Schizophrenia is a psychotic condition. The word means “the split of the soul” and is often mistakenly perceived as a personality split. A more accurate description is that the disease involves disturbances in thought processes and emotional expression. It is assumed that schizophrenia may be linked to disruptions in the brain’s metabolism.

Symptoms typically come late in adolescence or early adulthood. In some cases, severe psychological stress may act as a triggering factor.

The illness typically lasts a lifetime, but its severity can vary over periods. Severe periods usually occur during emotional upheavals and personal setbacks.

Symptoms of schizophrenia

The symptoms can appear gradually or suddenly, manifesting in the affected person withdrawing from their daily activities.

Speech becomes increasingly unclear, making it difficult for the person to follow even a simple conversation. Symptoms may appear unexpectedly but more often develop so slowly that it may be hard to determine when the psychosis began.

Among the symptoms are disturbances in thoughts and sometimes in movement patterns.

Thoughts

Disturbances in thought processes can manifest as slower thinking or thoughts jumping from one idea to another, making it difficult to follow a train of thought.

The affected person may also start doubting their own identity and believe they are someone else, such as a well-known personality.

Sometimes, the individual may begin to believe that others mean them harm and are trying to hurt them. They may also believe they are being persecuted or monitored.

Emotions

Disturbances in emotional expression may manifest as excessive joy, bewilderment, or despair. The affected person might laugh at a sad event or cry seemingly without cause, or to become suddenly aggressive. They may also appear entirely emotionless, making it impossible to establish emotional contact with them.

Movement

Disturbances in movement patterns may also occur. Muscles might become fixed or stiff, or the affected person may take on peculiar positions, such as standing on one leg for several hours.

An important form of schizophrenia is paranoid schizophrenia. The affected individual may then be convinced they are being persecuted and that others mean them harm. They may also believe they are being monitored and that their thoughts can be read.

How Common is it?

In Europe, approximately 1.5 million people are diagnosed with schizophrenia annually, with many of these cases leading to hospital admissions. The one-year prevalence of schizophrenia in the United States is around 1.1% of the adult population, equating to about 2.8 million people. While not all patients require hospitalization, schizophrenia remains a significant cause of inpatient psychiatric treatment in both regions.

The prevalence of schizophrenia is estimated to affect around 21 million people worldwide, emphasizing its global impact on healthcare systems. Many patients experience repeated hospitalizations due to acute episodes or the need for stabilization during psychosis.

Is it a genetic condition?

The disturbance in the brain’s metabolism that may underlie schizophrenia can be hereditary. However, having the illness in the family does not necessarily mean one will be affected. A person may have one of the known personality disorders, for example, a so-called schizoid personality disorder, characterized by shyness and withdrawal, or a paranoid personality, characterized by hypersensitivity and mistrust. Individuals with, for instance, a paranoid personality, usually do not develop psychosis unless they have hereditary predispositions for such a condition.

In approximately 30% of schizophrenia cases, hereditary factors play a decisive role in the development of the illness into psychosis.

Complications of Schizophrenia

The illness carries a risk that the affected person may harm themselves or others. There is also a risk of suicide.

If one suspects that someone in the family suffers from schizophrenia, one should try to get them to seek medical care. This is usually not easy, as psychotic people often do not realize anything is wrong. Even in cases where they realize something is amiss, they are often afraid of being admitted to a hospital. Therefore, it helps to ensure that the person receives treatment.

One should never leave an ill person alone in a state of confusion. Having a relative or friend present can have a calming effect while waiting for medical treatment and prevent them from harming themselves.

Symptoms of schizophrenia usually necessitate hospital admission for observation. Various examinations are also performed to rule out that the condition is caused by an organic illness, such as brain tumors.

Treatment

Severe forms of the illness require hospital care. Treatment generally includes medication, some form of psychotherapy, and rehabilitation.

The medications used are so-called neuroleptics, which affect the brain’s metabolism and have a calming effect. In recent years, modern preparations have been introduced, which have better effects and fewer side effects. In some cases, antidepressants are also administered, and in certain cases, electroconvulsive therapy is used.

The final stage of treatment is rehabilitation, where the patient is helped to return to normal activity and productivity. During the early stages of rehabilitation, the patient’s social tasks are gradually increased, giving them greater responsibility until the situation resembles their pre-illness life in society.

Patients are prepared for social life by being allowed, for increasingly longer periods, to leave the hospital and stay at home or live independently with some contact with the hospital. Some patients can return to work during hospitalization and thereby readjust to normal life.

Schizophrenia prognosis

Many individuals recover sufficiently after a period of illness to return to a somewhat normal life. However, the risk of relapse is high, especially when exposed to significant psychological stress. In some cases, the illness becomes chronic, meaning the patient remains withdrawn and emotionally isolated. The more severe expressions of the illness can, however, be managed through long-term medication.