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What is Schizophrenia?


Schizophrenia is a brain disorder that has affected people throughout history. About 1 percent of Americans have this illness.


The symptoms of schizophrenia fall into three broad categories: positive symptoms, negative symptoms, and cognitive symptoms. Individuals with schizophrenia vary a lot in the number of symptoms they have. Some people have only a few symptoms; others have many symptoms.

Positive symptoms

Positive symptoms are behaviors and perceptions that are either 1) not experienced by members of the general population or 2) distortions of the behaviors or perceptions of the general population. People with positive symptoms believe that their experiences are real even though they are not shared by others. Positive symptoms can vary in their intensity, especially depending on whether the individual is receiving treatment. Positive symptoms include the following:

Hallucinations are things a person sees, hears, smells, or feels that no one else can see, hear, smell, or feel. "Voices" are the most common type of hallucination in schizophrenia. Many people with the disorder hear voices. The voices may talk to the person about his or her behavior, orders the person to do things, or warn the person of danger. Sometimes the voices talk to each other. People with schizophrenia may hear voices for a long time before family and friends notice the problem.

Other types of hallucinations include seeing people or objects that are not there, smelling odors that no one else detects, and feeling things like invisible fingers touching their bodies when no one is near.

Delusions are false beliefs that are not part of the person's culture and do not change. The person believes delusions even after other people provide evidence that the beliefs are not true or logical. People with schizophrenia may have paranoid delusions and believe that others are trying to harm them, such as by cheating, harassing, poisoning, spying on, or plotting against them or the people they care about. They may also believe that people on television are directing special messages to them, or that radio stations are broadcasting their thoughts aloud to others. Sometimes they believe they are someone else, such as a famous historical figure.


Thought disorders are unusual or dysfunctional ways of thinking. One form of thought disorder is called "disorganized thinking." This is when a person has trouble organizing his or her thoughts or connecting them logically. They may talk in a garbled way that is hard to understand. Another form is called "thought blocking." This is when a person stops speaking abruptly in the middle of a thought. When asked why he or she stopped talking, the person may say that it felt as if the thought had been taken out of his or her head. Finally, a person with a thought disorder may use common words in unusual ways or use meaningless words.

Movement disorders may appear as agitated body movements. A person with a movement disorder may repeat certain motions over and over. In the other extreme, a person may become catatonic. Catatonia is a state in which a person does not move and does not respond to others.

Negative symptoms

Negative symptoms are decreases in the range of normal emotions and behaviors. These symptoms are harder to recognize as part of the disorder and can be mistaken for depression or other conditions. These symptoms include the following:
  • "Flat affect" (a person's face does not move or he or she talks in a dull or monotonous voice)
  • Lack of pleasure in everyday life
  • Lack of ability to begin and sustain planned activities
  • Speaking little, even when forced to interact.
In severe forms, people with negative symptoms may need help with everyday tasks. Other people may believe that a person with negative symptoms is being lazy or unwilling to help themselves, but the problems are symptoms caused by the schizophrenia.

Cognitive symptoms

Cognitive symptoms are subtle. Like negative symptoms, cognitive symptoms may be difficult to recognize as part of the disorder. Cognitive symptoms include the following:

  • Poor "executive functioning" (the ability to understand information and use it to make decisions)
  • Trouble focusing or paying attention
  • Problems with "working memory" (the ability to use information immediately after learning it).
Cognitive symptoms may make it hard to perform well at school or on a job.

Onset

Positive symptoms usually develop in men in their late teens or early twenties and women in the twenties and thirties. Before full positive symptoms develop, a person may experience milder forms of positive symptoms, which may result in a person being less social, having school or work problems, lacking drive or motivation, brief or intermittent hallucinations or unusual beliefs. A person may have glimpses of delusions but these may come and go. People with these early manifestations may feel that something odd or strange is happening to them, but they do not have a clear explanation for the feeling.

Treatment

This is a time of hope for people with schizophrenia. Although the exact causes of the disease have not yet been determined, current treatments can eliminate many of the symptoms and allow people with schizophrenia to live independent and fulfilling lives in the community.

Early Intervention

Many people with schizophrenia do not seek treatment until they have had severe symptoms for a long time, often up to two years. If treatments are started early in the course of the illness, they are likely to be more effective than if they are delayed.

What Families Can Do to Help

The symptoms of schizophrenia are complex and sometimes difficult to understand. Families can help individuals get an expert evaluation as soon as symptoms appear - this is key to getting the proper help and getting it as soon as possible. Family support is crucial to ensuring individuals with schizophrenia get a proper evaluation and appropriate treatment.




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