Schizophrenia

Schizophrenia and Bipolar Disorder (manic depression) are the two main forms of severe mental disorder. These disorders are typically associated with major disruption to an individual’s everyday life, affecting behavior, thinking and emotions. For many sufferers, this disruption may continue throughout his or her life. It is also common for these experiences to occur as intermittent episodes, between which an individual may return to relatively normal functioning.

While mental illness frequently has residual features that can disrupt a person’s functioning over the longer term, there are several specialized treatments available that can help minimize disruptions, and improve self-management of symptoms and overall quality of life.

What is Schizophrenia?

Schizophrenia generally manifests in late adolescence or early adulthood in approximately one percent of the population. This disorder involves a marked reduction in the ability to function in day-today life and may include any of the following symptoms:

• Hallucinations - A person registers sensations that other people do not experience in any of the five senses. Auditory hallucinations are common, where a person may be ‘given’ false information or believe that they are being directed to act in certain ways. This may trigger erratic or unpredictable behavior by the sufferer, or may trigger distress. Current expert opinion suggests this may occur due to the malfunction of brain messages.

• Delusions or incorrect beliefs. This involves the misinterpretation of events, despite contrary logical evidence. For example, some sufferers firmly believe others are persecuting them, or have the ability to read or control their mind or behavior. Other sufferers may believe they have special powers

• Disorganization. A person may find it difficult to think, speak or behave in a planned and logical manner. Generally, such interruption to thinking also interferes with attention and memory. Feelings may also be affected whereby a person might experience a change in their motivation, experience of pleasure or loss of control of experiencing feelings.

Contrary to some popular opinion, Schizophrenia is not the same as ‘multiple personality’ and the degree of risk to general public, including serious crime, is no greater than that found generally in the community.

Additionally, people with Schizophrenia often have reduced awareness of their condition, commonly termed ‘lack of insight’. The effects on social and occupational functioning can be quite marked, with many sufferers becoming isolated and withdrawn from those around them, often resulting in an inability to maintain employment.

What causes Schizophrenia?

Schizophrenia is a complex condition and, to date, no single cause has been identified. Current knowledge implicates a number of factors, including a component of genetic risk – not all family members automatically develop the condition, but there is approximately a 10 percent chance that first-degree relatives of schizophrenics will develop the illness. Environmental and social factors, or lifestyle factors which cause stress – including substance abuse and highly negative emotional relationships – also contribute.

Some people may develop psychotic features very gradually over a period of time, while others may experience a sudden onset of disturbance. Problems generally appear towards the end of puberty of males, or in early adulthood for females. Approximately 25 percent of people with Schizophrenia experience only one or two episodes and may continue to live productive and happy lives between schizophrenic episodes. For others, psychotic episodes are longer and more intense, limiting the extent to which the person can develop productive vocational involvements and social relationships. This pattern may continue throughout the sufferer’s life.

Treatment and Management

Optimal treatment includes a combination of anti-psychotic medication, psychological interventions and assistance with managing activities of daily living, such as budgeting and organization of accommodation. Some people also benefit from intensive case management and a structured rehabilitation program.

The use anti-psychotic medication requires close consultation and regular contact with a treating psychiatrist, particularly for management of possible side effects. Not all sufferers benefit from traditional medications, but there are now drugs available which can assist some schizophrenic who may not have benefited from drug therapy in the past.

In addition to medication, best practice management includes specialist treatment by a clinical psychologist who has extensive post-graduate training in the non-drug management of mental health disorders. The major form of psychological intervention is Cognitive Behavior Therapy (CBT), which provides strategies and techniques to change thinking patterns and behaviors, including difficulties with medication compliance. This approach assists schizophrenics and their families to cope more effectively with symptoms, thereby reducing stress and helping them gain more control over their lives. These types of psychological treatments help sufferers to reach their maximum potential. Recent and significant scientific research evidence shows that cognitive behavior therapy is very useful for most long-term sufferers, including many who may have medication-resistant delusions or hallucinations.

For sufferers with ongoing family contact, another important intervention, typically provided by clinical psychologist, is psychoeducational family therapy. This approach focuses on the person’s close family relationships and social situation and provides detailed educational information on the illness to family members, as well as strategies for reducing stress levels.