Schizophrenia has always been one of my favorite diseases to learn about and study. The way the brain works fascinates me. The disease is chronic and can be disabling to a person and their family. Schizophrenia is a mental disorder that can affect how a person thinks, feels, and behaves, making them seem almost “out of touch” with reality (National Institute of Mental Health, 2016). Without the proper treatment, these patients can really hurt themselves or someone else.
Although the disease is rare, it is still known as a serious mental condition. The worldwide prevalence of schizophrenia is hard to determine because the factors to diagnosis vary in different countries. It is estimated to affect about 1% of Americans. A person can develop schizophrenia at any point throughout the life but it most often affects women between the ages of late 20’s to early 30’s and men in the late teens to early 20’s (National Alliance on Mental Illness, n.d.). The incidence of schizophrenia is higher in men, but the prevalence is the same between men and women. Research has found the reason for this difference is based on “strong hypothesis,” which makes estrogen neuro-protective for women (Falkenberg & Tracy, 2012).
The pathophysiology on schizophrenia is very complex and no one knows the exact cause of the disease. An excess or deficiency of neurotransmitters, such as; serotonin, dopamine, and glutamate, provide the basis of the pathophysiology of schizophrenia (Patel et al., 2014). Researchers have also found that the patient with schizophrenia has an increase in size of the lateral and third ventricles and a smaller medial temporal lobe (Patel et al., 2014).
The symptoms of schizophrenia are divided into categories of positive, negative, or cognitive. Positive symptoms are cognitive issues that include hallucinations, delusions, thought disorders, and movement disorders. The negative symptoms are related to emotions and behaviors. The patient may stop communicating as much as they use to and start secluding themselves. They have a flat affect. Cognitive symptoms can be more severe and be more debilitating for the patient. The patient may not be able to fully understand in the capacity that a normal person would. They could have trouble focusing and making decisions (National Institute of Mental Health, n.d.).
One of the most important things to teach a patient with schizophrenia and their family is how vital it is to adhere to treatment regimens. Antipsychotic therapies have been proven to be 70-80% effective in patients who adhere to there antipsychotic therapies, but 50% of those patient prescribed antipsychotics do not stick to their treatment plan (El-Mallakh & Findlay, 2015). Patient who do not adhere to their treatments are at a greater risk to commit suicide. Antipsychotics are used to treat schizophrenia. These include Thorazine, Haldol. Prolixin, Abilify, Zyprexa, Seroquel, Risperdal, etc. Once patients and their physicians find the medication that works best for them, physicians will help the best develop coping strategies and ways to adjust to as much of a normal life as possible. Patients are encouraged to work and to or go to school and to develop goals for themselves. Recovery After Initial Schizophrenic Episode (RAISE) is a group that intervenes as early as possible to try to help patients with schizophrenia from becoming disabled and to improve their prognosis (National Institute of Mental Illness, n.d.). Unfortunately, there is no cure for schizophrenia. The patient will need to follow up with their primary care provider as well as psychiatrist long-term. It is also recommended that the patients become active in support groups.
El-Mallakh, P. & Findlay, J. (2015). Strategies to improve medication adherence in patients with schizophrenia: the role of support services. Neuropsychiatric Disease and Treatment, 11, 1077-1090. doi: 10.2147/NDT.S56107
Falkenburg, J., & Tracy, D. (2012) Sex and schizophrenia: a review of gender differences, Psychosis, 6:1, 61-69, DOI: 10.1080/17522439.2012.733405<https://doi.org/10.1080/17522439.2012.733405>
National Alliance on Mental Illness. (n.d.). Schizophrenia. Retrieved on Febraury 28, 2018 from https://www.nami.org/learn-more/mental-health-conditions/schizophrenia.
National Institute of Mental Health. (2016). Schizophrenia. Retrieved on February 28, 2018 from https://www.nimh.nih.gov/health/topics/schizophrenia/index.shtml
Patel, K., Cherian, J., Gohil, K., & Atkinson, D. (2014). Schizophrenia: Overview and treatment options. Pharmacy and Therapeutics, 39(9), 638-345.