Schizophrenia is a severe psychiatric disorder which affects how the person thinks, feels and behave. Schizophrenia will cause abnormal thinking and abnormal perception i.e. seeing, hearing and believing things that are not real. They will believe in their thoughts and perceptions so strongly that they will lose touch to the reality and create many imaginary things surrounding them. Many times it may be a chronic disorder and severely disabling for the person affected by it. The prevalence of schizophrenia is 1% in general population.
Symptoms of schizophrenia –
Symptoms of schizophrenia may vary from person to person but generally include following symptoms.
• Delusions – Person will have some false belief that is fixed, firm which will remain even if person is confronted with number of evidences contradicting his/ her belief. Examples of delusions include false belief that someone is talking about the person, someone trying to harm the person.
• Hallucinations – Perceiving things that are not real. For example person with schizophrenia may hear voices talking about him/ her even if no one is around or can see people which can not be seen by others.
• Behavioural disturbances – Aggressive, abusive behaviour towards others without any reason, muttering to self, smiling without reason, making odd gestures, decreased self care are some of the behavioural disturbances in schizophrenia.
• Speech disturbances – Irrelevant talks, losing track while talking on one subject.
• Mood symptoms – depressive symptoms, extreme unnecessary happiness (mania), mood swings.
• Cognitive symptoms – Person with chronic schizophrenia will have decline in their cognitive functioning like impairment in memory, information processing, and ability to think conceptually.
• Catatonia – Some patients with schizophrenia will have some peculiar behavioural symptoms like inability to move or interact with surrounding environment while being in clear consciousness or excess, purposeless and aimless activity.
• Negative symptoms – Some patients with schizophrenia will lose some of their abilities like ability to interact or emotional reactivity. As a result they will have these negative symptoms. Examples include social withdrawal, apathy or emotional aloofness, loss of motivation.
Causes of schizophrenia –
Genetic – Schizophrenia runs in families. If any close relative is affected by schizophrenia the risk of schizophrenia also increases in the person. Many genes have been shown to be associated with development of schizophrenia.
Biological factors – Disturbances in neurotransmitters have been associated with schizophrenia. Particularly high dopamine in mesolimbic system and low dopamine in mesocortical neurocircuitary have been shown to cause psychotic symptoms of schizophrenia. Loss of brain cells in hippocampal region has also been shown in the brains of patients with schizophrenia.
Risk factors for schizophrenia –
• Family history of schizophrenia
• Use of psychoactive substances like alcohol, cannabis etc.
• Childhood traumatic events
• Current life stressor
• Medical conditions like hormonal disturbance, neurological disorders
Treatment for schizophrenia –
With proper diagnosis and consistent treatment many patients with schizophrenia will respond to treatment. Treatment options for schizophrenia include –
Medicines – Antipsychotics are the drugs used for treatment of schizophrenia. We have many options of antipsychotics which can be selected according to symptoms and patient profile. Medications are the mainstay treatment for schizophrenia.
Psychotherapy – Supportive psychotherapy, cognitive behaviour therapy, social skill training are some of the psychotherapies used along with medicines to treat schizophrenia.
Electroconvulsive therapy (ECT) – ECT can be given in violent, suicidal or catatonic patients. It can also be given in case of poor medicine response.