Schizophrenia

Despite the etymology of the term from the Greek roots skhizein (σχίζειν, “to split”) and phrēn, phren- (φρήν, φρεν-; “mind”), schizophrenia does not imply a “split mind.” It is not the same as dissociative identity disorder or “multiple personality disorder” a condition with which it is often confused by the public. Schizophrenia is a mental disorder characterized by a disruption of processes. Thought, speech, emotions and perception ( how the brain handles signals from the 5 Senses) are all disturbed. It most commonly manifests as auditory hallucinations, paranoid or bizarre behavior and unshakeable but completely unrealistic delusions. The patients will lose touch with the actual world and may be accompanied by significant social or occupational dysfunction. This condition is effectively a form of psychosis. The onset of symptoms typically occurs in young adulthood. Diagnosis is based on observed behavior and the patient’s reported experiences. Schizophrenia affects 24 million people worldwide with 2.5 of those being in the United States. In Britain people are 3x more likely to be schizophrenic than to have cancer.

Genetics, early environment, neurobiology, psychological and social processes appear to be important contributing factors. Some recreational and prescription drugs also appear to cause or worsen symptoms. Current research is focused on the role of neurobiology, although no single isolated organic cause has been found. The many possible combinations of symptoms have triggered debate about whether the diagnosis represents a single disorder or a number of discrete syndromes.

The mainstay of treatment is antipsychotic medication, which primarily suppresses dopamine, and sometimes serotonin, receptor activity. Psychotherapy, vocational and social rehabilitation are also important in treatment. In more serious cases involuntary hospitalization may be necessary, although hospital stays are now shorter and less frequent than they had been in the past.

The disorder is thought mainly to affect cognition, but it also usually contributes to chronic problems with behavior and emotion. People with schizophrenia are likely to have additional conditions, including major depression and other anxiety disorders. The lifetime occurrence of substance abuse in people with schizophrenia is almost 50%. Social problems, such as long-term unemployment, poverty and homelessness, are common. The average life expectancy of people with the disorder is 12 to 15 years less than those without due to the result of increased physical health problems and a higher suicide rate.

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