Schizophrenia is a group of psychotic disorders characterised by disturbances in thought, perception, affect, behaviour and communication lasting longer than six months.
Schizophrenia is a disease of the brain. Changes in neurophysiological functions that characterise schizophrenia have been identified, but its exact causes are unknown. Genetic factors appear to play a role, as close relatives of a person with schizophrenia are more likely to develop the disorder. Problems with intrauterine development and birth may increase the risk of developing schizophrenia later in life.
Psychological and social factors may also play some role in its development. The level of social and family support appears to influence the course of illness and may help prevent relapse.
Types of Schizophrenia
There are 5 recognised types of schizophrenia: catatonic, paranoid, disorganised, undifferentiated and residual. Each type has different symptoms:
Catatonic type
- motor disturbances
- stupor
- negativism
- rigidity
- excitement
- may be unable to take care of personal needs
- decreased sensitivity to painful stimulus
Paranoid type
- delusional thoughts of a persecution or grandiose nature
- anxiety
- anger
- violence
- argumentative
Disorganised type
- incoherence (not understandable)
- regressive behaviour
- flat affect
- delusions
- hallucinations
- inappropriate laughter
- mannerisms
- social withdrawal
Undifferentiated type
- may have symptoms of more than one subtype of schizophrenia
Residual type
- the prominent symptoms of the illness have abated but some features, such as hallucinations and flat affect, may remain
Treatment
The goals of conventional treatment include helping patients toward normal interactions with others, enabling patients to live in the community, and controlling the illness through the smallest effective dosage of medication. A combination of medication and psychotherapy is usually required.
Clozapine, approved in the U.S. in 1990, has been helping many people unresponsive to other antipsychotic medications without causing a side effect known as Tardive Dyskinesia (TD), which triggers involuntary facial movements; it does, however, cause a serious decline in white blood cells in 1 percent of patients, so weekly blood tests are required.
A new drug, risperidone, appears to be able to relieve symptoms without this complication. Other new drugs (olanzapine and quetiapine) have been approved to treat this disabling disorder.