Schizophrenia is a group of severe brain disorders in which people interpret reality abnormally. Schizophrenia may result in some combination of hallucinations, delusions and disordered thinking and behavior. The ability of people with schizophrenia to function normally and to care for themselves tends to deteriorate over time.
Contrary to some popular belief, schizophrenia isn't split personality or multiple personality. The word "schizophrenia" does mean "split mind," but it refers to a disruption of the usual balance of emotions and thinking.
Schizophrenia is a chronic condition, requiring lifelong treatment.
The symptoms of schizophrenia also can be attributed to other mental illnesses, and no one symptom can pinpoint a diagnosis of schizophrenia. In men, schizophrenia symptoms typically start in the teens or 20s. In women, schizophrenia symptoms typically begin in the 20s or early 30s. It's uncommon for children to be diagnosed with schizophrenia and rare for those older than 40.
Signs and symptoms of schizophrenia generally are divided into three categories — positive, negative and cognitive.
When to see a doctor
Helping someone who may have schizophrenia
If your loved one poses a danger to self or others or can't provide his or her own food, clothing or shelter, you may need to call the police or other emergency responders for help. In some cases, emergency hospitalization may be needed. Laws on involuntary commitment for mental health treatment vary by state. You can contact community mental health agencies or police departments in your area for details.
It's not known what causes schizophrenia, but researchers believe that a combination of genetics and environment contributes to development of the disease.
Problems with certain naturally occurring brain chemicals, including the neurotransmitters dopamine and glutamate, also may contribute to schizophrenia. Neuroimaging studies show differences in the brain structure and central nervous system of people with schizophrenia. While researchers aren't certain about the significance of these changes, they support evidence that schizophrenia is a brain disease.
Although the precise cause of schizophrenia isn't known, researchers have identified certain factors that seem to increase the risk of developing or triggering schizophrenia, including:
Left untreated, schizophrenia can result in severe emotional, behavioral and health problems, as well as legal and financial problems that affect every area of life. Complications that schizophrenia may cause or be associated with include:
Preparing for your appointment
If you're seeking help for someone with mental illness, you may start by seeing his or her family doctor or a general practitioner. However, in some cases when you call to set up an appointment, you may be referred immediately to a psychiatrist.
It's a good idea to prepare for the appointment. Here's some information to help you.
What you can do
Preparing a list of questions ahead of time will help you make the most of your time with the doctor. For schizophrenia, some basic questions to ask include:
In addition to the questions that you've prepared to ask the doctor, don't hesitate to ask questions during the appointment anytime you don't understand something.
What to expect from the doctor
What you can do in the meantime
Tests and diagnosis
When doctors suspect someone has schizophrenia, they typically ask for medical and psychiatric histories, conduct a physical exam, and run a battery of medical and psychological tests and exams. These tests and exams generally include:
Diagnostic criteria for schizophrenia
Diagnosis of schizophrenia involves ruling out other mental health disorders and determining that symptoms aren't due to substance abuse, medication or a medical condition. In addition, a person must:
There are several subtypes of schizophrenia, but not everyone easily fits into a specific category. The five most common subtypes are:
Treatments and drugs
Schizophrenia is a chronic condition that requires lifelong treatment, even when symptoms have subsided. Treatment with medications and psychosocial therapy can help manage the condition. During crisis periods or times of severe symptoms, hospitalization may be necessary to ensure safety, proper nutrition, adequate sleep and basic hygiene.
A psychiatrist experienced in treating schizophrenia usually guides treatment. The treatment team also may include psychologists, social workers and psychiatric nurses and possibly a case manager to coordinate care. The full-team approach may be available in clinics with expertise in schizophrenia treatment.
Antipsychotic medications are the most commonly prescribed to treat schizophrenia. They're thought to control symptoms by affecting the brain neurotransmitters dopamine and serotonin. A person's willingness to cooperate with treatment may affect medication choice. Someone who is uncooperative may need to be given injections instead of taking a pill. Someone who is agitated may need to be calmed initially with benzodiazapine such as lorazepam (Ativan), which may be combined with an antipsychotic.
The Food and Drug Administration has approved Abilify and Risperdal for use in people ages 13 to 17. Side effects of atypical antipsychotic medications include weight gain, diabetes and high blood cholesterol.
Conventional, or typical, antipsychotics
These typical antipsychotics are often cheaper than newer counterparts, especially the generic versions, which can be an important consideration when long-term treatment is necessary.
It can take several weeks after first starting a medication to notice an improvement in symptoms. In general, the goal of treatment with antipsychotic medications is to effectively control signs and symptoms at the lowest possible dosage. The psychiatrist may try different medications, different dosages or combinations over time to achieve the desired result. Other medications also may be helpful, such as antidepressants or anti-anxiety medications.
Many communities have programs to help people with schizophrenia with jobs, housing, self-help groups and crisis situations. A case manager or someone on the health care team can help find one. With appropriate treatment, most people with schizophrenia can manage their condition.
Coping and support
Coping with an illness as serious as schizophrenia can be challenging, both for the person with the condition and for friends and family. Here are some ways to cope with schizophrenia:
There's no sure way to prevent schizophrenia. However, early treatment may help get symptoms under control before serious complications develop and may help improve the long-term outlook. Sticking with the treatment plan can help prevent relapses or worsening of schizophrenia symptoms. In addition, researchers hope that learning more about risk factors for schizophrenia may lead to earlier diagnosis and earlier treatment.
For people at increased risk of schizophrenia, taking proactive steps such as avoiding illicit drug use, reducing stress, getting enough sleep and starting antipsychotic medications as soon as necessary may help minimize symptoms or prevent them from worsening.
Last Updated: 2010-01-30
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