Schizophrenia

Schizophrenia is a disorder that manifests as hallucinations, delusions, and problems in thought, perception, and behavior. It has been found that in every 100,000 people, 15 have schizophrenia. It is more common in males in the younger population, while it is more common in females in older populations.

Last Updated: February 21, 2024

Schizophrenia is caused by: (1) abnormal structures in the brain. Using brain imaging techniques doctors can see certain parts of the brain that become altered which explains the change in behavior; (2) effects of the environment, for example exposure to cannabis, adverse prenatal exposures to persistent hunger. Additionally, environmental factors could also cause changes in the brain.

These environmental factors include:

  • Abnormal fetal development and low birth weight;
  • Gestational diabetes;
  • Preeclampsia;
  • Emergency cesarean section and other birthing complications;
  • Maternal malnutrition and vitamin D deficiency;
  • Urban residence.

Changes found in the brain:

  • Enlargement of the lateral ventricles, areas of the brain that allow brain fluid to flow through
  • Decreased volume of the temporal lobe cortex, the area of the brain that helps us understand information we hear
  • Damage to neurons or nerve cells, which are broken or torn apart due to repeated or prolonged stress
  • Decreasing brain activity due to reduced gray and white matter volume, the parts of the brain that play a role in our behavior and thought process

Schizophrenia is a psychotic disorder. Psychosis is a symptom that presents as self-importance, inability to identify what is real, as well as delusions, hallucinations, and disorganized speech and behavior. Specifically, the Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5) defines Schizophrenia as having two or more of the following symptoms and must be present for a significant amount of time during a one-month period: 

  • hallucinations; 
  • delusions;
  • disturbances in thought, perception and behavior

Additionally, social or occupational dysfunction should persist for at least six months and the symptoms stated above should persist for at least a month.

People who present with the mentioned changes in behavior should consult a licensed physician or a psychiatrist to receive the proper diagnosis and treatment. These doctors may also perform a few other tests to help support their diagnosis

Additionally, several other tests such as urea and electrolyte tests can be done to further investigate other potential causes. 

Two types of drugs are typically used to treat psychotic behaviors. First is the typical/conventional antipsychotics, such as Chlorpromazine and Fluphenazine. The other type of drug are the atypical antipsychotics, such as Amisulpride and Risperidone.

It is important to remember that these drugs have certain side effects. These include:

  • Tremor, rigidity, shuffling gait, pill rolling;
  • Rigid and painful contortions of the facial, eye, neck, and back muscles;
  • Uneasy and compelling internal sense of the need to move;
  • Abnormal and involuntary movements such as mouth and tongue movements, lip smacking, and puckering;
  • Weight gain resulting to obesity;
  • Glucose abnormalities leading to diabetes;
  • Lipid abnormalities leading to dyslipidemia;

Aside from adherence to medications, psychosocial treatment has varying levels of impact. They include, but are not limited to:

  • Cognitive Behavioral Therapy;
  • Supported Employment and Skills Training- where people with schizophrenia are given jobs; which take into consideration their situation and abilities;
  • Family-Based Services; 

Peer Support and Peer-Delivered Services.

 

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596

 

Hany M, Rehman B, Azhar Y, et al. Schizophrenia. [Updated 2022 May 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK539864/

 

Klosterkötter, J., Schultze-Lutter, F., Bechdolf, A., & Ruhrmann, S. (2011). Prediction and prevention of schizophrenia: what has been achieved and where to go next?. World psychiatry : official journal of the World Psychiatric Association (WPA), 10(3), 165–174. https://doi.org/10.1002/j.2051-5545.2011.tb00044.x

Last Updated: February 21, 2024