Schizophrenia is a serious and long-term condition that affects the way a person thinks, feels, acts, engages with other people, expresses emotion and perceives reality.

Neuraxpharm provides medication alternatives for schizophrenia and once your doctor has determined your specific needs, they can prescribe the product that best adapts to your needs and condition.

Find out more about its causes, symptoms and treatments.

What is schizophrenia?

Autism is a lifelong developmental condition that affects the way a person’s brain works and the way they communicate and make sense of the world. As a result, they may need support in some areas.

What are the main types of Autism?

Schizophrenia is a severe, chronic mental illness that causes a range of psychological symptoms and may mean the person affected can’t always distinguish their own thoughts and ideas from reality. It can lead to problems at work, school and in relationships. People with schizophrenia may become withdrawn and seem to lose touch with reality, which can cause distress for the individual concerned, as well as their family members and friends. 

There is no known cure and if left untreated, the symptoms of schizophrenia can be persistent and disabling. However, effective treatments are available to help individuals manage their symptoms, reduce the risk of a recurrence, and better enjoy day-to-day life.

There are many misconceptions about schizophrenia, however, most people affected are no more dangerous or violent than people in the general population.

What are the main types of schizophrenia?

Schizophrenia is the term used for a series of mental health disorders that fall along the same spectrum, including:

  • Paranoid schizophrenia: This includes symptoms such as delusions and hallucinations, disorganised speech and difficulty concentrating.
  • Hebephrenic or disorganised schizophrenia: These types of schizophrenia don’t include hallucinations or delusions but do include disorganised behaviour and speech. They may also include inappropriate emotional responses or lack of any emotional response.
  • Undifferentiated schizophrenia: People affected may display behaviours that are applicable to more than one subtype of schizophrenia. While there are different types of schizophrenia, these disorders fall on a spectrum and should be treated as such.
  • Residual schizophrenia: This is when someone has a previous diagnosis of schizophrenia but no longer has any prominent symptoms of the disorder. The symptoms have lessened in intensity and generally include poor attention, some mental disorganisation, and emotional withdrawal. Because many people with schizophrenia find their symptoms vary in frequency and intensity, this subtype is rarely used these days.
  • Catatonic schizophrenia: This subtype involves physical movement as a symptom. Catatonia can be its own disorder, but people with catatonic schizophrenia often have negative symptoms of schizophrenia and are not very responsive. 

Conditions related to schizophrenia include schizoaffective disorder, which includes elements of both schizophrenia and mood disorders. Its symptoms can include paranoid thoughts, delusions or hallucinations, difficulty concentrating, depression, problems with sleep and appetite, and social withdrawal.

Other related disorders include delusional disorder, brief psychotic disorder, schizophreniform disorder and psychosis.

How many people have schizophrenia?

Schizophrenia affects 20 million people worldwide, or one percent of the population in all cultures. It affects equal numbers of men and women, but the onset is often later in women than in men.

Symptoms

The severity of schizophrenia and its symptoms varies from person to person and symptoms may seem to worsen and improve in cycles known as relapses and remissions. Some people have only one psychotic episode, while others have many during a lifetime but lead relatively normal lives in between. Others may have more trouble functioning over time, with little improvement between full-blown psychotic episodes.

What are the symptoms of schizophrenia?

The symptoms of schizophrenia are generally referred to as either positive (or psychotic, based in non-reality), negative (things that are absent), cognitive or disorganised.

Positive symptoms include:

  • Hallucinations, including changes in vision, hearing, smell, touch, and taste
  • Unusual behaviours 
  • Delusions, including paranoia and irrational fears 

Negative symptoms include:

  • Losing motivation and energy
  • Losing interest in day-to-day life
  • Difficulty planning, beginning, and sustaining activities
  • Speaking less
  • Withdrawing from family, friends and social situations
  • Difficulty showing emotions
  • Reduced emotions 
  • Poor personal hygiene

Cognitive symptoms include:

  • Difficulties with concentration and memory
  • Difficulty processing and using information

Disorganised symptoms include:

  • Disorganised speech 
  • Shifting quickly from one thought to the next without logical connections between them
  • Moving slowly
  • Being unable to make decisions
  • Writing excessively but without meaning
  • Forgetting or losing things
  • Repeating movements or gestures, like pacing or walking in circles
  • Having problems making sense of everyday sights, sounds, and feelings

In catatonic schizophrenia, the person affected might stop speaking, and their body may be fixed in a single position for a very long time.

What are the stages of schizophrenia?

Schizophrenia can develop slowly, often during the teenage years, and for various reasons may initially be difficult to diagnose.

Early adulthood is the most common age for schizophrenia to appear, and there must be symptoms for at least six months for a diagnosis to be made. Men with schizophrenia may start experiencing symptoms in their late teens or early 20s, whilst for women symptoms may present later, up to their early 30s.

There are three phases of schizophrenia: the beginning stage; the acute/active stage; and the residual/recovery stage. The beginning (or ‘prodromal’) stage could last for days, but equally might continue for years. Lack of one specific trigger means that it might be difficult to identify, and behavioural changes might be subtle.

What are the early signs of schizophrenia?

Symptoms of possible schizophrenia could include changes in mood and social withdrawal, meaning the condition could easily be mistaken for a typical teenage ‘phase’. Lack of motivation, disrupted sleep, difficulty concentrating, an increased temper, trouble within relationships and difficulty at school are all symptoms that might manifest in teenagers when the condition is developing.

Those suffering from schizophrenia may experience an episode of psychosis, which often leads to their diagnosis. Mood changes and increased difficulty in social functioning may present themselves before the first episode of psychosis.

Those with the condition might find that their symptoms are sometimes severe, and sometimes less so.

Causes, risk factors and life expectancy

It isn’t currently known what exact combination of factors causes schizophrenia. Current treatment focuses on effectively managing symptoms and assisting those with the condition to live normal lives.

What causes schizophrenia?

The exact cause of schizophrenia is unknown, however, it is most likely linked to a combination of genetic and environmental factors.

It’s thought that some people are more vulnerable to developing schizophrenia and that certain situations, such as a stressful life event or drug misuse, can trigger the condition.

  • Genetic factors: Schizophrenia can run in families, however, it is not yet possible to use genetic information to predict who will develop schizophrenia.
  • Differences in the brain: In those who are vulnerable, changes to the brain during puberty may trigger psychotic episodes. Research shows that there is an important link between our brain and our gut and the beneficial microorganisms that live inside our digestive system (known as ‘the microbiota gut–brain axis’), which may affect the way we manage periods of stress. The gut-brain microbiota axis has been noted as an important factor in whether schizophrenia will develop. Differences in brain structure and function, and interactions between neurotransmitters have also been cited as contributors to development of the condition. 
  • Environmental factors: Poverty, unstable surroundings, and/or nutritional problems before birth have also been cited as factors that could influence the development of schizophrenia.

Is schizophrenia hereditary?

Schizophrenia is not hereditary, but rather is genetic – meaning that a combination of genes, rather than one single gene, is a factor in whether the condition will develop or not.

Who gets schizophrenia?

Schizophrenia can affect people anywhere in the world, across all races and cultures. 

Schizophrenia can be diagnosed in childhood, however this is relatively rare. Early-onset schizophrenia typically occurs between the ages of 13 and 18. A diagnosis under the age of 13 is extremely rare. Men may experience symptoms earlier than women, although the condition affects all genders equally. It is likely that the earlier the symptoms appear, the more severe the case of schizophrenia will be.

How long can you live with schizophrenia?

How long a person can live with schizophrenia depends on various factors, including the severity of their case and how receptive they are to treatment. Those living with the condition are likely to be able to live relatively normal lives alongside family if treatment is administered. People with schizophrenia are unlikely to live in psychiatric facilities in the long-term. Research to improve treatment is ongoing. 

Schizophrenia often co-occurs alongside other conditions, including psychosis, diabetes and heart disease. Because of this, those with schizophrenia have a life expectancy between 15 and 25 years lower than the general population. People with schizophrenia are two to three times more likely to die early than the general population.

Diagnosis

There’s no single test for schizophrenia and the condition is usually diagnosed after assessment by a specialist in mental health, sometimes after a period of psychosis.

Sometimes it might not be clear whether someone has schizophrenia or a related mental illness, such as bipolar disorder or schizoaffective disorder.

How is schizophrenia diagnosed?

Symptoms of schizophrenia must be present for six months, and consistently active for at least one of those months, before a diagnosis can be made. Two of the following symptoms will need to have been observed: 

  • Hallucinations
  • Disorganised speech
  • Delusions
  • Disorganised or catatonic behaviour
  • Negative symptoms (the absence of something, e.g. motivation or energy) 

Delusions, hallucinations or disorganised speech must be one of the symptoms noted for a positive diagnosis, and they cannot be the result of any other condition.

The doctor may attempt to rule out conditions that schizophrenia may be associated with, for example substance-induced psychosis, through the use of brain imaging or blood tests.

Test to diagnose schizophrenia

Diagnosing schizophrenia is based on observing someone’s actions and symptoms. However, doctors may carry out tests to make sure nothing else is at the root of the symptoms. For example, imaging studies or CT or MRI scans might be carried out, to rule out symptoms being caused by problems such as brain tumours, epilepsy, autoimmune conditions or infections. Inkblot, cognitive and/or personality tests may also be used. 

Doctors are also likely to perform tests to ensure that symptoms are not being caused by other factors, such as prescription medications, alcohol or drugs.

If a doctor suspects schizophrenia, they may refer to a psychiatrist, who may carry out assessments or observe behaviours in order to try and establish a clear diagnosis.

Treatment and medication

There are various treatment options for people with schizophrenia, which can help them to live their lives in a manageable way.

How is schizophrenia treated?

Schizophrenia is usually treated with a combination of medication and therapy, tailored to each individual person.

The aim is to ease the symptoms and to cut the chances of a relapse or the return of the symptoms. Treatment options are likely to include antipsychotic medicines and/or cognitive behavioural therapy (CBT).

Medication

Antipsychotic medications can help reduce the intensity and frequency of psychotic symptoms. They work by blocking the effect of the chemical dopamine on the brain.

The choice of antipsychotics should be made following a discussion with a doctor/psychiatrist about the likely benefits and side effects, which will differ from person to person. Side effects of some medication can include weight gain, dry mouth, restlessness, and drowsiness.

Most people with schizophrenia take medication for one or two years after their first psychotic episode in order to prevent further acute schizophrenic episodes occurring, and for longer if the illness is recurrent.

Therapy

Therapies such as cognitive behavioural therapy (CBT), family therapy and arts therapy, among others, can help people cope better with their hallucinations or delusions.

  • CBT:CBT aims to help people identify the thinking patterns that are causing them to have unwanted feelings and behaviours, and learn to change this thinking with more realistic and useful thoughts.
  • Family therapy: This aims to help people with schizophrenia and their families cope better with the condition.
  • Arts therapy:Creative therapy can allow people to express their experiences in a non-verbal way, helping them develop new ways of relating to others.
A combination of psychosocial therapies and antipsychotic medication in the treatment of schizophrenia is common.

Intervention

There are various interventions that may be suggested to those living with schizophrenia. They could include:

  • Coordinated specialty care (CSC):CSC is a recovery-focused treatment plan that combines medicine and therapy with social services, employment, and education, to treat schizophrenia when symptoms initially appear. The aim is to keep the family as involved as possible. CSC is used early on, during the first phase, with the aim of helping people lead a normal life.
  • Assertive community treatment (ACT):ACT is an intervention designed for those with schizophrenia who might be at risk of homelessness, or repeated hospitalisation. Lots of contact from a dedicated team is a key part of ACT.
  • Family support programmes:The condition may be made easier through the use of family education programmes, which can offer information and guidance on schizophrenia, its treatments, and the support strategies that can be utilised. This can assist with practical help, and increase the person’s confidence in their support network.
  • Electroconvulsive therapy (ECT):ECT therapy involves attaching electrodes to the scalp under general anaesthetic. It usually takes places two or three times a week for a few weeks. The aim is to improve mood through inducing a series of controlled seizures, which scientists believe may affect the release of neurotransmitters in the brain. Particularly in older schizophrenic people, the results can be apparent very quickly. It is most likely to be used when people are catatonic.

Diet

A bad diet may make the symptoms of schizophrenia worse, as might drinking alcohol to excess or taking drugs. There is also a chance that alcohol or drugs could interfere with some antipsychotic medications.

Certain foods in particular may help reduce the symptoms of schizophrenia and improve overall health.

  • Fruit and vegetables:Fruit and vegetables are a good source of fibre, which many people with schizophrenia and related health conditions (such as obesity, diabetes or heart disease) don’t get enough of.
  • Salmon and fatty fish:Salmon and fatty fish are good sources of Omega-3, which can reduce the symptoms of schizophrenia.
  • Chicken: The vitamin niacin may also help reduce symptoms; it can be found in chicken.
  • Beef:There may be a connection between low levels of zinc and schizophrenia. As zinc is found in beef, eating beef may help reduce symptoms.

Exercices

Exercise, as part of a behavioural modification programme, is necessary for sustained weight control, which is especially important for people with schizophrenia. Exercise that has been proven to have a positive effect includes:

  • Aerobic exercise:Interventions that include vigorous or aerobic exercise have been found to have a positive impact on people with schizophrenia.
  • Group exercise: Group exercise has also been found to have a positive success rate when it comes to improving heart health, metabolism, and overall physical fitness of people with schizophrenia.
It is important to note that even moderate levels of exercise can have a positive effect on health. People shouldn’t be put off starting to exercise if they don’t feel that they are fit already.

Prevention

At the moment, there is no way to prevent the onset of schizophrenia, although treatment methods have been developed that can enable those with the condition to live their lives in a relatively normal way.

Early diagnosis and engagement with treatment can help to lessen the disruption that might be experienced, and can reduce the chance of relapse. Relapses can often be prevented by:

  • Recognising the signs of an acute episode
  • Taking medication as prescribed and advised by doctors
  • Discussing the condition so that others are aware of the signs

Scientific studies

As the cause of schizophrenia isn’t yet known, research into areas including environment and genetics is hugely important. Also vital is research that leads to actions that reduce the impact that the condition can have on people’s lives. 

Future treatments for schizophrenia are under the microscope. Deep brain stimulation (DBS), which is a well-established treatment for Parkinson’s disease, may be important in the development of treatment for psychiatric disorders too, and researchers are looking into this.

There is also significant research to identify how genes could affect schizophrenia, with the aim of increasing the personalised medicine that can be offered in the future.

Referenced sources

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  2.  Miller JN, Black DW. Schizoaffective disorder: A review. Ann Clin Psychiatry. 2019;31(1):47-53.
  3.  Rebok F. Tratamiento farmacológico del trastorno esquizoafectivo, el trastorno esquizofreniforme y el trastorno psicótico breve [Pharmacological treatment of schizoaffective disorder, schizophreniform disorder and brief psychotic disorder]. Vertex. 2012;23(104):287-298.
  4.  Chan V. Schizophrenia and Psychosis: Diagnosis, Current Research Trends, and Model Treatment Approaches with Implications for Transitional Age Youth. Child Adolesc Psychiatr Clin N Am. 2017;26(2):341-366. doi:10.1016/j.chc.2016.12.014
  5.  GBD 2017 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017 [published correction appears in Lancet. 2019 Jun 22;393(10190):e44]. Lancet. 2018;392(10159):1789-1858. doi:10.1016/S0140-6736(18)32279-7
  6.  Schultz SH, North SW, Shields CG. Schizophrenia: a review. Am Fam Physician. 2007;75(12):1821-1829.
  7.  Cha HY, Yang SJ. Anti-Inflammatory Diets and Schizophrenia. Clin Nutr Res. 2020;9(4):241-257. Published 2020 Oct 28. doi:10.7762/cnr.2020.9.4.241
  8.  Lieberman JA, Perkins D, Belger A, et al. The early stages of schizophrenia: speculations on pathogenesis, pathophysiology, and therapeutic approaches [published correction appears in Biol Psychiatry 2002 Feb 15;51(4):346]. Biol Psychiatry. 2001;50(11):884-897. doi:10.1016/s0006-3223(01)01303-8
  9.  Caso JR, Balanzá-Martínez V, Palomo T, García-Bueno B. The Microbiota and Gut-Brain Axis: Contributions to the Immunopathogenesis of Schizophrenia. Curr Pharm Des. 2016;22(40):6122-6133. doi:10.2174/1381612822666160906160911
  10.  Remschmidt H, Theisen FM. Schizophrenia and related disorders in children and adolescents J Neural Transm Suppl. 2005;(69):121-141. doi:10.1007/3-211-31222-6_7
  11.  Wildgust HJ, Hodgson R, Beary M. The paradox of premature mortality in schizophrenia: new research questions. J Psychopharmacol. 2010;24(4 Suppl):9-15. doi:10.1177/1359786810382149
  12.  Laursen TM, Nordentoft M, Mortensen PB. Excess early mortality in schizophrenia. Annu Rev Clin Psychol. 2014;10:425-448. doi:10.1146/annurev-clinpsy-032813-153657
  13.  Faulkner G, Soundy AA, Lloyd K. Schizophrenia and weight management: a systematic review of interventions to control weight. Acta Psychiatr Scand. 2003;108(5):324-332. doi:10.1034/j.1600-0447.2003.00218.x
  14.  Fernández-Abascal B, Suárez-Pinilla P, Cobo-Corrales C, Crespo-Facorro B, Suarez-Pinilla M. In- and outpatient lifestyle interventions on diet and exercise and their effect on physical and psychological health: a systematic review and meta-analysis of randomised controlled trials in patients with schizophrenia spectrum disorders and first episode of psychosis [published online ahead of print, 2021 Jan 24]. Neurosci Biobehav Rev. 2021;S0149-7634(21)00019-1. doi:10.1016/j.neubiorev.2021.01.005
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