Schizophrenia( updated Oct 2006)

Schizophrenia is a mental disorder in which a person experiences several psychotic symptoms and subsequently loses contact with reality. It causes a decline in the person's general ability to function, as well as abnormal thinking, speech, and behaviour. About 180000 Australians are affected by schizophrenia at some point in their lives. One in one hundred people all over the world, from all walks of life, have the illness at some stage in their lives. It usually starts in the teenage years or early adulthood, but it can occur at any age. The first signs are often confusing or even shocking changes in the person's behaviour, thoughts, or manner of speaking. The course of schizophrenia is often unpredictable. For many people the disorder affects them for the rest of their lives.

There are five main types of symptoms:

• delusions, which are firmly held personal beliefs that are false. For example, a person may believe that aliens are trying to control him or her.
• hallucinations, in which a person senses things that don't exist. For example, a person may hear voices that no one else can hear, or see things that aren't there.
• disorganised speech, which can make it hard to understand a person with this condition
• disorganised or bizarre behaviour. This may include violent behaviour, strange movements, or a lack of movement.
• "negative" symptoms, or an absence of things that most people have. For example, a person with schizophrenia may lack energy, emotion, or the ability to feel pleasure.
• inability to concentrate

In addition, a person with schizophrenia often has social, work, or relationship problems because of the symptoms.

No single cause can account for this condition. It may be caused by a combination of inherited factors and the person's environment. Changes in the chemistry of the brain may also trigger it. A person with an affected relative is more likely to have schizophrenia. While the condition is equally common in males and females, females tend to have a milder coarse in most cases. There is no single test to diagnose schizophrenia. A psychiatrist makes the diagnosis based on the person's history and symptoms. Before the diagnosis is made, symptoms must be present for at least six months. Drug use or another medical condition must be ruled out as the cause of the symptoms. Blood, urine, and other tests may be done to look for any underlying medical disorders. Special x-ray tests of the brain, such as cranial CT scans, may also be done. Good care and treatment is essential for people with this condition. They often have problems with all aspects of thought, emotion, and expression. The course varies from one person to the next. People may be unable to work, have relationships, or even take care of themselves. Suicide is a serious danger. Roughly 10% of affected people eventually commit suicide.

Most people with schizophrenia are not violent. They are often withdrawn and want to be left alone. Drug abuse increases the risk of violence in affected people. A person who stops taking prescribed medication may be at a higher risk for violent behaviour. When violence does occur, it is most often targeted at family and friends, and most often takes place at home.


The goals of treatment are to:

• make symptoms less severe
• prevent a decline in function
• provide support so the person can function at the highest level possible

There are three major components of treatment:

• anti-psychotic medications to reduce symptoms. They may help the person to be more effective and appropriate in society.
• rehabilitation and community support activities to teach the skills needed to survive in society. These skills help an individual with schizophrenia to work, shop, manage a household, and get along with others.
• psychotherapy, with regularly scheduled talks between the individual and a doctor or psychologist. The sessions may focus on current or past problems, experiences, thoughts, feelings, or relationships. This may help the person understand and manage the illness, take medications, and manage stress.

Hospitalisation may be needed at times if the person poses a danger to self or others.


Antipsychotic medications offer a great deal of benefit for many patients but equally they can have many possible side effects. These may include drowsiness, restlessness, muscle spasms, dry mouth, and blurry vision. The long-term side effects may include tardive dyskinesia. This disorder causes uncontrollable, random movements. It is important that treatment be discussed with a psychiatrist as to obtain the most current information and understand all the options. Refusal to accept treatment or stopping treatment prematurely are the most common reasons for relapse of the symptoms which lead to further disability.

Most people with schizophrenia need some form of ongoing treatment for long periods of time, or for life. The outlook for an individual with this condition has improved over the past 25 years. Many people with schizophrenia improve enough with treatment to lead independent, satisfying lives. Group homes or structured living environments may be helpful for some individuals. A few people with severe forms of the disorder may need full time care in a safe and supportive setting.

Someone with schizophrenia needs ongoing monitoring and treatment. Symptoms may flare up and require hospitalisation. Without treatment and medications, some people become quite psychotic and disorganised. These people may be unable to care for their basic needs, such as food, clothing, and shelter. All too often, a person with schizophrenia that is poorly treated ends up on the streets or in jail, where he or she is unable to get effective treatment.

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