Schizophrenia

DEFINITION

Schizophrenia is a mental illness that affects the way an individual perceives, thinks and reacts to the world around them.

DESCRIPTION

Schizophrenia affects around 1% of the population and usually begins in early adulthood, although it has been known to begin in children or older adults. Schizophrenia does not refer to a single illness, but a group of disorders with varying symptoms. Schizophrenia is NOT a "split personality" or multiple personality disorder. Types of Schizophrenia include:
-Paranoid Schizophrenia. These people are troubled by delusions or hallucinations, but their speech and emotional reactions are normal.
-Disorganised Schizophrenia. These people suffer disorganised speech and behaviour and flat or inappropriate emotions.
-Catatonic Schizophrenia. These people show physical symptoms such as immobility or excessive movement or bizarre postures.
-Undifferentiated Schizophrenia. Involves a mixture of the above types.

CAUSE

The causes of Schizophrenia are not fully understood. It is likely to be caused by a combination of hereditary and environmental factors.

GENETIC FACTORS: Schizophrenia can run in families. It is possibly caused by abnormalities in several genes.

BIOCHEMICAL FACTORS: Certain chemicals in the brain, called neurotransmitters, help messages travel from one brain cell to the next. It is thought impairment in this transport system may cause some mental illnesses.

SUBSTANCE ABUSE: People with Schizophrenia have a high rate of substance abuse such as alcohol, marijuana, amphetamines (speed) and LSD. It is not known whether these substances cause Schizophrenia, or if the disease leads people to use substances as a means of coping.

STRESS: Traumatic life events often occur in people with Schizophrenia before their symptoms become obvious. However, as with substance abuse, it is not clear whether emotional stress is a cause or a symptom of Schizophrenia.

SIGNS AND SYMPTOMS

-Delusions (false beliefs). The person may believe others are plotting against them or intending to harm them. They may think words from television, books, newspapers or songs are directed at them. Some believe others can read their mind, or that their thoughts are being transmitted, or that others are planting thoughts into their head from outside.
-Hallucinations. A hallucination is when the person experiences a sensation that is not actually there. Auditory hallucinations ("hearing voices") are most common in Schizophrenia. The "voices" in the person's head may be directing him or her to perform some behaviour, or may be criticising or abusing them. Seeing, feeling, tasting or smelling imaginary things may also occur.
-Thought disorder. Speech is rambling or incoherent and the person may jump from one subject to another with no logical connection. Bizarre behaviour may occur, including childlike silliness, agitation and poor hygiene.
-Blunted emotions. The person's face may appear immobile, with poor eye contact and lack of expression. They do not react normally to their surroundings.
-Poverty of speech. The person does not talk, or gives one-word replies to queries. They appear to be "empty" inside.
-Decreased pleasure (called anhedonia). The person does not enjoy activities they used to enjoy. They become withdrawn and show a lack of interest in relationships.

TREATMENT OPTIONS

There is no known cure for Schizophrenia, but with careful management the condition can be controlled in many people. About one third of patients will achieve significant and lasting improvement; one third will have occasional relapses and mild disability; and one third will be severely and permanently incapacitated.

Treatment involves a combination of medication and therapy. A team of psychiatrists, mental health nurses, social workers, occupational therapists and psychologists will be required to determine the needs of the patient.

Anti-psychotic medication greatly reduces the severity of symptoms and helps the person function at the highest level possible. The patient will need to be closely monitored by their Doctor when they commence medication. Some anti-psychotic drugs may not be effective for certain people, while others are associated with side effects. These problems can be addressed by altering the dose or changing to a different medication. In many cases the person will need to remain on the medication for life.

Therapy or counselling is used to help the person develop better ways of coping with their symptoms. Therapy may be performed in individual, group or family settings, usually a combination of all three.

PREVENTION

There is no known prevention for Schizophrenia. However, the following tips may help reduce the severity of the disease.
-Prodromal (pre-illness) symptoms such as odd behaviour, moodiness and social withdrawal may exist for up to a year before Schizophrenia is diagnosed. Early recognition and treatment of these symptoms can prevent a psychotic episode from occurring and may slow the progression of the illness.
-Avoid alcohol and illicit drugs, which may worsen symptoms. Schizophrenia is associated with a high rate of substance abuse.
-Quit smoking. Smoking increases the severity of symptoms and can interact with some antipsychotic medications.

PHARMACIST'S ADVICE

1) If you suspect that you or someone you are concerned about is suffering from Schizophrenia, or another type or mental illness, ask your Pharmacist to refer you to a Doctor or the local community mental health centre for more information and support.
2) Your Pharmacist can help you if you have queries about any medication you are taking. Ask about the correct dosage and what side effects to look for.
3) Anti-smoking products can help reduce cravings if you are trying to quit. Ask your Pharmacist about nicotine replacement therapy.
4) Gentle exercise may help reduce stress. Many Pharmacies supply exercise equipment for hire or sale.

DISCLAIMER: The above information is an educational aid only. It is not intended to replace medical advice for individual conditions or treatments. Talk to your doctor, pharmacist, nurse or naturopath before following any medical regimen to see whether it is safe and effective for you.