Schizophrenia is a mental disorder that makes it hard to:
Schizophrenia is a complex illness. Mental health experts are not sure what causes it. However, genes may play a role.
Schizophrenia affects both men and women equally. It usually begins in the teen years or young adulthood, but it may begin later in life. It tends to begin later in women, and is more mild.
Childhood-onset schizophrenia begins after age 5. Childhood schizophrenia is rare and can be hard to tell apart from other developmental problems in childhood, such as autism.
Schizophrenia symptoms usually develop slowly over months or years. Sometimes you may have many symptoms, and at other times you may only have a few symptoms.
People with any type of schizophrenia may have trouble keeping friends and working. They may also have problems with anxiety, depression, and suicidal thoughts or behaviors.
At first, you may have the following symptoms:
As the illness continues, you may have problems with thinking, emotions, and behavior, including:
Symptoms depend on the type of schizophrenia you have.
Paranoid schizophrenia symptoms may include:
Disorganized schizophrenia symptoms may include:
Catatonic schizophrenia symptoms may include:
Undifferentiated schizophrenia may include symptoms of more than one other type of schizophrenia.
There are no medical tests to diagnose schizophrenia. A psychiatrist should examine you to make the diagnosis. The diagnosis is made based on an interview of you and your family members.
The health care provider will ask questions about:
Brain scans (such as CT or MRI) and blood tests may help rule out other conditions that have similar symptoms.
During an episode of schizophrenia, you may need to stay in the hospital for safety reasons.
Antipsychotic medications are the most effective treatment for schizophrenia. They change the balance of chemicals in the brain and can help control symptoms.
These medications are usually helpful, but they can cause side effects. Many side effects can be managed, and they should not prevent you from seeking treatment for this serious condition.
Common side effects from antipsychotics may include:
Long-term use of antipsychotic medications may increase your risk for a movement disorder called tardive dyskinesia. This condition causes repeated movements that you cannot control, especially around the mouth. Call your health care provider right away if you think you may have this condition.
When schizophrenia does not improve with several antipsychotics, the medication clozapine can be helpful. Clozapine is the most effective medication for reducing schizophrenia symptoms, but it also tends to cause more side effects than other antipsychotics.
Schizophrenia is a life-long illness. Most people with this condition need to stay on antipsychotic medication for life.
SUPPORT PROGRAMS AND THERAPIES
Supportive therapy may be helpful for many people with schizophrenia. Behavioral techniques, such as social skills training, can be used to improve social and work functioning. Job training and relationship-building classes are important.
Family members of a person with schizophrenia should be educated about the disease and offered support. Programs that offer outreach and community support services can help people who lack family and social support.
Family members and caregivers are often encouraged to help people with schizophrenia stay with their treatment.
It is important that the person with schizophrenia learns how to:
The outlook with schizophrenia is hard to predict. Most of the time, symptoms improve with medication. However, some people may have trouble functioning and are at risk for repeated episodes, especially during the early stages of the illness.
People with schizophrenia may need housing, job training, and other community support programs. People with the most severe forms of this disorder may not be able to live alone. They may need to live in group homes or other long-term, structured residences.
Symptoms will return if you do not take your medication.
Having schizophrenia increases your risk for:
Call your health care provider if:
There is no known way to prevent schizophrenia.
You can prevent symptoms by taking your medication exactly as your doctor told you to. Symptoms will return if you stop taking your medication.
Always talk to your doctor if you are thinking about changing or stopping your medications. See your doctor or therapist regularly.
Freudenreich O, Weiss AP, Goff DC. Psychosis and schizophrenia. In: Stern TA, Rosenbaum JF, Fava M, Biederman J, Rauch SL, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 1st ed. Philadelphia, Pa: Mosby Elsevier;2008:chap 28.
Lyness JM. Psychiatric disorders in medical practice. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 404.
Updated by: Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington; Timothy Rogge, MD, Medical Director, Family Medical Psychiatry Center, Kirkland, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.
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