Schizophrenia

Schizophrenia is a serious brain disorder that distorts the way a person thinks, acts, expresses emotions, perceives reality, and relates to others. The hallmark of Schizophrenia is a significant loss of contact with reality referred to as psychosis.

According to DSM-5, two or more of the following symptoms over a month. At least (1) or (2) or (3) must be present.  

1.Delusions: a false fixed belief , that is firmly held despite clear contradictory evidence. It is a disturbance in the content of thought. [Text Wrapping Break]2.Hallucinations: a sensory experience that occurs in the absence of any external perceptual stimulus. However, it seems very real to the person. [Text Wrapping Break]3.Disorganized Speech.[Text Wrapping Break]4.Grossly disorganized or catatonic behavior.  

5.Negative symptoms: the absence of required behaviors to cope with daily life.  

These signs of disturbance should last for at least 6 months and generate dysfunction in work, interpersonal relations or self care.  

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Symptoms

Prevalence

The prevalence of schizophrenia typically ranges from 0.2 to 0.4 percent across countries. It’s estimated that 20 million people in world had schizophrenia in 2017. Male to female ratio is 1.4 : 1. The average age of onset is 25 years for men & 29 years for women. Males tend to have a more severe form of schizophrenia. Even the brain structure anomalies in schizophrenia are more severe in males. The lifetime risk is higher if a parent is schizophrenic, and there is an observed higher risk if the father was older than the average at the time of their birth ( e.g., 50 years old ).

Prognosis

There is no known cure for schizophrenia, but the outlook for people who have this illness is improving.With treatment, many people with schizophrenia can recover to the point of living functional, rewarding lives in their communities.Ten years after diagnosis: 50% of people with schizophrenia are either recovered or improved to the point that they can work and live on their own. 25% are better but need help from a strong support network to get by. 15% are not better. Most of these are in the hospital. Long-term numbers for 30 years after diagnosis are similar to those at the decade mark, except that more people get better and can live on their own. The lifetime risk of suicide for people with schizophrenia is about 5%, but getting treatment and taking medication seems to lower that risk. Women seem to be better than men at staying in recovery long term. Factors affecting prognosis include: How well the person did in society and at work before schizophrenia began The amount of time from the start of symptoms to diagnosis and treatment. The sooner one is treated for schizophrenia once symptoms begin, the more likely they are to improve and recover. But prodrome - the time between when symptoms begin and full psychosis starts - can be days, weeks, or even years. The average length of time between the start of psychosis and first treatment is 6 to 7 years.

When to seek help

Treatment

Psychiatrists, primary care doctors, psychologists, social workers, and other mental health professionals are crucial in helping people with schizophrenia and their families explore sources of treatment.  

The earlier treatment is sought, the better the outcome.  

There are many ways to treat schizophrenia, ideally in a team approach. These include medication, psychotherapy, behavioral therapy, and social services, as well as employment and educational interventions.

  1. The medications doctors prescribe most often for schizophrenia are called antipsychotics. They ease   symptoms such as delusions and hallucinations.They can be taken during an episode to help relieve psychosis quickly, and also in the long term to prevent symptoms. 
  1. Psychotherapy for people with schizophrenia include:  
  • Individual therapy wherein the person learns how to deal with their thoughts and behaviors. They’ll learn more about their illness and its effects, as well as how to tell the difference between what’s real and what’s not. It also can help them manage everyday life.  
  • Cognitive behavior therapy (CBT) to help the person change their thinking and behavior. A therapist will show them ways to deal with voices and hallucinations. With a combination of CBT sessions and medication, they can eventually tell what triggers their psychotic episodes (times when hallucinations or delusions flare up) and how to reduce or stop them.
  • Cognitive enhancement therapy (CET). This type of therapy is also called cognitive remediation. It teaches people how to better recognize social cues, or triggers, and improve their attention, memory, and ability to organize their thoughts. It combines computer-based brain training and group sessions.
  • Types of psychosocial therapy also help schizophrenic people to fare better overall and learn how to become part of a community. It includes but is not limited to social skills training, rehabilitation, family education and self-help groups.
  1. Electroconvulsive Therapy (ECT) is another treatment option. A course of ECT therapy usually involves 2-3 treatments per week for several weeks. Each shock treatment causes a controlled seizure. A series of treatments over time leads to improvement in mood and thinking.