• Schizophrenia

    Definition

    Schizophrenia is a chronic, severe, disabling brain disorder. It interferes with the way a person interprets reality. People with schizophrenia may:
    • Hear voices or see things that others do not
    • Become paranoid that people are plotting against them
    • Experience cognitive deficits
    • Withdraw socially
    These and other symptoms make it difficult for people with schizophrenia to have positive relationships with others.
    Regions of the Brain
    Colored brain segments
    Schizophrenia affects many different areas of the brain causing a wide range of behavioral, emotional, and intellectual symptoms.
    Copyright © Nucleus Medical Media, Inc.

    Causes

    The cause of schizophrenia is unknown but it is associated with problems in brain structure and chemistry. There may be some genetic role.
    Schizophrenia does not develop because of one factor. You may have a gene that increases your chance of schizophrenia, but you may not develop the disease based on your environment. Environment means any outside factor like stress or infection.

    Risk Factors

    Factors that may increase your chance of schizophrenia include:
    • Having a parent or sibling with schizophrenia
    • Marijuana use or other drug use
    • Father being of older age
    • Other factors, like problems during pregnancy or birth

    Symptoms

    Men typically develop symptoms in their late teens or early twenties. Schizophrenia in women tends to occur in their twenties or thirties. In rare cases, it is seen in childhood.
    Symptoms often appear slowly. Early signs may include difficulty with relationships, school or work. The symptoms may become more disturbing and bizarre over time or occur in a matter of weeks or months.
    Positive symptoms are behaviors that are not generally seen in healthy people. They may lose touch with reality with:
    • Hallucinations—seeing or hearing things/voices that are not there
    • Delusions—strong but false personal beliefs that are not based in reality
    • Thought disorders
    • Movement disorders
    Negative symptoms are associated with breaks in normal emotions and behaviors, such as:
    • Emotional flatness—flat speech, lack of facial expression, and general disinterest and withdrawal
    • Reduced feelings of pleasure
    • Difficulty starting and continuing activities
    • Reduced speaking
    Cognitive symptoms are changes in memory and thinking, such as:
    • Poor ability to understand information and make decisions based on it
    • Difficulty focusing
    • Difficulty using information immediately after learning it

    Diagnosis

    You, or a loved one or caregiver, will be asked about your symptoms and medical and mental health history. A physical exam will be done. A psychological exam may also be done.
    It will take some time to confirm a schizophrenia diagnosis. Tests may be done to rule out other conditions or lifestyle habits such as drug use that can cause similar symptoms. Schizophrenia is diagnosed when 2 or more of the following symptoms occur and reduce ability of day to day life:
    • Delusions
    • Hallucinations
    • Disorganized speech
    • Disorganized or catatonic behavior
    • Symptoms that disrupt normal emotions and behaviors—also known as negative symptoms

    Treatment

    Schizophrenia is not curable, but symptoms can be reduced through treatment. Early, aggressive treatment can lead to better outcomes and may delay progression of schizophrenia to psychosis.
    Hospitalization may be required during acute episodes. Symptoms are usually controlled with antipsychotic medications. Talk to your doctor about the best treatment plan for you. Options may include one or more of the following:

    Antipsychotic Medications

    Antipsychotics work by blocking certain chemicals in the brain. This helps control the abnormal thinking that occurs in people with schizophrenia. Determining a drug plan can be a complicated process. Often medications or dosages need to be changed until the right balance is found. This can take months or even years. The right balance of medication will have the least amount of side effects possible with the greatest benefit.
    It is important to continue taking the medication even if you are feeling better. Symptoms will return once the medication has been stopped. A long-acting injection instead of daily pills may be used if you have difficulty taking regular medication.
    Antipsychotics also have side effects that may make it difficult to stick to a medication routine. Common side effects include:
    • Slow and stiff movements
    • Restlessness
    • Facial tics
    • Protruding tongue
    Medications called atypical antipsychotics have fewer side effects and are better tolerated over long periods of time. However, these medications may cause significant weight gain, high blood sugar, and high cholesterol.

    Medications for Coexisting Conditions

    Depression and anxiety can often occur with schizophrenia. They may be treated with:
    • Antidepressants
    • Anti-anxiety medications
    • Mood stabilizers
    • Anticonvulsants

    Supportive Therapy

    Schizophrenia is a lifelong condition. It can be confusing and frightening for the person with the disease and for family members. Individual and family therapy can address:
    • Social skills
    • Vocational guidance
    • Community resources
    • Family issues
    • Living arrangements
    • Emotional support

    Prevention

    There are no current guidelines to prevent schizophrenia because the cause is unknown.

    RESOURCES

    National Institute of Mental Health http://www.nimh.nih.gov

    National Alliance on Mental Illness https://www.nami.org

    CANADIAN RESOURCES

    Canadian Psychiatric Association http://www.cpa-apc.org

    Mental Health Canada http://www.mentalhealthcanada.com

    References

    Counseling therapies for shizophrenia. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated July 10, 2015. Accessed February 22, 2016.

    Medications for shizophrenia. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated December 22, 2015. Accessed February 22, 2016.

    Schizophrenia. American Psychiatric Association website. Available at: http://www.psychiatry.org/schizophrenia. Accessed February 22, 2016.

    Schizophrenia. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated October 23, 2015. Accessed February 22, 2016.

    Schizophrenia. National Institute of Mental Health website. Available at: http://www.nimh.nih.gov/health/topics/schizophrenia/index.shtml. Updated April 2, 2013. Accessed February 22, 2016.

    4/29/2016 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Stafford MR, Jackson H, Mayo-Wilson E, Morrison AP, Kendall T. Early interventions to prevent psychosis: systematic review and meta-analysis. BMJ. 2013;346:f185.

    Revision Information

  • LiveWell personal health survey

    How healthy are you really? Find out – free.Learn more

    It's time to stop guessing. If you want to make some changes but just aren't sure how, the free personal health survey from LiveWell is a great place to start.

  • HeartSHAPE Spotlight

    At risk for a heart attack? Learn more

    Fight heart disease and prevent heart attacks. HeartSHAPE® is a painless, non-invasive test that checks pictures of your heart for early-stage coronary disease.

  • Calories and Energy Needs

    Calorie NeedsLearn more

    How many calories do you need to eat each day to maintain your weight and fuel your physical activity? Enter a few of your stats into this calculator to find out.

  • Ideal Body Weight

    Ideal Body WeightLearn more

    Using body mass index as a reference, this calculator determines your ideal body weight range. All you need to do is enter your height.

  • Body Mass Index

    Body Mass IndexLearn more

    This tool considers your height and weight to assess your weight status.


  • Can we help answer your questions?

    Wellmont Nurse Connection is your resource for valuable health information any time, 24 hours a day, seven days a week. Speak to a Nurse any time, day or night, at (423) 723-6877 or toll-free at 1-877-230-NURSE.