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Schizophrenia requires lifelong treatment, even when symptoms have subsided. Treatment with medications and psychosocial therapy can help manage the condition. During crisis periods or times of severe symptoms, hospitalization may be necessary to ensure safety, proper nutrition, adequate sleep and basic hygiene.
A psychiatrist experienced in treating schizophrenia usually guides treatment. The treatment team also may include a psychologist, social worker, psychiatric nurse and possibly a case manager to coordinate care. The full-team approach may be available in clinics with expertise in schizophrenia treatment.
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These newer, second-generation medications are generally preferred because they pose a lower risk of serious side effects than do conventional medications. They include:
Schizophrenia is a mental disorder often characterized by abnormal social behavior and failure to recognize what is real. Common symptoms include false beliefs, unclear or confused thinking, auditory hallucinations, reduced social engagement and emotional expression, and inactivity. Diagnosis is based on observed behavior and the person's reported experiences. Genetics and early environment, as well as psychological and social processes, appear to be important contributory factors. Some recreational and prescription drugs appear to cause or worsen symptoms. The many possible combinations of symptoms have triggered debate about whether the diagnosis represents a single disorder or a number of separate syndromes. Despite the origin of the term from the Greek roots skhizein ("to split") and phrēn("mind"), schizophrenia does not imply a "split personality", or "multiple personality disorder"—a condition with which it is often confused in public perception. Rather, the term means a "splitting of mental functions", reflecting the presentation of the illness the mainstay of treatment is antipsychotic medication, which primarily suppresses dopamine receptor activity. Counseling, job training and social rehabilitation are also important in treatment. In more serious cases—where there is risk to self or others—involuntary hospitalization may be necessary, although hospital stays are now shorter and less frequent than they once were
Individual with schizophrenia may experience hallucinations (most reported are hearing voices), delusions (often bizarre or persecutory in nature), and disorganized thinking and speech. The last may range from loss of train of thought, to sentences only loosely connected in meaning, to speech that is not understandable known as word salad in severe cases. Social withdrawal, sloppiness of dress and hygiene, and loss of motivation and judgment are all common in schizophrenia. There is often an observable pattern of emotional difficulty, for example lack of responsiveness. Impairment in social cognition is associated with schizophrenia as are symptoms of paranoia. Social isolation commonly occurs Difficulties in working and long-term memory, attention, executive functioning, and speed of processing also commonly occur In one uncommon subtype, the person may be largely mute, remain motionless in bizarre postures, or exhibit purposeless agitation, all signs of catatonia. About 30 to 50% of people with schizophrenia fail to accept that they have an illness or their recommended treatment. Treatment may have some effect on insight People with schizophrenia often find facial emotion perception to be difficult.
The primary treatment of schizophrenia is antipsychotic medications, often in combination with psychological and social supports Hospitalization may occur for severe episodes either voluntarily or (if mental health legislation allows it) involuntarily. Long-term hospitalization is uncommon since deinstitutionalization beginning in the 1950s, although it still occurs. Community support services including drop-in centres, visits by members of a community mental health team, supported employment and support groups are common. Some evidence indicates that regular exercise has a positive effect on the physical and mental health of those with schizophrenia.
Symptoms begin typically in young adulthood, and about 0.3–0.7% of people are affected during their lifetime. In 2013 there was estimated to be 23.6 million cases globally. The disorder is thought to mainly affect the ability to think, but it also usually contributes to chronic problems with behaviour and emotion. People with schizophrenia are likely to have additional conditions, including major depression and anxiety disorders; the lifetime occurrence of substance use disorder is almost 50%. Social problems, such as long-term unemployment, poverty, and homelessness are common. The average life expectancy of people with the disorder is ten to twenty five years less than the average life expectancy. This is the result of increased physical health problems and a higher suicide rate. In 2013 an estimated 16,000 people died from behaviour related-to or caused by schizophrenia.
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This page was last updated on December 4, 2020