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Johns Hopkins Symptoms and Remedies

Johns Hopkins Medicine

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Schizophrenia

What is it?

Schizophrenia is a serious chronic mental disorder characterized by abnormal sensory experiences, such as hallucinations and delusions, that are called psychotic symptoms.Other symptoms include rambling speech, impaired thinking, flat affect, and poor social functioning. The word "schizophrenia" means "split mind" and refers to the loss of reality that sometimes occurs. The onset of schizophrenia can be sudden (days, weeks, or months), but it usually develops slowly over the course of several years. Typically affecting about 1 percent of the general population, the peak onset in males is between the ages of 15 and 25; in females, between ages 25 and 35. Schizophrenia can be divided into five subtypes: catatonic, disorganized (also known as hebephrenic), paranoid, undifferentiated, and residual. Each type has its own set of characteristics, in addition to the general symptoms of schizophrenia. Proper treatment and support enables 50 to 75 percent of people to be productive. About 25 percent of people with schizophrenia, however, have a poor prognosis. They are unable to hold a job or live independently. Suicide attempts and episodes of depression are common during the course of the illness.

What Causes It?

The cause of schizophrenia is unknown. However, experts believe it is linked to genetic as well as environmental factors, including: * Complications before, during, and after birth (such as blood type incompatibilities, nutritional deficiency, and the flu). * Certain types of brain damage (such as tumors or epilepsy). * Drugs such as alcohol and cocaine occasionally induce schizophrenia-like episodes.

Prevention

  • There is no known way to prevent schizophrenia, but relapses can be prevented through the use of antipsychotic medications.

Diagnosis

  • Physical examination and patient history by a mental health professional are necessary.
  • Depression and bipolar disorder should be ruled out (see Depression and Bipolar Disorder for more information).
  • Laboratory tests may be done to rule out some underlying cause of symptoms, such as an adverse drug reaction or another medical condition (such as seizures, a brain tumor, Huntington's disease, or Alzheimer's disease).

How to Treat It

  • Antipsychotic drugs, such as quetiapine, risperidone, and olanzapine are typically prescribed. These drugs, while effective, can have serious side effects, such as tardive dyskinesia (involuntary movements of the jaw, lips, tongue, and body). If the first-line antipsychotic medications prove ineffective, your doctor may prescribe clozapine. This drug requires frequent monitoring by a doctor as it may lead to seizures and low white blood cell counts. Your doctor will administer weekly blood tests to measure white cell levels.
  • Psychotherapy is an important part of the treatment of schizophrenia and any mental illness.
  • Occupational rehabilitation and training help restore function.
  • Community and familial support, in addition to medication, may help the individual to be productive in society and increase the time between relapses.
  • Hospitalization may be necessary for severe episodes.

When to Call a Doctor

  • New or worsening symptoms of schizophrenia always warrant contacting a physician or mental health professional.