1. 1. Definition
2. History of schizophrenia
3.Epidemiology of schizophrenia
4. Symptoms
5. Causes
6. Risk factors
7. Complications
8. Tests and diagnosis
9. Treatments and drugs
10. Coping and support
11. Prevention
12. Definition
Schizophrenia is a severe brain disorder in
which people interpret reality abnormally.
Schizophrenia may result in some combination
of hallucinations, delusions, and extremely
disordered thinking and behavior.

2. Contrary to popular belief, schizophrenia
isn't a split personality or multiple
personality. The word "schizophrenia" does
mean "split mind," but it refers to a
disruption of the usual balance of emotions
and thinking.
History of Schizophrenia
Although schizophrenia goes back several
thousand years, this most serious of psychiatric
disorders was not officially coined
“schizophrenia” until 1911. Throughout time the
disorder has been regarded and labeled in a
variety of ways. As early as 1400 B.C., writings
in the ancient Ayur-Veda manuscripts described
symptoms which sound very similar to
schizophrenia 1
.
Early barbaric treatments
Due to its bizarre and often frightening
symptoms, schizophrenia was believed for a
very long time to be the result of possession by
(or involvement with) the devil or an evil spirit of
some sort. Unfortunately, schizophrenics were
often exorcised, flogged, starved, or burned at

3. the stake as a result. Some were subjected to
“trephining”, in which holes where drilled into
the skull in an attempt to let the spirits out.
For several centuries, seriously mentally ill
individuals were also “treated” with a procedure
known as “bloodletting”. Bloodletting involved
cutting the patient and allowing “excess” blood
to be released. The illness was attributed to the
excess blood. As can be imagined, many
individuals with schizophrenia were killed by
these barbaric and cruel methods.
Progress in the late 19th century
In the latter part of the 1800s, scientists and
doctors were starting to develop a better grasp
of schizophrenia. The term “hebephrenia” was
coined by Ewald Hecker in 1871, for those with
symptoms of cognitive disorganization and
silliness 2
. The term is still used today by some
to refer to disorganized schizophrenia.
A few years later, Emile Kraepelin brought us
even closer to an understanding of the disorder.
He adopted the term “dementia praecox”, which
literally means early dementia, to refer to
schizophrenia symptoms which typically appear

4. in late adolescence or early to mid-twenties.
The term, however, was inaccurate in that
schizophrenia is not a type of dementia at all.
He did, however, correctly regard it as a brain
disorder.
Sadly, although progress was being made,
treatment hadn’t improved much.
Schizophrenics were often tied up or chained
and locked away in dark, filthy “insane
asylums”. It was not unusual for them to be
flogged as part of their treatment there. The
public could even pay money to come into
these dreadful institutions just to look at the
patients.
20th century
In 1911, Dr. Eugen Bleuler first used the term
“schizophrenia” to label this complex disorder.
A psychiatrist from Switzerland, Dr. Bleuler
noticed that many patients’ minds seemed to be
“split off” from reality. Hence his use of the term
“schizophrenia”, which literally translated
means “split mind”. A few decades later in
1957, the definition currently used for
schizophrenia was created by Kurt Schneider.

5. While the conditions of mental institutions
slowly improved with time, they were far from
ideal even in the early to mid-twentieth century.
Treatments for schizophrenia and other severe
psychiatric disorders now included electro-
shock therapy (ECT) and lobotomies, in which
part of the brain is surgically removed. ECT is
still used today in some cases, despite ongoing
controversy surrounding it as a treatment
option.
Antipsychotic medications
Treatment with antipsychotic medication first
started in the early 1950’s, with the introduction
of Thorazine. Since then, many antipsychotic
medications have been developed. These
medications, while far from ideal, have allowed
many individuals with schizophrenia to live
productive and fulfilling lives.
To date…
Currently, there is still no cure for
schizophrenia. While much progress continues
to be made in terms of better understanding the
disorder, there is still much to learn. Hopefully,
as time goes on, treatment options will continue

6. to improve and ultimately, either a cure and/or a
way to prevent the disorder will be discovered.
Epidemiology of schizophrenia
Schizophrenia affects around 0.3–0.7% of people at
some point in their life or 24 million people
worldwide as of 2011.]
It occurs 1.4 times more
frequently in males than females and typically
appears earlier in men—the peak ages of onset are
25 years for males and 27 years for females. Onset
in childhood is much rarer, as is onset in middle- or
old age Despite the received wisdom that
schizophrenia occurs at similar rates worldwide, its
frequency varies across the world, within
countries[1]
,]
and at the local and neighborhood level
It causes approximately 1% of worldwide disability
adjusted life yearsand resulted in 20,000 deaths in
2010 The rate of schizophrenia varies up to threefold
depending on how it is definedIn 2000, the World
Health Organization found the prevalence and
incidence of schizophrenia to be roughly similar
around the world, with age-standardized prevalence
per 100,000 ranging from 343 in Africa to 544 in

7. Japan and Oceania for men and from 378 in Africa
to 527 in
Schizophrenia is a chronic condition, requiring
lifelong treatment
Symptoms
In men, schizophrenia symptoms typically start
in the early to mid-20s. In women, symptoms
typically begin in the late 20s. It's uncommon for
children to be diagnosed with schizophrenia
and rare for those older than 45.
Schizophrenia involves a range of problems
with thinking (cognitive), behavior or emotions.
Signs and symptoms may vary, but they reflect
an impaired ability to function. Symptoms may
include:
 Delusions. These are false beliefs that are
not based in reality. For example, you're being
harmed or harassed; certain gestures or
comments are directed at you; you have
exceptional ability or fame; another person is
in love with you; a major catastrophe is about
to occur; or your body is not functioning

8. properly. Delusions occur in as many as 4 out
of 5 people with schizophrenia.
 Hallucinations. These usually involve seeing
or hearing things that don't exist. Yet for the
person with schizophrenia, they have the full
force and impact of a normal experience.
Hallucinations can be in any of the senses,
but hearing voices is the most common
hallucination.
 Disorganized thinking (speech).
Disorganized thinking is inferred from
disorganized speech. Effective
communication can be impaired, and answers
to questions may be partially or completely
unrelated. Rarely, speech may include putting
together meaningless words that can't be
understood, sometimes known as word salad.
 Extremely disorganized or abnormal motor
behavior. This may show in a number of
ways, ranging from childlike silliness to
unpredictable agitation. Behavior is not
focused on a goal, which makes it hard to
perform tasks. Abnormal motor behavior can
include resistance to instructions,
inappropriate and bizarre posture, a complete

9. lack of response, or useless and excessive
movement.
 Negative symptoms. This refers to reduced
ability or lack of ability to function normally.
For example, the person appears to lack
emotion, such as not making eye contact, not
changing facial expressions, speaking without
inflection or monotone, or not adding hand or
head movements that normally provide the
emotional emphasis in speech. Also, the
person may have a reduced ability to plan or
carry out activities, such as decreased talking
and neglect of personal hygiene, or have a
loss of interest in everyday activities, social
withdrawal or a lack of ability to experience
pleasure.
Symptoms in teenagers
Schizophrenia symptoms in teenagers are
similar to those in adults, but the condition may
be more difficult to recognize in this age group.
This may be in part because some of the early
symptoms of schizophrenia in teenagers are
common for typical development during teen
years, such as:

10.  Withdrawal from friends and family
 A drop in performance at school
 Trouble sleeping
 Irritability or depressed mood
 Lack of motivation
Compared with schizophrenia symptoms in
adults, teens may be:
 Less likely to have delusions
More likely to have visual hallucinations The
five schizophrenia subtypes are:
1. Paranoid
2. Disorganized
3. Catatonic
4. Undifferentiated
5. Residual
Paranoid
The most prominent symptoms of paranoid
schizophrenia are auditory hallucinations
(usually voices) and / or delusions. Typically,
the paranoid schizophrenic’s speech, cognitive

11. functioning, and emotional expression are less
impaired than in some of the other subtypes. Of
all the subtypes, paranoid schizophrenics are
more likely to be able to work and live on their
own.
Disorganized
The type of schizophrenic generally speaks and
acts in a manner which is, as the name
suggests, disorganized. Also, his/her emotional
expression is typically either blunted or
inappropriate. He/she is often incapable of
performing goal-oriented tasks, which makes
independent living generally impossible.
Catatonic
Catatonic schizophrenics may exhibit various
things, such as “negativism”, posturing, excited
or other abnormal movements, and being
physically rigid. He/she may be in a stupor at
times, and may also refuse to speak.
Undifferentiated
An individual with undifferentiated
schizophrenia doesn’t meet the criteria for
paranoid, disorganized, or catatonic subtypes.

12. However, he/she does have one or more of the
following symptoms:
 Delusions
 Hallucinations
 Extremely disorganized behavior
 Catatonic behavior
 “Negative symptoms” such as blunted
emotional expression, significantly impaired
thinking or speech, or the inability to begin and
carry out goal-oriented tasks, such as getting
dressed.
Residual
This subtype is diagnosed when the person has
a history of a definite schizophrenic episode,
but at the time of evaluation the person does
not exhibit prominent delusions or
hallucinations, or speech or behavior which is
extremely disorganized or catatonic. However,
he/she does show some symptoms which are
typical of schizophrenia, such as lack of
emotional expression, inability to start and carry

13. out goal-oriented tasks, odd beliefs, speech
which is somewhat disorganized, or behavior
which would be considered eccentric

Causes
It's not known what causes schizophrenia, but
researchers believe that a combination of genetics
and environment contributes to development of the
disorder.
Problems with certain naturally occurring brain
chemicals, including neurotransmitters called
dopamine and glutamate, also may contribute to
schizophrenia. Neuroimaging studies show
differences in the brain structure and central nervous
system of people with schizophrenia. While
researchers aren't certain about the significance of
these changes, they support evidence that
schizophrenia is a brain disease.
Risk factors
Although the precise cause of schizophrenia
isn't known, certain factors seem to increase
the risk of developing or triggering
schizophrenia, including:

14.  Having a family history of schizophrenia
 Exposure to viruses, toxins or malnutrition
while in the womb, particularly in the first and
second trimesters
 Increased immune system activation, such as
from inflammation or autoimmune diseases
 Older age of the father
Taking mind-altering (psychoactive or
psychotropic) drugs during teen years and
young adulthooD
Complications
Left untreated, schizophrenia can result in
severe emotional, behavioral and health
problems, as well as legal and financial
problems that affect every area of life.
Complications that schizophrenia may cause or
be associated with include:
 Suicide
 Any type of self-injury
 Anxiety and phobias
 Depression

15.  Abuse of alcohol, drugs or prescription
medications
 Poverty
 Homelessness
 Family conflicts
 Inability to work or attend school
 Social isolation
 Health problems, including those associated
with antipsychotic medications, smoking and
poor lifestyle choices
 Being a victim of aggressive behavior
 Aggressive behavior, although it's uncommon
and typically related to lack of treatment,
substance misuse or a history of violence
Tests and diagnosis
When doctors suspect someone has
schizophrenia, they typically ask for medical
and psychiatric histories, conduct a physical
exam, and run medical and psychological tests,
including:
 Tests and screenings. These may include a
lab test called a complete blood count (CBC),

16. other blood tests that may help rule out
conditions with similar symptoms, and
screening for alcohol and drugs. The doctor
may also request imaging studies, such as an
MRI or CT scan.
 Psychological evaluation. A doctor or
mental health provider will check mental
status by observing appearance and
demeanor and asking about thoughts, moods,
delusions, hallucinations, substance abuse,
and potential for violence or suicide.
Diagnostic criteria for schizophrenia
To be diagnosed with schizophrenia, a person
must meet the criteria in the Diagnostic and
Statistical Manual of Mental Disorders (DSM).
This manual, published by the American
Psychiatric Association, is used by mental
health providers to diagnose mental conditions.
Diagnosis of schizophrenia involves ruling out
other mental health disorders and determining
that symptoms aren't due to substance abuse,
medication or a medical condition. In addition, a
person must have at least two of the following
symptoms most of the time during a one-month

17. period, with some level of disturbance being
present over six months:
 Delusions
 Hallucinations
 Disorganized speech (indicating disorganized
thinking)
 Extremely disorganized behavior
 Catatonic behavior, which can ranges from a
coma-like daze to bizarre, hyperactive
behavior
 Negative symptoms, which relate to reduced
ability or lack of ability to function normally
At least one of the symptoms must be
delusions, hallucinations or disorganized
speech.
The person shows a significant decrease in the
ability to work, attend school or perform normal
daily tasks most of the time.
The American Psychiatric Association
eliminated the previous subtypes of
schizophrenia — paranoid, disorganized,
catatonic, undifferentiated and residual —
because of poor reliability. These subtypes

18. weren't shown to be valid and didn't help in
determining which treatment might be best for a
specific subtype
Treatments and drugs
Schizophrenia requires lifelong treatment, even
when symptoms have subsided. Treatment with
medications and psychosocial therapy can help
manage the condition. During crisis periods or
times of severe symptoms, hospitalization may
be necessary to ensure safety, proper nutrition,
adequate sleep and basic hygiene.
A psychiatrist experienced in treating
schizophrenia usually guides treatment. The
treatment team also may include a
psychologist, social worker, psychiatric nurse
and possibly a case manager to coordinate
care. The full-team approach may be available
in clinics with expertise in schizophrenia
treatment.
Medications
Medications are the cornerstone of
schizophrenia treatment. However, because
medications for schizophrenia can cause

19. serious but rare side effects, people with
schizophrenia may be reluctant to take them.
Antipsychotic medications are the most
commonly prescribed drugs to treat
schizophrenia. They're thought to control
symptoms by affecting the brain
neurotransmitters dopamine and serotonin.
Willingness to cooperate with treatment may
affect medication choice. Someone who is
resistant to taking medication consistently may
need to be given injections instead of taking a
pill. Someone who is agitated may need to be
calmed initially with a benzodiazepine such as
lorazepam (Ativan), which may be combined
with an antipsychotic.
Atypical antipsychotics
These newer, second-generation medications
are generally preferred because they pose a
lower risk of serious side effects than do
conventional medications. They include:
 Aripiprazole (Abilify)
 Asenapine (Saphris)
 Clozapine (Clozaril)

20.  Iloperidone (Fanapt)
 Lurasidone (Latuda)
 Olanzapine (Zyprexa)
 Paliperidone (Invega)
 Quetiapine (Seroquel)
 Risperidone (Risperdal)
 Ziprasidone (Geodon)
Ask your doctor about the benefits and side
effects of any medication that's prescribed.
Conventional, or typical, antipsychotics
These first-generation medications have
frequent and potentially significant neurological
side effects, including the possibility of
developing a movement disorder (tardive
dyskinesia) that may or may not be reversible.
This group of medications includes:
 Chlorpromazine
 Fluphenazine
 Haloperidol (Haldol)
 Perphenazine
These antipsychotics are often cheaper than
newer counterparts, especially the generic

21. versions, which can be an important
consideration when long-term treatment is
necessary.
It can take several weeks after first starting a
medication to notice an improvement in
symptoms. In general, the goal of treatment
with antipsychotic medications is to effectively
control signs and symptoms at the lowest
possible dosage. The psychiatrist may try
different medications, different dosages or
combinations over time to achieve the desired
result. Other medications also may help, such
as antidepressants or anti-anxiety medications.
Psychosocial interventions
Once psychosis recedes, psychological and
social (psychosocial) interventions are
important — in addition to continuing on
medication. These may include:
 Individual therapy. Learning to cope with
stress and identify early warning signs of
relapse can help people with schizophrenia
manage their illness.

22.  Social skills training. This focuses on
improving communication and social
interactions.
 Family therapy. This provides support and
education to families dealing with
schizophrenia.
 Vocational rehabilitation and supported
employment. This focuses on helping people
with schizophrenia prepare for, find and keep
jobs.
Most individuals with schizophrenia require
some form of daily living support. Many
communities have programs to help people with
schizophrenia with jobs, housing, self-help
groups and crisis situations. A case manager or
someone on the treatment team can help find
resources. With appropriate treatment, most
people with schizophrenia can manage their
condition.
Coping and support
Coping with a mental disorder as serious as
schizophrenia can be challenging, both for the
person with the condition and for friends and
family. Here are some ways to cope:

23.  Learn about schizophrenia. Education about
the condition can help motivate the person
with the disease to stick to the treatment plan.
Education can help friends and family
understand the condition and be more
compassionate with the person who has it.
 Join a support group. Support groups for
people with schizophrenia can help them
reach out to others facing similar challenges.
Support groups may also help family and
friends cope.
 Stay focused on goals. Managing
schizophrenia is an ongoing process. Keeping
treatment goals in mind can help the person
with schizophrenia stay motivated. Help your
loved one remember to take responsibility for
managing the illness and working toward
goals.
 Learn relaxation and stress management.
The person with schizophrenia and loved
ones may benefit from stress-reduction
techniques such as meditation, yoga or tai chi
Prevention

24. There's no sure way to prevent schizophrenia.
However, early treatment may help get
symptoms under control before serious
complications develop and may help improve
the long-term outlook.
Sticking with the treatment plan can help
prevent relapses or worsening of schizophrenia
symptoms. In addition, researchers hope that
learning more about risk factors for
schizophrenia may lead to earlier diagnosis and
treatment.