What is Schizophrenia?
Schizophrenia is a severe and disabling mental health condition, that affects how an individual thinks, feels, and behaves. Such individuals experience psychosis, that is, a loss of contact with reality. Their ability to perceive and respond to others becomes so disturbed that they may not be able to complete daily chores at home, fulfill assigned duties at work or maintain interpersonal relationships.
Symptoms of Schizophrenia
The symptoms of schizophrenia can be grouped into three categories.
- Positive symptoms – These are pathological additions to a person’s behavior such as hallucinations (sensory distortions), delusions (false beliefs), and thought disorders (dysfunctional ways of thinking).
- Negative symptoms – These are pathological deficits or characteristics lacking in an individual such as poverty of speech, blunted affect (low emotional expression), loss of volition (lack of interest or will in activities), and social withdrawal.
- Psychomotor symptoms – These include bizarre movements such as odd gestures and grimaces. Few individuals exhibit catatonia (immobility and marked muscular rigidity), inappropriate affect, poor executive functioning, and problems with attention and memory.
Diagnostic Criteria for Schizophrenia
According to the Diagnostic and Statistical Manual of Mental Disorders – Fifth Edition (DSM 5), schizophrenia can be diagnosed if two or more of the positive; negative or psychomotor symptoms are present for at least one month, and the signs of the disorder have been present for at least six months along with disruption in daily functioning in work; relationships; and self-care.
In the DSM 5, the categorization of schizophrenia follows a spectrum approach and is classified under Schizophrenia Spectrum and other Psychotic Disorders.
The problems faced by patients can be divided into three phases: prodromal, active, and residual.
The prodromal phase is marked by visible deterioration in the functioning and performance of the individual. The symptoms seen are peculiar behaviors (such as talking to self), outbursts of anger, increased tension, and restlessness.
This is followed by the active phase in which a psychotic episode (consisting of either hallucination, delusion, or disorganized speech) occurs.
The residual phase follows after the active phase and is defined by the symptoms of the prodromal phase with the negative symptoms being highly noticeable. The onset of schizophrenia occurs during adolescence or early adulthood. Men and women are equally affected.
Course for Schizophrenia
The course of schizophrenia is varied, as few patients may experience only one episode in their entire lifetime, while few others may have a minimal impairment, and the rest of them may suffer chronically for the rest of their lives.
A complex interplay between genetic and environmental factors is responsible for the onset and development of schizophrenia.
Family, twin, and adoption studies support the theory that genetic factors play a role in schizophrenia.
Biochemical and structural brain abnormalities caused due to poor nutrition, fetal development, birth complications, immune reactions, and toxins also play a major role. Environmental causes attributed to schizophrenia are dysfunctional family interactions, stressful life events, substance abuse, and unhealthy coping styles.
Treatments for Schizophrenia
Although there is no cure for schizophrenia, patients can successfully manage the disorder and lead productive lives with proper treatment.
The main aim of treatment is to overcome acute psychotic episodes and prevent future episodes. Hospitalization may become necessary in the active phases of the disorder as the patient may pose a danger to themself or others.
A multifaceted approach to treatment is generally undertaken. While antipsychotic medications are the primary method of treatment, psychotherapy and specialized training are provided to cope with and manage the disorder.
Antipsychotic medicines help in relieving thought and perceptual disturbances, and delaying relapses, thereby allowing the patient to gain insight, and actively participate in psychotherapy to make changes in behavior.
The most helpful forms of psychotherapy are cognitive-behavioral therapy and family therapy. Social skills training, psycho-education, and art therapy have also proven to be useful in improving the level of patients’ role functioning.
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