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Schizophrenia : Symptoms, Causes, Diagnosis and Treatment

Schizophrenia is a mental disorder that occurs in the long term. This disorder causes sufferers to experience hallucinations, delusions or understandings, a chaos of thinking, and behavioral changes. These symptoms are symptoms of psychosis, a condition in which the sufferer has difficulty distinguishing reality from his own mind.

Schizophrenia is often equated with psychosis, even though both are different. Psychosis is only one symptom of several mental disorders, including schizophrenia.

According to WHO, it is estimated that more than 21 million people worldwide suffer from schizophrenia. People with schizophrenia also have a 2-3 times higher risk of dying at a young age. In addition, half of the people with schizophrenia are known to suffer from other mental disorders, such as drug abuse, depression, and anxiety disorders.

Schizophrenia

Symptoms of Schizophrenia

The initial symptoms of schizophrenia generally appear in adolescence. Therefore, these early symptoms are often misinterpreted, because they are considered normal in adolescence. In men, the initial symptoms appear at the age of 15-30 years. Whereas in women, symptoms usually affect the age group 25-30 years.

A number of early symptoms of schizophrenia, namely:

  • Tend to isolate themselves from others.
  • Easy to get angry and depressed.
  • Changes in sleep patterns.
  • Lack of concentration and motivation.
  • Difficulty in doing school work.

Symptoms of schizophrenia are divided into two categories, namely positive and negative. Positive symptoms refer to behavior not seen in healthy individuals, including:




  • Hallucination is the feeling of experiencing something that feels real, but actually, that feeling only exists in the sufferer's mind. For example, feeling heard something, even though other people don't hear anything.
  • Delusion or understanding is believing something that is contrary to reality. Symptoms vary, ranging from feeling watched, followed, even while most people with schizophrenia experience these symptoms.
  • Screwed in thinking and talking. These symptoms can be known from the difficulty of the patient is speaking. Schizophrenics have difficulty concentrating, even reading a newspaper or watching television is very difficult. The way to communicate is also confusing, making it difficult for the interlocutor to understand.
  • Chaotic behavior. The behavior of schizophrenics is difficult to predict. Even the way to dress is also unusual. Unexpectedly, sufferers can suddenly scream and be angry for no reason.

Negative symptoms refer to the loss of interest previously possessed by the sufferer. Negative symptoms can last several years, before the patient experiences initial symptoms.

Often, relationships between patients and families are damaged due to negative symptoms. This is because negative symptoms are often misinterpreted as lazy or disrespectful. Negative symptoms generally appear gradually and worsen over time, including:

  • Odd emotional responses, such as facial expressions and monotonous speech.
  • It's hard to feel happy or satisfied.
  • Reluctant to socialize and prefer to stay at home.
  • Loss of interest and motivation in various activities, such as having a relationship or having sex.
  • Changing sleep patterns.
  • Not comfortable being near someone else, and don't want to start a conversation.
  • Don't care about appearance and personal hygiene.

Causes of Schizophrenia

Not yet known exactly what causes schizophrenia. However, schizophrenia is associated with a number of risk factors, such as:

Genetic factors

Someone from a family of schizophrenics, 10% is more at risk of experiencing the same condition. The risk will be 40% greater if both parents both suffer from schizophrenia. In people who have twins with schizophrenia, the risk increases by 50%.

Brain chemical factor

Research shows that imbalances in dopamine and serotonin levels run the risk of causing schizophrenia. Dopamine and serotonin are parts of the neurotransmitter, chemicals that function to send signals between brain cells.

It is well known, there are differences in brain structure and function in people with schizophrenia. Some of these differences include:

  • The connection between fewer brain cells.
  • Smaller temporal lobe size. The temporal lobe is the part of the brain associated with memory.
  • Larger brain ventricular size. Ventricles are parts of the brain that are filled with fluid.

Complications of pregnancy and childbirth

A number of conditions that occur during pregnancy are thought to be at risk of causing schizophrenia in children born. Among them are nutritional deficiencies, exposure to toxins and viruses, preeclampsia, diabetes, and bleeding during pregnancy.

Complications at delivery, also risk causing schizophrenia in children. For example, lack of oxygen at birth (asphyxia), low birth weight, and premature birth.

Some other risk factors are:

  • Increased immune system due to autoimmune diseases and inflammation.
  • Brain injury due to falls or accidents, including those that occur in childhood.
  • Viral infections, especially influenza and polio viruses.

In addition to a number of risk factors above, there are so-called trigger factors for schizophrenia. In people with the factors mentioned above, stress is the most important psychological factor that can trigger schizophrenia. Stress can occur due to divorce, loss of work or residence, and left by loved ones. Sexual harassment or physical and emotional abuse can also cause stress.

Drug abuse, such as cocaine, marijuana, and amphetamines, can also trigger schizophrenia in people with the above risk factors. Research shows that marijuana addicts have a four-fold higher risk of developing schizophrenia.

Schizophrenia Diagnosis

It is important to distinguish schizophrenia from other mental disorders. It is also important to ensure that the signs and symptoms that arise are not a result of the use of certain substances, certain medications or medical conditions.

Determining a diagnosis of schizophrenia can include:

  • Physical examination. This can be done to get rid of other medical problems that can cause similar signs and symptoms, and check for related complications.
  • Examination and screening. This can include examinations to rule out other conditions that can cause similar signs and symptoms, and screening related to a history of alcohol or certain drug use.
  • Doctors can also request imaging tests, including computerized tomography (CT) or magnetic resonance imaging (MRI), to see changes in the structure of the brain.
  • Psychiatric evaluation. Doctors can also do mental status checks by looking at the appearance and attitude of the individual, and asking questions about various things including thoughts, moods, delusions, hallucinations, the use of certain substances, and the possibility of violence or suicide. This examination also involves discussion of personal or family history.

Complications of Schizophrenia

Schizophrenia which is left untreated can trigger a number of serious complications, such as:

  • Think and try to commit suicide.
  • Phobia.
  • Depression.
  • Hurt Yourself.
  • Drug abuse and alcoholism.
  • Aggressive behavior and rowdy noise.

Schizophrenic sufferers can also have problems with their family and the environment, so they choose to isolate themselves. In addition, the symptoms experienced can make people difficult to work, so that it has a negative impact on their financial condition.

Schizophrenia Treatment

Until now, there is no cure for schizophrenia. The method of treatment carried out is only limited to controlling and reducing symptoms in patients. Some of the treatment methods are:

Drugs

To deal with hallucinations and delusions, the doctor will prescribe antipsychotic drugs in the lowest possible dose. Antipsychotics work by inhibiting the effects of dopamine and serotonin in the brain. The patient must continue to take antipsychotics for the rest of his life, even though the symptoms experienced have improved.

Antipsychotic drugs can be given in the form of tablets or injections. The form of medication given depends on the patient's willingness to be treated. In patients who are easily regulated, the doctor will give an antipsychotic tablet. But in patients who are difficult to give antipsychotic tablets, the doctor will give injectable type antipsychotics. Some side effects of antipsychotic drugs that can appear:

  • Increased weight
  • Decreased sex drive
  • Seizures
  • Dry mouth
  • Blurred vision
  • Dizzy
  • Tremor

Antipsychotics are divided into typical (old generation) and atypical (new generation) types. At present, doctors recommend more atypical antipsychotics, because they have fewer side effects than typical antipsychotics. Some types of typical antipsychotics are chlorpromazine, fluphenazine, and haloperidol. While atypical antipsychotics include aripiprazole, clozapine, olanzapine, and risperidone.

Psychotherapy

Psychotherapy for people with schizophrenia aims to allow patients to control their symptoms. This therapy will be combined with the administration of drugs. Some methods of psychotherapy include:

  • Individual therapy. In this therapy, psychiatrists will teach family and patient friends how to interact with patients. Among the ways is to understand the mindset and behavior of patients.
  • Cognitive-behavioral therapy. This therapy aims to change the behavior and mindset of the patient. A combination of cognitive-behavioral therapy and medication will help patients understand the triggers of hallucinations and delusions, and teach patients how to overcome them.
  • Cognitive remediation therapy. This therapy teaches patients how to understand the social environment, and improves the patient's ability to pay attention or remember something and control his mindset.

Electroconvulsive therapy

Electroconvulsive therapy is the most effective method, to relieve suicidal ideation, overcome symptoms of major depression, and deal with psychosis. Therapy is carried out 2-3 times a week, for 2-4 weeks, and can be combined with psychotherapy and drug administration.

In this therapy, patients will be given general anesthesia, and drugs to make the patient's muscles more relaxed. Then, the doctor will install electrodes on the crown of the patient. Low electric current will flow through the electrode, and trigger a short spasm in the patient's brain.

Prevention of Schizophrenia

There is no specific method that is fully proven to prevent schizophrenia. However, early treatment of this condition can control symptoms before serious complications occur that can affect the long-term condition of the person.

Ensure that appropriate treatment can prevent the worsening of symptoms.



References

References

1. US Department of Human and Health Services (2018). National Institute Mental of Health. Schizophrenia. 

2. World Health Organization (2018). Schizophrenia. 

3. Frankenburg, F.R. Medscape (2018). Schizophrenia. 


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Is a health and wellness enthusiast. In him free time, she loves to travel and taste different types of teas.

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