Schizophrenia

Schizophrenia

DEFINITION
Schizophrenia is a mental illness that affects the way an
individual perceives, thinks and reacts to the world around
them.
DESCRIPTION
Schizophrenia affects around 1% of the population and usually
begins in early adulthood, although it has been known to begin in
children or older adults. Schizophrenia does not refer to a single
illness, but a group of disorders with varying symptoms.
Schizophrenia is NOT a “split personality” or multiple personality
disorder. Types of Schizophrenia include:
  • Paranoid Schizophrenia. These people are troubled by delusions
    or hallucinations, but their speech and emotional reactions are
    normal.
  • Disorganised Schizophrenia. These people suffer disorganised
    speech and behaviour and flat or inappropriate emotions. 
  • Catatonic Schizophrenia. These people show physical symptoms
    such as immobility or excessive movement or bizarre
    postures. 
  • Undifferentiated Schizophrenia. Involves a mixture of the above
    types.
CAUSE
The causes of Schizophrenia are not fully understood. It is
likely to be caused by a combination of hereditary and
environmental factors.
GENETIC FACTORS: Schizophrenia can run in families. It is possibly
caused by abnormalities in several genes. 
BIOCHEMICAL FACTORS: Certain chemicals in the brain, called
neurotransmitters, help messages travel from one brain cell to the
next. It is thought impairment in this transport system may cause
some mental illnesses.
SUBSTANCE ABUSE: People with Schizophrenia have a high rate of
substance abuse such as alcohol, marijuana, amphetamines (speed)
and LSD. It is not known whether these substances cause
Schizophrenia, or if the disease leads people to use substances as
a means of coping.
STRESS: Traumatic life events often occur in people with
Schizophrenia before their symptoms become obvious. However, as
with substance abuse, it is not clear whether emotional stress is a
cause or a symptom of Schizophrenia.
SIGNS AND SYMPTOMS
  • Delusions (false beliefs). The person may believe others are
    plotting against them or intending to harm them. They may think
    words from television, books, newspapers or songs are directed at
    them. Some believe others can read their mind, or that their
    thoughts are being transmitted, or that others are planting
    thoughts into their head from outside. 
  • Hallucinations. A hallucination is when the person experiences
    a sensation that is not actually there. Auditory hallucinations
    (“hearing voices”) are most common in Schizophrenia. The “voices”
    in the person’s head may be directing him or her to perform some
    behaviour, or may be criticising or abusing them. Seeing, feeling,
    tasting or smelling imaginary things may also occur.
  • Thought disorder. Speech is rambling or incoherent and the
    person may jump from one subject to another with no logical
    connection. Bizarre behaviour may occur, including childlike
    silliness, agitation and poor hygiene. 
  • Blunted emotions. The person’s face may appear immobile, with
    poor eye contact and lack of expression. They do not react normally
    to their surroundings.
  • Poverty of speech. The person does not talk, or gives one-word
    replies to queries. They appear to be “empty” inside.
  • Decreased pleasure (called anhedonia). The person does not
    enjoy activities they used to enjoy. They become withdrawn and show
    a lack of interest in relationships.
TREATMENT OPTIONS
There is no known cure for Schizophrenia, but with careful
management the condition can be controlled in many people. About
one third of patients will achieve significant and lasting
improvement; one third will have occasional relapses and mild
disability; and one third will be severely and permanently
incapacitated.
Treatment involves a combination of medication and therapy. A
team of psychiatrists, mental health nurses, social workers,
occupational therapists and psychologists will be required to
determine the needs of the patient.
Anti-psychotic medication greatly reduces the severity of symptoms
and helps the person function at the highest level possible. The
patient will need to be closely monitored by their Doctor when they
commence medication. Some anti-psychotic drugs may not be effective
for certain people, while others are associated with side effects.
These problems can be addressed by altering the dose or changing to
a different medication. In many cases the person will need to
remain on the medication for life.
Therapy or counselling is used to help the person develop
better ways of coping with their symptoms. Therapy may be performed
in individual, group or family settings, usually a combination of
all three.
PREVENTION
There is no known prevention for Schizophrenia. However, the
following tips may help reduce the severity of the disease.
  • Prodromal (pre-illness) symptoms such as odd behaviour,
    moodiness and social withdrawal may exist for up to a year before
    Schizophrenia is diagnosed. Early recognition and treatment of
    these symptoms can prevent a psychotic episode from occurring and
    may slow the progression of the illness.
  • Avoid alcohol and illicit drugs, which may worsen symptoms.
    Schizophrenia is associated with a high rate of substance
    abuse. 
  • Quit smoking. Smoking increases the severity of symptoms and
    can interact with some anti-psychotic medications.
ORGANISATIONS & SUPPORT GROUPS
See the Australian National Association for Mental Health
topic on the Healthpoint.
PHARMACIST’S ADVICE
  1. If you suspect that you or someone you are concerned about is
    suffering from Schizophrenia, or another type or mental illness,
    ask your Pharmacist to refer you to a Doctor or the local community
    mental health centre for more information and support.
  2. Your Pharmacist can help you if you have queries about any
    medication you are taking. Ask about the correct dosage and what
    side effects to look for.
  3. Anti-smoking products can help reduce cravings if you are
    trying to quit. Ask your Pharmacist about nicotine replacement
    therapy.
  4. Gentle exercise may help reduce stress. Many Pharmacies supply
    exercise equipment for hire or sale. See the Exercising for Health
    topic on the Healthpoint for further information.