Schizophrenia
(Psychosis · Psychotic Disorders)
In this condition factsheet:
The Facts on Schizophrenia
Schizophrenia is a serious and chronic medical condition. It is a disorder of the message system in the brain. Someone with schizophrenia loses the ability to act properly or to think clearly–their mind is "split from reality" (hence schizo "split" and phrenia "mind" from ancient Greek). The term schizophrenia does not refer to multiple personality disorder.
Schizophrenia affects about 1% of people throughout the world. It sometimes starts during childhood, but most often shows up in the late teens or 20s. While it affects men and women proportionately, the average age of onset is somewhat lower in men.
It can develop gradually, over the course of weeks or months, or it can seem to come on very suddenly. The signs of schizophrenia are easy to misunderstand, and can sometimes be frightening to other people. While this disorder never goes away, it can often be managed with proper medical care and family support.
Causes of Schizophrenia
We do not yet know what causes schizophrenia. There are many theories, but it is most likely a result of genetic factors that trigger complex changes in the brain's chemistry and structure. Research has demonstrated that people with schizophrenia have changes in brain function and anatomy. However, it's not clear whether schizophrenia is a single disorder or a number of "syndromes" with different causes.
Some experts believe that the condition is triggered by stressors (e.g., substance misuse, stressful life events) in people whose brains are predisposed.
Symptoms and Complications of Schizophrenia
Schizophrenia can have a gradual or sudden onset. But for most people, mild symptoms are followed by more severe ones. Symptoms of schizophrenia can vary widely in severity, can come and go, or be persistent. For those who experience mild symptoms initially, the first signs may be withdrawal from friends or social activities, poor school performance, caring less about personal appearance, and perceiving things differently.
The symptoms of schizophrenia usually fall into one of several groups:
- Positive symptoms are symptoms associated with excess or distortion of normal function. Positive symptoms include delusions, hallucinations, and disorganized thoughts and behaviours.
- Delusions are false beliefs (e.g., being followed, reading or watching something and thinking the message is directed at them personally, thinking people can read their mind or control their thoughts).
- Hallucinations are hearing, seeing, feeling, smelling, or tasting things that are not actually there.Hearing voices (auditory) is the most common type of hallucinations with schizophrenia.
- Disorganized thinking can result in switching topics quickly when talking or not making sense when talking. Disorganization can also cause inappropriate behaviour (e.g., agitation, poor hygiene, and disturbances in feelings (e.g., may feel devoid of emotion, or may experience sudden, inappropriate bursts of feeling, or may find it difficult to express feelings).
- Negative symptoms refer to a decrease or loss of normal function. This can include lack of eye contact, lack of emotional response, decreased talking, decreased pleasure, reduced motivation, and decreased interest in social activities and relationships. They may find it difficult to carry out daily activities such as going to work or shopping.
- Cognitive impairment can include difficulties with concentration, attention, learning, problem solving, and problems with memory.
Emotional and mood symptoms such as anxiety, depression or inappropriate behaviour can also occur with schizophrenia.
Some people may present with physical symptoms, including sleep disturbances and catatonia (impaired, excessive, or unusual mobility). It is also associated with diabetes, high blood pressure, and high cholesterol.
During the acute phase of the disease, psychotic symptoms get worse and influence the ability to function normally. Stabilization refers to a period when symptoms are being treated and controlled by medications. There may not be any obvious psychotic symptoms during this phase, but some people still have problems coping with day-to-day situations.
About 5% of people with schizophrenia commit suicide, and around 20% have made an attempt. People most at risk for suicide are those who have paranoid schizophrenia, especially if they were functioning well prior to having schizophrenia. This high suicide rate partially explains the 10-year reduction in expected lifespan for those with the disorder.
