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Schizophrenia
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(The
information provided on this site should not be used for diagnosing or
treating a health problem or disease. It is not a substitute for
professional care. If you have or suspect that you have a health
problem, you should consult your health care provider.) |
Signs and Symptoms
Schizophrenia is a mental illness that usually strikes in late adolescence or
early adulthood, but can strike at any time in life. The signs and symptoms vary
from individual to individual, but all people with
the disorder show one or more of the following symptoms:
| 1. Delusions: These are
beliefs that are not true, such as feeling people are following or trying
to hurt them, believing other people can read their minds, or beliefs that
they have special powers or abilities. |
| 2. Hallucinations: This
usually takes the form of hearing voices that are not there, but people
with schizophrenia may also see, smell, taste, and feel things that are not
there. |
| 3. Bizarre behavior: This can
be expressed in many different ways. In short, the individual behaves in
ways that seem inappropriate or strange to other people. |
| 4. Disorganized speech:
The individual speaks in ways that are hard to understand. For instance,
sentences might not make sense, or topic of conversation changes with
little or no connection between sentences. Sometimes speech is completely
incomprehensible. |
| 5. "Negative
symptoms": This includes lack of motivation or interest,
diminished cognitive functioning, and decreased emotional expression.
Individuals may lose interest in attending to their own personal hygiene,
have little interest in interacting with others, and rarely seem to feel
or express strong emotions. |
In addition to
these above symptoms, people with schizophrenia suffer a decline in their level
of functioning; for instance, they may not be able to work at a job that
requires the same level of skill or concentration as the job they held before
they became ill required, or they may lose all ability to withstand the pressures of the
working world. They may show a decline in their ability to attend to household
chores or all the demands of raising their children, and/or they may not be able
to have a full social life anymore.
Sometimes schizophrenia is a chronic condition, and the
individual afflicted is constantly experiencing hallucinations or other symptoms
of the disorder. Other people have periods of time when they are relatively
symptom-free but have periods of more acute psychosis. Every individual is
different, and every person with schizophrenia experiences the disease in a
different way.
A brief history of schizophrenia
Mental illness has been recognized for thousands of years. At
one point, all people who were considered "abnormal," whether due to
mental illness, mental retardation, or physical deformities, were largely
treated the same. Early theories supposed that mental disorders were caused by
evil possession of the body, and the appropriate treatment was then exorcising
these demons, through various means, ranging from innocuous treatments, such as
exposing the patient to certain types of music, to dangerous and sometimes
deadly means, such as releasing the evil spirits by drilling holes in the
patient's skull.
One of the first to classify the mental disorders into different categories was
the German physician, Emil Kraepelin. He used the term "dementia
praecox" for individuals who had symptoms that we now associate with
schizophrenia. The classifications for mental disorders continue to be revised.
The most recent diagnostic classification system that is most commonly used in
the United States is the Diagnostic and Statistical Manual for Mental Disorders
- Fourth Edition (DSM-IV).
The
Swiss psychiatrist, Eugen Bleuler, coined the term, "schizophrenia" in
1911. This word comes from the Greek roots schizo (split) and phrene (mind) to
describe the fragmented thinking of people with the disorder. His term was not
meant to convey the idea of split or multiple personality, a common
misunderstanding by the public at large. Since Bleuler's time, the definition of
schizophrenia has continued to change, as scientists attempt to more accurately
delineate the different types of mental diseases. Without knowing the exact
causes of these diseases, scientists can only base their classifications on the
observation that some symptoms tend to occur together.
Both Bleuler and Kraepelin subdivided schizophrenia into
categories, based on prominent symptoms and prognoses. Over the years, those
working in this field have continued to attempt to classify types of
schizophrenia. Five types were delineated in the DSM-III: disorganized,
catatonic, paranoid, residual, and undifferentiated. The first three categories
were originally proposed by Kraepelin. These classifications, while still
employed in DSM-IV, have not shown to be helpful in predicting outcome of the
disorder, and the types are not reliably diagnosed. Many researchers are using
other systems to classify types of the disorder, based on the preponderance of
"positive" vs "negative" symptoms (see symptoms of
schizophrenia above), the progression of the disorder in terms of type and
severity of symptoms over time, and the co-occurrence of other mental disorders
and syndromes. It is hoped that differentiating types of schizophrenia based
on clinical symptoms will help to determine different etiologies or causes of
the disorder.
What treatments are currently available?
Just as different people with schizophrenia can experience different symptoms,
the effective treatment for each person is different. Each individual's
treatment program can include one or more of the following:
| Medication: Finding the
right medication can be difficult, and a trial-and-error process may have
to occur. It is important to be open with the psychiatrist, reporting what
symptoms and side-effects are occurring, so the doctor can help to find
the best medication to meet individual needs of each patient. It is also
important to learn the contraindications of certain medications, such as
the effects of alcohol or sunlight on the effectiveness of the medication. |
| Education: The person
with schizophrenia and his or her family members can benefit from learning
all they can about the disorder, including how to diminish stress and
conflict, which can sometimes help spark a relapse. It is also important
to learn what resources are available in the community for treating
mental illnesses. |
| Individual, group, and
family therapy: This can help with problems that arise day to day, as
well as setting realistic goals and defining strategies for reaching those
goals. |
| Hospitalization: This is
required during some acute phases of the illness or sometimes in order to
make changes in medication in a well-controlled, monitored environment. |
| Support groups: These
can be very important for those with schizophrenia and for their family
members and friends. See below for a list of support groups. |
| Residential, day-treatment,
and vocational programs: These programs can help the person with
schizophrenia reach his or her highest potential and greatest level of
independence. Staff in these programs become well-acquainted with their
clients and can help find living arrangements, work, and recreational
activities that are well-suited to each client's needs. |
What help is available for the
family and caretakers of individuals with schizophrenia?
There are a number of national organizations that provide
information and support to individuals with schizophrenia and their loved ones.
The internet site www.schizophrenia.com
contains a comprehensive information source and referral service. You should
also check with local agencies in addition to these national organizations:
Organizations and their
websites:
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