Schizophrenia Pictures Slideshow: Types, Causes, Symptoms, and Treatment
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What Is Schizophrenia?
Schizophrenia, also sometimes called split personality disorder, is a chronic, severe and debilitating mental illness. It is considered one of the psychotic mental disorders and is characterized by symptoms of thought, behavior, and social problems. The thought problems associated with schizophrenia are described as psychosis, in that the person's thinking is completely out of touch with reality at times.
What Is the History of Schizophrenia?
The term schizophrenia has only been in use since 1911. Soon before that, it was deemed a separate mental illness in 1887 by Emil Kraepelin. Despite that relatively recent history, it has been described throughout written history. Ancient Egyptian, Hindu, Chinese, Greek, and Roman writings described symptoms similar to the positive symptoms of schizophrenia. During medieval times, schizophrenia, like other illnesses, was often viewed as evidence of the sufferer being possessed by spirits or evil powers.
Who Is Affected?
Schizophrenia affects about 1% of the population, corresponding to more than 2 million people in the United States and 100,000-200,000 newly diagnosed people every year. Other statistics about schizophrenia include that it affects men about one and a half times more commonly than women and that 50% of people in hospital psychiatric care have schizophrenia. Diagnosis is usually in people aged 17-35 years with the illness appearing earlier in men (in the late teens or early 20s) than in women (who are affected in the 20s to early 30s).
How Common Is Schizophrenia in Children?
Although there have been fewer studies on schizophrenia in children compared to adults, researchers are finding that children as young as 6 years old can be found to have all the symptoms of their adult counterparts and continue to have those symptoms into adulthood.
Types of Schizophrenia
There are five types of schizophrenia, each based on the kind of symptoms the person has at the time of assessment:
- Paranoid schizophrenia
- Disorganized schizophrenia
- Catatonic schizophrenia
- Undifferentiated schizophrenia
- Residual schizophrenia
We'll take a look at each type on the following slides…
Paranoid Schizophrenia
Paranoid-type schizophrenia is characterized by delusions and auditory hallucinations but relatively normal intellectual functioning and expression of affect. The delusions can often be about being persecuted unfairly or being some other person who is famous. People with paranoid-type schizophrenia can exhibit anger, aloofness, anxiety, and argumentativeness.
Disorganized Schizophrenia
Disorganized-type schizophrenia is characterized by speech and behavior that are disorganized or difficult to understand, and flattening or inappropriate emotions. People with disorganized-type schizophrenia may laugh at the changing color of a traffic light or at something not closely related to what they are saying or doing. Their disorganized behavior may disrupt normal activities, such as showering, dressing, and preparing meals.
Catatonic Schizophrenia
Catatonic-type schizophrenia is characterized by disturbances of movement. People with catatonic-type schizophrenia may keep themselves completely immobile or move all over the place. They may not say anything for hours, or they may repeat anything you say or do senselessly. Either way, the behavior is putting these people at high risk because it impairs their ability to take care of themselves.
Undifferentiated Schizophrenia
Undifferentiated-type schizophrenia is characterized by episodes of two or more of the following symptoms: delusions, hallucinations, disorganized speech or behavior, catatonic behavior or negative symptoms, but the individual does not qualify for a diagnosis of paranoid, disorganized, or catatonic type of schizophrenia.
Residual Schizophrenia
Residual-type schizophrenia is characterized by a past history of at least one episode of schizophrenia, but the person currently has no positive symptoms (delusions, hallucinations, disorganized speech or behavior). It may represent a transition between a full-blown episode and complete remission, or it may continue for years without any further psychotic episodes.
What Are Causes of Schizophrenia?
There is no single cause for schizophrenia. Rather, it is the result of a complex group of genetic, psychological, and environmental factors. Genetically, schizophrenia and bipolar disorder have much in common, in that the two disorders share a number of the same risk genes. However, the fact is that both illnesses also have some genetic factors that are unique. Environmentally, the risks of developing schizophrenia can even occur before birth. For example, the risk of schizophrenia is increased in individuals whose mother had one of certain infections during pregnancy. Difficult life circumstances during childhood, like the early loss of a parent, parental poverty, bullying, witnessing parental violence; emotional, sexual, or physical abuse; physical or emotional neglect; and insecure attachment have been associated with the development of this illness.
Is Schizophrenia Hereditary?
One frequently asked question about schizophrenia is if it is hereditary. As with most other mental disorders, schizophrenia is not directly passed from one generation to another genetically, but it is known to run in families. Thus, the risk of illness in an identical twin of a person with schizophrenia is 40%-50% and a child of a parent suffering from schizophrenia has a 10% chance of developing the illness.
Schizophrenia Symptoms
A person with schizophrenia may not have any outward appearance of being ill. In other cases, the illness may be more apparent, causing changes in behavior as well as bizarre behaviors. These may include social withdrawal, depersonalization (intense anxiety and a feeling of being unreal), loss of appetite, loss of hygiene, delusions, hallucinations, and a sense of being controlled by outside forces. In order to better understand schizophrenia, the concept of clusters of symptoms is often used. Thus, people with schizophrenia can experience symptoms that may be grouped under the following categories shown in the slides that immediately follow.
Positive (More Overtly Psychotic) Symptoms
- Beliefs that have no basis in reality (delusions)
- Hearing, seeing, feeling, smelling, or tasting things that have no basis in reality (hallucinations)
- Disorganized speech
- Disorganized behaviors
- Catatonic behaviors
Negative (Deficit) Symptoms
- Social withdrawal
- Difficulty in expressing emotions
- Difficulty in taking care of themselves
- Inability to feel pleasure
Cognitive Symptoms
Cognitive symptoms include difficulties attending to and processing of information, in understanding the environment, and in remembering simple tasks.
Affective (or Mood) Symptoms
The most notable affective symptom is depression, which accounts for a very high rate of attempted suicide in people suffering from schizophrenia.
How Is Schizophrenia Diagnosed?
As is true with virtually any mental-health diagnosis, there is no one test that definitively indicates that someone has schizophrenia. Therefore, health-care practitioners diagnose this disorder by gathering comprehensive medical, family, and mental-health information. Patients tend to benefit when the professional takes into account their client's entire life and background. This includes but is not limited to the person's gender, sexual orientation, cultural, religious and ethnic background, and socioeconomic status. The practitioner will also either perform a physical examination or request that the individual's primary-care doctor perform one. The medical examination will usually include lab tests to evaluate the person's general health and to explore whether or not the individual has a medical condition that might produce psychological symptoms.
How Is Schizophrenia Diagnosed? (Continued)
In asking questions about mental-health symptoms, mental-health professionals are often exploring if the individual suffers from hallucinations or delusions, depression and/or manic symptoms, anxiety, substance abuse, as well as some personality disorders (for example, schizotypal personality disorder) and developmental disorders (for example, autism spectrum disorders). Since some of the symptoms of schizophrenia can also occur in other mental illnesses, the mental-health screening is to determine if the individual suffers from schizoaffective disorder or other psychotic disorder, bipolar disorder, an anxiety disorder, or a substance abuse or personality disorder. In order to assess the person's current emotional state, health-care providers perform a mental-status examination as well.
Schizophrenia Treatment - Medications
While there are a number of helpful treatments available, medication remains the cornerstone of treatment for people with schizophrenia. These medications are often referred to as antipsychotics since they help decrease the intensity of psychotic symptoms. Many health-care professionals prescribe one of these medications, sometimes in combination of one or more other psychiatric medications, in order to maximize the benefit for the person with schizophrenia.
Medications that are thought to be particularly effective in treating positive symptoms of schizophrenia include olanzapine (Zyprexa), risperidone (Risperdal), quetiapine (Seroquel), ziprasidone (), aripiprazole (Abilify), paliperidone (Invega), and asenapine (Saphris).
Schizophrenia Treatment - Medications (Continued)
Mood-stabilizer medications like lithium (Lithobid), divalproex (Depakote), carbamazepine and lamotrigine (Lamictal) can be useful in treating mood swings that sometimes occur in individuals who have a diagnosable mood disorder in addition to psychotic symptoms.
Antidepressant medications are the primary medical treatment for the depression that can often accompany schizophrenia. Examples of antidepressants that are commonly prescribed for that purpose include serotonergic (SSRI) medications that affect serotonin levels like fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), citalopram (Celexa), and escitalopram (Lexapro); combination serotonergic/adrenergic medications (SNRIs) like venlafaxine (Effexor), desvenlafaxine (Pristiq), and duloxetine (Cymbalta), as well as bupropion (Wellbutrin), which is a dopaminergic (affecting dopamine levels) antidepressant.
Schizophrenia Treatment - Psychosocial Interventions
Family psycho-education:
This form of treatment consists of providing family support, problem-solving skills, and access to care providers during times of crises. When this intervention is consistently provided for at least several months, it has been found to decrease the relapse rate for the individual with schizophrenia and improve the person's social and emotional outcomes. Also, the burden that family members experience as a result of having a loved one with schizophrenia is lessened, family members tend to be more knowledgeable about the disorder and feel more supported by the professionals involved, and family relationships are improved.
Schizophrenia Treatment - Psychosocial Interventions (Continued)
Assertive community treatment (ACT):
This intervention consists of members of the person's treatment team meeting with that individual on a daily basis, in community settings (for example, home, work, or other places the person with schizophrenia frequents) rather than in an office or hospital setting. The treatment team is made up of a variety of professionals. For example, a psychiatrist, nurse, case manager, employment counselor, and substance-abuse counselor often make up an ACT team. ACT tends to be successful in reducing how often people with schizophrenia are hospitalized or become homeless.
Schizophrenia Treatment - Psychosocial Interventions (Continued)
Substance abuse treatment:
Providing medical and psychosocial interventions that address substance abuse should be an integral part of treatment as about 50% of individuals with schizophrenia suffer from some kind of substance abuse or dependence.
Schizophrenia Treatment - Psychosocial Interventions (Continued)
Social skills training:
Also called illness management and recovery programming, social-skills training involves teaching clients ways to handle social situations appropriately. It often involves the person scripting (thinking through or role-playing) situations that occur in social settings in order to prepare for those situations when they actually occur. This treatment type has been found to help people with schizophrenia resist using drugs of abuse, as well as improve their relationships with health-care professionals and with people at work.
Schizophrenia Treatment - Psychosocial Interventions (Continued)
Supported employment:
This intervention provides supports like a work coach (someone who periodically or consistently counsels the client in the workplace), as well as instruction on constructing a résumé, interviewing for jobs, and education and support for employers to hire individuals with chronic mental illness. Supported employment has been found to help schizophrenia sufferers secure employment, earn more money, and increase the number of hours they are able to work.
Schizophrenia Treatment - Psychosocial Interventions (Continued)
Cognitive behavioral therapy (CBT):
CBT is a reality-based intervention that focuses on helping a client understand and change patterns that tend to interfere with his or her ability to interact with others and otherwise function. Except for people who are actively psychotic, CBT has been found to help individuals with schizophrenia decrease symptoms and improve their ability to function socially. This intervention can be done either individually or in group sessions.
Schizophrenia Treatment - Psychosocial Interventions (Continued)
Weight management:
Educating people with schizophrenia about weight gain and related health problems that can be a side effect of some antipsychotic and other psychiatric medications has been found to be helpful in resulting in a modest weight loss. That is also true when schizophrenia sufferers are provided with behavioral interventions to assist with weight loss.
What Is the Prognosis for Schizophrenia?
Individuals with schizophrenia have more than twice the rate of death than those without the disorder. Almost half of people with schizophrenia will suffer from a substance-use disorder (for example, alcohol, marijuana, or other substance) during their lifetime. Research shows that people with schizophrenia or schizoaffective disorder have a better quality of life if their family members tend to be more supportive and less critical of them.
More Reading on Mental Illness
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REFERENCES:
MedicineNet: Schizophrenia
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