Schizophrenia

Schizophrenia is severe psychiatric illness affecting one percent of population. Schizophrenia affects how one feels thinks talks and behave.

Any one part or combination of four parts may be affected in varying severity. This is precise reason we can see large variation in presenting symptoms.

What causes schizophrenia?

We cannot pin point one reason for illness in any patients. Common reason said to cause schizophrenia are genetic, environment and chemical changes in brain.

Any one factor or combination of factors leads to schizophrenia. All patients have chemical changes in different parts of brain. Symptoms are determined by which part of brain is more affected.

Few factors that increases risk are:

Unfortunately, pt. with schizophrenia seek treatment very late. Common reason being slow onset of symptoms, ignoring initial unusual symptoms by family members, seeking help from faith healers, chalta hai attitude of people, seeking close family members to counsel pt. for his abnormal behavior etc.
Usually relatives seek treatment for acute symptoms.

False beliefs such as paranoia or delusions–thinking people are conspiring against you when they are not or believing that people are talking about u, people are harassing me,

Hearing voices that no one else can hear or seeing, tasting, smelling or feeling things that are not there (hallucinations)
Believing that objects, events or people control your thoughts or actions in a way that can’t be explained.
Confused and muddled thinking; speech may be hard to understand
Loss of feelings or emotions
Loss of energy and interest in other people; becoming wrapped up in yourself
Symptoms may change according to stage patient in. false beliefs hearing voices etc are more seen in acute stage while Under-activity - which also affects speech, Low motivation, Social withdrawal, Emotional flattening, Self-neglect, talking less, keeping with oneself, decrease interest is more seen in chronic illness.
In children and adolescents, there may be a prodromal period in which family and friends may notice subtle changes in behaviour and personality.

Treatment :

Treatment depends upon severity, violence, insight about illness, type of symptoms etc.

Medicine class anti-psychotic drugs form main stray of treatment. This has revolutionise treatment of this severe psychiatric illness. Before this class of medicine were discovered, all patients were secluded in mental hospital for years together.

Beside this electro-convulsive therapy also is many time useful in treatment.

How patient fare after diagnosis of schizophrenia:

It depends on host of factors. Few are type of symptoms, duration of untreated illness, insight into illness, family history of illness, psycho-social support etc. if we roughly make assumptions then out of 100 patients 20 will recover completely 60 will needs regular treatment for long period, 20 will not respond in spite of regular treatment and will carry significant symptoms lifelong.

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