Schizophrenia

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Do you know someone who seems like he or
she has “lost touch” with reality? Does this
person talk about “hearing voices” no one
else can hear? Does he or she see and feel
things no one else can? Does this person
believe things that aren‟t true?
Sometimes people with these symptoms

What is Schizophrenia ?
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• a chronic, severe and
debilitating mental illness.
• considered one of the
psychotic mental disorders
and is characterized by
symptoms of thought,
behavior, and social problems.
• person's thinking is completely
out of touch with reality at
times.

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Anyone can develop
schizophrenia. It
affects men and
women equally in all
ethnic groups. Teens
can also develop
schizophrenia. In rare
cases, children have
the illness too.

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Statistics shows that
schizophrenia affects men
about one and a half times
more commonly than women
and that 50% of people in
hospital psychiatric care have
schizophrenia. Diagnosis is
usually in people aged 17-35
years with the illness appearing
earlier in men (in the late teens
or early 20s) than in women
(who are affected in the 20s to

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Fewer studies on
schizophrenia in
children compared to
adults, researchers
find out that children
as young as 6 years
old can be found to
have all the symptoms
of their adult
counterparts and
continue to have those
symptoms into

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Several factors may
contribute to schizophrenia,
including:
• Genes, because the illness
runs in families
• The environment, such as
viruses and nutrition
problems before birth
• Different brain structure and
brain chemistry.

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Schizophrenia Symptoms
range from mild to severe.
There are Four main types
of symptoms.
1. Positive (More Overtly
Psychotic) Symptoms
2. Negative (Deficit)
Symptoms
3. Cognitive Symptoms
4. Affective (or Mood)

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1. Positive (More Overtly
Psychotic) Symptoms
• refer to a distortion of a
person‟s normal thinking and
functioning. They are
“psychotic” behaviors. People
with these symptoms are
sometimes unable to tell
what‟s real from what is
imagined. Positive symptoms

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Halluci-
nations
when a person sees,
hears, smells, or feels
things that no one else
can. “Hearing voices”
is common for people
with schizophrenia.
People who hear
voices may hear them
for a long time before
family or friends notice
a problem.

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Delusion
s
when a person
believes things that are
not true. For example,
a person may believe
that people on the
radio and television are
talking directly to him
or her. Sometimes
people believe that
they are in danger—
that other people are
trying to hurt them.

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Thought
Disorders
ways of thinking that
are not usual or
helpful. People with
thought disorders may
have trouble
organizing their
thoughts. Sometimes a
person will stop talking
in the middle of a
thought. And some
people make up words
that have no meaning.

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Movement
Disorders
may appear as
agitated body
movements. A person
with a movement
disorder may repeat
certain motions over
and over. In the other
extreme, a person may
stop moving
or talking for a while, a
rare condition called
“catatonia.”

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Disorganized
behaviors
Catatonic
behaviors

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2. Negative (Deficit)
Symptoms
•refer to difficulty showing
emotions or functioning
normally. When a person
with schizophrenia has
negative symptoms, it may
look like depression.
People with negative
symptoms may:

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Talk in a
dull voice
Show no facial
expression, like
a smile or frown

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Have
trouble in
having fun
Difficulty in
taking care of
themselves

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Social
withdrawal
Talk very little to
other people,
even when they
need to.

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3. Cognitive Symptoms
•include difficulties
attending to and
processing of
information, in
understanding the
environment, and in
remembering simple

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4. Affective (or Mood)
Symptoms
•The most notable
affective symptom is
depression, which
accounts for a very
high rate of attempted
suicide in people
suffering from

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Types of
Schizophrenia

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Paranoid Schizophrenia
Disorganized Schizophrenia
Catatonic schizophrenia
Undifferentiated Schizophrenia
Residual Schizophrenia

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1. Paranoid
Schizophrenia Paranoid-characterized by
delusions and auditory
hallucinations but relatively
normal intellectual
functioning and expression of
affect.
 People with paranoid-type
schizophrenia can exhibit
anger, aloofness, anxiety,
and argumentativeness.

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Common characteristics of
people who tend to be
paranoid include:poor self-image
social isolation
an expectation that others are trying to take
advantage of them
an inability to relax
an inability to work with others
a deep mistrust of others
an inability to let go of insults or to forgive
others
a poor sense of humor

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2. Disorganized
Schizophrenia Disorganized-characterized
by speech and behavior that
are disorganized or difficult to
understand, and flattening or
inappropriate emotions.
 People with disorganized-
type schizophrenia may laugh
at the changing color of a
traffic light or at something not
closely related to what they are

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Disorganized
Schizophrenia
 Their disorganized
behavior may disrupt normal
activities, such as showering,
dressing, and preparing
meals.

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3. Catatonic
Schizophrenia Characterized by
disturbances of movement.
People with catatonic-type
schizophrenia may keep
themselves completely
immobile or move all over the
place.

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4. Undifferentiated
Schizophrenia
• Characterized by episodes of
two or more of the following
symptoms: delusions,
hallucinations, disorganized
speech or behavior, catatonic
behavior or negative symptoms,
but the individual does not
qualify for a diagnosis of
paranoid, disorganized, or
catatonic.

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5. Residual
Schizophrenia
•Characterized by a past
history of at least one
episode of schizophrenia, but
the person currently has no
positive symptoms
(delusions, hallucinations,
disorganized speech or
behavior).

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5. Residual
Schizophrenia
•It may represent a
transition between a full-
blown episode and
complete remission, or it
may continue for years
without any further
psychotic episodes.

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A. Antipsychotic
Medications are helpful to people with
schizophrenia, schizoaffective
disorder and some forms of
bipolar disorder. They are able to
reduce, or sometimes eliminate,
the distressing and disabling
symptoms of psychosis, such as
paranoia, confused thinking,
delusions and hallucinations, so
that the person taking them feels
better.

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There are two types of antipsychotic
medications:
1. atypical (newer) and
2. typical (older)
Helpful to people with schizophrenia,
schizoaffective disorder and some
forms of bipolar disorder. They are
able to reduce, or sometimes
eliminate, the distressing and
disabling symptoms of psychosis,
such as paranoia, confused thinking,
delusions and hallucinations, so that
the person taking them feels better.

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Advantages
of Atypical
Medications

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•Fewer side-effects such
as trembling or stiffening
of muscles.
•Less risk of developing
„tardive dyskinesia‟:
movement of the mouth,
tongue and sometimes
other parts of the body
over which the person has
no control.

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A. Antipsychotic
Medications•Some evidence suggests that
the newer medications may be
effective in improving overall
mood, thinking and motivation.
•Antipsychotics, like many
medications, change the way you
feel. This means that if you stop
taking the medication you may
start to feel the way you did
before the treatment

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A. Antipsychotic
Medications•However, antipsychotic
medications are not addictive,
and you will not become
dependant on them (you do
not need to take higher and
higher doses to get the same
benefits).

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What about
injections –
depot
medication?

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 Depot medication is given
by injection, which releases
the drug slowly over some
weeks. Some people prefer
injections as they find
remembering to take tablets
difficult. Some people are
required to take depot
medication as a condition of
a community treatment order.

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Side
Effects

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 dry mouth
low blood pressure
lower sexual
responsiveness
tiredness
loss of periods in women
dizziness
stiffness or trembling in
muscles
nausea, constipation
mild involuntary
movements

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B. Mood-stabilizer
Medications
 lithium (Lithobid)
divalproex (Depakote)
carbamazepine
lamotrigine (Lamictal)

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B. Mood-stabilizer
Medications
These medicines are
available in syrup, tablet,
capsule, and chewable tablet
forms.
Can be useful in treating
mood swings that sometimes
occur in individuals who have
a diagnosable mood disorder
in addition to psychotic

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Examples
B. Mood-stabilizer
Medicines
Generic Name Brand New
carbamazepine Equetro, Tegretol
divalproex Depakote
valproate Depakene syrup

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Side
Effects

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Nausea, vomiting, and
diarrhea.
Trembling.
Increased thirst and
increased need to urinate.
Weight gain in the first few
months of use.
Drowsiness.
A metallic taste in the mouth.
Abnormalities in kidney
function.
Abnormalities in thyroid

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C. Antidepressants
Medications:
Examples of antidepressants that
are commonly prescribed for that
purpose include:
serotonergic (SSRI)
medications that affect serotonin
levels like fluoxetine (Prozac)
sertraline (Zoloft)
paroxetine (Paxil)
citalopram (Celexa)
escitalopram (Lexapro)

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C. Antidepressants
Medications:
•Antidepressant medications are
the primary medical treatment
for the depression that can often
accompany schizophrenia.
•Used under the guidance of a
mental health professional, may
relieve some of your depression
symptoms. But antidepressants
also come with significant side
effects and dangers.

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C. Antidepressants
Medications:
•Recent studies have raised
questions about their
effectiveness. At the very least, it‟s
clear that medication alone isn‟t
enough—you also need to make
changes in your lifestyle. Learning
the facts about antidepressants
and weighing the benefits against
the risks can help you make an
informed and personal decision
about what‟s right for you.

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Side
Effects

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Nausea
Insomnia
Anxiety
Restlessness
Decreased sex drive
Dizziness
Weight gain
Tremors
Sweating
Sleepiness or fatigue
Dry mouth
Diarrhea
Constipation
Headaches

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Family Psycho-
education
This form of treatment consists of
providing family support, problem-
solving skills, and access to care
providers during times of crises.
When this intervention is consistently
provided for at least several months,
it has been found to decrease the
relapse rate for the individual with
schizophrenia and improve the
person's social and emotional
outcomes.

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Assertive Community
Treatment (ACT):
This intervention consists of
members of the person's
treatment team meeting with that
individual on a daily basis, in
community settings (for example,
home, work, or other places the
person with schizophrenia
frequents) rather than in an office
or hospital setting. The treatment
team is made up of a variety of

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Substance Abuse
Treatment
Providing medical and
psychosocial interventions
that address substance
abuse should be an integral
part of treatment as about
50% of individuals with
schizophrenia suffer from
some kind of substance
abuse or dependence.

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Social Skills
Training
Also called illness management
and recovery programming,
social-skills training involve
teaching clients ways to handle
social situations appropriately. It
often involves the person
scripting (thinking through or role-
playing) situations that occur in
social settings in order to prepare
for those situations when they

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Supported
Employment
This intervention provides
supports like a work coach
(someone who periodically or
consistently counsels the client in
the workplace), as well as
instruction on constructing a
résumé, interviewing for jobs,
and education and support for
employers to hire individuals with
chronic mental illness.

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Cognitive Behavioral
Therapy (CBT):
CBT is a reality-based
intervention that focuses on
helping a client understand
and change patterns that
tend to interfere with his or
her ability to interact with
others and otherwise
function.

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Weight
Management:
Educating people with
schizophrenia about weight
gain and related health
problems that can be a side
effect of some antipsychotic
and other psychiatric
medications has been found
to be helpful in resulting in a
modest weight loss.

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Output and Income Lost
When willing and able workers do not find employment,
they are deprived of income and the economy does not
benefit from the output they would have produced.

Schizophrenia

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