Schizophrenia

About

Schizophrenia

What is schizophrenia?

Schizophrenia is a complicated, long-term mental illness that should not be ignored. It can affect the way a person perceives reality, experiences appropriate emotions, or makes sound decisions. Early diagnosis and management are critical. Minor changes in mood and daily activities may be the only initial signs people possess with this mental disorder making it that much more difficult to recognize early on.

Who suffers from this type of disorder?

The precise number of people diagnosed with schizophrenia is hard to calculate, but it is believed that about 1 percent of Americans suffer from this disease. Schizophrenia can occur in men and women equally, but symptoms tend to occur earlier in men. Men can experience symptoms of schizophrenia as early as their late teens, whereas women usually do not have signs and symptoms until early adulthood. Younger children may also experience schizophrenia. However, this is a rarity. It is also uncommon to have a new diagnosis of schizophrenia after the age of 40.

What are cultural differences in regards to the acceptance of schizophrenia?

There is research that believes schizophrenia may be underdiagnosed in minority communities. African Americans and Hispanics are some of the most common ethnic groups underrepresented with this mental illness due to the cultural stigma regarding this disease. They also tend to lack resources for treatment.

Causes

What causes schizophrenia?

Schizophrenia and its cause are not well understood at this time due to its complex nature. However, it is believed that there are multiple risk factors that may contribute to the development of this mental illness. 

What risk factors are there for developing schizophrenia?

There are a variety of risk factors associated with the development of schizophrenia. They include:

  • Brain structure factors- there is research regarding the amount of the neurotransmitter dopamine and how it may play a role in the development of schizophrenia. It may impact the way the brain connections or functions work.
  • Environmental factors- evidence shows that being exposed to stressful events such as poverty may predispose someone to develop schizophrenia. Prenatal health has also been linked to the development of schizophrenia as exposure to toxins, viruses, and nutritional deficiencies while being pregnant may also be a cause.
  • Genetic factors- there has been a correlation between multiple family members suffering from schizophrenia, so it is believed that genetics may play a role in developing this disorder. However, just because a family suffers from schizophrenia does not mean family members will develop this illness as well.
  • Substance abuse- early abuse of controlled substances, especially mind-altering ones, can place young teens and adults at higher risk of developing schizophrenia.

A combination of these risk factors seems to be the most accepted cause of this mental illness.

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Symptoms

What are the symptoms of schizophrenia?

Schizophrenia symptoms are usually categorized under three categories:

  • Psychotic- usually involves the loss of reality and unusual behavior. Examples include:
  1. Hallucinations
  2. Delusions
  3. Bizarre thinking
  4. Disorganized speech
  • Negative- lack of interest in previous activities once enjoyed or difficulty functioning in normal daily activities. Examples include:
  1. Decreased interest in previously enjoyable activities
  2. Reduced emotions (“flat affect”)
  3. Dull, disconnected speech
  • Cognitive- usually subtle changes involving difficulty with memorization or concentration. Other changes may be more severe and negatively impact their daily activities. Examples include:
  1. Problems with decision making
  2. Disorganized thought process

Is suicide commonly seen in people with schizophrenia?

Suicide can occur in schizophrenic patients. This is why early treatment and intervention are needed to prevent serious complications from the illness.

What other complications are associated with schizophrenia?

As previously discussed, serious complications such as suicidal thoughts may be seen with schizophrenia. Other complications may also exist so early treatment and intervention should be attempted aggressively to avoid the following problems:

  • Substance abuse
  • Homelessness
  • Anxiety
  • Depression
  • Social withdrawal or isolation
  • Inability to function in a work or school environment

Diagnosis

How is schizophrenia diagnosed?

As with other mental illnesses, a thorough history and physical examination by a licensed medical professional must be performed to be accurately diagnosed with schizophrenia. It is important to note that at least two symptoms must be present for a minimum of six months before a diagnosis of schizophrenia can be made.

What test can be performed to confirm schizophrenia?  

Currently, there is no single test or exam that can be used to diagnose schizophrenia. Usually, diagnosis involves ruling out other medical causes of symptoms and ensuring drug use is also not the cause of the symptoms.

What other medical conditions may mimic schizophrenia?

A thorough exam is needed to make an accurate diagnosis of schizophrenia as many other mental illnesses and medical problems may look similar. Other similar conditions include:

  • Brain tumor
  • Depression
  • Bipolar disorder
  • Substance abuse

Treatment

What are the treatment options available for schizophrenia? 

It is important to understand there is no cure for schizophrenia. Therefore, treatment for this mental illness is long-term. Because of the complexity of schizophrenia, currently, treatment involves the management of symptoms only. Here are some treatment options available:

  • Psychotherapy: This type of therapy is used to help with the negative and cognitive symptoms associated with schizophrenia. There are a variety of options used to help with coping skills to manage symptoms. Examples of psychotherapy include:
  1. Behavioral skills
  2. Supported employment
  3. Cognitive remediation
  • Medication: Antipsychotics are a very popular option and usually the gold standard for the treatment of schizophrenia. Multiple preparations such as oral pills or injections are available and can be given daily or even once a month for convenience. They do have several side effects that must be closely managed by a healthcare provider. Anti-anxiety and antidepressants may also be used if these symptoms are also present.
  • Electroconvulsive therapy (ECT):  ECT is usually reserved when medications and psychotherapy have failed with managing schizophrenic symptoms.
  • Inpatient treatment: Hospitalizations for schizophrenia are serious risks if early treatment intervention is not provided or successful. This form of treatment is usually reserved for serious symptoms to protect the person who has schizophrenia from hurting themselves or others, providing proper nutrition, and hygiene. 

Many times combination treatment is the best approach to manage schizophrenia which regularly incorporates different types of psychotherapy with medication. 

Are there support programs available?

Yes, there are many educational programs for family members who want to learn how to better help and cope with their loved one’s schizophrenia. It usually provides guidance on how to recognize symptoms, develop their own coping skills, and develop techniques to assist their loved ones. This can be done individually or in a group setting. Our trained healthcare providers at TeleMed2U are always available to help you and your family get the support you need, which can even be done from the comfort of your home.

What is coordinated specialty care?

Coordinated specialty care is a type of recovery program specifically for those who have just suffered their first psychotic episode during early schizophrenia. This is usually a multidisciplinary approach where multiple specialists develop a comprehensive treatment plan. It has been shown to be an effective treatment approach for those in the early stages of treatment. Early treatment for schizophrenia helps prevent long-term problems and complications from the disorder.

Is treatment for schizophrenia successful?

Yes. Although treatment may be difficult as many schizophrenic patients suffer from anosognosia where there is sometimes denial about the illness, treatments can be successful and patients may have a good quality of life. Because many other mental illnesses may coincide with schizophrenia, it is important to identify other illnesses that may need to be addressed for a successful treatment program. Other illnesses that may coincide with schizophrenia include:

  • Post-traumatic stress disorder
  • Substance abuse
  • Depression
  • Obsessive-compulsive disorder

The best way to help yourself or a loved one suffering from schizophrenia is to get early and continuous treatment. This reduces the chance of hospitalizations and homelessness. If you are struggling with your symptoms of schizophrenia, we may be able to help at TeleMed2U any time you are ready.

Information

Medically reviewed by:

Dr Roy Kedem, MD

Dr Zenon Andreou studied medicine at University College London, graduating in 2006. His postgraduate training was in hospitals in and around London and he trained for four years in Otolaryngology before completing his training in General practice

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Your copay
Depending on insurance

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Initial Visit

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Follow Up