PREVENTION

There's no sure way to prevent schizophrenia. However, early treatment may help get symptoms under control before serious complications develop and may help improve the long-term outlook.

Sticking with the treatment plan can help prevent relapses or worsening of schizophrenia symptoms. In addition, researchers hope that learning more about risk factors for schizophrenia may lead to earlier diagnosis and treatment.

WHEN TO SEE A DOCTOR

In men, schizophrenia symptoms typically start in the early to mid-20s. In women, symptoms typically begin in the late 20s. It's uncommon for children to be diagnosed with schizophrenia and rare for those older than 45. If the symptoms long for at least one month , we need to worry about that.

People with schizophrenia often lack awareness that their difficulties stem from a mental illness that requires medical attention. So it often falls to family or friends to get them help.

TREATMENT

Schizophrenia requires lifelong treatment, even when symptoms have subsided. Treatment with medications and psychosocial therapy can help manage the condition. During crisis periods or times of severe symptoms, hospitalization may be necessary to ensure safety, proper nutrition, adequate sleep and basic hygiene.

A psychiatrist experienced in treating schizophrenia usually guides treatment. The treatment team also may include a psychologist, social worker, psychiatric nurse and possibly a case manager to coordinate care. The full-team approach may be available in clinics with expertise in schizophrenia treatment.

Medications

Medications are the cornerstone of schizophrenia treatment. However, because medications for schizophrenia can cause serious but rare side effects, people with schizophrenia may be reluctant to take them.

Antipsychotic medications are the most commonly prescribed drugs to treat schizophrenia. They're thought to control symptoms by affecting the brain neurotransmitters dopamine and serotonin.

Willingness to cooperate with treatment may affect medication choice. Someone who is resistant to taking medication consistently may need to be given injections instead of taking a pill. Someone who is agitated may need to be calmed initially with a benzodiazepine such as lorazepam (Ativan), which may be combined with an antipsychotic.

Psychosocial interventions

Once psychosis recedes, psychological and social (psychosocial) interventions are important — in addition to continuing on medication. These may include:

• Individual therapy. Learning to cope with stress and identify early warning signs of relapse can help people with schizophrenia manage their illness.
• Social skills training. This focuses on improving communication and social interactions.
• Family therapy. This provides support and education to families dealing with schizophrenia.
• Vocational rehabilitation and supported employment. This focuses on helping people with schizophrenia prepare for, find and keep jobs.

Complications

Left untreated, schizophrenia can result in severe emotional, behavioral and health problems, as well as legal and financial problems that affect every area of life. Complications that schizophrenia may cause or be associated with include:

•      Suicide
•      Any type of self-injury
•      Anxiety and phobias
•      Depression
•      Abuse of alcohol, drugs or prescription medications
•      Poverty
•      Homelessness
•      Family conflicts
•      Inability to work or attend school
•      Social isolation
•      Health problems, including those associated with antipsychotic medications, smoking and poor lifestyle choices
•      Being a victim of aggressive behavior
•     Aggressive behavior, although it's uncommon and typically related to lack of treatment substance misuse or a history of violence

RISK FACTORS

Although the precise cause of schizophrenia isn't known, certain factors seem to increase the risk of developing or triggering schizophrenia, including:

•       Having a family history of schizophrenia
•     Exposure to viruses, toxins or malnutrition while in the womb, particularly in the first and second trimesters
•     Increased immune system activation, such as from inflammation or autoimmune diseases
•     Older age of the father
•     Taking mind-altering (psychoactive or psychotropic) drugs during teen years and young adulthood

CAUSES OF SCHIZOPHRENIA

It's not known exactly what causes schizophrenia, but researchers believe that a combination of genetics and environment contributes to development of the disorder.

Problems with certain naturally occurring brain chemicals, including neurotransmitters called dopamine and glutamate, also may contribute to schizophrenia. Neuroimaging studies show differences in the brain structure and central nervous system of people with schizophrenia. While researchers aren't certain about the significance of these changes, they support evidence that schizophrenia is a brain disease. In short, we can say that these are the main causes of schizophrenia:

•    Genetic causes of schizophrenia
•    Environmental causes of schizophrenia
•     Brain chemical imbalances
•    Abnormal brain structure

SYMPTOMS IN TEENAGERS

Schizophrenia symptoms in teenagers are similar to those in adults, but the condition may be more difficult to recognize in this age group. This may be in part because some of the early symptoms of schizophrenia in teenagers are common for typical development during teen years, such as:

·        Withdrawal from friends and family

·        A drop in performance at school

·        Trouble sleeping

·        Irritability or depressed mood

·        Lack of motivation

Compared with schizophrenia symptoms in adults, teens may be:

·        Less likely to have delusions

·        More likely to have visual hallucinations

SYMPTOMS OF SCHIZOPHRENIA

 Schizophrenia involves a range of problems with thinking (cognitive), behavior or emotions. Signs and symptoms may vary, but they reflect an impaired ability to function. Symptoms may include:

·        Delusions. These are false beliefs that are not based in reality. For example, you're being harmed or harassed; certain gestures or comments are directed at you; you have exceptional ability or fame; another person is in love with you; a major catastrophe is about to occur; or your body is not functioning properly. Delusions occur in as many as 4 out of 5 people with schizophrenia.

·        Hallucinations. These usually involve seeing or hearing things that don't exist. Yet for the person with schizophrenia, they have the full force and impact of a normal experience. Hallucinations can be in any of the senses, but hearing voices is the most common hallucination.

·        Disorganized thinking (speech). Disorganized thinking is inferred from disorganized speech. Effective communication can be impaired, and answers to questions may be partially or completely unrelated. Rarely, speech may include putting together meaningless words that can't be understood, sometimes known as word salad.

·        Extremely disorganized or abnormal motor behavior. This may show in a number of ways, ranging from childlike silliness to unpredictable agitation. Behavior is not focused on a goal, which makes it hard to perform tasks. Abnormal motor behavior can include resistance to instructions, inappropriate and bizarre posture, a complete lack of response, or useless and excessive movement.

·        Negative symptoms. This refers to reduced ability or lack of ability to function normally. For example, the person appears to lack emotion, such as not making eye contact, not changing facial expressions, speaking without inflection or monotone, or not adding hand or head movements that normally provide the emotional emphasis in speech. Also, the person may have a reduced ability to plan or carry out activities, such as decreased talking and neglect of personal hygiene, or have a loss of interest in everyday activities, social withdrawal or a lack of ability to experience pleasure.

     Suicidal thoughts and behavior. Suicidal thoughts and behavior are common among people with schizophrenia.

—  UNDIFFERENTIATED SCHIZOPHRENIA 

This subtype is diagnosed when the person's symptoms do not clearly represent one of the other three subtypes (disorganized / hebephrenic, paranoid and catatonic schizophrenia).

—  RESIDUAL SCHIZOPHRENIA

In this type of schizophrenia, the severity of schizophrenia symptoms

has decreased. Hallucinations, delusions, or other symptoms may still

be present but are considerably less than when the schizophrenia was

originally diagnosed.

—  CATATONIC SCHIZOPHRENIA

    The most striking symptoms of this type are physical. People with catatonic schizophrenia are generally immobile and unresponsive to the world around them. They often become very rigid and stiff, and unwilling to move. Occasionally, these people have peculiar movements like grimacing or assume bizarre postures. Or, they might repeat a word or phrase just spoken by another person. People with catatonic schizophrenia are at increased risk of malnutrition, exhaustion, or self-inflicted injury.

    

PARANOID SCHIZOPHRENIA

People with this type are preoccupied with false beliefs (delusions) about being persecuted or being punished by someone. Their thinking, speech and emotions, however, remain fairly normal.

—  DISORGANIZED/HEBEPHRENIC SCHIZOPHRENIA

     People with this type often are confused and   incoherent, and have jumbled speech. Their outward behavior may be emotionless or flat or inappropriate, even silly or childlike. Often they have disorganized behavior that may disrupt their ability to perform normal daily activities such as showering or preparing meals. 

CONDITION OF BRAIN IN SCHIZOPHRENIA

NORMAL BRAIN VS. SCHIZOPHRENIC BRAIN