrenia.

Marijuana use has been linked strongly to presentation of schizophrenia. Individuals who start smoking marijuana at teen age, are at strong risk of developing psychosis and or symptoms of schizophrenia.

Other psychedelic drugs such as PCP, mushrooms and some prescription medications could cause psychosis and present with symptoms of schizophrenia.

What are the symptoms and signs of schizophrenia?

Symptoms of schizophrenia usually start between ages 16 and 30. In rare cases, children have schizophrenia too.

The symptoms of schizophrenia fall into three categories: positive, negative, and cognitive.

Positive symptoms: “Positive” symptoms are psychotic behaviors not generally seen in healthy people. People with positive symptoms may “lose touch” with some aspects of reality. Symptoms include:

  • Hallucinations
  • Delusions
  • Thought disorders (unusual or dysfunctional ways of thinking)
  • Movement disorders (agitated body movements)

Negative symptoms: “Negative” symptoms are associated with disruptions to normal emotions and behaviors. Symptoms include:

  • “Flat affect” (reduced expression of emotions via facial expression or voice tone)
  • Reduced feelings of pleasure in everyday life
  • Difficulty beginning and sustaining activities
  • Reduced speaking

Cognitive symptoms: For some patients, the cognitive symptoms of schizophrenia are subtle, but for others, they are more severe and patients may notice changes in their memory or other aspects of thinking. Symptoms include:

  • Poor “executive functioning” (the ability to understand information and use it to make decisions)
  • Trouble focusing or paying attention
  • Problems with “working memory” (the ability to use information immediately after learning it)

Are there any laboratory work up for diagnosing schizophrenia?

Although there are no specific diagnostic test for diagnosing schizophrenia, clinicians could use a variety of tools to exclude the other health conditions that could present with psychosis and other symptoms of schizophrenia. CT scan and fMRI often are used to exclude structural causes of psychosis such as brain tumor, changes to brain function and damages to brain tissue.

How is schizophrenia managed?

Because the causes of schizophrenia are still unknown, treatments focus on eliminating the symptoms of the disease. Treatments include:

Antipsychotics

Antipsychotic medications are usually taken daily in pill or liquid form. Some antipsychotics are injections that are given once or twice a month. Some people have side effects when they start taking medications, but most side effects go away after a few days. Doctors and patients can work together to find the best medication or medication combination, and the right dose.

Psychosocial Treatments

These treatments are helpful after patients and their doctor find a medication that works. Learning and using coping skills to address the everyday challenges of schizophrenia helps people to pursue their life goals, such as attending school or work. Individuals who participate in regular psychosocial treatment are less likely to have relapses or be hospitalized.

Coordinated specialty care (CSC)

This treatment model integrates medication, psychosocial therapies, case management, family involvement, and supported education and employment services, all aimed at reducing symptoms and improving quality of life.

What can be done to reduce the risk of development of schizophrenia?

  • Avoid street drugs
  • Limit drinking alcohol to safe drinking levels
  • Improve and enhance social skills
  • Avoid social isolation
  • Make an ongoing effort to maintain social connections and network
  • Learn how to handle anxiety and panic
  • Have healthy lifestyle
  • Seek help as soon as you experience symptoms of mental illnesses
  • Follow healthy diet guides
  • Begin prenatal planning at least 3 months in advance, if you decide to be pregnant

Important note:

This document is prepared by the “Mental Health for All” team. The general information provided on the Website is for informational purposes only and is not professional medical advice, diagnosis, treatment, or care, nor is it intended to be a substitute therefore. Always seek the advice of your physician or other qualified health provider properly licensed to practise medicine or general healthcare in your jurisdiction concerning any questions you may have regarding any information obtained from this Website and any medical condition you believe may be relevant to you or to someone else. Never disregard professional medical advice or delay in seeking it because of something you have read on this Website. Always consult with your physician or other qualified healthcare provider before embarking on a new treatment, diet, or fitness program. Information obtained on the Website is not exhaustive and does not cover all diseases, ailments, physical conditions, or their treatment.

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