Category Archives: Schizophrenia

The Difference Between Acute Schizophrenia And Chronic Schizophrenia

April 8, 2009

Schizophrenia develops in around 1% of the population and affects males and females in roughly equal numbers although males are likely to develop schizophrenia in young adulthood between the ages of 15 and 25 and females slightly later. As schizophrenia usually starts in young adults, this is the most likely time to experience acute schizophrenia.

Acute schizophrenia is when a person who was previously healthy starts to display odd behaviour and develops symptoms of schizophrenia over a short period of time. In other words the symptoms appear abruptly and they can either subside or develop into long term chronic schizophrenia.

Some people will only have one episode of psychosis and make a complete recovery whereas others might have many over the course of their lifetime. Some people with schizophrenia might no longer experience psychosis but will still suffer from the so called negative symptoms of schizophrenia.

The statistics

•    25% of people diagnosed with schizophrenia will go on to make a full and complete recovery
•    50% of people diagnosed with schizophrenia will manage their schizophrenia with appropriate treatment and support and have periods of remission where they appear quite well. Many of these can lead full and satisfying lives
•    25% of people diagnosed with schizophrenia will need constant treatment and a high level of support with no periods of remission

Positive and Negative Symptoms of Schizophrenia

The symptoms of schizophrenia are classified into ‘positive’ and ‘negative’ symptoms.

The positive symptoms include hallucinations, delusions and disorganised thoughts. Hallucinations can affect any one of the senses but in schizophrenia auditory hallucinations (hearing voices) is the most common. Delusions can take the form of an inflated sense of self importance or paranoia.

The negative symptoms of schizophrenia include a flattening of the emotions and speech, apathy, a general disinterest in life and social withdrawal. People with the negative symptoms of schizophrenia will often neglect themselves and their appearance and alcohol and substance abuse is quite common.

Chronic schizophrenia can be described as the long term state of schizophrenia and although there can be episodes of psychosis; the most common symptoms associated with chronic schizophrenia are the negative symptoms. These can be much more difficult to treat as they do not respond to anti-psychotic medication which can be quite efficient at treating the positive symptoms of schizophrenia. Sometimes anti-depressants are prescribed.

It’s important to get help as soon as the first signs of schizophrenia appear as there is evidence that the longer treatment is delayed when the schizophrenia first develops the worse the long term outlook is likely to be.

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Where To Get Schizophrenia Information

April 6, 2009

First of all, if you think that you or someone close to you is developing the first signs of schizophrenia or are exhibiting strange behaviours, ideas or beliefs, it is vital that you seek professional help as soon as possible. There is some evidence that the longer schizophrenia treatment is delayed, the worse the long term outlook is likely to be.

In the first instance, your doctor will be able to refer an individual for psychiatric assessment and will also point you in the direction of where to find more information and support in your local area.

The following are other some other sources of help and information which might prove useful for anyone affected by Schizophrenia.

Sources in the UK

•    Rethink – formerly known as National Schizophrenia Fellowship. Rethink is a leading mental health charity offering information and support to people with mental health problems
•    Royal College of Psychiatrists – on their website you will find a number of informative leaflets about schizophrenia and mental health in general
•    Mind – a leading mental health charity in England and Wales that are working to ‘create a better life for everyone with experience of mental distress’
•    Mental Health Foundation – a leading UK based charity which provides information, conducts research and organises campaigns to improve the services for anyone affected by mental health problems
•    NHS Direct – if you are worried and want to speak to someone immediately you can contact the NHS direct which offers a 24 hour health advice and information service. They will also be able to advise you on any self help or support organisations in your area.

Sources in the USA

•    National Alliance for the Mentally Ill (NAMI) – NAMI is ‘the largest grassroots organization for people with mental illness and their families’ they have affiliates in every state and over 1000 local communities across the country
•    National Alliance for Research on Schizophrenia and Depression (NARSAD) – NARSAD has a lot of information on their site including news regarding treatments and the latest research on psychiatric conditions
•    National Institute of Mental Health – their site has a lot of useful information on different mental health conditions including schizophrenia which is available in PDF file in both English and Spanish

Other resources

Schizophrenia.com provides information and support to anyone who has been affected by schizophrenia including individuals themselves, their families and carers.

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What Is Undifferentiated Schizophrenia?

April 6, 2009

Undifferentiated schizophrenia is diagnosed when the individual’s symptoms cannot be assigned to any one of the other types of schizophrenia or when the symptoms of more than one type of schizophrenia are present.

Sub types of schizophrenia

•    Paranoid schizophrenia – hallucinations and delusions are present but no disorganised speech or behaviour
•    Disorganised schizophrenia – Disorganised thinking, speech and behaviour
•    Catatonic schizophrenia – bizarre body movements and positions, echolalia and echopraxia may be present, in extreme cases a complete lack of responsiveness
•    Residual schizophrenia – no longer showing positive symptoms but negative symptoms still present
•    Undifferentiated schizophrenia – no clear category of schizophrenia can be identified

So if there is no clear indication as to which type of schizophrenia the individual is suffering from or if there is fluctuating or a mixed set of symptoms, undifferentiated schizophrenia might be diagnosed. Symptoms of schizophrenia are generally classified into positive and negative symptoms/

Positive symptoms of schizophrenia

The positive symptoms of schizophrenia include hallucinations, delusions and disorganised thinking, speech and behaviour.

Hallucinations are perceptions of something as real in the absence of any physical stimuli. They can affect any one of the senses.

•    Visual hallucinations – seeing something that isn’t there and that other people cannot see
•    Auditory hallucinations – hearing something that isn’t there, and that other people cannot hear. This may take the form of voices telling them what to do, having conversations with them, criticising them etc.
•    Tactile hallucinations – Feeling something touching you or something on the skin that isn’t there
•    Olfactory hallucinations – hallucinations involving the sense of smell
•    Gustatory hallucinations – hallucinations involving the sense of taste

Delusions can be described as believing in something (false beliefs) that is obviously untrue despite evidence to the contrary.

•    Delusions of grandeur, for example, believing that you can fly, that you are a secret spy or that you are famous
•    Delusions of persecution where the individual believes he is being plotted against and others have harmful intentions towards them
•    Delusions of reference, for example, where everyday things take on a special significance and are directly related to the individual, such as believing that television and radio broadcasts are sending them secret messages
•    Somatic delusions may involve the body such as a belief that they are suffering from a terrible illness

Disorganised thinking, speech and behaviour

Thoughts are disorganised and speech becomes rambling, incoherent or nonsensical to the extent that it severely impairs communication. Behaviour might be bizarre and purposeless or catatonic.

Negative symptoms of schizophrenia

Negative symptoms of schizophrenia are more difficult to diagnose and include a flattening of speech and the emotions, lack of facial expression, apathy, disinterest, inappropriate social skills and social withdrawal.

Undifferentiated Diagnosis

There isn’t a test that can diagnose schizophrenia so diagnosis depends on reporting of the symptoms by the individual or family members and observation. Consequently it can take a significant amount of time to obtain a diagnosis particularly with undifferentiated schizophrenia as the symptoms do not clearly fit one of the other subtypes of schizophrenia.

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The Prognosis For Chronic Schizophrenia

April 6, 2009

Chronic schizophrenia is the long term state of schizophrenia, as opposed to acute schizophrenia which is when a previously healthy person develops hallucinations and delusions or other symptoms of schizophrenia.

Schizophrenia is a serious mental disorder for which there is currently no cure. It is characterised by a distortion of reality which can manifest itself by hallucinations, delusions and bizarre thought processes and ideas. It affects males and females in equal numbers although males tend to develop schizophrenia earlier than females. Roughly one percent of the population will develop schizophrenia.

The most common symptoms of chronic schizophrenia include social withdrawal, bizarre ideas or behaviours, depression, lack of interest in life, a reluctance to participate in conversation and general neglect of themselves and their appearance. Alcohol and substance abuse is often a feature.

Of course not everyone with chronic schizophrenia will display all the symptoms or to the same degree.

There isn’t a single identifiable cause of schizophrenia and instead several factors appear to play a role including genetics, brain chemistry, and biological and environmental factors.

Treatment tends to consist of anti-psychotic medication and psychological intervention. There isn’t a single treatment that is effective for all, what works for one person may not work for another so it really is a case of trial and error to find the best medication and therapy for each individual.

On saying all that, researchers have made progress towards an understanding of schizophrenia and treatment methods are improving. The outlook for people with schizophrenia is now a lot better than it was in the past.

Research shows that around a quarter of people diagnosed with schizophrenia will go on to make a full recovery, half will be able to cope and lead a satisfying life, and another quarter will find they need long term care and treatment.

Factors affecting long term outlook for people with chronic schizophrenia

It is important that treatment starts early as there is some evidence that the longer treatment is delayed, the worse the outlook.

Anti-psychotic medication is generally quite effective at treating the positive symptoms of schizophrenia such as hallucinations and delusions but will not do anything to help the so called negative symptoms of schizophrenia such as lack of motivation and general apathy.

Family intervention therapies and some form of psychotherapy can help prevent further relapses and can make it easier for the person with schizophrenia to cope with their condition.

The long term outlook for people with chronic schizophrenia is likely to be worse if the symptoms of schizophrenia developed gradually, if treatment is delayed or stopped, or where there is poor social or family support.

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Symptoms Of The Different Types Of Schizophrenia

April 6, 2009

The symptoms of Schizophrenia are divided into positive and negative symptoms. In general, the positive symptoms consist of hallucinations and delusions and the negative symptoms include lack of emotion, social withdrawal and apathy.

There are several different sub categories of schizophrenia, each of which is recognised by the dominant symptoms within that type. The following represents a list of the different types of schizophrenia along with a description of their symptoms.

Paranoid Schizophrenia

As the name suggests, this type of schizophrenia is characterised by paranoia and suspicion. The individual tends to be very suspicious of the actions and intentions of others and may believe that he or she is being persecuted, followed, and plotted against by others, even family members. They may show anger and aggression in an attempt to defend themselves against their perceived persecution.

Hallucinations and delusions are a feature of this type of schizophrenia. Auditory hallucinations may take the form of voices telling them what to do or criticising them. Delusions may involve delusions of grandeur where the individual may believe themselves to be some famous personality or religious figure and of course, delusions of persecution.

Disorganised Schizophrenia

People with this type of schizophrenia may have great difficulty in expressing their emotions and feelings and their speech tends to be disorganised, incoherent and rambling.
Another characteristic of this type is expressing emotions that are not appropriate to the situation, for example laughing or smiling on hearing bad news and becoming visibly upset at good news. Delusions and hallucinations may be present but don’t tend to be extreme.

A person with this type may not be able to function or care for themselves effectively so their normal daily routines are affected.

Catatonic Schizophrenia

Symptoms of Catatonic schizophrenia include extreme social withdrawal, lack of facial expression and emotion and odd or bizarre bodily positions. For example they may maintain the same body position for hours on end even though it looks uncomfortable or they might move about and fidget constantly.

The person with this type may say nothing for hours or they might repeat in a parrot like fashion everything someone else says (echolalia) or they may mimic someone else’s body movements and gestures (echopraxia).

Residual Schizophrenia

If a person has had at least one episode of schizophrenia before but is showing no positive symptoms at the moment, such as hallucinations and delusions, they may be diagnosed with residual schizophrenia. With this type of schizophrenia the individual will often display negative symptoms.

Undifferentiated Schizophrenia

When an individual displays symptoms that cannot be clearly attributed to any one type of schizophrenia or they are showing symptoms of more than one type, then undifferentiated schizophrenia may be diagnosed.

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What Are Schizophrenia Delusions?

April 6, 2009

People with schizophrenia have problems interpreting reality and differentiating between what is real and what is not. Hallucinations and delusions are therefore common. Hallucinations can be defined as hearing or seeing something that isn’t really there, although any one of the senses can be affected. Delusions on the other hand can be defined as believing in something that is obviously not true.

Delusions and Schizophrenia

As we have ascertained, delusions can basically be described as ‘false beliefs’. Delusions of grandeur and delusions of paranoia or persecution are quite common features in schizophrenia.

With delusions of grandeur the person may have a fixed idea which is totally bizarre, such as believing they are a famous figure or religious personality, or otherwise special or important in some way. They might think they have special magical powers or they might believe they are a secret spy on a special mission or that they are the ‘chosen’ one to carry out an important role or task in society. Even a simple television programme or a news broadcast might lead them to believe that people talking on the television set are sending personal messages to them.

With delusions of paranoia the individual is likely to be suspicious of the intention of others, even members of their own family. Again, the idea can be fixed. They might think there is a government plot out to assassinate them, that their neighbours want to kill them, that they are being followed, spied upon, talked about, conspired against and so on. Everyday events are misinterpreted to reinforce their beliefs.

The individual with schizophrenia will usually not consider alternative explanations and are rigid in their belief system despite all attempts to reason with them.  It might even lead them to believe that the person trying to reason with them is part of a secret plot and is out to get them.

What is interesting about schizophrenia and delusions is that there are some similar features and themes.

A study by Skodlar et al published last year in 2008 describes how when communism collapsed in Slovenia and people were once again able to follow a religion, religious delusions increased.

Delusions involving information being beamed to an individual over the airwaves is quite common now but didn’t exist before television and radio were invented.

Today, with huge developments in information and communication technologies persecution and paranoia delusions are more common than in the past and researchers are now starting to publish their findings on studies of schizophrenic patients with delusions regarding the Internet.

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How Is Schizophrenia Diagnosed?

March 31, 2009

Schizophrenia can only be diagnosed by a psychiatrist, not a psychologist as some people mistakenly believe. A psychiatrist differs from a psychologist in that a psychiatrist will have completed medical training first and is able to prescribe drugs. A psychologist will have studied human behaviour and the mind so can implement psychological therapies but cannot prescribe medication.

Symptoms of schizophrenia are usually classified into positive and negative symptoms. Positive symptoms include hallucinations, delusions, disorganised speech and behaviour. Negative symptoms are so called because they represent a lack of responses rather than positive responses, for example, lack of emotion, lack of motivation, lack of movement, disinterest, apathy, saying few words if anything, staring into space and so on.

The DSM-IV criteria states that schizophrenia can be diagnosed if two or more of the following symptoms are present:

•    Hallucinations
•    Delusions
•    Disorganised Speech
•    Disorganised Behaviour
•    Catatonia
•    Negative Symptoms

and

•    There have been signs of disturbance for a period of 6 months or more

and

•    Poor social and occupational functioning

What is known about the causes of Schizophrenia?

Scientists believe that there is a strong genetic element to schizophrenia and have managed to pinpoint certain genes that are known to have an impact on the development of schizophrenia.

The genetic element is also apparent when we consider that schizophrenia appears to run in families. For example, if one identical twin develops schizophrenia then there is a 50% chance that the other will develop it too. If a parent has schizophrenia then their children have a 17% chance of developing the condition. This is vastly different to the 1% affecting the population in general.

Some studies have indicated that brain chemistry plays a role in schizophrenia, particularly regarding the neurotransmitter dopamine as an excess of dopamine or oversensitivity to dopamine has been implicated in some individuals with schizophrenia.

Brain structure is also a consideration as particular ventricles have been found to be enlarged in some people with schizophrenia.

Psychological factors are also believed to play a part in developing schizophrenia and even in how well we recover from it. It is interesting to note that people from lower social backgrounds or those who have suffered abuse as a child appear to be more at risk of developing schizophrenia.

As there is such a wide variety of possible causes and triggers, some professionals now believe that schizophrenia may actually be a range of disorders as opposed to just one.

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Schizophrenia, anxiety and stress

March 31, 2009

Schizophrenia, anxiety and stress

Schizophrenia is a chronic mental health disorder that is characterised by hallucinations, delusions and disorganised thinking. These can be terrifying both for person who suffers from them and for family members who have to witness their loved one’s distress.

It is now well established that stress can make the symptoms of schizophrenia much worse as many research studies have shown that people with Schizophrenia are far more susceptible to the negative effects of anxiety and stress than other people who don’t have schizophrenia.

We know that people respond to stress in different ways. For example someone might suffer from depression after losing their job, experiencing bereavement or going through divorce, whereas others may find they are still able to function and carry out their normal routines.  For people suffering from Schizophrenia, the stress associated with these kinds of life events and even much more minor events can trigger an episode of psychosis.

There is now a growing consensus amongst medical professionals that stress and schizophrenia are much more closely linked than what was previously thought.

A study by Rabkin et al in 1982 showed that people with schizophrenia are more likely to report a stressful event prior to an episode of illness than anyone in the general population.

The results of another study, this time by Beck and Worthen in 1972 found that stressful life events prior to an episode of schizophrenia are often quite mild and not as severe as stressful events experienced prior to other forms of mental health problems like depression.

Even maternal stress can act as a catalyst for developing schizophrenia later in life.
Take for example one study by researchers at New York University School of Medicine who found that children born to women who were in the first trimester of pregnancy during the six day war in 1967 were more likely to develop Schizophrenia later in life than children who were born later. According to the author of the research, Dolores Malaspina, “the placenta is very sensitive to stress hormones in the mother and these hormones were probably amplified during the time of the war”.

Although some level of stress is perfectly normal and can indeed be beneficial, it is part of the fight or flight response, prolonged or severe stress can be detrimental to health and may even bring about physical damage to the brain as a result of something known as the “stress cascade”. Basically stress releases certain hormones in the brain which causes a physiological reaction that leads to actual physical changes in the brain itself.

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Is Schizophrenia Depression?

March 31, 2009

Is Schizophrenia Depression?

Schizophrenia is a mental disorder where sufferers can experience hallucinations and delusions as well as paranoia, disorganised thinking, disorganised speech, erratic or bizarre behaviour and display poor social and occupational functioning. Depression is very common in patients suffering from Schizophrenia. When Schizophrenia is accompanied by depression there is real cause for concern as there is an increased risk of suicide.

There are many different types and sub types of depression a few of which are clinical depression, bi-polar disorder, teen depression, childhood depression, winter depression and post natal depression. The basic symptoms of depression include the following:

•    Low moods
•    Lack of pleasure in activities that were once enjoyable
•    Difficulty making decisions or concentrating
•    Feelings of guilt and worthlessness
•    Self blame
•    Sleep disturbances
•    Loss of libido
•    Weight fluctuations
•    Irritability
•    Anxiety
•    Fatigue
•    Apathy
•    Recurrent thoughts of death or suicide

People with Bi-Polar disorder or manic depression as it is often referred to, suffer from extreme mood swings (highs and lows) where they experience cyclical periods where they are feeling low (depressed) and then become extremely high (manic). Delusions may also be present.

Treatment for depression will usually involve anti-depressant medication in all but the mildest forms of depression, possibly combined with some form of psychotherapy.

Treatment for schizophrenia will usually involve some sort of anti-psychotic medication in order to control the psychosis as well as some form of psychological intervention. However, many schizophrenia sufferers will also be offered anti-depressant medication too in order to treat any underlying depression at the same time.

Both Schizophrenia and manic depression are believed to have a genetic element as both conditions have a tendency to run in families. Now, recent research conducted by researchers at Cambridge University has indicated that schizophrenia and manic depression may have a similar genetic cause. One study identified that in both conditions, a particular gene that is involved in producing myelin sheaths which protects nerve cells in the brain is absent.

Many medical professionals now believe that schizophrenia may not be just one disorder but a whole range of disorders instead. Depression is a common feature of schizophrenia.

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Is Schizophrenia Psychological?

March 31, 2009

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Is Schizophrenia Psychological?

There is still much confusion among the general public as to whether schizophrenia is psychological or biological in nature. Once upon a time it was thought to be purely psychological but that isn’t the case today.

What we know now is that Schizophrenia is a complex disorder that can cause hallucinations, delusions, paranoia and depression affecting roughly one percent of the general population and that genetics, biology and psychology all play a role.

On saying that, Schizophrenia is still poorly understood by the medical profession and we have a lot to learn about it in order to understand it despite the amount of research that has been done. However, progress is being made all the time.

What the research does tell us is that there is a definite genetic element to schizophrenia. Two recent studies by Scientists at the Howard Hughes Medical Institute and at Edinburgh University in Scotland have managed to identify one single gene, a mutated version of the DISC1 gene, which is involved in both the development of schizophrenia and how well individuals will respond to treatment.

At the moment treatment for Schizophrenia will almost certainly involve some kind of anti-psychotic medication if psychosis is present. However, psychological interventions are proving very helpful in most cases. The types of psychological interventions available include both individual and group psychotherapy sessions and skills training. These can help an individual with Schizophrenia as well as their families to learn to cope with schizophrenia on a daily basis and improve the quality of life and the prognosis for the person suffering with schizophrenia.

There are also biological factors involved in Schizophrenia and some evidence exists that the seeds of schizophrenia may be sown in the very early days of pregnancy, possibly even before a woman discovers she is pregnant. For this reason women are advised to pay special attention to their health before they even decide to conceive.

With regard to psychological factors, many health professionals now believe that the psychology of an individual can influence to some extent whether a person will develop schizophrenia and how well a person with schizophrenia might respond to treatment. The extent to which psychological factors play a role is not known and will of course vary considerably from person to person.

Many things can influence how a person behaves, thinks and feels, in other words the psychology of an individual, including family circumstances, genetics, brain chemistry, social and environmental situations, stress, and anxiety and so on. It is also true that the psychology of an individual can have an influence on brain chemistry. The important point here is that one isn’t isolated from the other.

So to answer the question is Schizophrenia psychological? A simple yes or no answer will not suffice. Psychology affects the brain and the brain has an impact on psychology, both play a role in schizophrenia.

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