Schizophrenia - An Overview

What is schizophrenia?

Schizophrenia is a biologically based brain disease characterized by delusions and hallucinations. The illness impairs a person’s ability to think clearly and relate to others. People with this condition are often unresponsive and withdrawn.  There are many other symptoms which effect different sufferers to varying degrees. There is no known cure, but with appropriate medication, therapy and support, victims can live more "normal" lives.

Symptoms

Positive symptoms:

• Hallucinations - things a person sees, hears, smells or feels that no one else experiences. "Voices" are the most common hallucination.

• Delusions - false beliefs that do not change despite proof to the contrary. A person with schizophrenia may believe he or she is someone else, or that others want to harass, hurt or kill him or her.

• Disorganized thinking, including confused speech. The person may make up words or sounds, or speak them out of order. They may jump from one topic to another with no apparent connection, or may stop mid-thought, unable to finish.

 

Negative symptoms:

• Decreased expression - immobile facial expression, monotonous voice.

• Decreased ability to start and finish tasks.

• Lack of pleasure in everyday life and activities.

• Speech that is brief and lacks content.

Cognitive deficits:

• Decreased ability to absorb and interpret information and make decisions.

• Decreased attention span.

• Decreased short term memory.

In addition there are a number of other medical conditions associated with schizophrenia. Some of these relate directly to antipschotic medications, lifestyle or perhaps a genetic link. 

Schizophrenia In context

Until the late 1700’s people with schizophrenia, perhaps experiencing hallucinations and delusional behaviour were placed in asylums which were more like prisons than hospitals. Some thought the mentally ill were possessed by evil spirits.

In France Dr. Philippe Pinel at the Asylum Bicetre removed the restraints from his patients and began to apply more humane treatments. Some of these enlightened ideas soon spread to other countries.

 When the brain areas dedicated to thinking and personality are not working properly schizophrenia may develop. About 1 percent of people will develop schizophrenia. There is good evidence that thoughts, moods and understanding are the result of neurotransmitters, responsible for chemical signals in the brain. We can now identify some of the areas of the brain that are affected by the instability of different neurotransmitters.

 With a population of about 60 million we would expect 600,000 to suffer from schizophrenia at some time in their lives. It is estimated that there are about 250,000 victims in the UK at any one time.

 There appears to be a genetic basis, though psychosocial stresses are known to make the condition worse or even bring on symptoms.

Both sexes are equally affected, with symptoms typically starting in the late teens in males and mid twenties in females. Symptoms include hallucinations (hearing, seeing, feeling or smelling that tat others cannot sense), delusions (believing something to be true that could not be possible, e.g., paranoia), disorganized thoughts (inability to connect thoughts and ideas logically or making up words) and movement disorders (unusual mannerisms, facial expressions or repetitious movements or lack of any movement).
 
These symptoms are disturbing to the affected individuals and to those around them. Psychotic behaviour continues to be misunderstood by the general public. When a spectacular murder in which the perpetrator claims insanity as a defence is in the news, it reinforces the idea that mental illness leads to violence. In reality, violent behaviour is unrelated to schizophrenia; people either have the ability to be violent or not without regard to any mental illness. If someone who is violent develops schizophrenia, their violence is more often directed to themselves or family than to anyone else.

 With about 250,000 sufferers in the UK at any one time it is not surprising that a few commit violent acts towards others – we would expect this anyway from the general population. People with schizophrenia are not well focussed and have difficulty in organising or socialising. It is likely that the deficits caused by the illness actually make it less likely that victims will get involved in crime.

Over the last 50 years, many medications have been developed that treat and stabilize problems related to imbalances of brain neurotransmitters. In combination with psychotherapy and support from family and social service networks, schizophrenia is often manageable. The days of long-term hospitalization for schizophrenia are past. Unfortunately, there is, as yet, no cure.

Individuals affected with schizophrenia are not necessarily limited in their ability to get an education and hold jobs, even highly technical ones. There may be little effect on intellectual functioning. As with many chronic illnesses, family and social support is very important since relapses can occur.

There is still much to learn about schizophrenia. When people are confronted with a friend or family member whose ideas and perceptions are illogical or disordered, it can be disturbing. Since the affected person's brain is not processing information properly, he or she thinks everything is fine and will continue to act upon what they perceive even though it is incorrect. Persuading them to accept help can be problematic. Unless they are in danger of hurting themselves or others, their legal rights prevent forcible treatment, so it's best to consult a mental health professional for help.