Schizophrenia

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Definitions

Description

Schizophrenia is a mental disorder characterized by a breakdown of thought processes and by impaired emotional responses. Common symptoms include delusions, such as paranoid beliefs; hallucinations; disorganized thinking; and negative symptoms, such as lack of emotion and lack of motivation. Schizophrenia causes significant social and work problems. Symptoms begin typically in young adulthood and about 0.3–0.7% of people are affected during their lifetime. Diagnosis is based on observed behavior and the person's reported experiences.

Genetics, early environment, neurobiology, psychological and social processes appear to be important contributory factors. Some recreational and prescription drugs appear to cause or worsen symptoms. Current research is focused on the role of neurobiology, although no single isolated organic cause has been found. The many possible combinations of symptoms have triggered debate about whether the diagnosis represents a single disorder or a number of discrete syndromes. Despite the origin of the term from the Greek roots skhizein (σχίζειν, "to split") and phrēn, phren- (φρήν, φρεν-; "mind"), schizophrenia does not imply a "split personality", or "multiple personality disorder" (which is known these days as dissociative identity disorder)—a condition with which it is often confused in public perception. Rather, the term means a "splitting of mental functions", because of the symptomatic presentation of the illness.

The mainstay of treatment is antipsychotic medication, which primarily suppresses dopamine (and sometimes serotonin) receptor activity. Psychotherapy and vocational and social rehabilitation are also important in treatment. In more serious cases—where there is risk to self and others—involuntary hospitalization may be necessary, although hospital stays are now shorter and less frequent than they once were.

The disorder is thought mainly to affect cognition, but it also usually contributes to chronic problems with behavior and emotion. People with schizophrenia are likely to have additional (comorbid) conditions, including major depression and anxiety disorders; the lifetime occurrence of substance use disorder is almost 50%. Social problems, such as long-term unemployment, poverty, and homelessness are common. The average life expectancy of people with the disorder is 12 to 15 years less than those without, the result of increased physical health problems and a higher suicide rate (about 5%).[1]