What is it
Schizophrenia is a psychic disorder characterized by disorders of thought, behavior and affectivity.
Thought disorders affect both the way in which it manifests itself and the content of thought itself.
As for the way, there is an increase or decrease in the speed of association of ideas; loss of speech thread (derailment); illogicality; inability to reason in an abstract and metaphorical way to refer only to concrete things and situations (for example, idioms are taken literally).
As for the content, delusions (of persecution, jealousy, of grandeur, religious, hypochondriacs) are characteristic, that is, convictions – often bizarre – that are not affected by any demonstration of falsehood. They are frequently accompanied by auditory hallucinations and sometimes even visual or olfactory.
Currently, schizophrenia is considered not a single disease, but a class of disorders, the characteristic symptoms of which can present themselves in various ways.
Depending on the type of symptoms that prevail, we can distinguish between paranoid, catatonic, disorganized schizophrenia, etc.
Causes
It is believed that the development of schizophrenia depends on a multiplicity of factors, among which certainly includes a genetic component.
The risk of disease in the general population is in fact equal to 1 percent, while among identical twins (monozygotes), if one of the two is affected by schizophrenia, the risk that the other will also develop it is 45 percent.
The genetic component, which also involves many genes, however, provides only a predisposition to the disease on which environmental stressors intervene.
Most common symptoms
Hallucinations, delusions, “disorganized” speeches, serious behavioral disorders (in clothing, habits, sleep disorders, frequent and inappropriate bursts of crying or laughter).
Then there are disinterest, absence, disorders of attention and intellectual abilities, lack of eye contact, affective indifference, poor emotional responses, mutism, catatonia.
The symptoms are generally divided into two classes: the so-called “positive” ones (delusions, hallucinations, thought disorders) and the “negative” ones (emotional detachment, lack of motivation, inadequacy of behavior).
Complications
Among schizophrenic patients, the risk of attempted suicide (50 percent) and suicide (10 percent) is high.
The establishment of alcohol and drug dependence is also likely, as well as the impairment of social and work relationships.
Care
The therapy, which is aimed at the control and best possible management of the disease, is primarily pharmacological.
Antipsychotic drugs (neuroleptics) are used, divided into conventional, which allow to control positive symptoms, but not negative ones; and the so-called atypical that have a certain effectiveness also on the latter.
| Neuroleptic drugs | Active ingredients |
|---|---|
| Conventional | Chlorpromazine, haloperidol, fluphenazine, etc. |
| Atypical | Risperidone, clozapine, olanzapine, quetiapine |
Hospitalization, temporary, is necessary in the case of delusions or severe hallucinations, and risk of suicide.
One of the problems of therapy is the tendency of the patient to stop treatments due to delusions, side effects or distrust. This carries the risk of relapse into acute psychotic episodes and a worsening of the situation.
Among the most common side effects of drugs are dry mouth, constipation, drowsiness, weight gain, visual disturbance.
Motor problems such as stiffness, tremors, muscle spasms and, albeit rarely, the most serious tardive dyskinesia can also occur.
Psychosocial rehabilitation programs should also be considered part of the treatment, since those who attend them continue drug treatment more easily, manage the disease better and achieve a better quality of life.
When to consult your doctor
Early diagnosis allows better control of the disease, which most often begins in late adolescence and early adulthood, although some forms occur in adulthood.
The onset can occur suddenly with an acute psychotic episode (delusions, hallucinations), but it is often preceded by a period in which the person closes in on himself, appears less and less interested in the surrounding world, leaves friends and romantic relationships for no reason, interrupts school or loses his job.
Signs of behavior change of this kind can be alarm bells. Unfortunately, if the onset is early, many of these signals can be mistaken for normal adolescent crises. In general, a six-month observation period is required to have a definite diagnosis.
Joycelyn Elders is the author and creator of EmpowerEssence, a health and wellness blog. Elders is a respected public health advocate and pediatrician dedicated to promoting general health and well-being.
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