What is Schizophrenia?

Schizophrenia is a very severe, chronic and disabling disorder of the mind that affects circa 1% of the total population at a point in their entire lifetime. It is characterized by hallucinations, delusions, physical agitation, and incoherence among other schizophrenic symptoms that send the mind into total confusion. While there is enough evidence to prove that genetic factors have a significant role in the development of this disorder, there are other causes, albeit unknown, that are believed to trigger the onset of the condition, or worsen an existing mild condition.

One point of note is that schizophrenia falls under the category of a “thought” disorder, while its closest relative, Bipolar Disorder, falls under the “mood” disorder category. In general, while Bipolar disorder can sometimes include psychotic features related to those of schizophrenia, very rarely will you find someone suffering from schizophrenia having mood swings.

Another point of note is that this condition tends to develop much earlier in men than their female counterparts, mostly in their late teens or during their early twenties. Women on the other hand may develop the condition in their late twenties or during their early thirties. Needless to mention, someone going through the delusions and hallucinations brought about by this disorder will often have very disturbed interpersonal relationships. No wonder most patients are often very withdrawn and fearful all the time, with disorganized behavior and speech.

The good news is that there are very effective medications in the market which can help keep the condition under control, especially if it is detected early enough.

Types of Schizophrenia

Schizophrenia is a severe mental disorder that takes a patient from reality to a world full of hallucinations, confusion, delusions and terrifying danger. These and other symptoms are often categorized as either positive, negative or cognitive, and it is from the symptoms that the various types of schizophrenia are derived and classed. They include:-

Disorganized-type schizophrenia – this type is marked by behavior and speech that are difficult to comprehend, disorganized and inappropriate or flattening emotions. Someone suffering from this type of schizophrenia can laugh at the changing colors of traffic lights. Needless to mention, such a disorganized behavior is known to disrupt normal activities like preparing meals, eating, dressing, showering etc.

Paranoid-type schizophrenia – this category is marked by auditory hallucinations and delusions. This is where someone is hearing voices that do not exist although they have near-perfect intellectual expression and functioning of effect. The delusions could be about being another person such as a celebrity and can be exhibited through anxiety, aloofness, anger etc.

Catatonic-type schizophrenia – third category is a type that affects movement. Someone suffering from this category can decide to be completely immobile or very mobile, moving up and down all over the place. They can decide to keep quiet for hours, or to repeat every word said to them.

Residual-type schizophrenia – this category is characterized by prior history of at least a single episode of schizophrenia, but the patient has no positive symptoms to write home about.

Undifferentiated-type schizophrenia – marked by all the above-mentioned symptoms of different categories but not enough symptoms to be categorized and defined any specific type of schizophrenia.

Treatment of Schizophrenia

Since there is no known cause of schizophrenia that can be singled out, all treatments of schizophrenia available in the market today focus on getting rid of the symptoms that come with the disorder. Treatments generally include different psychological treatments and the use of antipsychotic medications.  Antipsychotics have been in existence since mid 50’s when they were developed. The earliest antipsychotic medications available in the market today and which are used include Fluphenazine (Prolixin), Haloperidol (Haldol), Chlorpromazine (Thorazine) and Perphenazine (Etrafon, Trilafon). The latest antipsychotic medications available in the market and which were developed during the 90s are known as “atypical” or second generation antipsychotics and include:-

Clozapine(clozaril) which has been used effectively in treating hallucinations, psychotic symptoms as well as breaks or losing touch with reality. This medication has however been reported to cause a condition known as agranulocytosis, which is basically the loss of white blood cells in the body that will help someone fight off opportunistic infections. As such, those under this medication are often scheduled for weekly white blood cell count checks. It is the cost of weekly blood tests and the actual cost of medication that makes the treatment of schizophrenia with clozapine unaffordable to many people. Even so, this medication has proven quite effective in people who are not responsive to antipsychotic medications. Other medications that have been developed over the years for this disease include:-

  • Paliperidone (Invega).
  • Aripiprazole (Abilify)
  • Quetiapine (Seroquel)
  • Olanzapine (Zyprexa)
  • Ziprasidone (Geodon)
  • Risperidone (Risperdal)

Symptoms of Schizophrenia

scary schizophreniaThe symptoms for schizophrenia are normally divided into three major categories. The first category is what is referred to as positive symptoms, followed by negative symptoms and lastly the cognitive symptoms.

Positive symptoms

These are psychotic behaviors that are not clearly evident in healthy people. Patients with positive schizophrenia symptoms tend to lose touch with their reality and unlike the other broad categories of symptoms of schizophrenia; the positive symptoms will often appear and disappear. During the on again off again periods, the symptoms can be very severe, and sometimes they can be hardly noticeable. The severity of the symptoms is depended on whether one is under treatment. Some of the symptoms falling under this category include hallucinations and delusions.

Negative symptoms

These are the symptoms that are linked to disruptions from normal behavior and emotions. These symptoms are the hardest to tell as part and parcel of schizophrenia, and most people often mistake them for symptoms of other disorders such as depression. They include inability to start or sustain a scheduled activity, lack of pleasure in day-to-day life, withdrawal from normal activities, someone experiencing what is described as a “flat effect” i.e. not showing any movement signs when talking or assuming a monotonous or dull voice when talking.

Cognitive symptoms

The last category of symptoms of schizophrenia is the subtle symptoms which, just like their negative counterparts, can be very difficult to identify as part of schizophrenia. These symptoms are mostly associated with the disorder when other tests are done. They include inability to pay attention or remain focused, poor judgmental skills, inability to digest and use information when one learns.

Schizophrenia Statistics

Schizophrenia is a severe, chronic, and disabling mental disorder typified by deficits in perceptions, thought processes, and emotional responsiveness. It is a very severe form of mental illness which according to the World Health Organization, affects circa 7 per 1000 adults, mostly between ages 15 – 35 years. While the incidences of the disease are significantly low, currently at 3 per 10,000, no doubt the prevalence is quite high because of chronicity.  Here are more statistics surrounding schizophrenia:

Schizophrenia Facts and Figures

  • The condition affects approximately 24 million people throughout the world
  • Over 1.5% of the 24 million persons with schizophrenia are in the US.
  • Over 50% of people with the disease are not getting the right treatment and follow-up care
  • Over 90% of people living with the disorder are in developing countries
  • It is a treatable disorder whose treatment efficacy is quite high in its initial stages
  • Care of people living with schizophrenia can effectively be provided at the community level with community involvement and active family participation.
  • The disease starts at early childhood, with men starting slightly earlier than in women. In other words, while most men will develop the disease between the ages of 15 and 25 years, most women will develop the symptoms, such as hallucinations, a few years later. Even so, the incidences are significantly higher in women after 30 years of age than in men.
  • The average onset age is 18 and 25 in men and women respectively.
  • Onset of schizophrenia is rare for people below the age of 10 or those above the age of 40.

Schizophrenia Hallucinations

schizophrenia experienceMost people describe having an increased sensitivity to basic sensations like sound and light long before schizophrenia incapacitates them. This explains the reason why hallucinations are categorized under positive symptoms for schizophrenia as the hallucinations can be pleasant although for a short period of time. Once the sensation becomes overly intense, the resulting distraction will make it hard for one to perform certain routine functions.

Just think for a moment if the room surrounding you becomes several times brighter, with startling and shimmering colors that are so intense you have a problem looking straight at the lights. Each corner you turn, you are faced with the same intense sights of bright colors. Just think of how easy it will be for you to think normal and behave normal as it is expected of you in such a world surrounded by colors.

Closely related to the above illustration is the auditory hallucinations that are known to create the same ugly effects on someone. This explains the reason why most schizophrenia patients have a problem concentrating on a given subject or task. It is hard for someone to pay close attention to another when talking to them, sticking to a particular line of thought, or simply understanding what is happening around them if all they are hearing are loud voices banging in their ears.

It is a well known fact that people with this disorder often hear some internal voices only peculiar to them. These internal voices alone can be quite terrifying and disorienting. Just think for a moment how it would be like to live for a day with voices that originate from within your head.

Schizophrenia Diagnostic Criteria

In order to have a psychiatrist diagnose mental disorder symptoms that someone is experiencing as schizophrenia, the patient should have experienced certain symptoms over a specified period of time. Schizophrenia diagnostic criterion also expect one to rule out all other medical conditions that could trigger the same symptoms as those of schizophrenia. As such, a thorough diagnostic criterion puts the patient under a thorough physical examination, a series of blood tests, and other tests and analysis including urine and blood analysis to determine the presence of some of the most commonly abused drugs.

Schizophrenia diagnostic criteria starts with the psychiatrist reviewing the patient and immediate family members, checks the medical records, studies the patient’s history etc in search of pointers to some of the most obvious symptoms for schizophrenia. A diagnostic of schizophrenia can only be positive if a patient meets the below-mentioned criteria:-

  • The presence of some obvious signs and symptoms of the disorder for at least six months
  • At least two of the following symptoms should be there for a period not less than 30 days if no treatment has been administered. Delusions, hallucinations, disorganized behavior, negative symptoms, disorganized speech.
  • There should be no signs of bipolar disorder i.e. symptoms of depression alternating with mania.
  • There should be no other neurological or medical cause of all present symptoms that a patient is experiencing.
  • The symptoms a patient suffering from schizophrenia is experiencing should not be as a result of alcohol, illegal drugs, or medication