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General overview

Schizophrenia is a mental health condition which is characterized by specific symptoms. The can be divided into positive and negative symptoms and they need to be present for at least 6 months.

This condition is incorrectly thought of as causing split personalities, which isn't the case. Rather, it causes a disruption of the usual balance of thoughts and emotions

Demographics

The usual onset of schizophrenia in men is in their mid-20's, and women develop this condition in their late 20's. It's uncommon for patients above the age of 45 to be diagnosed with with this condition. Schizophrenia has been reported to develop in teenagers as well and, unfortunately, the younger the patient is diagnosed with this condition, the worse their prognosis will be.

Signs and symptoms

Positive signs and symptoms

  • Hallucinations - patients can experience seeing or hearing things which aren't actually there. Hallucinations can affect all the senses including sensation, taste and smell.
  • Delusions - these are defined as having false beliefs which aren't based on reality and can occur in up to 80% of schizophrenic patients. Examples would include delusions of grandeur where one thinks that they are a king, or paranoid delusions where the patient thinks that people are purposefully out to harm them.
  • Disorganized thoughts and speech - the disorganized thoughts are constructed from the disorganized speech. Here, communication affected and answers to questions may be completely or partially unrelated.
  • Abnormal motor behaviour - these can include childlike behaviours, agitation, inappropriate movements or postures, useless or excessive movements or lack of response.

Negative symptoms

Negative symptoms are due to deficits of normal emotional responses or other processes of thought. Patients with more prominent negative symptoms also seem to respond poorly to medication as opposed to those with positive symptoms and therefore contribute to a poorer quality of life.

These symptoms include:

  • Poor eye contact.
  • Lack of emotions.
  • Inability to experience pleasure and lack of interest in activities.
  • Don't use hand movements or gestures during speech and being monotonous (poverty of speech).
  • No desire to form relationships.
  • Neglect personal hygiene.
  • Lack of motivation.

Teenagers

The signs and symptoms in teenagers may mimic normal signs of development so one needs to carefully assess these patients. They may have the following issues:

  • A drop in performance at school.
  • Withdrawal from family and friends.
  • Depressed.
  • Irritable.
  • Lack motivation.
  • Trouble sleeping.
  • They are less likely to suffer from delusions.
  • More likely to experience visual hallucinations.

Management

A multidisciplinary approach is needed in managing patients with schizophrenia. It's important to remember that treating this condition is a lifelong process even when symptoms have subsided.

Medical doctors prescribe oral or injectable medications, depending on the severity of the condition, in order to control the signs and symptoms. These medications can cause the patient to seem more lethargic, but they help to manage the symptoms so that the patient can try and have a better quality of life.

Psychotherapy, occupational therapy and social welfare is incorporated in the management of this condition. These are the protocols incorporated by these disciplines:

  • Individual therapy - where patients are taught to cope with stress and to note early warning signs of relapse. This helps people with schizophrenia manage their illness better.
  • Family therapy - support and education is provided to families dealing with schizophrenia.
  • Social skills training - focuses on improving social interactions and communication.
  • Vocational rehabilitation and supported employment - helping people with schizophrenia prepare for, find and keep jobs.

 

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