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What is Schizophrenia?

Schizophrenia is a chronic and severe mental disorder characterized by profound disruptions in thinking, emotions, behaviour, and perception of reality. It impairs the distinction between what is real and unreal, altering both thoughts and perceptions. Schizophrenia typically emerges in the late teens to mid-twenties. The lifetime prevalence rate is about 1.1% worldwide. Men tend to have earlier onset compared to women.

Schizophrenia involves a “splitting of mental functions” leading to hallucinations, delusions, disorganized thinking and speaking, abnormal motor behaviour, diminished emotional expression, lack of motivation, and impaired cognition. It limits one’s ability to function normally. People with schizophrenia often have trouble holding down jobs or caring for themselves. At its worst, schizophrenia leaves them frightened and withdrawn.

Positive and negative symptoms

Schizophrenia symptoms are categorized as positive or negative:
Positive symptoms are psychotic behaviours not seen in healthy people. These reflect an excess or distortion of normal functions. Positive symptoms include:

Schizophrenia-Hallucinations2

Hallucinations

hearing, seeing, smelling or feeling things that don’t exist.

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Schizophrenia-Delusions

Delusions

fixed, false beliefs held despite evidence to the contrary.
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Disorganized thinking-schizophrenia

Disorganized Thinking

incoherent or illogical thought patterns.
Disorganized speech-Schizophrenia

Disorganized Speech

a pattern of speech difficult to follow, jumping
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Abnormal psychomotor behaviour-Schizophrenia

Abnormal Psychomotor Behaviour

Repetitive, bizarre movements or complete immobility.

Negative symptoms represent a loss or deficiency of normal thoughts, feelings and behaviours. These include:
Avolition-Schizophrenia

Avolition

Lack of motivation, energy or interest to carry out goals.
Asociality-Schizophrenia

Asociality

Minimal interest in social interactions and relationships.
Alogia -Schizophrenia

Alogia

Reduced speech output. Replies may be brief, empty or irrelevant.
Anhedonia -Schizophrenia

Anhedonia

Inability to experience pleasure. Activities once enjoyed offer no joy.

Blunted affect -Schizophrenia

Blunted affect

Reduced ability to express emotions via facial expressions, gestures or voice.

Subtypes

There are five subtypes of schizophrenia based on predominant symptoms:

Paranoid schizophrenia-Subtypes

Paranoid Schizophrenia

Preoccupation with delusions or auditory hallucinations related

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Disorganized schizophrenia-Subtypes

Disorganized Schizophrenia

Prominence of thought and speech disorganization.

Catatonic schizophrenia-Subtypes

Catatonic Schizophrenia

Disturbances of movement ranging from total immobility
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Undifferentiated schizophrenia-Subtypes

Undifferentiated Uchizophrenia

Mixed symptoms.

Residual schizophrenia-Subtypes

Residual Schizophrenia

The presence of past positive symptoms now in remission.

Causes

Research suggests schizophrenia arises from a complex interplay of genetics, brain chemistry, neurobiology and environmental influences. Genetic inheritance seems to be the strongest risk factor. Schizophrenia has been linked to excess dopamine activity and neurotransmitter imbalances, but the exact cause remains unknown.

Diagnosis

Diagnosis is based on the documented persistence of two or more major positive symptoms, along with declining functioning, for at least six months. Schizoaffective disorder is diagnosed if a mood disorder is also present. Delusions or hallucinations from medical conditions or substance use rule out a schizophrenia diagnosis.

Treatments

Schizophrenia-treatment
Schizophrenia requires lifelong treatment. Medications like antipsychotics treat positive symptoms. Psychosocial interventions like cognitive behavioural therapy and social skills training treat negative symptoms and improve functioning. Community support services and vocational rehabilitation enable greater independence. With comprehensive treatment, the disorder can be managed, though outcomes vary.

Schizophrenia remains a profound mystery in many ways. However, greater awareness and compassion for those struggling with it can make a meaningful difference in their lives. Ongoing research brings hope for better understanding and care for this complex, life-altering condition.