Schizophrenia

Schizophrenia is a severe, chronic, complex mental disorder.^1-3 It affects how someone thinks, feels and behaves.^1-3 People with schizophrenia experience episodes of psychosis. This means that they may hallucinate (see or hear things that aren’t there); have delusions (believe things that aren’t real); and struggle with disordered thoughts, feelings, and motivation.^1-3

If schizophrenia is not treated, it can become worse, to the point where it becomes considerably disabling^2,3 with significant repercussions on someone’s education or career.³ It even increases mortality.^1,3 Effective treatments exist, and yet more than two out of three people with psychosis in the world do not receive specialist mental health care.³

While each person with schizophrenia may have different symptoms,¹ they can generally be grouped into four categories:⁴

• Positive symptoms: these don’t occur in healthy people, but are the result of the disease, and represent a change in behaviour or thoughts. For example: hearing voices, incoherent speech.^1,4
• Negative symptoms: this means that certain qualities are diminished or missing in people with the disease. For example: losing interest and motivation in life and daily activities, and not being able to make plans, feel emotion, express oneself, or initiate a conversation.^1,2,4
• Affective symptoms: these include depressed mood, anxiety, loss of sleep and appetite, and even thoughts of death or suicide.^4,5
• Cognitive symptoms: these affect attention, concentration, and memory. For example: not recognising people, or not being able to follow conversations, learn new things or remember appointments.²

Schizophrenia affects more than 20 million people worldwide.^1,3 In the UK, around 220,000 people are being treated for schizophrenia at any one time.⁶ It is typically diagnosed in men when they are in their late adolescence to early twenties, and in women when they are in their early twenties to early thirties.²

Genetic factors can contribute to the risk of developing Schizophrenia, as can certain environmental factors, such as poverty, stressful surroundings, or having been exposed to viruses or nutritional problems before birth.²

The impact of this disease on someone's life can be enormous. People with schizophrenia are more likely to be homeless,⁷ and are 2-3 times more likely to die early from preventable physical illnesses and infections, as they are less inclined to seek care.³ The risk for suicide is also 9 times higher for those with schizophrenia.¹

It is still not clear what causes schizophrenia, but we know that it is treatable with medicine and psychosocial support (such as help with participating in the community, and connecting with family and friends), ideally in combination.^2,3 The earlier someone is treated for schizophrenia, the more effective the treatment will be,¹ and the more likely they are to succeed in school and at work, achieve independent lives, and enjoy personal relationships.²

Antipsychotic medications can help reduce the intensity and frequency of psychotic symptoms. While some medications can have side effects, it is important not to suddenly stop taking the medication without consulting your doctor or pharmacist, as it can cause symptoms to worsen.²

Psychological therapies, which involve talking about your thoughts with a professional, can help reduce symptoms, and prevent relapse and hospitalisation.^1,2 Cognitive Behavioural Therapy (CBT) helps people cope with everyday activities and pursue personal goals,² giving them a chance at a normal life.

As schizophrenia is often misunderstood, programs to educate and support family, friends and partners are extremely important. Caring for someone with schizophrenia is very challenging, especially when you don’t know what is happening, or how to respond to someone who is experiencing psychosis.

When loved ones better recognise the psychotic symptoms, know what treatment options might be available, and understand that recovery is a lifelong commitment, they will be better able to effectively assist the person with schizophrenia. Awareness of the disease can lessen distress, bolster empowerment, and strengthen the capacity to cope – for both patients and caregivers.²

1. What could have caused my symptoms?

2. How will this specific treatment help me? What sort of improvements might I expect?

3. What are the risks of this medication? Are there side effects? Is it addictive?

4. What happens if I choose not to start on antipsychotic medications, or decide to stop taking them?

5. What can I do to prevent a relapse?

6. How will I know if I am relapsing? What symptoms can I expect, and where should I seek help?

7. What are my options for treatment, other than the first one you have recommended?

8. In what ways should I anticipate my relationships, job, and other aspects of my life to be affected by schizophrenia or its treatment?

9. What should I tell friends, family, and co-workers about my condition?
10. What resources or support groups are there for me and my family to help us cope?