What is Schizophrenia

Schizophrenia or schizophrenic personality disorder is a serious chronic mental illness. According to the World Health Organization, more than 20 million people have this diagnosis.

From the ancient Greek language, the term can be translated as “split the mind.” The disease has been known for a long time. Even a few centuries before our era, the first descriptions of the symptoms characteristic of schizophrenia were found in the treatise of Ebers. As an independent disease, it was identified in 1908 by the Swiss psychiatrist Eugen Bleuler. Since then, the symptoms of the disorder, its classification, and treatment methods have changed many times, but the essence of the diagnosis has remained unchanged – a person’s perception of the world, thinking and behavior are disturbing.

Important! Schizophrenia is less common than other mental disorders. However, in such patients the risk of mortality is 2-3 times higher than in other people. This is due to physical pathologies, which, as a rule, go along with the main diagnosis.
Schizophrenia

Causes of Schizophrenia

What causes schizophrenia is a complex question. Scientists have been trying to understand this issue for a long time, but so far they have not come to a consensus. At the moment, it is known for sure that it is impossible to acquire a disease in the process of life. Just like you can’t get infected. Schizophrenia is considered an endogenous pathology, i.e. its causes are within the psyche and do not depend on any external factors.

There are several theories for the development of schizophrenia:

Infectious – When failure occurs in the early stages of fetal development. According to this assumption, the disease is caused by various viruses, infections, and even maternal antibodies that have appeared due to them. All these pathogens can cause malfunctions in the formation of the nervous system.

Hereditary – Science has been able to find over a hundred genes that can provoke the development of the disease. Most of them are related to the autoimmune system. It is also known that if there are people in the family with the appropriate diagnosis, then the risk of getting schizophrenia reaches 40%.

Neurophysiological – Theory suggests that schizophrenics have pronounced changes in the structure and function of nerve tissues

Neurotransmitter – A theory based on the idea that due to a violation of cell membranes, receptors cannot perceive dopamine – the hormone of joy

Various psychological theories – For example, schizophrenia appears due to the peculiarities of upbringing or in the formation of one’s own “I”.

Other theories of the development of the disease are already in the past.

 

Schizophrenia Risk factors

Research on the origin of schizophrenia is still ongoing. Specialists study the influence of various factors on the body in order to understand their involvement. So far, against the background of the rest, genetics is “leading”. It has already been established that the risk of inheriting the disease is quite high and varies between 70-85%. Moreover, a specific gene responsible for this mental disorder has not been found. Scientists are inclined to believe that the cause of schizophrenia lies in the combination of several factors at once.

It is equally important for science to understand whether there is a connection between diagnosis and ecology. Now experts have been able to establish that the prefrontal region of the frontal and temporal lobes of the brain is most severely affected by the disorder. According to research, the thalamus, hippocampus and cerebellum are involved in the process.

Another risk factor is a predisposition, the so-called schizophrenic diathesis, which is present in approximately 40% of the population. Stress is associated with it. It is he who can give impetus to the manifestation of the disease.

Among other provoking factors, doctors distinguish:

  • Drug use;
  • Severe stress or very long;
  • Pregnancy and childbirth.

 

Symptoms of Schizophrenia

The signs of schizophrenia can be completely different and are often perceived as ordinary human eccentricity. The clinical picture is indeed very diverse. In most cases, it begins to make itself felt after 12 years, intensifying with age.

The symptoms of schizophrenia are divided into positive and negative. The first does not appear in a healthy person:

  • Rave;
  • Hallucinations;
  • Illogical, incoherent verbosity that does not carry any ideas and goals.

Negative symptoms include:

  • Decrease in social activity;
  • Apathy;
  • Emotional poverty;
  • Behavioral disturbance, manifested in confused thinking, failures in memory and speech, as well as reaction speed;
  • Change in the level of communication.

The clinical picture sometimes resembles an attack: the symptoms last from several days to several months, after which a period of health begins 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 schizophrenic is able to completely stop contact with the outside world even when he was a fairly sociable person. 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 own appearance. Compliance with hygiene standards may not be respected in principle, or it may be greatly 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 tends to take longer. True, one should not draw hasty conclusions here. Similar manifestations are sometimes caused by ordinary depression.

Sudden religiosity and fascination with mysticism – People diagnosed with schizophrenia are prone to extremes and may suddenly become very religious or fanatical about esotericism, mysticism, the occult, or aliens.

jerky movements – Sudden involuntary jerky movements of the arms, legs, or tremors in the body a symptom that occurs quite often. 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 simply “discuss” some things. Here, the disunity of thinking is actively manifested – a person realizes the voices of others, but cannot always resist them.

Example

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

In men, the disease manifests itself earlier than in women, at about 18-25 years. It takes on a more severe form. The combination of symptoms can be very diverse. The productive signs here are as follows: it seems to the man that he is being controlled; someone is constantly chasing him; those around him ridicule or condemn him. There may also be auditory hallucinations, due to which a person can become dangerous to himself and others. Negative signs: lack of positive emotions, the occurrence of apathy and indifference; withdrawal into the inner world; simultaneous sensation of polar feelings – sadness and joy; lack of coherent thoughts.

 

Schizophrenia in women

The first signs of female schizophrenia are associated, as a rule, with obsessive unfounded fears and strange rituals. She can complain about absurd diseases, and describe them in detail. The behavior of the lady is aimed at attracting attention to herself as much as possible and does not always correspond to generally accepted standards.

Productive symptoms: voices capable of ordering, insulting, or, conversely, praising. Delusional thoughts about being chased and being controlled; unsupported strong jealousy; strange reasoning about one’s own appearance, dissatisfaction with it.

Negative symptoms of schizophrenia in women: loss of interest in family, relatives, everyday life; inability to experience strong emotions; confused and illogical thinking.

 

Thinking and perception of a schizophrenic

Mental disorders of a patient with schizophrenia in most cases are associated with two concepts: delusions and hallucinations.

Delusions are his thoughts, and beliefs that have nothing to do with reality. This includes persecution mania, a sense of one’s own exclusivity, and the prediction of some kind of emergency.

Hallucinations are what a person perceives through the senses: visions, voices, and smells.

Important! To make a definitive diagnosis, it is necessary that the clinic manifest itself for at least six months.

Schizophrenia pathogenesis

The course of the disease partly consists of two types of disorders:

1. Neurochemical disorders

We are talking about the lack of balance among the substances that carry nerve impulses in synapses:

  • Dopamine. It is believed that it has the strongest effect on the pathogenesis of the disease. Its excess contributes to the development of productive symptoms, and its deficiency – is negative.
  • Serotonin. It is believed that blocking certain receptors helps to reduce the manifestation of negative symptoms.
  • Glutamate. Presumably, if there is a malfunction in the function of NMDA receptors, then this will affect the balance of dopamine. The glutamate system is also important in the development of neuronal pathways. Violations here can upset the process of development of the central nervous system at puberty.

2. Structural changes in the brain

Deviations in the structure of the brain in schizophrenic personality disorder, as a rule, are diverse. For example:

  • Expansion of the lateral ventricles;
  • A decrease in the volume of gray matter in the temporal, frontal, parietal lobes, and structures of the limbic system;
  • Decrease in white matter;
  • Violations of the conduction pathways of the brain.

However, the effect of structural disorders is so small that they are not enough to make a diagnosis. Scientists are now giving much more importance to dysontogenesis – a failure in the development of the nervous system in the prenatal period and early childhood.

According to studies, babies who later suffered from schizophrenia had a delay in motor and behavioral skills. It has also been observed that certain structural changes in the brain appear much earlier than the disease itself.

Plus, relatives of schizophrenics have similar phenomena. This indicates the heredity of the disorder and a possible external influence.

The “double strike theory” is also attributed to pathogenesis. It is interpreted as follows:

  • The first blow is “delivered” in early childhood, that is, before the age of three. At this time, there are already minimal brain disorders;
  • The second stroke begins in adolescents due to age-related changes in the brain.

 

Types of schizophrenia

Experts in the field of psychiatry say that in order to understand the essence of the disease, to prescribe treatment, it is necessary to identify the form, the symptoms. There are five types:

  1. Paranoid schizophrenia . The most common type. It is characterized by auditory and olfactory hallucinations, delirium, altered behavior, weak expressiveness of emotions (flattened affect);
  2. Hebephrenic schizophrenia . It is more common in adolescence and adolescence. The disorganized form is accompanied by emotional flattening, disorder of thinking. Treatment is carried out for life;
  3. Catatonic schizophrenia . A rare type of disease. It is diagnosed in about 3% of patients. Accompanied by psychomotor disorders. Patients are characterized by slow speech, lack of facial expressions, stupor, agitation;
  4. Undifferentiated schizophrenia . This type is characterized by symptoms that do not fit into the clinical picture of any of the types listed above;
  5. Residual schizophrenia . A residual form of the disease in which the patient has mild symptoms.

Doctors also distinguish between simple schizophrenia and post-schizophrenic depression. The first type is manifested by the gradual development of negative symptoms. There are no acute psychoses. The second type (post-schizophrenic depression) is characterized by prolonged depressive symptoms. Decreased mental and physical activity, performance. It occurs in about 25% of patients. As the disorder intensifies, the symptoms of each type increase. In most cases, the diagnosis of schizophrenia is made already when the disease is running.

 

Subtypes of schizophrenia

Doctors distinguish two subtypes of the disease:

  • Deficient – when negative signs come to the fore;
  • Non-deficient – when positive signs predominate.

 

Manifestation of schizophrenia

The manifestation of the disease means the most pronounced symptoms of a diagnosis. In the case of schizophrenia, they can be divided into those that come before and during development.

Symptoms of the disease before:

  • Strange hobbies and hobbies;
  • Unusual behavior;
  • Focus on your inner world, avoiding communication and mass events;
  • Inertia and passivity;
  • Extreme interest in religion, philosophy, and esotericism;
  • Lack of friends and relationships with the opposite sex.

During an illness, a person can be tormented by:

  • Headaches;
  • Severe fatigue;
  • Back and muscle pain;
  • Weakness;
  • Problems with the gastrointestinal tract.

As a rule, at this time a person works worse and copes with everyday life.

 

Childhood Schizophrenia

Psychiatrists divide the manifestations of childhood schizophrenia by age:

Preschool – With initial negative symptoms of the disease. This is manifested through a decrease in the need for games and communication, passivity, and the inability to reproduce vivid emotions. When the child grows up, productive symptoms join. Schizophrenia at this time can develop into severe forms of the disease in a short time.

Junior classes – The disease is almost imperceptible to others because it proceeds smoothly and without bright attacks. Children gradually withdraw into themselves, stop contacting their classmates and family, are often afraid of something, and give out strange, previously unusual fantasies.

Teenage – Almost always it proceeds in the same way as in adults. This can manifest itself in the form of dissatisfaction with one’s appearance, fictitious cosmetic problems of the body, a strong 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, sharply, suddenly.

Note! According to statistics, schizophrenia is more common in boys than in girls.

Complications of Schizophrenia

Schizophrenia is not just strange behavior, it is a whole complex of problems that a person suffers from. As a rule, they appear in the form:

  • Sleep and eating disorders;
  • Headaches, sometimes very strong;
  • Irritability, up to aggressiveness;
  • Obsessive thoughts and ideas, from which both the patient himself and the people around him can physically suffer. The person becomes dangerous;
  • Increased risk of disability;
  • Cardiovascular and oncological diseases.

 

Diagnosis of the Schizophrenia

As with any disease, it is important to diagnose it as early as possible. However, there is no specific analysis to test for schizophrenia. The diagnosis is made on the basis of a comprehensive study.

Information is collected from the patient himself, his relatives, and the environment. According to the American scale, the diagnosis requires:

  • Manifestation of more than two long-term specific symptoms within six months: delirium, hallucinations, inappropriate behavior, etc.
  • The prodromal stage of schizophrenia or the weakening of the signs of the disease that affect work, communication with people, and the possibility of self-care. A period of six months is considered, of which at least one month should have active symptoms.

 

Differential Diagnosis of the Schizophrenia

It is formed from the data of the medical history, tests, and neuroimaging. It is important. The doctor should exclude other diagnoses that are similar in symptoms.

You need to see a doctor as soon as you notice signs of illness in yourself or in loved ones. No preparation for the visit is required. The doctor will conduct a survey and use diagnostic tests and scales.

 

Treatment of Schizophrenia

There is no cure for schizophrenia once and for all. However, it is quite possible to help the patient to adapt as much as possible to society and make him safe for himself and the environment. Therefore, the goals of therapeutic treatment are as follows:

  • To establish the interaction of the patient with the outside world;
  • To increase the level of his social opportunities and functions;
  • Build a person’s confidence in treatment;
  • Improving the quality of life;
  • Reducing the number of exacerbations.

Drug therapy is selected according to the symptoms and severity of the disease. First of all, it is designed to relieve exacerbation and stabilize the mental state of a person. Subsequently, the task of medications is to maintain the achieved improvement and prevent relapses.

Non-drug treatments are electroconvulsive therapy (ECT) and transcranial magnetic stimulation (TMS). They are required when medicines do not help.

 

Forecast and prevention of Schizophrenia

Scientists have concluded that there are a number of factors that can improve the prognosis of schizophrenia, regardless of species. This is:

  • Female;
  • Acute onset of the disease compared with a long-term process;
  • A manifestation that appears quite late;
  • The predominance of positive symptoms;
  • A high level of social functioning and personal autonomy in the pre-initial period of the disease.

Among other things, the attitude of society towards such patients is important. It is necessary to help schizophrenics to merge into ordinary life and develop their creative potential, which, by the way, they have is quite large, thanks to non-standard thinking.

Due to the inability to unambiguously answer the question about the causes of the disease, it will not be possible to develop preventive measures at the moment. The maximum that can be done is to find out if there were people with schizophrenia in your family. If yes, then the tendency to disorder increases.

 

Recommendations for interacting with patients with schizophrenia

The actions of loved ones play an important role in the treatment of a person and maintaining the results achieved by him. Therefore it is necessary:

  • Observe the person, and if symptoms appear, consult a doctor;
  • Comply with all doctor’s prescriptions and monitor the timely intake of prescribed drugs;
  • Motivate the patient for successful treatment;
  • Monitor compliance with the daily routine, diet, and bad habits of the patient;
  • Provide assistance at home.

An attack of schizophrenia can seriously complicate the life of both the person himself and his family. However, timely treatment can save you from serious consequences and make people’s everyday life quite normal for many years.

 

FAQ

Schizophrenia can be treated in different ways, depending on the manifestations of the disease. It can be all kinds of drugs, electroconvulsive therapy, transcranial magnetic stimulation, as well as group psychotherapy sessions.
As a rule, the disease makes itself felt in adolescence and older. The final diagnosis will be made only by a doctor. But it is worth paying attention if a person suddenly becomes withdrawn, forgets about his appearance, his mood changes dramatically, outbreaks of aggression, inappropriate behavior, incoherent speech appear.
Yes, during an attack, a person goes into his own world, sees hallucinations and can say strange things that are commonly called delusions.
Scientists are not yet ready to give a definite answer, but they assign great importance to heredity. Schizophrenia cannot be contracted.
The appearance of a person can change, because he ceases to take care of himself. In addition, the patient begins to behave strangely, withdraws into himself, suddenly becomes aggressive, or vice versa, falls into a stupor. In fact, there are a lot of symptoms that make it possible to identify schizophrenia.
In severe forms of schizophrenia, a person becomes dangerous to himself and others. Need urgent hospitalization and medical attention. The outcome of the disease may be different. It is impossible to give an unambiguous answer here.
Medical treatment will be required. Most likely in a hospital setting.

 

Expert opinion

An attack of schizophrenia can seriously complicate the life of both the person himself and his family. However, timely treatment can save you from serious consequences and make people’s everyday life quite normal for many years.