Schizophrenia is a mental disorder that generally appears in late adolescence or early adulthood - however, it can emerge at any time in life.
It is one of many brain diseases that may include delusions, loss of personality (flat affect), confusion, agitation, social withdrawal, psychosis, and bizarre behavior.
Contents of this article:
You will also see introductions at the end of some sections to any recent developments that have been covered by MNT's news stories. Also look out for links to information about related conditions.
What is schizophrenia?
Individuals with schizophrenia may hear voices that are not there. Some may be convinced that others are reading their minds, controlling how they think, or plotting against them. This can distress patients severely and persistently, making them withdrawn and frantic.
Others may find it hard to make sense of what a person with schizophrenia is talking about. In some cases, the individual may spend hours completely still, without talking. On other occasions he or she may seem fine, until they start explaining what they are truly thinking.
The effects of schizophrenia reach far beyond the patient - schizophrenia does not only affect the person with the disorder. Families, friends and society are affected too. A sizable proportion of people with schizophrenia have to rely on others, because they are unable to hold a job or care for themselves.
With proper treatment, patients can lead productive lives - according to the National Institute of Mental Health1 (NIMN), treatment can help relieve many of the symptoms of schizophrenia. However, the majority of patients with the disorder have to cope with the symptoms for life. This does not mean that a person with schizophrenia who receives treatment cannot lead a rewarding, productive and meaningful life in his or her community.
Schizophrenia most commonly strikes between the ages of 15 to 25 among men, and about 25 to 35 in women. In many cases the disorder develops so slowly that the sufferer does not know he/she has it for a long time. While, with other people it can strike suddenly and develop fast.
Schizophrenia, possibly many illnesses combined - it is a complex, chronic, severe, and disabling brain disorder and affects approximately 1% of all adults globally. Experts say schizophrenia is probably many illnesses masquerading as one. Research indicates that schizophrenia is likely to be the result of faulty neuronal development in the brain of the fetus, which later in life emerges as a full-blown illness.
John Forbes Nash Jr. (born June 13, 1928) has lived
with paranoid schizophrenia.
Photo by Peter Badge.
The Schizophrenic Disorders Clinic3 at the Stanford School of Medicine describes schizophrenia as "a thought disorder: a brain disorder that interferes with a person's ability to think clearly, manage emotions, make decisions, and relate to others."
John Nash, an American mathematician who worked at Princeton University, won the Nobel Prize in Economics and lived with paranoid schizophrenia most of his life. He eventually managed to live without medication. A film was made of his life "A Beautiful Mind", which Nash says was "loosely accurate". John Nash sadly died in 2015 in a car crash.
The word schizophrenia comes from the Greek word skhizein meaning "to split" and the Greek word Phrenos (phren) meaning "diaphragm, heart, mind". In 1910, the Swiss psychiatrist, Eugen Bleuler (1857-1939) coined the term Schizophrenie in a lecture in Berlin on April 24th, 1908.
Our brain consists of billions of nerve cells. Each nerve cell has branches that give out and receive messages from other nerve cells.
The ending of these nerve cells release neurotransmitters - types of chemicals. These neurotransmitters carry messages from the endings of one nerve cell to the nerve cell body of another. In the brain of a person who has schizophrenia, this messaging system does not work properly.
Symptoms of schizophrenia
There is, to date, no physical or laboratory test that can absolutely diagnose schizophrenia. The doctor, a psychiatrist, will make a diagnosis based on the patient's clinical symptoms. However, physical testing can rule out some other disorders and conditions which sometimes have similar symptoms, such as seizure disorders, thyroid dysfunction, brain tumor, drug use, and metabolic disorders.
Symptoms and signs of schizophrenia will vary, depending on the individual. The symptoms are classified into four categories:
- Positive symptoms - also known as psychotic symptoms. These are symptoms that appear, which people without schizophrenia do not have. For example, delusion.
- Negative symptoms - these refer to elements that are taken away from the individual; loss or absence of normal traits or abilities that people without schizophrenia normally have. For example, blunted emotion.
- Cognitive symptoms - these are symptoms within the person's thought processes. They may be positive or negative symptoms, for example, poor concentration is a negative symptom.
- Emotional symptoms - these are symptoms within the person's feelings. They are usually negative symptoms, such as blunted emotions.
Below is a list of the major symptoms:
- Delusions - The patient has false beliefs of persecution, guilt of grandeur. He/she may feel things are being controlled from outside. It is not uncommon for people with schizophrenia to describe plots against them. They may think they have extraordinary powers and gifts. Some patients with schizophrenia may hide in order to protect themselves from an imagined persecution.
- Hallucinations - hearing voices is much more common than seeing, feeling, tasting, or smelling things which are not there, but seem very real to the patient.
- Thought disorder - the person may jump from one subject to another for no logical reason. The speaker may be hard to follow. The patient's speech might be muddled and incoherent. In some cases the patient may believe that somebody is messing with his/her mind.
Other symptoms schizophrenia patients may experience include:
- Lack of motivation (avolition) - the patient loses his/her drive. Everyday automatic actions, such as washing and cooking are abandoned. It is important that those close to the patient understand that this loss of drive is due to the illness, and has nothing to do with slothfulness.
- Poor expression of emotions - responses to happy or sad occasions may be lacking, or inappropriate.
- Social withdrawal - when a patient with schizophrenia withdraws socially it is often because he/she believes somebody is going to harm them. Other reasons could be a fear of interacting with other humans because of poor social skills.
- Unaware of illness - as the hallucinations and delusions seem so real for the patients, many of them may not believe they are ill. They may refuse to take medications which could help them enormously for fear of side-effects, for example.
- Cognitive difficulties - the patient's ability to concentrate, remember things, plan ahead, and to organize himself/herself are affected. Communication becomes more difficult.
Recent developments on the symptoms of schizophrenia from MNT news
Researchers from the University of British Columbia explained in the Journal of Neuroscience that people with schizophrenia find it harder to follow a moving dot on a computer screen.
On the next page we look at the causes of schizophrenia and the tests and diagnosis for the condition.