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What is schizophrenia? Causes, Symptoms and Treatment

Schizophrenia is a psychiatric illness that affects almost 1 in 100 people. The people affected are no longer in the real world and suffer from acute psychotic episodes. The symptoms of this chronic disease are severe and variable. They usually declare themselves between 15 and 25 years old. The most common symptoms are delusions and hallucinations. Schizophrenia requires treatment for life.

Often, the person with schizophrenia encounters social difficulties. Especially because this disease remains unknown and worried. The general public thinks that these patients are dangerous. Yet people with schizophrenia have an aggressiveness that they return most of the time against themselves and not against others.

Schizophrenia does not correspond to a split personality.  Schizo means in Greek “split” and phrenia, “spirit”. But this dissociation of the mind corresponds to that of emotions and thought, not to that of the personality.

Schizophrenia is not a rare disease as it affects about 1% of the world’s population. There are 400 000 patients in France, with 10 000 new cases per year.

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Causes of schizophrenia

The causes of schizophrenia are unknown. Researchers often put forward several causes, genetic and environmental, to explain the development of the disease. For example, some neurotransmitters like dopamine and glutamate are singled out, as is a particular brain structure. The consumption of cannabis would also be responsible for the increased risk of developing schizophrenia.

Complications

The disease has a very different face from one person to another. The same is true for complications, which can also be very variable. Left untreated, schizophrenia can lead to depression, anxiety, phobias, family conflict, drug or alcohol abuse, social isolation or suicide attempts.

What are the symptoms of schizophrenia?

Patients experience acute phases, that is to say a period during which their quality of life is very degraded, and periods more “calm”. People with schizophrenia have a high risk of suicide. The delirious may beings one of the first symptoms. Hospitalization is often necessary when they appear.

Thus, the symptoms of this disease are very variable from person to person. Some are said to be positive (and are the most impressive, it is hallucinations for example) and other negative (social withdrawal, isolation …). Some of the most common symptoms include:

  • delusions
  • Hallucinations, visual and auditory mainly
  • anxieties
  • Sleeping troubles
  • Lack of motivation
  • Feeling of persecution, paranoia (people who suffer from it feel that some people are trying to hurt them)
  • Feeling insecure
  • Strange impressions, invading ideas
  • Troubles of thought
  • Obsessions, phobias
  • Inconsistent speech
  • Lack of reaction, emotion
  • Unpredictable behaviors
  • Difficulties to communicate
  • Forgetting everyday tasks (clothing, cleaning, body wash …)
  • Isolation
  • Depression
  • Difficulty in distinguishing what is real from what is not

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What are the risk factors for schizophrenia?

Risk factors are very diverse. Having a parent with the disease increases the risk. Exposure to a virus, such as the influenza virus, during intrauterine life is another risk factor. For its part, a team from Inserm  observed, after analyzing 13 studies on the subject, the effect of the father’s ageon the appearance of the disease. Scientists have shown that the risk increases with age, from age 35, with a risk multiplied by two at this age, then by four to 50 years. Other researchers had already arrived at the same results, some also showing a link between age and bipolar disorder and between age and autism. Finally, cannabis use could also double the risk of schizophrenia.

People at risk

Schizophrenia affects all environments, and both men and women. However, the disease would develop earlier in men (between 15 and 25 versus 20 and 30 in women) and would be more disabling.

What are the treatments for schizophrenia?

Schizophrenia is a chronic disease that requires treatment for life. It associates the taking of drugs with a psychotherapeutic and psychosocial follow-up. When symptoms are important, especially in the acute period of the disease, hospitalization may be necessary. Today, some patients achieve lasting remission through treatment.

The most frequently prescribed drugs are antipsychotics. These drugs do not cause a cure but they reduce the symptoms of the disease and thus improve the quality of life of patients. Their effects are usually visible after a few weeks of treatment. Then the medical teams will look for the lowest effective doses.

Antipsychotics may be combined with anxiolytics, mood stabilizers, and antidepressants. But the proposed drug treatments can sometimes have significant side effects, which does not promote their regular intake (which is however necessary for a good control of the disease). It is common for sick people to stop their treatment after a few months, as soon as symptoms subside, and then relapse. In case of poor compliance, doctors can offer long-acting injectables to replace oral pills.

There are other treatments available in case of intolerance, contraindications or resistance to antipsychotics. This is for example seismotherapy (electroconvulsive therapy or electroconvulsive therapy). The latter may also be offered, in some cases, in addition to taking antipsychotics.

Prevention

There are no ways to prevent this disease. However, it is important that schizophrenia be managed as soon as possible, as soon as the first symptoms appear. The implementation of a fast treatment makes it more efficient. Symptoms can be controlled more quickly, which can limit complications in the longer term.

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