WISCONSIN UNITED
for MENTAL HEALTH

Schizophrenia is a serious but treatable brain disorder. It affects the brain in ways that make it difficult to distinguish between what is real and unreal. Without treatment, persons with schizophrenia have trouble thinking logically and behaving normally in their interactions with other people.

Unlike the myths of earlier years, a person with schizophrenia does not have a “split personality.” Instead, one might say the person has a shattered personality or a mind separated from its ability to function normally. In most people it is not a disorder that results in violent behavior. It can, however, produce disturbing symptoms that other people find alarming.

In some people, symptoms develop slowly; in others, suddenly. Most people have a slow onset characterized by social withdrawal, lack of energy, inability to express emotions, and difficulty concentrating.

An acute episode generally follows. This stage may be marked by delusions (false beliefs), hallucinations (hearing, seeing, or feeling things that are not there), and disordered thinking and speaking (talking nonsense). Acute episodes tend to produce difficulties in work, education, self-care, and social relations.

How is schizophrenia diagnosed?
Diagnosis of schizophrenia depends not on lab tests but on evaluation of symptoms by a psychiatrist. Doctors look for a history of the symptoms characteristic of schizophrenia and for noticeable difficulties in social and occupational functioning.

In recent years, new technologies have enabled physicians to identify abnormalities in the size and shape of certain brain structures in persons with schizophrenia. Researchers have also found differences in the activity level of the prefrontal cortex, the part of the brain involved in thought and higher mental functions.

How common is schizophrenia?
Schizophrenia affects about 1 percent of the US population, which amounts to about 2.5 million persons. Generally, schizophrenia first appears in young adults between the ages of 15 and 25. Symptoms often appear in men earlier than in women. The onset occurs only occasionally in childhood, but when it does, the disease has a more chronic course.

What causes schizophrenia?
No one is certain what causes schizophrenia. Theories include genetics (heredity), biology (imbalance in brain chemistry), viral infections, and immune disorders. What we do know is that the disease has a physical cause and is not the result of bad parenting.

Research shows that schizophrenia tends to run in families. There is about a 40 percent chance a child will have schizophrenia if both parents have the disease and about a 12 percent chance if one parent is affected. The identical twin of a person with schizophrenia has about a 50 percent chance of developing the disorder. A fraternal twin has about a 14 percent chance. These studies show that heredity is involved but is not the only factor in causing schizophrenia.

An imbalance in brain chemistry is another element. If certain neurotransmitters, which are natural substances that act as “chemical messengers,” are too abundant, they affect the brain’s reactions to the person’s surroundings. The result may be acute sensitivity to sights and sounds.

Some researchers argue that the risk of schizophrenia increases if the mother contracts a viral illness during the second three months of pregnancy. This theory rests on the fact that schizophrenia is more common among people born in winter, when viral infections occur more frequently. Others suggest the risk is related to complications during birth.

How is schizophrenia treated?
There is no cure for schizophrenia, but treatment with medications can promote recovery by reducing symptoms and the probability of relapse. Some of the newer medications are quite effective in changing the brain’s chemical balance, and they have fewer side effects than earlier antipsychotic medications. Most people with schizophrenia have to take medications throughout their lives.

Treatment usually includes psychotherapy, which can help patients understand their illness, develop skills in dealing with its effects, and gain confidence in their abilities. Peer support, education, and vocational programs are important additions to medical and social services.

How to help
Schizophrenia can have a severe impact on a person’s relations with friends and family. Bizarre behavior, lack of attention to personal hygiene, a tendency to retreat from social contacts-all contribute to isolation of the person with the disease. The onset of severe symptoms is no time to abandon the person, however. Prompt and appropriate medical care can relieve symptoms and, if obtained early, may alter the course of the disease.

The period between acute episodes is a time when friends and family members should be especially alert to the possibility of depression and the risk of suicide. This period is risky because the person with schizophrenia is thinking relatively clearly and can develop an understanding of the illness. About 20 percent of people with schizophrenia attempt suicide, and about 10 percent complete the act.

Negative reactions from people who lack information about schizophrenia or fear the person who has the disease can deepen the patient’s depression and isolation. Support from friends and family members can help the patient follow a treatment plan and achieve a high level of rehabilitation.

from the WUMH Mental Health brochure