Schizophrenia

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Do you know someone who seems like he or she has “lost touch” with reality? Does this person talk about “hearing voices” no one else can hear? Does he or she see and feel things no one else can? Does this person believe things that aren’t true?

Sometimes people with these symptoms have…


What is Schizophrenia ? Search Your text here

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• a chronic, severe and debilitating mental illness.

• considered one of the psychotic mental disorders and is characterized by symptoms of thought, behavior, and social problems.

• person's thinking is completely out of touch with reality at times.



Who gets schizophrenia



Anyone can develop schizophrenia. It affects men and

women equally in all ethnic groups.

Teens can also develop

schizophrenia. In rare cases, children

have the illness too.



When does it start



Statistics shows that schizophrenia affects men about one and a half times

more commonly than women and that 50% of

people in hospital psychiatric care have

schizophrenia. Diagnosis is usually in people aged 17-35 years with the illness

appearing earlier in men (in the late teens or early 20s)

than in women (who are affected in the 20s to early

30s).



Fewer studies on schizophrenia in

children compared to adults,

researchers find out that children as

young as 6 years old can be found to

have all the symptoms of their adult counterparts

and continue to have those

symptoms into adulthood.



What causes Schizophrenia



Several factors may contribute to schizophrenia, including:

• Genes, because the illness runs in families

• The environment, such as viruses and nutrition problems before birth

• Different brain structure and brain chemistry.



What are the symptoms of schizophrenia



Schizophrenia Symptoms range from mild to severe. There are Four main types of symptoms.

1. Positive (More Overtly Psychotic) Symptoms

2. Negative (Deficit) Symptoms

3. Cognitive Symptoms4. Affective (or Mood)

Symptoms



1. Positive (More Overtly Psychotic)

Symptoms• refer to a distortion of a person’s normal thinking and functioning. They are

“psychotic” behaviors. People with these

symptoms are sometimes unable to tell what’s real from what is imagined.

Positive symptoms include:



Halluci-nations

when a person sees, hears, smells, or feels things that no one else can. “Hearing voices” is common for people with schizophrenia. People who hear

voices may hear them for a long time before

family or friends notice a problem.



Delusions

when a person believes things that are not true. For example, a person may believe

that people on the radio and television are talking directly to him

or her. Sometimes people believe that

they are in danger—that other people are trying to hurt them.



Thought Disorde

rs

ways of thinking that are not usual or

helpful. People with thought disorders may

have trouble organizing their

thoughts. Sometimes a person will stop talking

in the middle of a thought. And some

people make up words that have no meaning.



Movement

Disorders

may appear as agitated body

movements. A person with a movement

disorder may repeat certain motions over and over. In the other

extreme, a person may stop moving

or talking for a while, a rare condition called

“catatonia.”



Disorganized behaviors

Catatonic behaviors



2. Negative (Deficit) Symptoms

•refer to difficulty showing emotions or functioning normally. When a person with schizophrenia has

negative symptoms, it may look like

depression. People with negative symptoms

may:



Talk in a dull voice

Show no facial expression, like a smile or frown



Have trouble in

having fun

Difficulty in taking care

of themselves



Social withdrawal

Talk very little to other

people, even when they need to.



3. Cognitive Symptoms

•include difficulties attending to and

processing of information, in

understanding the environment, and in remembering simple

tasks.



4. Affective (or Mood) Symptoms

•The most notable affective symptom is depression, which accounts for a very high rate of attempted suicide in people suffering from schizophrenia.



Types of Schizophrenia



Paranoid Schizophrenia

Disorganized Schizophrenia

Catatonic schizophrenia

Undifferentiated Schizophrenia

Residual Schizophrenia



1. Paranoid Schizophrenia Paranoid-characterized

by delusions and auditory hallucinations but relatively normal

intellectual functioning and expression of affect. People with paranoid-type schizophrenia can

exhibit anger, aloofness, anxiety, and

argumentativeness.



Common characteristics of people who tend to be

paranoid include:poor self-imagesocial isolationan expectation that others are trying to takeadvantage of theman inability to relaxan inability to work with othersa deep mistrust of othersan inability to let go of insults or to forgive othersa poor sense of humor



2. Disorganized Schizophrenia Disorganized-

characterized by speech and behavior that are disorganized or difficult to understand, and flattening or inappropriate emotions. People with disorganized-type schizophrenia may laugh at the changing color of a traffic light or at something not closely related to what they are saying or doing.



Disorganized Schizophrenia Their disorganized

behavior may disrupt normal activities, such as showering, dressing, and preparing meals.



3. Catatonic Schizophrenia Characterized by

disturbances of movement. People with catatonic-type schizophrenia may keep themselves completely immobile or move all over the place.



4. Undifferentiated Schizophrenia• Characterized by episodes of two or more of the following symptoms: delusions, hallucinations, disorganized speech or behavior, catatonic behavior or negative symptoms, but the individual does not qualify for a diagnosis of paranoid, disorganized, or catatonic.



5. Residual Schizophrenia

•Characterized by a past history of at least one episode of schizophrenia, but the person currently has no positive symptoms (delusions, hallucinations, disorganized speech or behavior).



5. Residual Schizophrenia

•It may represent a transition between a full-blown episode and complete remission, or it may continue for years without any further psychotic episodes.



Schizophrenia Treatment – Medications



A. Antipsychotic Medications are helpful to people with

schizophrenia, schizoaffective disorder and some forms of bipolar disorder. They are able to reduce, or sometimes eliminate, the distressing and disabling symptoms of psychosis, such as paranoia, confused thinking, delusions and hallucinations, so that the person taking them feels better.



There are two types of antipsychotic medications:1. atypical (newer) and2. typical (older)

Helpful to people with schizophrenia, schizoaffective disorder and some forms of bipolar disorder. They are able to reduce, or sometimes eliminate, the distressing and disabling symptoms of psychosis, such as paranoia, confused thinking, delusions and hallucinations, so that the person taking them feels better.



Advantages of Atypical

Medications



•Fewer side-effects such as trembling or stiffening of muscles.•Less risk of developing ‘tardive dyskinesia’: movement of the mouth, tongue and sometimes other parts of the body over which the person has no control.



A. Antipsychotic Medications•Some evidence suggests

that the newer medications may be effective in improving overall mood, thinking and motivation. •Antipsychotics, like many medications, change the way you feel. This means that if you stop taking the medication you may start to feel the way you did before the treatment



A. Antipsychotic Medications•However, antipsychotic

medications are not addictive, and you will not become dependant on them (you do not need to take higher and higher doses to get the same benefits).



What about injections –

depot medication?



Depot medication is given by injection, which releases the drug slowly over some weeks. Some people prefer injections

as they find remembering to take tablets difficult.

Some people are required to take depot medication

as a condition of a community treatment

order.



Side Effects



dry mouth low blood pressure lower sexual responsivenesstirednessloss of periods in women dizzinessstiffness or trembling in musclesnausea, constipationmild involuntary movementsweight gain



B. Mood-stabilizer Medications

lithium (Lithobid)divalproex (Depakote)carbamazepinelamotrigine (Lamictal)



B. Mood-stabilizer Medications

These medicines are available in syrup, tablet, capsule, and chewable tablet forms. Can be useful in treating mood swings that sometimes occur in individuals who have a diagnosable mood disorder in addition to psychotic symptoms.



Examples

B. Mood-stabilizer Medicines

Generic Name Brand New

carbamazepine Equetro, Tegretol

divalproex Depakote

valproate Depakene syrup



Side Effects



Nausea, vomiting, and diarrhea.Trembling.Increased thirst and increased need to urinate.Weight gain in the first few months of use.Drowsiness.A metallic taste in the mouth.Abnormalities in kidney function.Abnormalities in thyroid function.



C. Antidepressants Medications:

Examples of antidepressants that are commonly prescribed for that purpose include:serotonergic (SSRI) medications that affect serotonin levels like fluoxetine (Prozac)sertraline (Zoloft)paroxetine (Paxil)citalopram (Celexa)escitalopram (Lexapro)




•Antidepressant medications are the primary medical treatment for the depression that can often accompany schizophrenia. •Used under the guidance of a mental health professional, may relieve some of your depression symptoms. But antidepressants also come with significant side effects and dangers.




•Recent studies have raised questions about their effectiveness. At the very least, it’s clear that medication alone isn’t enough—you also need to make changes in your lifestyle. Learning the facts about antidepressants and weighing the benefits against the risks can help you make an informed and personal decision about what’s right for you.



Side Effects



NauseaInsomniaAnxietyRestlessnessDecreased sex driveDizzinessWeight gainTremorsSweatingSleepiness or fatigueDry mouthDiarrheaConstipationHeadaches



Schizophrenia Treatment - Psychosocial Interventions



Family Psycho-education

This form of treatment consists of providing family support, problem-solving skills, and access to care providers during times of crises. When this intervention is consistently provided for at least several months, it has been found to decrease the relapse rate for the individual with schizophrenia and improve the person's social and emotional outcomes.



Assertive Community Treatment (ACT):

This intervention consists of members of the person's treatment team meeting with that individual on a daily basis, in community settings (for example, home, work, or other places the person with schizophrenia frequents) rather than in an office or hospital setting. The treatment team is made up of a variety of professionals.



Substance Abuse Treatment

Providing medical and psychosocial interventions that address substance abuse should be an integral part of treatment as about 50% of individuals with schizophrenia suffer from some kind of substance abuse or dependence.



Social Skills Training

Also called illness management and recovery programming, social-skills training involve teaching clients ways to handle social situations appropriately. It often involves the person scripting (thinking through or role-playing) situations that occur in social settings in order to prepare for those situations when they actually occur.



Supported Employment

This intervention provides supports like a work coach (someone who periodically or consistently counsels the client in the workplace), as well as instruction on constructing a résumé, interviewing for jobs, and education and support for employers to hire individuals with chronic mental illness.



Cognitive Behavioral

Therapy (CBT): CBT is a reality-based intervention that focuses on helping a client understand and change patterns that tend to interfere with his or her ability to interact with others and otherwise function.



Weight Management:

Educating people with schizophrenia about weight gain and related health problems that can be a side effect of some antipsychotic and other psychiatric medications has been found to be helpful in resulting in a modest weight loss.



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Schizophrenia

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