Misunderstood. Feared. Stigmatized. Individuals diagnosed with schizophrenia regularly battle derogatory stereotypes. The media portrays those with schizophrenia as crazy, suffering from split personalities, or as deranged killers that commit mass murders. Others use the term “schizophrenic” to describe erratic weather patterns. But the psychiatric illness that is schizophrenia is none of this. Schizophrenia is a disabling brain disorder that impacts about 1% of the adult population.
The DSM-5 Criteria: Schizophrenia
Presence of 2 or more of the following symptoms
- Delusions – fixed, false beliefs)
- Hallucinations – auditory, visual, olfactory
- Disorganized speech – speech/thought processing that is difficult to follow
- Disorganized or catatonic behavior – catatonia is a syndrome characterized by abnormal movements and behavior such as mutism (absence of speech), withdrawal, waxy flexibility (maintaining body position for prolonged periods of time after individual is placed into that position by someone else), echolalia (repeating words of others), echopraxia (repeating movements of others), negativism (refusal to comply with the request of others), or overexcitability
- Negative symptoms – minimal facial expressions, lack of will/motivation
Symptoms negatively impact level of functioning with respect to work, interpersonal relations, and/or self-care
Continuous signs of the disturbance persist for at least 6 months with at least 1 month of active symptoms
What to Know
1) Psychosis or loss of touch with reality is the halllmark of schizophrenia and other psychotic disorders. Psychosis includes hallucinations, delusions, and disorganized speech and behaviors. These symptoms are also referred to as the positive symptoms of schizophrenia.
2) Just as there are the positive symptoms of schizophrenia, there are also the negative symptoms. Negative symptoms especially impact social interactions and include behaviors such as flat affect (lack of or blunted facial expressions), amotivation (lack of desire or will), poverty of speech (little conversation with others), and lack of pleasure or interest in things.
3) individuals diagnosed with schizophrenia also experience impaired cognition. People typically have difficulty with attention and concentration, very poor insight and utter lack of awareness of psychiatric illness called anosognosia, and impaired executive functioning which refers to the skills necessary to manage thoughts, feelings, and behaviors and complete tasks (planning, organizing, prioritizing, regulating emotions).
4) While there is no cure, schizophrenia is a treatable disease. The mainstay of treatment is antipsychotic medications which are taken orally or through long-acting injections. Psychotropic medications help individuals manage their symptoms. Non-medication treatment options include individual therapy, family therapy, support groups, psychoeducation, and day treatment programs.
5) Schizophrenia occurs almost equally in men and women and across all racial and ethnic groups. Men typically experience symptoms in their late teens and early 20s while women may not manifest symptoms until their late 20s or 30s.
6) There is no single cause of schizophrenia. Certain brain chemicals called neurotransmitters have been implicated in the etiology of schizophrenia – glutamate, dopamine.
7) There are no specific laboratory tests used to diagnose schizophrenia. Commonly, a psychiatrist, a physician specializing in the evaluation and treatment of mental disorders, makes the diagnosis of schizophrenia through a combination of clinical history taking/review of psychiatric symptoms, mental status examination, and ruling out possibility of medical causes that might mimic schizophrenia through laboratory studies or brain imaging (head CT, MRI, and/or electroencephalogram or EEG).
8) Risk factors for schizophrenia include family history, being born during the winter months, substance use, trauma or other adverse childhood events, or maternal complications or illness during pregnancy or birth such as malnutrition or contracting the influenza virus.
9) The overwhelming majority of individuals with schizophrenia are not violent or dangerous. Rather, they are at much greater risk of being the victim of violent crime instead of the perpetrator.
10) People diagnosed with schizophrenia have higher rates of morbidity (sickness) and mortality (death). They die 28.5 years earlier than the general adult population, in part attributable to higher rates of cardiovascular disease, deaths from accidents, and deaths from suicide. 10% – 15% of adults with schizophrenia have committed suicide.