An Overview of Schizophrenia

[Mr. Rasel]

Schizophrenia

Schizophrenia is a type of mental illness that affects how the brain works. This leads to chronic problems with disordered thoughts and behaviors. It usually requires lifelong care and treatment.
Researchers estimate that schizophrenia affects approximately 0.3 percent to 0.7 percent of people (between 3 in 1000 and 7 in 1000). Schizophrenia affects people from all racial backgrounds and ethnicities. Schizophrenia is slightly more common in men than in women.

Symptoms
Two of the major categories of schizophrenia symptoms are “positive” or “negative" symptoms. These terms don't refer to whether the symptoms are good or bad as some people might think, but rather to the way symptoms present.

Positive Symptoms
Positive symptoms are active problems that shouldn’t be present (like
hallucinations). They are "positive" in the sense that they represent an addition to someone's typical day-to-day experience.
Some of the positive symptoms of schizophrenia include:
•   Hallucinations
•   Delusions
•   Disorganized thinking and speech
Hallucinations: During a hallucination, a person hears, sees, feels, or smells something that is not actually present. Most often this occurs in the form of hearing voices that others do not hear. These voices may be reassuring, threatening, or anything in between. Sometimes a person experiences these only as intrusive thoughts, but often they seem to come from outside the self.
Delusions: Delusions are false beliefs held by a person that are not shared by other people. Someone with a delusion has a very fixed view of a situation and cannot be talked out of it with reason. For example, someone with schizophrenia might believe he is the subject of a government conspiracy, or that aliens are trying to monitor his activities.
Disorganized Speech: People with disorganized speech may be difficult to understand because their sentences are unconnected or because the person is frequently switching topics in a way that doesn’t make sense to the listener. However, the speech may have meaning for the individual in a way that is connected to their internal experience.

Negative Symptoms
Characteristics that seem to be absent or diminished in someone with schizophrenia are called negative symptoms.3 Negative symptoms of schizophrenia can include:
•   Decreased emotional expression
•   Lack of initiation in goal-directed activities
People may also have additional cognitive symptoms like difficulty concentrating, remembering, or planning activities. People with schizophrenia may also have poor self-care and poor interpersonal, school, or career functioning. The illness also makes it more challenging for the individual to join in social events, and participate in meaningful relationships.

Fluctuation of Symptoms
Symptoms may have periods of worsening, and periods of improvement. Periods of worsening symptoms are called flares or relapses.4 With treatment, most of these symptoms may diminish or go away (especially "positive" symptoms). Disease remission refers to periods of six months or longer in which a person experiences no symptoms or only mild symptoms.
On the whole, negative symptoms tend to be harder to treat than positive ones.
In the traditional biomedical model of schizophrenia, these symptoms are purely pathological. However, people in the hearing voices movementargue that hearing voices is sometimes a meaningful human experience and that it shouldn't be seen purely as a sign of illness.

Age of Onset
The early symptoms of schizophrenia often start to appear gradually and then become more severe and obvious to others. Typically, symptoms of schizophrenia first appear sometime between adolescence and a person’s mid-30s.5 However, sometimes symptoms appear earlier or later. In women, symptoms tend to begin at a later age than in men.
Changes in the Brain
Scientists are continuing to learn about how schizophrenia affects the brain, as the condition is associated with a number of alterations in how the brain functions. These brain changes reflect the specific symptoms of the disease. The following are some of the brain regions thought to have disordered functioning in schizophrenia:
•   Medial temporal lobe (causing problems with working memory)
•   Superior temporal lobe (causing problems processing auditory information)
•   Prefrontal lobe (causing problems with decision-making and inhibition)

Diagnosis
There isn’t a simple blood test or brain scan that health providers can use to diagnose schizophrenia. To diagnose schizophrenia, a physician takes a thorough medical history and performs a medical exam. A clinician will need to rule out other psychiatric conditions that can cause hallucinations or delusions. People with schizoaffective disorder, for instance, have many of the same symptoms of schizophrenia, but they also have specific problems with their mood and emotions.
Some other medical conditions that can cause some similar symptoms to schizophrenia include:
•   Substance-related disorders
•   Dementia
•   Endocrine and inflammatory conditions
•   Brain tumor
•   Delirium
In some cases, an individual might need additional tests to rule out other conditions like these.

Time Matters
The time period of symptoms is also important in diagnosis. To be diagnosed with schizophrenia, a person must display at least a six-month period of symptoms. If you or a loved one have had symptoms for less than a month, the diagnosis may instead be what is called a brief psychotic disorder.
Someone who has had symptoms for more than a month but less than six months might be diagnosed with something called schizophreniform disorder. Sometimes people with these conditions have persistent symptoms and are later officially diagnosed with schizophrenia.

Causes
The causes of schizophrenia are complex and not completely understood, though research does indicate certain risk factors.
Genetics
Genetics seem to play a role in those who have schizophrenia. You are more likely to have schizophrenia if you inherited variations of certain genes (portions of DNA) from your parents.
People who have a relative with schizophrenia have a somewhat increased risk of also having schizophrenia or a related disorder, like schizoaffective disorder.
Identical twins (who share identical DNA) are more likely to have schizophrenia than fraternal twins (who do not). This implies that genetics play a role in triggering schizophrenia, probably through several different genes.

Other Risk Factors
Schizophrenia can occur in people who have no history of it in their family. And just because you have schizophrenia in your family, doesn’t mean you will have it yourself.
Various environmental factors have been linked to an increased risk of schizophrenia. Some of these include:
•   Obstetric complications at your birth
•   Infection of the central nervous system in early childhood
•   Childhood trauma
•   Social stressors, such as economic adversity
However, many people with schizophrenia have none of these risk factors.
Schizophrenia likely emerges as a complex result of a variety of genetic, environmental, social, and psychological factors that are not yet well understood.

Treatment
Ideally, treatment for schizophrenia combines a multidisciplinary approach from a collaborative team of health professionals. Early treatment can help improve the chances of a fuller recovery.
Elements of treatment should include:
•   Psychiatric medication
•   Psychological treatment
•   Social support
Many people with schizophrenia will need to initially be hospitalized for psychiatric treatment so that doctors can stabilize their condition.

Source: VeryWellMind