Schizophrenia

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Schizophrenia is a severe brain disorder in which people interpret reality abnormally. Schizophrenia may result in some combination of hallucinations, delusions, and extremely disordered thinking and behavior.

Symptoms

  • Delusions.
  • Hallucinations.
  • Disorganized thinking (speech).
  • Extremely disorganized or abnormal motor behavior.
  • Negative symptoms.

Symptoms in teenagers

  • Withdrawal from friends and family
  • A drop in performance at school
  • Trouble sleeping
  • Irritability or depressed mood
  • Lack of motivation

Compared with schizophrenia symptoms in adults, teens may be:

  • Less likely to have delusions
  • More likely to have visual hallucinations

When to see a doctor

People with schizophrenia often lack awareness that their difficulties stem from a mental illness that requires medical attention. So it often falls to family or friends to get them help.

Risk factors

Although the precise cause of schizophrenia isn’t known, certain factors seem to increase the risk of developing or triggering schizophrenia, including:

  • Having a family history of schizophrenia
  • Exposure to viruses, toxins or malnutrition while in the womb, particularly in the first and second trimesters
  • Increased immune system activation, such as from inflammation or autoimmune diseases
  • Older age of the father
  • Taking mind-altering (psychoactive or psychotropic) drugs during teen years and young adulthood

Complications

Left untreated, schizophrenia can result in severe emotional, behavioral and health problems, as well as legal and financial problems that affect every area of life. Complications that schizophrenia may cause or be associated with include:

  • Suicide
  • Any type of self-injury
  • Anxiety and phobias
  • Depression
  • Abuse of alcohol, drugs or prescription medications
  • Poverty
  • Homelessness
  • Family conflicts
  • Inability to work or attend school
  • Social isolation
  • Health problems, including those associated with antipsychotic medications, smoking and poor lifestyle choices
  • Being a victim of aggressive behavior
  • Aggressive behavior, although it’s uncommon and typically related to lack of treatment, substance misuse or a history of violence

Tests and diagnosis

When doctors suspect someone has schizophrenia, they typically ask for medical and psychiatric histories, conduct a physical exam, and run medical and psychological tests, including:

  • Tests and screenings.
  • Psychological evaluation.

Diagnostic criteria for schizophrenia

To be diagnosed with schizophrenia, a person must meet the criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM).

In addition, a person must have at least two of the following symptoms most of the time during a one-month period, with some level of disturbance being present over six months:

  • Delusions
  • Hallucinations
  • Disorganized speech (indicating disorganized thinking)
  • Extremely disorganized behavior
  • Catatonic behavior, which can ranges from a coma-like daze to bizarre, hyperactive behavior
  • Negative symptoms, which relate to reduced ability or lack of ability to function normally

At least one of the symptoms must be delusions, hallucinations or disorganized speech.

Treatments and drugs

Schizophrenia requires lifelong treatment, even when symptoms have subsided. Treatment with medications and psychosocial therapy can help manage the condition. During crisis periods or times of severe symptoms, hospitalization may be necessary to ensure safety, proper nutrition, adequate sleep and basic hygiene.

Medications

Antipsychotic medications are the most commonly prescribed drugs to treat schizophrenia. They’re thought to control symptoms by affecting the brain neurotransmitters dopamine and serotonin.

Atypical antipsychotics

These newer, second-generation medications are generally preferred because they pose a lower risk of serious side effects than do conventional medications. They include:

  • Aripiprazole
  • Asenapine
  • Clozapine
  • Iloperidone
  • Lurasidone
  • Olanzapine
  • Paliperidone
  • Quetiapine
  • Risperidone
  • Ziprasidone

Ask your doctor about the benefits and side effects of any medication that’s prescribed.

Conventional, or typical, antipsychotics

  • Chlorpromazine
  • Fluphenazine
  • Haloperidol (Haldol)
  • Perphenazine

Psychosocial interventions

Once psychosis recedes, psychological and social (psychosocial) interventions are important — in addition to continuing on medication. These may include:

  • Individual therapy.
  • Social skills training.
  • Family therapy.
  • Vocational rehabilitation and supported employment.

Prevention

There’s no sure way to prevent schizophrenia. However, early treatment may help get symptoms under control before serious complications develop and may help improve the long-term outlook.

 

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