There are about 24 million people with schizophrenia globally. The disease has many symptoms and theories of its occurrence, but fortunately, in some cases, it is treatable. Today’s article attempts to explain in simple words: schizophrenia – what it is, what its causes are, what its symptoms are, and whether the disease is treatable.
What is schizophrenia?
Schizophrenia or schizophrenic personality disorder is a severe chronic mental illness. According to the World Health Organization, more than 20 million people are diagnosed with it.
From ancient Greek, the term can be translated as “split mind. The disease has been known for a long time. Found even a few centuries before our era, the first descriptions of symptoms characteristic of schizophrenia
in the treatise of Ebers. The Swiss psychiatrist Eugen Bleuler distinguished it as an independent disease in 1908. Since then, the symptoms of the disorder, its classification, and treatment methods have undergone many changes. The essence of the diagnosis remains the same: the individual’s perceptions of the world, thinking and behavior are affected.
Important! Schizophrenia is less common than other mental disorders. At the same time, such patients have a 2-3 times higher risk of mortality than other people. It is due to physical pathologies, which, as a rule, go together with the primary diagnosis.
Causes of schizophrenia
It is difficult to understand what causes schizophrenia. This question has been a complex one for many years. Scientists have struggled to find a consensus. It is currently not possible to contract the disease during your lifetime. It is not possible to get it. Schizophrenia can be considered an endogenous disease, meaning that its causes are internal and not dependent on external factors.
There are several theories of the development of schizophrenia:
- Infectious – when the disruption occurs in the early stages of fetal development. According to this assumption, the disease is caused by viruses, infections, and even maternal antibodies. All of these pathogens can provoke a failure in the formation of the nervous system.
- Hereditary – science has found over a hundred genes that may provoke the development of the disease. Many of these are linked to the autoimmune system. The risk of developing schizophrenia increases by 40% if there is a family member with the same diagnosis.
- Neurophysiological – the theory suggesting that people with schizophrenia have pronounced changes in the structure and function of nervous tissues
- Neurotransmitter theory is based on the idea that due to a disturbance on cell membranes, receptors cannot perceive dopamine, the hormone of joy.
- Various psychological theories – for example, schizophrenia appears because of the features of upbringing or the formation of the self.
Other theories about the development of the disease are a thing of the past.
Research on where schizophrenia comes from is still going on. Specialists study the influence of various factors on the body to understand their involvement. So far, genetics “leads the way.” It has already been established that the risk of inheriting the disease is relatively high and varies between 70-85%. Scientists are inclined to believe that the risk of inheriting the disease is relatively high, ranging from 70 to 85%. Scientists are inclined to believe that the cause of schizophrenia lies in a combination of several factors.
It is equally essential for science to understand whether there is a connection between the diagnosis and the environment. Now experts have established that the prefrontal area of the frontal and temporal lobe of the brain is most severely affected by the disorder. According to research, the thalamus, hippocampus, and cerebellum are involved.
Another risk factor is a predisposition, the so-called schizophrenic diathesis, which about 40% of the population has. Stress works in conjunction with it. He is the one who can cause the manifestation of the illness.
Among other triggering factors, doctors highlight:
- Drug use;
- High levels of stress, or very prolonged stress;
- Pregnancy and childbirth.
Symptoms of schizophrenia
Signs of schizophrenia can be completely different and are often perceived as a typical human oddity. The clinical picture is indeed very diverse. In most cases, it begins to make itself felt after the age of 12, intensifying with age.
The symptoms of schizophrenia are divided into positive and negative symptoms. The former do not manifest themselves in any way in a healthy person:
- Illogical, incoherent verbosity that carries no ideas or goals.
Negative symptoms include:
- Decreased social activity;
- Emotional poverty;
- Conduct disorder, manifested by confused thinking, failures in memory and speech, and reaction speed;
- Changes in the level and quality of social interaction
The clinical picture sometimes resembles a seizure: symptoms last from several days to several months, after which there is a period of health when the person behaves as usual.
Early signs of schizophrenia
Psychiatrists understand that the sooner the diagnosis is made, the sooner the patient can receive the necessary treatment. Schizophrenia is no exception, so experts have identified the first signs of the disease:
Self-isolation from the outside world – A person with schizophrenia can stop contact with the outside world even when he is relatively friendly. He will strive for solitude even from friends and relatives. At the same time, he can hardly explain the reasons for his behavior. The desire for loneliness will become so strong that studies, work, and hobbies will be left aside.
Personal care – Another characteristic sign of an upcoming attack is indifference to one’s appearance. Compliance with hygiene standards may not be respected or significantly stretched over time. People with schizophrenic personality disorder find it difficult to perform simple activities—brushing their teeth, washing their face, taking a shower or bath—so the process takes longer. True, one should not draw hasty conclusions here. Similar manifestations are sometimes caused by ordinary depression.
Sudden religious enthusiasm and fascination with mysticism – People with schizophrenia may become obsessed with occultism, aliens, and esotericism.
Common symptoms include involuntary, sudden jerky movements of your arms, legs, or body. The facial expressions on the patient’s face become very active, nervous, and torn. True, if it was such before, then schizophrenia has nothing to do with it.
Hallucinations – A mental disorder has a direct impact on all the feelings and sensations of a person. The most common phenomenon is auditory hallucinations. People hear a voice or many voices that can order something to be done or “discuss” some things. Here, the disunity of thinking is actively manifested – a person realizes the voices of others but cannot always resist them.
It seemed to the 27-year-old patient that she had superpowers – she began to hear the thoughts of others. At first, the girl was amused, but then the situation began to get out of control. She could not move away from the hum of various voices, moreover, there was a fear that someone was reading her thoughts too. In the end, the situation developed until the moment when the girl at the exam began to justify her forgotten knowledge of the materials with her brain taken out of her head.
Schizophrenia in men
The disease appears earlier in men, about 18-25 years old, than in women. It occurs in a more severe form. Combinations of symptoms can be very diverse. Productive signs here are as follows: the man feels he is being controlled; someone constantly pursues him; those around him ridicule or condemn him. There may also be auditory hallucinations, which can make the man dangerous to himself and others. Negative signs include a lack of positive emotions, apathy, indifference, withdrawal into the inner realm, simultaneous feelings of polar emotions – sadness, joy, and absence of coherent thought.
Schizophrenia in women
The first signs of female schizophrenia are usually associated with obsessive unfounded fears and strange rituals. She may complain of absurd illnesses, describing them in detail. The lady’s behavior aims to draw attention to herself as much as possible and does not always conform to generally accepted norms.
Productive symptoms are voices capable of ordering, insulting, or praising. Delusions of being stalked and controlled; Unsupported intense jealousy, strange arguments about one’s appearance, dissatisfaction.
Negative signs of schizophrenia in women include loss of interest, inability to feel intense emotions, confusion, illogical thinking, and inability to care for family and friends.
Pathogenesis of the disease
The course of the disease consists in part of two types of disorders:
1. Neurochemical disorders
It is a question of a lack of balance among the substances that carry nerve impulses in synapses:
- Dopamine. It is considered to have the most substantial influence on the pathogenesis of the disease. Its overabundance promotes productive symptoms, and its deficiency promotes negative ones.
- Serotonin. There is an opinion that blocking specific receptors helps to reduce the manifestation of negative symptoms.
- Glutamate. Presumably, if there is a malfunction in the function of NMDA receptors, the balance of dopamine will be affected. The glutamate system is also essential in the development of neuronal pathways. Disorders here can upset the development of the central nervous system during puberty.
2. Structural changes in the brain
Abnormalities in the brain’s structure in schizophrenic personality disorder are usually diverse. For example:
- Enlargement of the lateral ventricles;
- Reduction of gray matter volume in temporal, frontal, parietal lobes, and limbic system structures;
- Reduction of white matter;
- Abnormalities of cerebral conductive pathways.
However, the effect of structural abnormalities is so tiny that it is not enough to make a diagnosis. Scientists are now paying much more attention to dysontogenesis – a failure in the development of the nervous system in the prenatal period and early childhood.
According to studies, babies who subsequently had schizophrenia had delayed motor and behavioral skills. It has also been noticed that specific structural changes in the brain appear much earlier than the disease.
Plus, there are similar phenomena in relatives of people with schizophrenia. It indicates the heredity of the disorder and possible external influence.
Another thing attributed to pathogenesis is the “double blow theory.” It is interpreted as follows:
- The first blow is “stuck” in early childhood, i.e., before three. At this time, minimal brain damage is already present;
- The second stroke begins in adolescence due to age-related brain changes.
The diagnosis of schizophrenia can be found in two systems: the international system and the DSM-V, which is used more by American specialists. In the latter, the division of the disorder into forms no longer exists—globally, doctors act according to ICD-10.
Types of schizophrenia
Four types of schizophrenia are distinguished:
- Paranoid – The most common. Patients are delusional and often see or hear hallucinations. Other symptoms are mild or absent.
- Hebephrenic – Here, the main symptoms consist of bizarre, mannerly, and often unpredictable behavior. Frequent mood swings and lack of logic in actions and thoughts are possible. Productive symptoms are mild.
- Catatonic – Tied to vivid fluctuations between intense motor excitement and complete stupor. Seizures alternate and states may alternate sharply.
- Simple type – There is no delirium, hallucinations, or motor activity. It is characterised by autism, momentary polarity, loss of control over emotions and inability to respond appropriately to different situations. It severely affects daily interactions with others. In most cases, the disorder is sluggish.
Subtypes of schizophrenia
Doctors distinguish two subtypes of the disease:
- Deficient – when negative signs come to the fore;
- Non-deficit, when positive signs predominate.
Special types of schizophrenia
There are two particular types of schizophrenia that psychiatrists distinguish.
- Febrile (lethal catatonia) is a relatively rare condition requiring urgent medical attention. It is characterized by a catatonic manifestation, i.e., sudden stupor, sudden aggression, etc. Also among the accompanying signs: are fever and swelling of the brain.
- A prolonged puberty attack – develops in adolescence and manifests as neurosis, psychopathy, delusions, and excessive fascination with philosophy. The child often behaves inadequately and tries to assert himself.
Manifestation of illness refers to the most pronounced symptoms of some diagnosis. In the case of schizophrenia, they can be divided into those that come before and during development.
The symptomatology of the disease before:
- Strange hobbies and hobbies;
- Unusual behavior;
- Focus on his inner world, avoidance of communication and public events;
- Inertness and passivity;
- Extreme interest in religion, philosophy, and esoterics;
- Lack of friends and relationships with the opposite sex.
During the illness, the person may be tormented by:
- Severe fatigue;
- Back and muscle pain;
- Gastrointestinal problems.
As a rule, at this time, a person is less able to work and cope with everyday life.
Stages of the disease
Among other things, schizophrenia is divided into stages. There are six of them:
- Premorbid – when a person has personality and behavioral traits characteristic of people with schizophrenia. They manifest themselves long before the seizures and look simply as individual features. For example, this may include reticence, unwillingness to stand out against the background of the others, etc.
- Prodromal – the time when a person complains about some ailments.
- Psychosis (acute) – a period of exacerbation of schizophrenia when an acute psychotic disorder develops.
- Residual – a stage of remission between periods of exacerbations. If schizophrenia proceeds without interruption, there can be no remission.
- Relapse is when symptoms return.
Psychiatrists divide the symptoms of childhood schizophrenia by age:
- Pre-school – With initial negative symptoms of the disease. It manifests through a decreased need for play and communication, passivity, and an inability to reproduce vivid emotions. As the child grows older, productive symptoms join. Schizophrenia at this time can develop into severe forms of illness in a short time.
- Junior School – The disease is almost invisible to others, as it proceeds smoothly and without vivid attacks. Children gradually withdraw into themselves, stop communicating with classmates and family, are often afraid of something, and have strange, unusual fantasies.
- Teenage – It almost always runs the same way as in adults. It can manifest as dissatisfaction with one’s appearance, imaginary cosmetic body problems, intense immersion in the world of philosophy and esoteric sciences, and a rapid transition from a normal state to a “child” state. All this happens, as a rule, abruptly, suddenly.
Note! Statistically, schizophrenia occurs more often in boys than in girls.
Complications of schizophrenia
Schizophrenia is not just bizarre behavior; it is a whole set of problems from which a person suffers. Typically, they manifest as:
- Sleep and eating disorders;
- Headaches, sometimes very severe;
- Irritability, up to aggressiveness;
- Obsessive thoughts and ideas may physically harm the patient and others around him. The person becomes dangerous;
- An increased risk of disability;
- Cardiovascular disease and cancer.
Diagnosis of the Schizophrenia
As with any illness, you are being diagnosed as early as possible is essential. However, there is no specific test for schizophrenia. The diagnosis is made based on a comprehensive examination.
Information is gathered from the patient, his loved ones, and his surroundings. According to the American scale, a diagnosis requires:
- Manifestation of more than two specific symptoms in six months: delusions and hallucinations, bad behavior, etc.;
- The prodromal stage is a period of diminished symptoms that affect work, communication, and one’s ability to care for yourself. It is recommended to consider six months with at least one month of active symptoms.
It is formed from data from medical history, tests, and neuroimaging—It is essential. The doctor must rule out other symptom-similar diagnoses.
Go to the doctor as soon as you notice the disease in yourself or a loved one. No preparation for the visit is necessary. The doctor will interview you and use diagnostic tests and scales.
There is no single standard for scales to define schizophrenia. Psychiatrists use the most popular scales:
- Positive and negative symptom assessment (PANNS);
- Brief Assessment of Negative Symptoms Scale (BNNS);
- Calgary depression in patients with schizophrenia;
- Personality and social functioning (PSP).
Specialists may also administer the MMPI, Schulte Tables, memory tests, “fourth-alone,” pictographs, and the Lusher Test.
Treatment of Schizophrenia
It is not possible to cure schizophrenia once and for all. However, it is possible to help the patient adapt to society as much as possible and make them safe for themself and their surroundings. Therefore, the treatment objectives are as follows:
- To establish the patient’s interaction with the outside world;
- To increase his level of social abilities and functions;
- To form a person’s trust in the treatment;
- To increase the quality of life;
- To reduce the number of exacerbations.
The severity of the disease and its symptoms determine which drug therapy is chosen. It is first intended to alleviate an exacerbation, and stabilize the patient’s mental health. Subsequently, the task of medication is to maintain the improvement achieved and prevent relapses.
Non-drug therapies are electroconvulsive therapy (ECT) and transcranial magnetic stimulation (TMS). They are required when medication does not work.
Scientists have concluded that several factors can improve the prognosis for schizophrenia, regardless of species. These are:
- Female gender;
- Acute onset of the disease versus a long-standing, ongoing process;
- Manifestation appears quite late;
- The predominance of positive symptomatology;
- In the initial phase of the disease, there was a high level of personal autonomy and social functioning.
Among other things, society’s attitude toward such patients is essential. It is necessary to help people with schizophrenia to integrate into everyday life and develop their creative potential, which, by the way, they have pretty great, thanks to their non-standard thinking.
Because of the impossibility of unequivocally answering the question about the causes of the disease, it is impossible to develop preventive measures at the moment. The most that can be done is to find out if there were people with schizophrenia in your family. If yes, then the propensity for the disorder increases.
Recommendations for interacting with patients with schizophrenia
The actions of loved ones play an important role in treating the person and maintaining their results. Therefore, it is necessary to:
- Observe the person, and seek medical attention when symptoms appear;
- Observe all doctor’s prescriptions and monitor the timely administration of prescribed medications;
- Motivate the patient for successful treatment;
Monitor the patient’s daily routine, diet, and bad habits;
- Assist at home.
A schizophrenic episode can seriously complicate a person’s life and family. However, timely treatment can prevent severe consequences and make people’s everyday lives quite normal for years to come.