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Schizophrenia is a long-term mental health problem. People with schizophrenia can have a range of symptoms including periods when they cannot tell the difference between what is real and what is imagined. Schizophrenia seriously disturbs the way people think, feel and relate to others.
About one person in 100 develops schizophrenia. Men and women are affected equally; however, men tend to have their first episode of schizophrenia in their late teens or early 20s. For women, the onset is usually a few years later. In most cases, the symptoms develop gradually. In some cases the onset is rapid.
The symptoms of schizophrenia fall into two categories—positive symptoms and negative symptoms. Positive symptoms (sometimes called psychotic symptoms) refers to behaviours and experiences of people with schizophrenia that people without schizophrenia do not have (e.g., hallucinations, delusions). Negative symptoms refers to traits that are absent or reduced in people with schizophrenia (e.g., social withdrawal, lack of motivation).
Positive symptoms
- delusions (fixed, false beliefs that are not consistent with the person's culture, and have no basis in fact)
- hallucinations (people hear, see, taste, smell or feel something that does not actually exist)
- disorganized thoughts (unconnected thoughts that make it impossible to communicate clearly with other people)
- disorganized mood (finding it hard to express feelings; feeling inappropriate or intense bursts of emotion; feeling empty of any emotions)
- disorganized behaviour (cannot complete everyday tasks such as bathing, dressing appropriately and preparing simple meals)
- changes in sensitivity (more sensitive and aware of other people; or withdrawn and seeming to pay no attention to others).
Negative symptoms
- slowing of physical activity levels or, more rarely, overactivity
- reduced motivation, for example, problems finishing tasks or making long-term plans
- loss of interest in the feelings and lives of others
- less concern for personal appearance.
No single cause has been found for schizophrenia, although there is a clear genetic link. Environmental and social factors may also be involved in the development of schizophrenia.
People with schizophrenia may be treated as outpatients or they may be hospitalized. Treatment usually consists of medication and psychosocial interventions.
Medication
Antipsychotic medications are the main class of drugs used to treat schizophrenia. They relieve symptoms of psychosis and may help to prevent relapse. Other medications may be prescribed to help manage the side-effects of antipsychotics or to treat particular symptoms, such as depression, anxiety or sleep difficulties.
Psychosocial treatment
Psychosocial treatments include:
- cognitive-behavioural therapy
- psychoeducation
- family support and education and family counselling
- social skills and life skills training.
Schizophrenia usually develops in young people during the years when they would normally develop the skills needed for independent living. A variety of programs, such as case management, academic and employment counselling and housing programs, are often used to help people develop these skills.
Recovery
It is difficult to predict how well a person will recover after the onset of schizophrenia.
- Some people only have one episode of symptoms.
- Some people have recurring episodes of symptoms. Many of these people can live independently with limited supports between episodes
- Some people will need medication and support for the rest of their lives.
Adapted from Schizophrenia: A Guide for People with Schizophrenia and Their Families © 1999 Centre for Addiction and Mental Health