Most people go about their day without worrying about how difficult seemingly simple tasks can be. However, some people in this world can’t do things like watch television, talk on the phone, or converse with co-workers without professional help. Approximately 54 million Americans suffer from some sort of mental illness per year and a very few of those suffer from a chronic, severe disorder called schizophrenia. Experts are not sure on the exact causes of schizophrenia. Many say it is a mixture of genes and environment. What is known for sure are the signs and symptoms of schizophrenia.
The most common positive symptoms are hallucinations, delusions, dysfunctional thinking, and some movement disorders. Hallucinations are things a person sees, feels, smells, or hears that are not really there. The most common hallucinations are “voices” the sufferer hears. Those voices talk to the person and usually tell them what to do or tell them they are in danger. Sometimes, if there are multiple voices, they talk to each other as well. Delusions are false beliefs that are abnormal to their culture and lifestyle. Sufferers commonly believe people are trying to control or hurt them.
Negative symptoms are hard to recognize as schizophrenia and are often mistaken for symptoms of other disorders. Those are the “flax affect”, lack of pleasure in everyday life, reduced ability to start and go through with planned activities, and little vocal response even when forced to interact. The “flax affect” is when a person’s face either does not move or they have a dull or monotone voice. Cognitive symptoms are difficult to recognize without testing for the symptoms themselves.
Those cognitive symptoms are the lack of ability to understand new information and use it to make decisions (called “executive functioning), trouble focusing, and difficulty using information immediately after learning it (NIMH). These symptoms, along with other barriers, such as social anxiety, inability to hold employment, and difficulty adjusting to new environments, make getting help with their disorder very difficult.
They often turn reclusive and separate themselves from family and lifelong friends. To qualify for the diagnosis of schizophrenia the patient must have two or more of these symptoms for at least a month, must have social or occupational dysfunction since the onset of the disturbance, and must have a continuous disturbance for at least six months.
There are five different subtypes of schizophrenia defined in the DSM-IV-TR; they are paranoid, disorganized, catatonic, undifferentiated, and residual. However, the ICD-10 defines two additional subtypes; post-schizophrenic depression and simple schizophrenia. Paranoid schizophrenia is when delusions and auditory hallucinations are present but thought disorders and disorganized behavior is not. Disorganized schizophrenia (named by the ICD as hebephrenic schizophrenia) is when thought disorder and flax affect are present together.
Catatonic schizophrenia is when the sufferer makes purposeless, agitated movements or is immobile all together and does not respond to physical contact. The undifferentiated type is when psychotic symptoms are present but the criteria for the other types are not yet met. Residual schizophrenia is diagnosed when the positive symptoms are present but only at a low intensity (ICD-10).
Only 1 percent of Americans have schizophrenia and the symptoms most often start between the ages of 16 and 30. (NIMH) About 10 percent of people develop it if they have a first-degree relative who also has it and the chances are higher than the general population if there is a second-degree relative as well. The highest risk is for a person who is an identical twin of one with the disorder, resulting in a 40 to 65 percent chance of developing it (Cardno and Gottesman). The prognosis of a person with schizophrenia is a decreased life expectancy of 12-15 years. Suicide rates are higher and 80 to 90 percent of people with the disorder are heavy smokers. Obesity and substance abuse are also prominent risk factors.
There are many medications and programs to help. Antipsychotic medications have been around since the 1950’s and are very commonly prescribed for sufferers of schizophrenia. They have proven to be effective and new studies and technology are helping raise their effectiveness. There are many negative side effects with most of the medications, such as, drowsiness, skin rash, rigidity, and tremors. Also, they have many negative interactions with other medications and the high cost of those medications impedes many low-income sufferers from getting them.
There are many different forms of therapy available now. There is cognitive behavior therapy, rehabilitation, self-help groups, and family education. Teaching the family of schizophrenia patients on the disease and how to cope with it can greatly help the patients themselves keep close ties with them.
NIMH · Schizophrenia. (n.d.). NIMH · Home. Retrieved March 26, 2012, from http://www.nimh.nih.gov/health/publications/schizophrenia/complete-index.shtml Cardno, A., & Gottesman. (2000). Twin studies of schizophrenia: from bow-and-arrow concordances to star wars Mx and functional genomics. American Journal of Medical Genetics, Spring 97(1), 12-17.