Schizophrenia is one of the most serious and complex diseases in psychiatry. It begins to appear at the age of 16-25 years in men, and 25-35 years in women. Schizophrenia is a personality disorder, a loss of control over the coordinated work of the emotional and cognitive spheres, which can progress over several years. The onset of the disease is often characterized by a feeling of internal emptiness, derealization, emotional coldness, then hallucinations (usually auditory) are added to the symptoms, which can threaten or give orders. The disease occurs in periods of exacerbations and remissions. With schizophrenia, patients can lead an everyday, socially active life if they are stabilized with medication. Unfortunately, schizophrenia is not completely curable, but with timely consultation with a doctor and constant use of medications, stable remission can be achieved.
Schizophrenia is a chronic mental illness that is characterized by impaired thinking, inappropriate behavior, emotional disturbances, and psychosis. At the same time, a person’s intellectual and cognitive abilities may remain intact, however, the progression of the disease leads to splitting of the patient’s personality and impaired perception. Often, with schizophrenia, people have a feeling of involvement of strangers in their thoughts and actions, and the boundaries between the individual and the world are blurred.
According to modern data, schizophrenia affects approximately 1% of the population (according to some sources up to 2%). This disease occurs with approximately the same frequency in different countries and regions. There is no difference in the prevalence of schizophrenia between men and women. Schizophrenia in men begins to appear more often between 15 - 25 years, in women between 20 - 45 years. The onset of schizophrenia before the age of 10 years or over the age of 50 years is extremely rare.
The cause of schizophrenia is not fully understood. Schizophrenia appears to be a heterogeneous disorder, with various factors involved in its development. The main most generally accepted theory of the emergence of schizophrenia is the model of predisposition to the influence of stress. According to this model, a person may be predisposed to developing symptoms of schizophrenia. It should be noted that the influence of genetic factors on the development of schizophrenia has been statistically proven. If one of the parents is diagnosed with schizophrenia, the risk of developing the disease in the child is 12%; if both parents are sick, then the risk increases to 40%. If one of the monozygotic (identical) twins is sick, then the risk of developing the disease in the second is 47%. Studies conducted on adopted twins have shown that their risk of the disease is the same as that of those raised by biological parents. These results indicate that genetic influences play a large role in the development of schizophrenia. However, recently, diseases caused by the external environment (for example, schizophrenia induced by massive drug use) have most often been identified.
The symptoms of schizophrenia are so varied that there is still no complete consensus on whether it is a single disease or a group of diseases with similar manifestations. When making a diagnosis, doctors pay attention to the so-called productive symptoms of schizophrenia and negative symptoms of schizophrenia.
Productive symptoms of schizophrenia:
• Auditory or visual hallucinations. Most often, a person hears voices in the head or in the surrounding space that conduct a conversation, comment, and evaluate a person’s actions, and, as schizophrenia progresses, order or threaten.
• Delusional thoughts and ideas. They arise in the patient to explain what is happening to him and to others. The belief in the openness of one's thoughts and changing them from the outside makes the patient think about the influence of otherworldly forces, government agencies or secret societies, cosmic rays, etc.
• Inappropriate emotions. The patient may laugh when given bad news, or cry during a joyful event.
• Split personality. For the patient, the boundaries between “I” and the world are blurred, he cannot say who he is, and there is a feeling that he is “in someone else’s body.”
Negative symptoms of schizophrenia:
• Apathy, reluctance to do anything. The patient refuses to do usual actions and stops performing his work and household duties.
• Withdrawal, decreased social interaction.
• Incoherent speech, impoverished speech, new verbal formations (neologisms).
• Impaired memory, attention, thinking. A person cannot distinguish the important from the insignificant; incoherent thoughts and a sharp transition from one topic to another may be observed. There may be absent-mindedness, an inability to remember any words, actions, or events.
In modern psychiatry, it is customary to distinguish several forms of schizophrenia:
Paranoid schizophrenia (F20). In paranoid schizophrenia, auditory hallucinations and distinct delusions are observed. At the same time, changes in the emotional and volitional sphere are less pronounced than in other forms of schizophrenia.
Hebephrenic schizophrenia, hebephrenia (F20.1). Typically diagnosed in adolescents. In the hebephrenic form, negative symptoms, disturbances of affect (emotions and feelings are superficial and inadequate) and volitional regulation are clearly manifested. Hallucinations and delusions may occur in fragments.
Catatonic schizophrenia (F20.2). This diagnosis is made if the patient has psychomotor disorders (stereotypical movements, stupor). In catatonic schizophrenia, pronounced visual hallucinations, fantastic visions, mutism, negativism, and automatic behavior are noted.
Residual schizophrenia, or residual schizophrenia (F20.5). This is a manifestation of the chronic stage of schizophrenia and is characterized mainly by pronounced negative symptoms (impoverished speech, apathy, flattening of emotions, inhibition, disturbances of the volitional sphere).
Simple form of schizophrenia (F20.6). It is characterized by the presence of mainly negative symptoms. With this form, gradual changes in personal characteristics and a decrease in productivity in study and work are observed. Residual symptoms of this form of schizophrenia occur without acute psychosis.
In the early stages, schizophrenia may occur without the manifestation of distinct symptoms, however, family and friends should pay attention to the following signs indicating the possible onset of the development of the disease:
Statements “someone controls me”, “there is someone else in me”, “I have changed”, “there are two people in me at the same time”.
Statements that someone has taken away feelings and thoughts, a feeling of emptiness and coldness. “Endless emptiness”, “emptiness without boundaries”, “falling into emptiness or an abyss” - this is how patients diagnosed with schizophrenia describe their condition.
Claims that someone is to blame for the change in condition - neighbors, secret organizations, mystical forces.
Endowing objects and facts with a certain meaning or symbolic meaning. For example, a certain color, according to the patient, may pose a threat to him, or certain gestures of people confirm some of the person’s thoughts.
Statement of inability to feel, express emotions, reflection of a “mask” in the mirror instead of a face. Or, on the contrary, too strong emotions in an insignificant situation.
Perception of the surrounding world is distorted, changed. Often people with schizophrenia say that houses, people, and streets seem sketchy to them.
Creative people may have unusually shaped animals in their drawings, a combination of incompatible images (agglutination), or unusual or stereotypical images.
A person has stopped taking care of himself, does not follow hygiene rules, and has lost interest in his own appearance.
Confusion of thoughts. Losing the thread of a conversation, often a person cannot remember where he started the conversation and what he wanted to say with this or that phrase. Illogical construction of sentences.
Loss of interest in work, communication with friends and loved ones, desire for loneliness.
If you notice changes in the usual behavior of your loved one, you should contact a qualified psychiatrist. It is important to remember that as schizophrenia progresses, periods of exacerbation and periods of remission are possible. If the signs of schizophrenia are not noticed in time, the patient’s personality may continue to disintegrate, which will lead to disruption of social connections, increasing apathy and increased negative symptoms.
Schizophrenia can occur both with periods of remission and in severe status. If the disease is mild, the patient can practically live a full life - work, play sports and have a family. In such situations, the patient simply periodically visits his doctor and adjusts the medication as necessary. As a rule, periods of exacerbation occur in autumn and spring.
However, in some cases, schizophrenia is expressed in severe forms. Usually in such cases the patient does not understand that he is sick. He perceives the surrounding reality very acutely and painfully, his brain tries to “explain” everything that is happening, but from the outside there is an understanding that his behavior is inadequate. Such patients can, at the command of a voice, kill someone, suddenly attack a person sitting next to them, and commit other antisocial acts. In this case, constant supervision by specialists is required - such patients are placed in closed departments of a psychiatric hospital.
Scientists have found that on average the percentage of schizophrenia among women and men is approximately the same - that is, both women and men have the same risks of developing schizophrenia.
However, the age at which schizophrenia most often begins to manifest differs - if in men schizophrenia most often manifests itself at 16-26 years, then in women a little later - from 20 to 45 years.
Often in women, schizophrenia begins to manifest itself after childbirth. And at first it is often confused with postpartum psychosis. It is childbirth that often becomes the trigger for mental disorder. This is not surprising, because pregnancy, labor and subsequent childcare are a serious test for the body and psyche.
In women, schizophrenia most often begins to manifest itself as follows:
• obsessive neurotic deviations. A woman always feels the need to perform some illogical action. In particular, she cannot calmly enter a building unless she first counts to ten, cannot sit down unless she first touches her left earlobe, and so on;
• strange behavior. A woman may suddenly burst into laughter and cry immediately afterwards. This behavior is not an isolated incident but is often repeated.
Male schizophrenia will most often manifest itself as follows:
• voices. The man will experience intrusive auditory hallucinations all the time. He will imagine voices that will talk to him all the time and even order something, direct his actions;
• the pursuit. The man will feel like someone is following him all the time. He will become more suspicious, withdrawn and aggressive;
• condemnation. The patient will feel that everyone is judging him and laughing behind his back. This will cause him fear, panic, and, as a result, unpredictable, spontaneous reactions.
Psychiatry and pharmacology do not stand still in the treatment of schizophrenia - today we can say that effective treatment of schizophrenia is possible. It is important to identify the disease as early as possible, prescribe a treatment regimen, train the patient and his relatives to cope with the manifestations of schizophrenia and follow all the doctor’s instructions and recommendations.
Modern medications have minimal side effects and effectively relieve symptoms of schizophrenia. Such medications allow the patient to lead a normal life. Unfortunately, patients with a long history of treatment with old-generation drugs that have many side effects and do not affect negative symptoms often come to the «IsraClinic». Incorrectly prescribed treatment leads to a deterioration in the patient’s well-being and provokes the progression of schizophrenia, which significantly complicates therapy. Today, drug therapy involves treatment with 1-2 selected drugs in the required dosage, rather than complex regimens of heavy medications, many of which have been banned for use in Israel for several decades.
The «IsraClinic» practices a comprehensive approach to the treatment of schizophrenia. The therapy process is supervised by a psychiatrist who selects medications and monitors the progress of treatment. If necessary, a psychotherapy specialist conducts individual consultations with the patient, as well as family consultations for the patient’s relatives. Individual classes include art therapy, bibliotherapy, music therapy, along with the most modern methods of psychotherapy for patients diagnosed with schizophrenia. The sports therapist helps the patient enter a sports regime, which is very important, since such patients often stop taking care of themselves and playing sports.
Therapy aimed at preventing relapse of schizophrenia plays an important role in the treatment process. For this purpose, modern drugs with a prolonged effect are used, as well as supportive psychotherapy. This process should be long-term and include both observation of the patient and the dynamics of his condition, and constant sessions with a psychotherapist. In addition, relatives should be involved in supportive therapy, who are trained at «IsraClinic» in how to behave with the patient to prevent relapse.