Schizophrenia

includes a group of psychotic disorders characterized by disturbances in thought, perception, affect, behavior and communication that last longer than 6 months. Schizophrenia is a chronic disability best treatment by medication and supportive therapy. We can provide supportive counseling to both those suffering from this chronic and debilitating disorder as well as with the families.

We can support patients in following the medication regimen required to help them keep stabilized and live independently with modulated symptoms.  We help them maintain the lowest level of care necessary to keep them stabilized and safe with symptoms abated. We help the family manage the emotional and psychological toll imposed on them in managing the consequences of this disease on family and its individual members. Often dealing with a family member with this disease causes differing levels of trauma within the family.  We help the family and individuals to deal with emerging feelings of frustration, and helplessness in the face of this disease.

Causes, Incidence and Risk Factors

Characteristic Pathology

• Affects 1% of population
• Childhood onset mimics autism; has strong family component
• Effects both boys and girls equally
• Cause: Unknown

Presenting Observable Factors

• Genetic Factors: Relatives are more likely to have schizophrenia than non-relatives

• Psychological/Social Factors: Disturbed family and interpersonal relationships may play a role
• Age of Onset: Commonly before age 45
• Minimum Continuous Symptoms for Official Diagnosis: 6+ months
• External Evidence: Deterioration in functioning in areas of self-care, work, and social relationships

Symptoms

• Delusion – Unfounded beliefs held to be true even when contradictory
• Hallucinations – Sensory perception without external stimuli affects all five senses. Auditory Hallucinations are most common.
• Incoherent Speech –Disordered and non-logical
• Catatonia – Idiosyncratic bizarre movement or lack of movement. No relation to environment stimuli.
• Flat affect – Shows no emotion or apathetic mood.
• Five types of Schizophrenia (see table below)

Diagnosis

Important Note: Difficult to diagnose

Diagnosis Factors Include:

• Developmental background
• Family history
• Current stressors
• Level of functioning (current and prior to onset)
• Course of illness
• Response to therapy
• Enlarged ventricles in brain (evidence detected in CT scan)

Treatment

• Hospitalizations to prevent harm to self or others; provide back needs.
• Anti-psychotic or neuroleptic meds control symptoms
• Phenothiazines
• Thioxanthenes,
• Dihydronindolones
• Butyrohenones
• Dibenzoxazepines
• Med compliance is very important
• Psychotherapy is supportive
• Family therapy used to support family
• Behavioral techniques used in therapeutic setting

Prognosis

• Poor (without medication to abate symptoms)
• Many need supportive living environments throughout life