Schizophrenia is a mental illness affecting 1% of the population. Symptoms most frequently begin in the teenage years or the 20’s. The most common features are hallucinations, delusions, disorganized thinking and behavior, loss of interest in social activities, lack of energy and drive, and problems of attention, memory, and decision making. Some of these symptoms may be quite distressing or even frightening to the individual with schizophrenia. Individuals with schizophrenia tend to have difficulties at work or school, in relationships with family and friends, and sometimes in basic self-care. Schizophrenia is frequently associated with substance abuse, and, at times, unpredictable or aggressive behavior. Some people with schizophrenia do not believe they are ill.
It is now clear that schizophrenia is a disease of the brain. It is possible that the brain abnormality is from the abnormal growth or developmental of brain cells, or from a problem in the chemistry of the brain cells. Why these brain abnormalities occur is not fully known, though genes inherited from one or both parents are probably important. It is suspected that factors other than genes may also be involved, such as exposure at a young ages to certain infections or other stressors, but much remains unknown.
There is no test for schizophrenia. The diagnosis is based on an interview of the patient by an experienced clinician and a detailed history of symptoms provided by both the patient and by individuals who know the patient well. Blood tests, brain scans, and EEG (brain wave tests) will often be obtained to search for the presence of other diseases that may cause symptoms similar to the symptoms of schizophrenia.
What is the treatment for schizophrenia? A number of approaches to treatment are typically necessary; the focus of treatment will be different for each patient. Most patients will benefit by treatment with medicines.
Treatment in addition to medicine is often essential. Many patients benefit from individual, family, or group psychotherapy (counseling). These sessions typically emphasize the emotional and practical consequences of the illness, and how the individual or family can work to gain control over the illness. Discussion may focus on the nature and symptoms of the disease itself, the recognition of early signs of a relapse, the importance of medicine and the recognition of medicine side-effects, coping with symptoms when they do occur, relationships with family or co-workers, finding and keeping a job, or staying school. Many patients also benefit from programs that emphasize rehabilitation and practical skills. The emphasis is again different for each individual, but may range from self-care to finding and keeping a job.