Schizophrenia: All that you want to know

Schizophrenia is a chronic brain disorder that combines hallucinations, delusions, and disordered thinking and behavior. Schizophrenia affects 1 in 300 people worldwide and has its onset in the late adolescent period or when the individual is in their twenties. It is often confused with multiple personality disorder, although the two are different regarding symptoms and occurrence.

Depending on the onset period and symptoms, schizophrenia can be categorized into

Simple Schizophrenia

An uncommon subtype of schizophrenia characterized by negative symptoms like apathy reduced affection display, and lack of initiative and motivation levels but without hallucinations or delusions.

Paranoid Schizophrenia

It is a schizophrenia subtype where the person feels distrustful or suspicious of other people and exhibits symptoms of delusions and hallucinations. Paranoid schizophrenia is usually triggered by stress and requires lifelong treatment even when the symptoms have subsided.

Hebephrenic Schizophrenia

Hebephrenic schizophrenia onsets between the ages of fifteen to twenty-five. It is characterized by incoherent speech , flat facial expressions, unpredictable reactions, and an overall disorganized thought process that impacts the individual's academic, social, and personal life.

Catatonic Schizophrenia

Catatonic schizophrenia is a combination of genetic factors and environmental triggers like stress. It is characterized by erratic motor behavior like catalepsy, stupor, mutism (lack of verbal response), lack of response stimuli or instruction, and waxy flexibility.

Undifferentiated Schizophrenia

Undifferentiated schizophrenia is the term used to describe people in the schizophrenia spectrum disorder who meet the criteria for schizophrenia diagnosis but cannot be classified into any subtypes. An insidious and gradual interest in external interests and a lack of emotions are some of its chief characteristic symptoms.

Residual Schizophrenia

Residual schizophrenia is a milder form of schizophrenia chiefly characterized by negative emotions like low energy, lack of motivation, and a depressed mood. It is even referred to as the third stage of schizophrenia after the prodromal and active phases when the person no longer experiences hallucinations or delusions.

Unspecified Schizophrenia

Unspecified schizophrenia is when the physician does not communicate about the schizophrenia type or has insufficient information about categorizing it.

The Diagnostic and Statistical Manual of Mental Disorders made the classification mentioned above in its previous manual ( DSM-4 ) and described the symptoms as such. However, the recent DSM manual ( DSM-5 ) specifies a specific set of symptoms and advises that the individual must exhibit any of the two symptoms for one month to be diagnosed with schizophrenia.

• Delusions

• Hallucinations

• Disorganized speech

• Disorganized or Catatonic Behavior

• Negative Symptoms

Causes of Schizophrenia

While the exact cause of schizophrenia varies from person to person and is unclear in several cases, medical experts as the following reasons as the main causes responsible for schizophrenic behavior

Genetic Inheritance

Schizophrenia does not occur because of a single abnormal gene. Instead, it is the result of several different genes and their mutations. The Psychiatric Genomics Consortium Study has found the genetic changes leading to schizophrenia to be concentrated in the neurons of the brain and absent in other tissues or cells.

Changes in brain chemistry

Using neuroimaging technology, researchers have observed a reduced gray matter volume and disrupted white matter in people with pre-onset schizophrenia symptoms. The reduced gray matter is especially seen in the medial temporal, superior temporal, and prefrontal areas.

Stress

Using animal studies, researchers have demonstrated that stress increases the cortisol levels in the hippocampus and inhibits glucose transport resulting in schizophrenic cognitive deficits.

Drug and substance Abuse

Drug and substance abuse does not cause schizophrenia. But they can increase the severity and frequency of psychotic episodes by acting as an environmental trigger.

Diagnosis of Schizophrenia

While diagnosing schizophrenia, the physician conducts a careful systemic evaluation to rule out other mental health issues with similar symptoms. Some of the ways in which physicians diagnose schizophrenia are

Physical evaluation

Physical evaluation helps the physician determine factors like speech difficulties, motor issues, and palpation changes because of the problem. It also helps them determine the extent and severity of the situation.

Psychiatric Evaluation

In psychiatric evaluation, the physician determines the family history or specific trigger causing the psychotic episodes and assesses the delusions, hallucinations, and negative emotions.

Diagnostic Criteria

Most physicians use the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association to evaluate the type, grade, and severity of schizophrenia.

Tests and Screenings

Blood tests, MRIs, and CT-Scan are some of the tests that physicians use for diagnosing schizophrenia.

Treatment

Schizophrenia Treatment depends on your symptoms and your tolerance or adherence to the treatment options. Some of the chief treatment options for schizophrenia are

Psychotherapy

The therapist or psychiatrist teaches the patient how to deal with hallucinations, negative emotions, and thinking patterns.

Medications

That controls the brain triggers causing the symptoms and helps the patient calm down and lead a life free from psychotic symptoms.

Psychosocial Interventions

Focus on family and individual therapy and aim to rehabilitate the persons dealing with the problem.