Schizophrenia

Schizophrenia is a chronic brain disorder with long-term effects on how a person behaves, thinks, and feels, making it difficult to engage in everyday activities.

What is Schizophrenia?

Schizophrenia is characterized by a constellation of symptoms further classified as positive symptoms, negative symptoms, and cognitive symptoms. Positive symptoms are those that reflect a change in how a person acts, thinks, and perceives their surroundings. Examples of positive symptoms are hallucinations and delusions.

Negative symptoms are those that reflect a person's loss of interest in activities they previously enjoyed, difficulty expressing and show emotions, and social isolation. Examples of negative symptoms are avoiding situations requiring social interactions, using little facial expression or speaking in a monotonous manner, and having extremely low energy.

Cognitive symptoms are those that reflect impairment in their ability to concentrate and remember. Examples of cognitive symptoms are difficulty or an inability to concentrate, having trouble processing information to make decisions, and trouble remembering things after learning them.

Schizophrenia is usually diagnosed in late adolescence or young adulthood after a person has their first episode of psychosis. Even before the first episode of psychosis when schizophrenia is diagnosed, symptoms often begin developing and manifest in a milder form.

A family history of schizophrenia, especially in first-degree relatives, increases a person's risk for developing it themself. However, research has shown other factors also contribute to the risk for development, including brain structure and environmental factors.

If someone has symptoms of schizophrenia, their symptoms should be evaluated further by a health care provider.

What are the symptoms of schizophrenia?

Some symptoms include:

• Hallucinations
• Delusions
• Hypervigilance, suspiciousness
• Speaking more slowly and lacking vocal inflections
• Limited facial expression or blunted affect
• Withdrawal from social interactions
• Illogical behavior
• Slow cognitive processing speed
• Poor attention
• Difficulty with memory and learning

How is schizophrenia treated?

It is important to note that symptoms of schizophrenia are similar to those seen in other psychiatric disorders (e.g., bipolar disorder, unipolar depression) and also other health condition, which can make schizophrenia difficult to diagnose.

Therefore, if a person believes they are experiencing symptoms of schizophrenia, they should speak with a psychiatrist or a health care provider, who can then refer them to a psychiatrist. A psychiatrist can determine a diagnose and recommend a targeted treatment with medications as well as psychosocial interventions.

Some examples of useful therapies are cognitive behavioral therapy (CBT) for psychotic symptoms not responding to medication, family therapy and psychoeducation, and personal therapy that focuses on regulating emotional expression and developing skills to better cope and manage emotional stress.

Other examples of social interventions include coordinated specialty care (CSC) and assertive community treatment (ACT). CSC are programs that focus on early symptom recovery in those after a first episode of psychosis, and ACT is designed to address the needs of those who are homeless or who are likely to have multiple hospitalizations for their symptoms.

The most common medication used to treat schizophrenia are antipsychotics, which are used to not only improve symptoms but also improve the person's everyday functioning and, ultimately, their ability to engage in fulfilling activities and relationships with others.

Most antipsychotics are available in a pill or liquid form, and some are available as a once monthly injection. It is important for a person to tell their health care provider what other treatment or medication they are currently taking, including prescription medications, dietary supplements, and over-the-counter medications.

Through shared decision making, the most helpful treatment can then be determined, while avoiding potential interactions with any other medications a person might be taking.

Untreated symptoms of schizophrenia can be detrimental to daily functioning as well as increase a person's risk of suicide; therefore, it is important to continue treatment and to avoid stopping treatment without talking to a doctor first.