Schizophrenia facts

Schizophrenia, also sometimes colloquially called split personality disorder, is a chronic, severe, debilitating mental illness that affects about 1% of the population, more than 2 million people in the United States alone. With the sudden onset of severe psychotic symptoms, the individual is said to be experiencing acute schizophrenia. Psychoticmeans out of touch with reality or unable to separate real from unreal experiences. There is no known single cause of schizophrenia. As discussed later, it appears that genetic factors produce a vulnerability to schizophrenia, with environmental factors contributing to different degrees in different individuals. There are a number of various treatments for schizophrenia. Given the complexity of schizophrenia, the major questions about this disorder (its cause or causes, prevention, and treatment) are unlikely to be resolved in the near future. The public should beware of those offering "the cure" for (or "the cause" of) schizophrenia. Schizophrenia is one of the psychotic mental disorders and is characterized by symptoms of thought, behavior, and social problems. Symptoms of schizophrenia may include delusions, hallucinations, catatonia, negative symptoms, and disorganized speech or behavior. There are five types of schizophrenia based on the kind of symptoms the person has at the time of assessment: paranoid, disorganized, catatonic, undifferentiated, and residual. Children as young as 6 years of age can be found to have all the symptoms of schizophrenia as their adult counterparts and to continue to have those symptoms into adulthood. Although the term schizophrenia has only been in used since 1911, its symptoms have been described throughout written history. Schizophrenia is considered to be the result of a complex group of genetic, psychological, and environmental factors. Health-care practitioners diagnose schizophrenia by gathering comprehensive medical, family, mental-health, and social/cultural information. The practitioner will also either perform a physical examination or request that the individual's primary-care doctor perform one. The medical examination will usually include lab tests. In addition to providing treatment that is appropriate to the diagnosis, professionals attempt to determine the presence of mental illnesses that may co-occur. People with schizophrenia are at increased risk of having a number of other mental-health conditions, committing suicide, and otherwise dying earlier than people without this disorder. Medications that have been found to be most effective in treating the positive symptoms of schizophrenia are first- and second-generation antipsychotics. Psychosocial interventions for schizophrenia include education of family members, assertive community treatment, substance-abuse treatment, social-skills training, supported employment, cognitive behavioral therapy, and weight management.

Cognitive remediation, peer-to-peer treatment, and weight-management interventions remain the focus topics for research.

What is schizophrenia?
Schizophrenia, also sometimes colloquially called split personality disorder, is a chronic, severe, debilitating mental illness that affects about 1% of the population, corresponding to more than 2 million people in the United States alone. Other statistics about schizophrenia include that it affects men about one and a half times more commonly than women. It is one of the psychotic mental disorders and is characterized by symptoms of thought, behavior, and social problems. The thought problems associated with schizophrenia are described as psychosis, in that the person's thinking is completely out of touch with reality at times. For example, the sufferer may hear voices or see people that are in no way present or feel like bugs are crawling on their skin when there are none. The individual with this disorder may also have disorganized speech, disorganized behavior, physically rigid or lax behavior (catatonia), significantly decreased behaviors or feelings, as well as delusions, which are ideas about themselves or others that have no basis in reality (for example, the individual might experience paranoia, in that he or she thinks others are plotting against them when they are not).

What are the different types of schizophrenia?

There are five types of schizophrenia, each based on the kind of symptoms the person has at the time of assessment.

Paranoid schizophrenia: The individual is preoccupied with one or more delusions or many auditory hallucinations but does not have symptoms of disorganized schizophrenia. Disorganized schizophrenia: Prominent symptoms are disorganized speech and behavior, as well as flat or inappropriate affect. The person does not have enough symptoms to be characterized as suffering from catatonic schizophrenia. Catatonic schizophrenia: The person with this type of schizophrenia primarily has at least two of the following symptoms: difficulty moving, resistance to moving, excessive movement, abnormal movements, and/or repeating what others say or do. Undifferentiated schizophrenia: This is characterized by episodes of two or more of the following symptoms: delusions, hallucinations, disorganized speech or behavior, catatonic behavior or negative symptoms, but the individual does not qualify for a diagnosis of paranoid, disorganized, or catatonic type of schizophrenia. Residual schizophrenia: While the full-blown characteristic positive symptoms of schizophrenia (those that involve an excess of normal behavior, such as delusions, paranoia, or heightened sensitivity) are absent, the sufferer has a less severe form of the disorder or has only negative symptoms (symptoms characterized by a decrease in function, such as withdrawal, disinterest, and not speaking).

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What Is Schizophrenia
The word schizophrenia comes from the Greek word skhizein meaning "to split" and the Greek word Phrenos (phren) meaning "diaphragm, heart, mind". According to Medilexicon's medical dictionary, schizophrenia is "A term coined by Bleuler, synonymous with and replacing dementia praecox, denoting a common type of psychosis, characterized by abnormalities in perception, content of thought, and thought processes (hallucinations and delusions) and by extensive withdrawal of interest from other people and the outside world, with excessive focusing on one's own mental life. Now considered a group or spectrum of disorders rather than a single entity, with distinction sometimes made between process schizophrenia and reactive schizophrenia. The "split" personality of schizophrenia, in which individual psychic components or functions split off and become autonomous, is popularly but erroneously identified with multiple personality, in which two or more relatively complete personalities dominate by turns the psychic life of a patient.". In 1910, the Swiss psychiatrist, Eugen Bleuler (1857-1939) created the term Schizophrenie. Schizophrenia is a mental disorder that generally appears in late adolescence or early adulthood - however, it can emerge at any time in life. It most commonly strikes between the ages of 15 to 25 among men, and about 25 to 35 in women. In many cases the disorder develops so slowly that the sufferer does not know he/she has it for a long time. While, with other people it can strike suddenly and develop fast. It is a complex, chronic, severe, and disabling brain disorder and affects approximately 1% of all adults globally. Experts say schizophrenia is probably many illnesses masquerading as one. Research indicates that schizophrenia is likely to be the result of faulty neuronal development in the brain of the fetus, which later in life emerges as a full-blown illness.

The brain
Our brain consists of billions of nerve cells. Each nerve cell has branches that give out and receive messages from other nerve cells. The ending of these nerve cells release neurotransmitters - types of chemicals. These neurotransmitters carry messages from the endings of one nerve cell to the nerve cell body of another. In the brain of a person who has schizophrenia, this messaging system does not work properly.

What are the signs and symptoms of schizophrenia?

There is, to date, no physical or laboratory test that can absolutely diagnose schizophrenia. The doctor, a psychiatrist, will make a diagnosis based on the patient's clinical symptoms. However, physical testing can rule out some other disorders and conditions which sometimes have similar symptoms, such as seizure disorders, thyroid dysfunction, brain tumor, drug use, and metabolic disorders.

Symptoms and signs of schizophrenia will vary, depending on the individual. The symptoms are classified into four categories:

Positive symptoms - also known as psychotic symptoms. These are symptoms that appear, which people without schizophrenia do not have. For example, delusion. Negative symptoms - these refer to elements that are taken away from the individual; loss or absence of normal traits or abilities that people without schizophrenia normally have. For example, blunted emotion. Cognitive symptoms - these are symptoms within the person's thought processes. They may be positive or negative symptoms, for example, poor concentration is a negative symptom. Emotional symptoms - these are symptoms within the person's feelings. They are usually negative symptoms, such as blunted emotions.

Below is a list of the major symptoms:

Delusions - The patient has false beliefs of persecution, guilt of grandeur. He/she may feel things are being controlled from outside. It is not uncommon for people with schizophrenia to describe plots against them. They may think they have extraordinary powers and gifts. Some patients with schizophrenia may hide in order to protect themselves from an imagined persecution. Hallucinations - hearing voices is much more common than seeing, feeling, tasting, or smelling things which are not there, but seem very real to the patient. Thought disorder - the person may jump from one subject to another for no logical reason. The speaker may be hard to follow. The patient's speech might be muddled and incoherent. In some cases the patient may believe that somebody is messing with his/her mind.

Other symptoms schizophrenia patients may experience include:

Lack of motivation (avolition) - the patient loses his/her drive. Everyday automatic actions, such as washing and cooking are abandoned. It is important that those close to the patient understand that this loss of drive is due to the illness, and has nothing to do with slothfulness. Poor expression of emotions - responses to happy or sad occasions may be lacking, or inappropriate. Social withdrawal - when a patient with schizophrenia withdraws socially it is often because he/she believes somebody is going to harm them. Other reasons could be a fear of interacting with other humans because of poor social skills. Unaware of illness - as the hallucinations and delusions seem so real for the patients, many of them may not believe they are ill. They may refuse to take medications which could help them enormously for fear of side-effects, for example. Cognitive difficulties - the patient's ability to concentrate, remember things, plan ahead, and to organize himself/herself are affected. Communication becomes more difficult.

What causes schizophrenia?

Nobody has been able to pinpoint one single cause. Experts believe several factors are generally involved in contributing to the onset of schizophrenia.

The likely factors do not work in isolation, either. Evidence does suggest that genetic and environmental factors generally act together to bring about schizophrenia. Evidence indicated that the diagnosis of schizophrenia has an inherited element, but it is also significantly influenced by environmental triggers. In other words, imagine your body is full of buttons, and some of those buttons result in schizophrenia if somebody comes and presses them enough times and in the right sequences. The buttons would be your genetic susceptibility, while the person pressing them would be the environmental factors. Below is a list of the factors that are thought to contribute towards the onset of schizophrenia:

Your genes If there is no history of schizophrenia in your family your chances of developing it are less than 1%. However, that risk rises to 10% if one of your parents was/is a sufferer. A gene that is probably the most studied "schizophrenia gene" plays a surprising role in the brain: It controls the birth of new neurons in addition to their integration into existing brain circuitry, according to an article published by Cell. A Swedish study found that schizophrenia and bipolar disorder have the same genetic causes.

Chemical imbalance in the brain Experts believe that an imbalance of dopamine, a neurotransmitter, is involved in the onset of schizophrenia. They also believe that this imbalance is most likely caused by your genes making you susceptible to the illness. Some researchers say other the levels of other neurotransmitters, such as serotonin, may also be involved. Changes in key brain functions, such as perception, emotion and behavior lead experts to conclude that the brain is the biological site of schizophrenia. Schizophrenia could be caused by faulty signaling in the brain, according to research published in the journal Molecular Psychiatry.

Family relationships Although there is no evidence to prove or even indicate that family relationships might cause schizophrenia, some patients with the illness believe family tension may trigger relapses.

Environment Although there is yet no definite proof, many suspect that prenatal or perinatal trauma, and viral infections may contribute to the development of the disease. Perinatal means "occurring about 5 months before and up to one month after birth". Stressful experiences often precede the emergence of schizophrenia. Before any acute symptoms are apparent, people with schizophrenia habitually become bad-tempered, anxious, and unfocussed. This can trigger relationship problems, divorce and unemployment. These factors are often blamed for the onset of the disease, when really it was the other way round the disease caused the crisis. Therefore, it is extremely difficult to know whether schizophrenia caused certain stresses or occurred as a result of them.

Some drugs Cannabis and LSD are known to cause schizophrenia relapses.

What are the treatment options for schizophrenia?

Psychiatrists say the most effective treatment for schizophrenia patients is usually a combination of medication, psychological counseling, and self-help resources. Anti-psychosis drugs have transformed schizophrenia treatment. Thanks to them, the majority of patients are able to live in the community, rather than stay in hospital. In many parts of the world care is delivered in the community, rather than in hospital. The primary schizophrenia treatment is medication. Sadly, compliance is a major problem. Compliance, in medicine, means following the medication regimen. People with schizophrenia often go off their medication for long periods during their lives, at huge personal costs to themselves and often to those around them as well. The majority of patients go off their medication within the first year of treatment. In order to address this, successful schizophrenia treatment needs to consist of a life-long regimen of both drug and psychosocial, support therapies. The medication can help control the patient's hallucinations and delusions, but it cannot help them learn to communicate with others, get a job, and thrive in society. Although a significant number of people with schizophrenia live in poverty, this does not have to be the case. A person with schizophrenia who complies with the treatment regimen long-term will be able to lead a happy and productive life. The first time a person experiences schizophrenia symptoms can be very unpleasant. He/she may take a long time to recover, and that recovery can be a lonely experience. It is crucial that a schizophrenia sufferer receives the full support of his/her family, friends, and community services when onset appears for the first time. Medications

The medical management of schizophrenia generally involves drugs for psychosis, depressionand anxiety. This is because schizophrenia is a combination of thought disorder, mood disorder and anxiety disorder. The most common antipsychotic drugs are Risperidone (Risperdal), Olanzapine (Zyprexa), Quetiapine (Seroquel), Ziprasidone (Geodon), and Clozapine (Clozaril):

Risperidone (Risperdal) - introduced in America in 1994. This drug is less sedating than other atypical antipsychotics. There is a higher probability, compared to other atypical antipsychotics, of extrapyramidal symptoms (affecting the extrapyramidal motor system, a neural network located in the brain that is involved in the coordination of movement). Although weight gain and diabetes are possible risks, they are less likely to happen, compared with Clozapine or Olanzapine. Olanzapine (Zyprexa) - approved in the USA in 1996. A typical dose is 10 to 20 mg per day. Risk of extrapyramidal symptoms is low, compared to Risperidone. This drug may also improve negative symptoms. However, the risks of serious weight gain and the development of diabetes are significant. Quetiapine (Seroquel) - came onto the market in America in 1997. Typical dose is between 400 to 800 mg per day. If the patient is resistant to treatment the dose may be higher. The risk of extrapyramidal symptoms is low, compared to Risperidone. There is a risk of weight gain and diabetes, however the risk is lower than Clozapine or Olanzapine. Ziprasidone (Geodon) - became available in the USA in 2001. Typical doses range from 80 to 160 mg per day. This drug can be given orally or by intramuscular administration. The risk of extrapyramidal symptoms is low. The risk of weight gain and diabetes is lower than other atypical antipsychotics. However, it might contribute to cardiac arrhythmia, and must not be taken together with other drugs that also have this side effect. Clozapine (Clozaril) - has been available in the USA since 1990. A typical dose ranges from 300 to 700 mg per day. It is very effective for patients who have been resistant to treatment. It is known to lower suicidal behaviors. Patients must have their blood regularly monitored as it can affect the white blood cell count. The risk of weight gain and diabetes is significant.

How common is schizophrenia?

The prevalence of schizophrenia globally varies a slightly, depending on which report you look at, from about 0.7% to 1.2% of the adult population in general. Most of these percentages refer to people suffering from schizophrenia "at some time during their lives". An Australian study found that schizophrenia is more common in developed nations than developing ones. It also found that the illness is less widespread than previously thought. Estimates of 10 per 1,000 people should be changed to 7 or 8 per 1,000 people, the study concluded. In the USA about 2.2 million adults, or about 1.1% of the population age 18 and older in a given year have schizophrenia. Schizophrenia is not a 'very' common disease. Approximately 1% of people throughout the globe suffer from schizophrenia (or perhaps a little less than 1% in developing countries) at some point in their lives. It is estimated that about 1.2% of Americans, a total of 3.2 million people, have the

disorder at some point in their lives. Globally, about 1.5 million people each year are diagnosed with schizophrenia. In the UK it is estimated that about 600,000 people have schizophrenia.

http://www.medicalnewstoday.com/articles/36942.php

Schizophrenia
(The

information provided on this site should not be used for diagnosing or treating a health problem or disease. It is not a substitute for professional care. If you have or suspect that you have a health problem, you should consult your health care provider.)

Signs and Symptoms Schizophrenia is a mental illness that usually strikes in late adolescence or early adulthood, but can strike at any time in life. The signs and symptoms vary from individual to individual, but all people with the disorder show one or more of the following symptoms:
1. Delusions: These are beliefs that are not true, such as feeling people are following or trying to hurt them, believing other people can read their minds, or beliefs that they have special powers or abilities. 2. Hallucinations: This usually takes the form of hearing voices that are not there, but people with schizophrenia may also see, smell, taste, and feel things that are not there. 3. Bizarre behavior: This can be expressed in many different ways. In short, the individual behaves in ways that seem inappropriate or strange to other people. 4. Disorganized speech: The individual speaks in ways that are hard to understand. For instance, sentences might not make sense, or topic of conversation changes with little or no connection between sentences. Sometimes speech is completely incomprehensible. 5. "Negative symptoms": This includes lack of motivation or interest, diminished cognitive functioning, and decreased emotional expression. Individuals may lose interest in attending to their own personal hygiene, have little interest in interacting with others, and rarely seem to feel or express strong emotions.

In addition to these above symptoms, people with schizophrenia suffer a decline in their level of functioning; for instance, they may not be able to work at a job that requires the same level of skill or concentration as the job they held before they became ill required, or they may lose all ability to withstand the pressures of the working world. They may show a decline in their ability to attend to household chores or all the demands of raising their children, and/or they may not be able to have a full social life anymore. Sometimes schizophrenia is a chronic condition, and the individual afflicted is constantly experiencing hallucinations or other symptoms of the disorder. Other people have periods of time when they are relatively symptom-free but have periods of more acute psychosis. Every individual is different, and every person with schizophrenia experiences the disease in a different way.

A brief history of schizophrenia

Mental illness has been recognized for thousands of years. At one point, all people who were considered "abnormal," whether due to mental illness, mental retardation, or physical deformities, were largely treated the same. Early theories supposed that mental disorders were caused by evil possession of the body, and the appropriate treatment was then exorcising these demons, through various means, ranging from innocuous treatments, such as exposing the patient to certain types of music, to dangerous and sometimes deadly means, such as releasing the evil spirits by drilling holes in the patient's skull. One of the first to classify the mental disorders into different categories was the German physician, Emil Kraepelin. He used the term "dementia praecox" for individuals who had symptoms that we now associate with schizophrenia. The classifications for mental disorders continue to be revised. The most recent diagnostic classification system that is most commonly used in the United States is the Diagnostic and Statistical Manual for Mental Disorders - Fourth Edition (DSM-IV). The Swiss psychiatrist, Eugen Bleuler, coined the term, "schizophrenia" in 1911. This word comes from the Greek roots schizo (split) and phrene (mind) to describe the fragmented thinking of people with the disorder. His term was not meant to convey the idea of split or multiple personality, a common misunderstanding by the public at large. Since Bleuler's time, the definition of schizophrenia has continued to change, as scientists attempt to more accurately delineate the different types of mental diseases. Without knowing the exact causes of these diseases, scientists can only base their classifications on the observation that some symptoms tend to occur together. Both Bleuler and Kraepelin subdivided schizophrenia into categories, based on prominent symptoms and prognoses. Over the years, those working in this field have continued to attempt to classify types of schizophrenia. Five types were delineated in the DSM-III: disorganized, catatonic, paranoid, residual, and undifferentiated. The first three categories were originally proposed by Kraepelin. These classifications, while still employed in DSM-IV, have not shown to be helpful in predicting outcome of the disorder, and the types are not reliably diagnosed. Many researchers are using other systems to classify types of the disorder, based on the preponderance of "positive" vs "negative" symptoms (see symptoms of schizophrenia above), the progression of the disorder in terms of type and severity of symptoms over time, and the co-occurrence of other mental disorders and syndromes. It is hoped that differentiating types of schizophrenia based on clinical symptoms will help to determine different etiologies or causes of the disorder. What treatments are currently available? Just as different people with schizophrenia can experience different symptoms, the effective treatment for each person is different. Each individual's treatment program can include one or more of the following:
Medication: Finding the right medication can be difficult, and a trial-and-error process may have to occur. It is important to be open with the psychiatrist, reporting what symptoms and side-effects are occurring, so the doctor can help to find the best medication to meet individual needs of each patient. It is also important to learn the contraindications of certain medications, such as the effects of alcohol or sunlight on the effectiveness of the medication. Education: The person with schizophrenia and his or her family members can benefit from learning all

they can about the disorder, including how to diminish stress and conflict, which can sometimes help spark a relapse. It is also important to learn what resources are available in the community for treating mental illnesses. Individual, group, and family therapy: This can help with problems that arise day to day, as well as setting realistic goals and defining strategies for reaching those goals. Hospitalization: This is required during some acute phases of the illness or sometimes in order to make changes in medication in a well-controlled, monitored environment. Support groups: These can be very important for those with schizophrenia and for their family members and friends. See below for a list of support groups. Residential, day-treatment, and vocational programs: These programs can help the person with schizophrenia reach his or her highest potential and greatest level of independence. Staff in these programs become well-acquainted with their clients and can help find living arrangements, work, and recreational activities that are well-suited to each client's needs.

What help is available for the family and caretakers of individuals with schizophrenia? There are a number of national organizations that provide information and support to individuals with schizophrenia and their loved ones. The internet site www.schizophrenia.com contains a comprehensive information source and referral service. You should also check with local agencies in addition to these national organizations:
http://www.hopkinsmedicine.org/epigen/szwhatis.htm http://www.localhealth.com/article/schizophrenia-1

Bipolar disorder, also known as manicdepressive disorder, is a condition that affects ones mood, emotions, and behavior. This section will describe the common symptoms of the disease, but bear in mind that there are a wide variety of clinical presentations of the disorder.
http://www.hopkinsmedicine.org/epigen/bpwhatis.htm statistic: http://eprints.utm.my/5897/1/aziziyahskizo.pdf , http://www.ncbi.nlm.nih.gov/pubmed/18642120 , http://resources.metapress.com/pdfpreview.axd?code=kh53770618j7830p&size=largest