Schizophrenia is when a person has gone through a long-term psychosis or multiple psychoses and doesn’t function properly in the intervening periods. A psychosis is a condition, in which a person’s contact with reality is severely disrupted. People with schizophrenia often make a confused impression. Schizophrenia is a serious and complex psychiatric disease.
Cause
Schizophrenia is usually caused by a combination of biological, psychological and social factors:
- Biological factors. In the development of schizophrenia, predisposition plays the most important role. Predisposition is partly determined by hereditary factors. Schizophrenia is more common in certain families. The basis of the disease is probably a disorder in the development of the brains that already occurs before the sixth month of pregnancy. In people with schizophrenia, defects are found in the structure of specific areas in the brains and in semiochemicals in the brains. These allow that the processing of information from the outside world doesn’t proceed optimal.
- Psychological and social factors. These also determine whether the predisposition or vulnerability to schizophrenia actually manifests itself. Major events, such as the death of a loved one, a broken relationship, a relocation, difficulties at work and the transition from puberty to adolescence, may trigger the disease. People with schizophrenia can't stand changes and stress. The use of drugs can trigger a psychosis in people who are predisposed.
Symptoms
People with schizophrenia have various signs and symptoms:
- Positive symptoms. Clearly present symptoms, such as delusions and hallucinations.
- Negative symptoms. Signs of reduced functioning, such as lack of energy and motivation and absence or flattening of, for example, emotion, speech or thoughts.
- Disturbed thinking, talking and doing. Inconsistent speech, chaotic behavior and abnormal body movements (urge to move).
Diagnosis
The diagnosis of schizophrenia is made by means of psychiatric examination. This includes a conversation with the patient, the observation of his or her behavior and gathering information from relatives. Information about the history is also important. Additional tests, such as blood tests or brain scans, are sometimes needed in order to exclude other disorders.
Treatment
Schizophrenia cannot be cured, but is usually well treatable. The sooner treatment starts, the better the expected results. With therapy and medication, it’s often possible to gain control over the disease and learn to use the capacities and capabilities that remain:
- Therapy. Counseling contributes to a reduction in symptoms, a better understanding of the disease, early detection of the signals, controlling a new psychosis and correct use of medicines. Social skills training helps to improve social functioning. Labour rehabilitation can subsequently help to find and maintain (adjusted) work. Contact with fellow-sufferers can help a person with schizophrenia and his environment to accept the disease and cope with it.
- Medication. Drugs play an important role in the treatment of schizophrenia. Antipsychotics can reduce a psychosis. They help thinking more clearly and reduce the delusions and hallucinations into the background. They also reduce the negative symptoms, such as absence and inaccessibility. After a first psychosis, medications should be used for at least two years.
Prognosis
The prospects of schizophrenia vary in the long term. The prognosis depends on the person, the factors that worsen the disorder, whether people stick to their treatment and the extent to which relatives can provide support. Most people maintain psychological and social restrictions. Some people with schizophrenia continue to be psychotic or suffer so much from negative symptoms, that a long stay in a psychiatric hospital is required. Relatively many people with schizophrenia are also homeless. There’s an increased risk of suicide. It is estimated that five to ten percent of people with schizophrenia commit suïcide.
Considerations
- Try to live a regular life. Ensure a fixed day and sleep rhythm.
- Find an environment with little tension. Learn to deal with stress.
- Always use the prescribed medication at a fixed time.
- Learn the factors that trigger a psychosis and recognize the signs of a new psychosis.
- Raise the alarm in time when you feel that things are about to go wrong.
- Find someone you trust and with whom you can share your experiences and feelings. Make a ‘contingency plan’ together with your environment and practitioner, for how to handle in case of a new psychosis or crisis.
- Adjust future expectations. Processing a psychosis takes time. The damage caused must be repaired, as well as former social contacts. Many people know that, after a psychosis, they are permanently less capable than before. Working or studying as usual often doesn’t work anymore. Maintaining social contacts or a relationship is often difficult.
Facts
- The Swiss psychiatrist Paul Eugen Bleuler described a group of psychiatric disorders in 1911 and gave it the name ‘schizophrenia’.
- The term ‘schizophrenia’ is derived from the Greek words schizein (splitting) and phrèn (diaphragm, heart, character, feeling, sense).
- The prevalence of schizophrenia is 1%.
- Men have a slightly higher risk of having this disorder than women.