What is schizophrenia?
Chat Issue Winter 2001
Clinic Care: Information Point
This section aims to be a source of useful information for patients, staff and relatives. It hopes to inform readers of specific issues relating to mental health. Articles will focus upon mental health issues such as specific diagnosis, proposed and existing legislation, government policy, benefits, community support and any other issues that you the readers suggest. This edition features Schizophrenia.
What is schizophrenia?
Schizophrenia is a complex illness that manifests differently in each sufferer. The term Schizophrenia refers to a broad range of symptoms and although a single person is unlikely to have all the symptoms it can be one of most disabling and emotionally devastating illnesses known to man. As if this were not enough, its victims have been undeservingly stigmatised due the disease being misunderstood for so long. A common misconception, which of course is not true, is that schizophrenia means split personality. Another misconception is that it is caused through bad parenting or personal weakness. In fact like cancer and diabetes its cause is probably biologically based, however because the brain is complex, identifying the correct treatment is not simple and can take considerable time.
Schizophrenia is not an uncommon disease, with an estimated one percent of the population being diagnosed with it over the course of their lives. While there is no known cure for schizophrenia, it is a very treatable disease.
Diagnosing schizophrenia involves recognizing a variety of signs and symptoms associated with impaired occupational or social functioning. The criteria used is an internationally agreed classification which essentially refers to:
- Abnormal thoughts (specifically processes such as hallucinations, delusions, distortions, and paranoia);
- Abnormal moods (specifically feelings, states of pleasure or displeasure);
- Behaviours (specifically those dangerous behaviours arising from paranoid or grandiose delusions or previous traumatic events).
What is the course of the disease?
Whilst some people recover completely the majority of sufferers do improve to the point where they can live independently, and many are able to re-build or return to productive and fulfilling lives. Most require maintenance with medication, however approximately 15 percent of people with schizophrenia respond only moderately to medication and require extensive support throughout their lives, while another 15 percent simply do not respond to existing treatments
How is it treated?
In cases of acute schizophrenia hospitalisation is often necessary in order to ensure the safety of the affected person. Hospitalisation also allows observation by trained mental health professionals to determine whether schizophrenia is the appropriate diagnosis and for the initiation of medication under close supervision. Antipsychotic drugs (also called neuroleptics), available since the 1950s, can dramatically improve the functioning of people with schizophrenia. Most people taking neuroleptics experience uncomfortable side effects to varying degrees, which can be eased with other medication (called Anticholinergic). Although side effects do reduce with time, according to a study released in 1998 (mentalhelp.net/articles/schizo3.htm), sixty six percent of psychiatrists and 48 percent of patients who took part in the study considered antipsychotic side effects to be a major reason for non-compliance with medication. These findings highlight the importance of working in partnership to find the correct balance in order to maintain compliance with medication and reduce risk of relapse of the illness.
Depending on the seriousness and consequences of the disease the person may need assistance in coping with simple activities of daily living and social interaction. Throughout this process and once his or her symptoms are controlled, supportive counselling may be appropriate for these individuals as a source of friendship, encouragement, and practical advice. Once the most troubling symptoms are controlled by medication, the person often does not require hospitalisation and a Community Mental Health Team will continue the support provided in hospital. Relatives and friends can also assist in maintaining the patient’s well being through visits rebuilding the person's social skills. Such support is very important.