Understanding Schizophrenia

Schizophrenia, often mistaken for general psychosis, is a chronic and complex mental health disorder that disrupts an individual’s thoughts, emotions, and behaviours. Those affected may experience a loss of connection with reality, which can be distressing both for them and their loved ones.

Previously, schizophrenia was categorised into subtypes based on dominant symptoms. However, the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) now categorises schizophrenia as a spectrum, recognising that symptoms can vary significantly in intensity and type. This approach improves diagnosis and treatment outcomes.

Symptoms

Symptoms of schizophrenia vary widely but typically fall into three main categories: psychotic, negative, and cognitive symptoms.

Research indicates that individuals with schizophrenia are more prone to depression, while those with depression may also experience psychosis. Recognising this relationship can help in early diagnosis and management of symptoms.

Causes of Schizophrenia

Schizophrenia’s exact cause remains unknown, but it is likely a combination of genetic, neurochemical, and environmental factors.

• Genetics: The disorder is more likely in individuals with a family history of schizophrenia.
• Brain chemistry: Imbalances in neurotransmitters, particularly dopamine and glutamate, may contribute.
• Environmental factors: Factors such as prenatal exposure to infections, malnutrition, or birth complications may increase the likelihood of developing schizophrenia.

Diagnosing and Treating Schizophrenia

Diagnosis

A comprehensive evaluation by a psychiatrist or clinical psychologist is essential for diagnosing schizophrenia. This involves assessing symptoms, reviewing medical history, and ruling out other potential causes. A thorough diagnostic process is critical for initiating effective treatment.

Treatment

Managing schizophrenia requires a multi-faceted approach, including medication, therapy, and support services. Treatment aims to alleviate symptoms, improve quality of life, and facilitate recovery.

Medication

Two primary types of antipsychotics are used in schizophrenia treatment:

• First-Generation Antipsychotics (Typical): These medications, including haloperidol and chlorpromazine, mainly target dopamine receptors to manage positive symptoms. However, they may cause significant side effects, such as extrapyramidal symptoms (movement disorders) and tardive dyskinesia.
• Second-Generation Antipsychotics (Atypical): Medications like risperidone, olanzapine, and clozapine affect both dopamine and serotonin receptors. These are generally preferred due to fewer side effects. Clozapine is particularly effective for treatment-resistant schizophrenia but requires regular blood monitoring due to a risk of agranulocytosis (a drop in white blood cell count).

Psychotherapy

Psychotherapy, particularly cognitive behavioural therapy (CBT), helps individuals identify and manage thought patterns associated with distress. CBT is valuable for symptom management, improving emotional response, and creating strategies for healthier thought processes.

Electroconvulsive Therapy (ECT)

ECT is considered for treatment-resistant schizophrenia or severe cases where rapid symptom relief is required. Although not a first-line treatment, ECT can be beneficial when other treatments are unsuccessful.

Additional Therapies

• Family therapy: Engages the family in providing support and understanding to the individual, which can be crucial for long-term management.
• Arts therapy: Useful for individuals who struggle with verbal expression, art therapy offers alternative ways to communicate emotions, aiding in self-awareness and social engagement.

While schizophrenia cannot be prevented, early intervention and management can minimise its impact. Identifying symptoms early and providing treatment significantly improves outcomes, helping to prevent severe relapses.

Schedule an Appointment at Gleneagles Hospitals

Living with schizophrenia can present unique challenges, but effective, personalised treatment provides hope. If you or someone you know is dealing with schizophrenia, contact the expert team of mental health professionals at Gleneagles Hospitals for consultation. We assure you the best possible care tailored to your specific needs.