Overview

WebMD Health Information: Schizophrenia

Schizophrenia Overview: Schizophrenia symptoms include distorted thoughts and

hallucinations. Usually starting in young adulthood, schizophrenia can also cause the sufferer to
feel frightened and paranoid, sometimes to the point

Schizophrenia is a severe brain disease that interferes with normal brain and mental function—it
can trigger hallucinations, delusions, paranoia, and significant lack of motivation. Without
treatment, Schizophrenia is a severe brain disease and psychiatric illness that, without treatment,
interferes with the ability to think clearly, manage emotions, and interact with other people. It
causes symptoms such as hallucinations, delusions, paranoia, and disorganized thinking.

The cause of schizophrenia is not clear. Treatment to manage the symptoms of schizophrenia
consists of medications, counseling, and a good support network.

Schizophrenia is not the same condition as multiple personality disorder (dissociative identity
disorder).

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Cause
There are many theories about the cause of schizophrenia, but none have been proven.
Scientists do know that schizophrenia is a disorder affecting the brain.

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There is some evidence that genetics may play a role. Your chance of developing schizophrenia
is 10 times greater if your parent or sibling has the disease.2 But having a relative with
schizophrenia does not mean you will get this disease. Many people develop schizophrenia who
do not have a relative with this condition.

Schizophrenia may also be related to problems experienced during pregnancy, including

malnutrition or exposure to a viral infection, that can damage an unborn child's developing brain
and nervous system.2 Recent evidence suggests that treating a pregnant woman who has high
blood pressure with diuretics during the third trimester may put the baby at risk for later
developing schizophrenia.3

Another recent study suggests that a child is at greater risk for developing schizophrenia if the
father is older than age 50 when the child is conceived.4 Another possible cause is a head injury
in a child who has a parent or sibling with schizophrenia—the head injury may trigger this brain
disease if the child is genetically already at risk.5

There may also be a link between the use of illegal drugs and the development of schizophrenia.

More research is needed to understand the cause

Symptoms
Symptoms of schizophrenia are divided into two groups: negative and positive.

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Negative symptoms include:

• Inability to experience pleasure. This is a common symptom in schizophrenia and
includes difficulty enjoying activities that once brought pleasure, such as playing golf or visiting
with friends.

• Lack of emotion. This can lead to few friendships or social contacts. Showing little facial
expression, having poor eye contact, and slowed speech are characteristic.
 • Loss of motivation to succeed or accomplish goals. Job or school performance problems
are common.

• Problems focusing or paying attention, difficulty processing information, confusion, and

fragmented thoughts.

• Self-neglect, such as poor hygiene, wearing dirty clothes, or neglecting living space until
it becomes untidy or cluttered.

Negative symptoms usually occur first and can be confused with other health problems such as
depression or substance abuse. Substance abuse often occurs before the symptoms of
schizophrenia become apparent.6

Positive symptoms include:

• Hallucinations. These usually involve hearing noises or voices, but they can involve all
the senses—seeing, tasting, touching, hearing, or smelling something that is not there.

• Delusions. These are firmly held but false beliefs. Some common experiences include
thinking you are a powerful person, or that you are being persecuted or chased by the police or
by demons.

• Disordered (confused) thinking and speech that does not make any sense. Examples
include inappropriate responses to questions, not being able to respond with enough
information, or always giving a one-word reply to questions.

• Bizarre or disorganized behavior. Usually the behavior involves being overly excited,
angry, or unresponsive to other people. It may also include bizarre body movements, such as
rocking back and forth or grimacing repeatedly.

• Inappropriate emotions, such as smiling when speaking of sad topics or laughing for no
reason.

Some people with schizophrenia also have unusual symptoms, such as jerking eye movements.

Other symptoms can occur, depending on the type of schizophrenia you have:

• Paranoid schizophrenia causes unreasonable fears due to misinterpretations of what is

going on around you.

• Catatonic schizophrenia causes peculiar behaviors such as standing in an awkward

position for long periods of time.
 • Disorganized schizophrenia causes unusual speech and behavior, such as making up
words or constantly rhyming words.

Symptoms of schizophrenia usually emerge during adolescence or early adulthood and may
appear suddenly or develop gradually. When symptoms develop gradually, they may be
misdiagnosed with other conditions with similar symptoms, such as bipolar disorder or substance
abuse (which commonly occurs with schizophrenia).

Author: Jeannette Curtis

What Happens
Symptoms of schizophrenia usually emerge in the late teens to mid-20s for men and the late 20s
to 30s for women.2 Symptoms can also develop in children and younger teens, although this is
rare. The symptoms may either appear suddenly or evolve gradually. Men tend to have more
severe symptoms and a more difficult time with the effects of schizophrenia than do women.7

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There are three phases of disease progression: prodromal, active, and residual.6, 8

Prodromal phase
• Negative symptoms (such as lack of emotion or motivation), which may appear suddenly
or slowly over time

• Social withdrawal

• Poor hygiene, such as wearing dirty clothes or not bathing

• Loss of interest in school or work

• Outbursts of anger

• Unusual or out-of-character behavior

• Anxiety

• Confusion or confused speech

 • Terror or unreasonable fear of something or someone

• Depression

The prodromal phase may last for days, months, or years before the active illness begins. At first
the symptoms may be confused with depression or other anxiety disorders. Stressful events such
as emotional trauma or substance abuse can trigger symptoms of schizophrenia in those who are
at risk for developing the disease.7

Active or acute phase

• Positive symptoms (such as hallucinations or confused thinking or speaking) may appear
either suddenly or slowly over time.

• Negative symptoms may also continue to occur during this phase.

During the active or acute phase of schizophrenia, symptoms may fluctuate between episodes of
severe positive symptoms and periods of stabilized symptoms (remission).6 A person usually
develops a unique pattern of illness within the first 5 to 10 years of the active phase of
schizophrenia.

Residual phase
• Positive symptoms tend to become less intense.

• You may regain some social and job skills.

• The disease may become easier to manage, although people in this phase of
schizophrenia may not fully recover from its effects on the quality of their lives.6

While the positive symptoms may become less intense as the disease progresses, the negative
symptoms (such as lack of emotional response) may get worse. Even with treatment, up to 40%
of people with schizophrenia will relapse within 2 years; but without treatment, up to 80% will
have a relapse.7

Knowing how to recognize the first signs of relapse, such as social withdrawal, may help you get
early treatment, which may help you recover more quickly.

Up to 30% of people with schizophrenia attempt suicide, and between 4% and 10% will die by
suicide.7, 9 Continuous treatment is important. People with schizophrenia are also at risk for other
problems, such as violence and polydipsia (drinking so much water that it leads to health
problems).
Recovery rates vary between 29% and 83%, and about 20% to 30% of people with schizophrenia
deteriorate rather than recover from symptoms even with treatment.7

People with schizophrenia are likely to develop other social and physical conditions (such as
homelessness) or have additional disorders (such as substance abuse and depression).

Author: Jeannette Curtis