What is schizophrenia?

Schizophrenia is a chronic mental disorder in which people interpret reality abnormally. It has affected people throughout history. It makes difficult to distinguish between what is real and unreal showing a combination of hallucinations, delusions, and extremely disordered thinking and behavior. It is a complex, long-term medical illness.  It affects men about one and a half times more commonly than women. Although schizophrenia can occur at any age, the average age of onset tends to be in the late teens to the early 20s for men, and the late 20s to early 30s for women.

Schizophrenia is not ‘Split Personality’. It is one of the psychotic mental disorders and is characterized by symptoms of thought, behavior, and social problems. Some of the symptoms include false beliefs, unreal thinking, hallucinations, social isolation and reduced or abnormal emotional expression and lack of motivation. Diagnosis of schizophrenia is clinical and is based on observed behavior and the person’s reported experiences.

 The thought problems associated with schizophrenia are described as psychosis, in that the person’s thinking is completely out of touch with reality at times. They may see or hear things that don’t exist, speak in strange or confusing ways, believe that others are trying to harm them, or feel like they’re being constantly watched.

The vast majority of people with schizophrenia are not violent and do not pose any danger to others. They may be unresponsive or withdrawn; and may have difficulty expressing normal emotions in social situations. It is uncommon for schizophrenia to be diagnosed in a person younger than 12 or older than 40. It is possible to live well with schizophrenia.

Among the contributory factors we have genetics and early environment, psychological, environmental and social processes. Some drugs too can cause or worsen symptoms. Patients of schizophrenia have imbalance of brain chemicals (serotonin and dopamine) which are among the neurotransmitters found in brain. This imbalance leads to exaggerated or abnormal looking response to stimuli like light sound smell and taste. Such ‘abnormal’ responses are seen as delusions and hallucinations.

They may also have other conditions like anxiety or depression. In addition schizophrenia affects social life, professional life, relationships and family life. It may lead to unemployment, poverty, suicide and homelessness or abandoned by family.

Warning signs and symptoms:

  • Hearing or seeing something that isn’t there for others
  • Suspicion or feeling of being watched
  • Abnormal speech
  • Sudden and negative change in personality
  • Falling academic or work performance
  • Falling personal hygiene and appearance
  • Feeling indifferent to important issues or situations
  • Strange body postures or positions
  • Increasing social avoidance
  • Abnormal social response
  • Inability to sleep
  • Unreasonable bizarre behavior

Prognosis

Better prognosis or outcome

  • People having a higher level of functioning before the start of their illness
  • No structural abnormality of brain
  • Shorter episodes

Poor prognosis or outcome

  • Gradual or insidious onset
  • Structural brain abnormalities
  • Failure to return to functioning level after episode
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