Schizophrenia

Overview

Schizophrenia is a complex psychological disorder. People with schizophrenia may experience hallucinations, delusions, disorganized thinking (speech), abnormal motor skills, affective symptoms, and cognitive impairment. Schizophrenia can be debilitating, causing someone not to be able to function in everyday life. Much research has gone into understanding schizophrenia and how to treat it, but researchers are still looking into what exactly it is. 

Symptoms

Schizophrenia involves a range of symptoms that affect cognition, behavior, and emotions. Symptoms and signs vary based on a variety of factors, but they often include delusions, hallucinations, or disorganized speech.  These symptoms may negatively impact an individual’s ability to function, causing them to seek medical treatment. Schizophrenia is a condition that requires lifelong management, with a combination of medication, psychotherapy, and sometimes cognitive remediation therapy. The earlier someone with schizophrenia gets intervention, they may be likely to control symptoms before they become severe and more complicated to manage.  

Delusions are false beliefs that are not reality. Individuals with schizophrenia may have beliefs that are strange, but at the time may seem very real. Sometimes, individuals with schizophrenia may think they are being watched, someone is putting messages into their heads, or that someone is taking away their thoughts. Other times, people with schizophrenia may feel like they have superpowers, or that a famous person is in love with them. These delusions are typically brought on by sensory experiences or emotional states.

Hallucinations are seeing, feeling, or hearing things that don’t exist. People with schizophrenia may hear voices, which may sound angry or may lead a person to take an urgent action. Other hallucinations may include visual hallucinations, which cause someone to see things that are not there. People with schizophrenia may see people or figures, like clowns in an audience. Lastly, people with schizophrenia may smell or taste things that are not present, which may cause someone with schizophrenia to avoid eating.

Disorganized speech is when a person speaks or responds verbally in a way without a consistent train of thought. For example, an individual with schizophrenia may speak incoherently, or respond to question with an answer that is not appropriate to the question. Other times, someone with schizophrenia may say something illogical, or have trouble maintaining the focus of a topic in a conversation. This can be frustrating for both the individual with schizophrenia and others around them, as the ability for the individual with schizophrenia to focus may seem not to be present which may cause people to avoid engaging with them.

Abnormal motor skills vary in numerous ways. Sometimes, people with schizophrenia may appear clumsy as they may bump into objects or drop things. Holding objects still may be difficult, as people with schizophrenia tend to sway their upper extremities. Complex motor skill tasks may be troublesome, such as tying shoelaces or engaging in activities requiring high dexterity. People with schizophrenia may work with an occupational therapist or physical therapist to work on their motor skills.

Affective symptoms are often associated with manic or depressive episodes. Individuals may experience prolonged sadness, irritability, anxiety, lethargic, abnormal eating and sleeping habits, and more. Affective symptoms in schizophrenia are usually treated with a combination of medication and psychotherapy.

Are schizophrenia symptoms lifelong?

No, symptoms of schizophrenia vary in type and severity over time. Some time periods may involve the worsening of symptoms, and others may be remission of symptoms. Some individuals have persistent symptoms, while others may only experience them intermittently.

Can anyone have schizophrenia?

Yes. In men, schizophrenia symptoms often start to precipitate in their early to mid-20s, whereas women often experience symptoms in their late 20s. Children and individuals over the age of 45 rarely get diagnosed. However, people may start to experience symptoms of schizophrenia in their teenage years. It is always best to seek medical advice at the first notice or experience of symptoms, as early intervention can help someone avoid experiencing psychosis.

Is schizophrenia a genetic disorder, a developmental disability, or a combination of both?

In some ways, schizophrenia may be considered a genetic disorder. Genetic studies focused on single nucleotide polymorphisms have found several genes of interest that may be responsible for causing schizophrenia. Namely, researchers have identified that mutations on chromosome 6p21.3-22.1, 2q32.1, chromosome 8, and 18q21.2 may be linked to schizophrenia. Other genes of interest are involved in signaling pathways and the potassium channel. Currently, researchers have identified 43 genes that may be involved in causing schizophrenia, but it appears that a variety of genetic abnormalities may cause schizophrenia. 

 

Some researchers and medical professionals think of schizophrenia as a developmental disorder. Researchers have found that people with schizophrenia have different brain development. Research indicates that affected individuals might have reduced myelination, interneuron activity, and excessive excitatory pruning. With abnormal brain development, people with schizophrenia interpret and process information differently. 

 

Other researchers are discovering the influence of recreational substance use, such as marijuana, methamphetamines or LSD, which can cause individuals to develop similar signs and symptoms of schizophrenia.

How to help someone with schizophrenia

The best advice is to consult a doctor and receive medical advice for proper diagnosis. The Substance Abuse and Mental Health Services Administration (SAMHSA) provides a service called the Behavioral Health Treatment Services Locator to help individuals find mental health treatment facilities and programs. SAMHSA’s Early Serious Mental Illness Treatment Locator provides information about treatment facilities that offer coordinated specialty care.

What treatment is available?

There are many other treatment options available. One of the most popular treatment options is using a clinician trained in the NEAR cognitive remediation therapy (Neuropsychological Educational Approach to Remediation) founded by Dr. Alice Medalia of Columbia University approach.

 

Learn about how the HOPE program at the University of Texas Southwestern Medical Center conducts its research and treatment for individuals with schizophrenia.