Schizophrenia

Schizophrenia is a serious mental disorder characterized by a dissociation of psychic functions, causing severe disturbances in thought, perception, emotions, or will. People with schizophrenia perceive and interpret reality in a distorted way, which severely hinders their daily life.

It belongs to the group of psychotic disorders, meaning that people with schizophrenia may have difficulty distinguishing between reality and the thoughts, ideas, or perceptions produced by the illness.

The relationship of symptoms and standard diagnostic systems are listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM). In its fourth edition, five types of schizophrenia were described, based on the predominance of symptoms; however, in the DSM-5, the current version of the manual from 2013, these categories are no longer used. The main reason for this is that they shared common symptoms and there wasn't enough accuracy in the diagnoses. However, it is still useful to know them as some patients or their families use this terminology.

Schizophrenia is a relatively common illness that usually appears in adolescence or between the ages of 20 and 30. It is considered one of the most disabling medical disorders and, additionally, patients often become victims of stigmatization and discrimination.

Symptoms

The schizophrenic condition is not uniform, and its symptoms can appear in other mental disorders. Furthermore, most of the symptoms of schizophrenia are subjective: they are only experienced by the patient and cannot be verified. They can also vary over time, alternating between periods of worsening and remission. However, some may always be present.

The common symptoms are divided into three categories:

Positive or psychotic symptoms:

• Hallucinations: perceiving non-existent things. These can be auditory (hearing voices is the most common hallucination), visual, somatic, olfactory, or gustatory.
• Delusions: firmly held false beliefs despite contradictory evidence. These can be paranoid delusions or delusions of grandeur, among others.
• Disorganized thinking: speech is incoherent, incomprehensible, and with altered fluency.
• Behavior and movement disorders: disorganized or abnormal attitudes, such as constant repetition of movements, strange postures, slowness, or extreme agitation.

Negative symptoms, or emotional deterioration:

• Loss of motivation and interest in everyday activities.
• Anhedonia: the inability to experience pleasure or satisfaction.
• Apathy, lack of energy.
• Lack of expressiveness, absence of eye contact.
• Limited speech.
• Social withdrawal or isolation.
• In extreme cases, catatonia: the person shows states of complete immobility.

Cognitive symptoms:

• Difficulty concentrating or paying attention.
• Problems processing information and solving problems.
• Learning and memory issues.
• Poor verbal understanding and social interaction skills.

In addition to the symptoms, it is common for patients to lack awareness of their illness, which greatly complicates treatment.

When schizophrenia manifests in teenagers, the illness can be difficult to identify, as some early signs may be confused with typical adolescent development traits, such as sleep disorders, distancing from friends and family, decreased academic performance, apathy, irritability, or low mood. Also, the negative symptoms of schizophrenia can be easily confused with other mental disorders like depression.

Causes

Although the ultimate cause of schizophrenia is unknown, it is believed to be due to an interaction between three factors:

• Genetic predisposition: the combination of certain genes increases the likelihood of developing the disorder.
• Environmental factors: highly stressful, dangerous, or traumatic environments, or exposure to viruses or nutritional problems before birth.
• Brain abnormalities: changes in brain structure, neurotransmitter activity, or brain functions.

Risk Factors

Conditions that seem to increase the risk of developing schizophrenia include:

• Family history.
• Complications during pregnancy or birth that may affect brain development.
• Exposure to viruses, toxins, or malnutrition during pregnancy.
• Consumption of psychoactive or psychotropic drugs during adolescence and youth.

Complications

Without treatment, schizophrenia can cause severe problems in the patient's life, leading to episodes of violence, depression, or suicidal thoughts and attempts. It can also result in incapacitation.

Prevention

Although there is no effective way to prevent schizophrenia, risk factors can be reduced, mainly by avoiding drug use.

What doctor treats schizophrenia?

Schizophrenia is evaluated and treated by specialists in psychiatry, psychology.