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Schizophrenia is a serious mental illness that affects an individual’s ability to think, to manage emotions and may also affect the behaviour of the person. This is often distressing for both the patient and their loved ones. Although only 1% of the population worldwide is diagnosed with schizophrenia, the World Health Organization ranked schizophrenia as one of the top 10 disorders leading to the global burden of illness.
Learn more about the causes, symptoms and possible intervention options for schizophrenia.
Schizophrenia is a type of psychotic disorder. According to the American Psychological Association, schizophrenia is a serious mental illness (SMI) characterized by unclear or irrational thoughts, unusual behavior and speech, and delusions or hallucinations.
Even though the exact causes of schizophrenia are complex and not yet fully understood, scientists believe that schizophrenia can be caused by physical, genetic, social and environmental factors.
Symptoms of schizophrenia can typically be described as positive and negative. Positive symptoms are additional behaviors that are only displayed in schizophrenic individuals, while negative symptoms refer to an absence of normal mental functions due to schizophrenia. Some common positive symptoms that schizophrenic patients experience are:
Schizophrenic patients usually suffer from delusions known as fervent beliefs that have no basis in real-life situations. Common delusions include:
Patients with schizophrenia may hallucinate and see, hear or feel sensations that do not exist in reality. There are four types of hallucinations:
Schizophrenia may reduce cognitive abilities in patients. Common cognitive symptoms include illogical, disconnected thought and speech patterns, thought alienation and derailment.
On the contrary, schizophrenia can also disrupt normal mental functions and give rise to negative symptoms such as:
Mental health professionals often employ the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to diagnose patients susceptible to schizophrenia. The DSM-5 has made several modifications for the section named “Schizophrenia and Other Psychotic Disorders” to make the diagnosis more valid and reliable.
According to the DSM-criteria for schizophrenia, individuals who show two of the following symptoms over one month may have schizophrenia:
At least one of the symptoms must be delusions, hallucinations or disorganized speech.
Since the onset of schizophrenia is sometimes associated with brain structure abnormalities, psychiatrists may order brain scans like magnetic resonance imaging (MRI) and computed tomography (CT) as part of the investigations.
Biological treatments and psychological treatments are often combined to treat schizophrenia.
Antipsychotic medications are used in the management of schizophrenia. There are the older first-generation antipsychotic medications (FGAs) and the newer second-generation antipsychotics (SGAs or atypical). Nowadays, SGAs are used more commonly as the first-line treatment in schizophrenia because they tend to have a more favorable side effect profile. Examples of some common side effects include sedation, extrapyramidal side effects such as stiffness of joints, shuffling steps, dry mouth, blurred vision, weight gain, and less commonly tardive dyskinesia which are abnormal writhing movements.
Psychological treatments may be helpful as long-term support for patients with schizophrenia. There is good evidence to support the use of cognitive behavioral therapy for psychosis.
Whilst psychological treatments are generally safe with little to no side effects, most psychological treatments require extensive time and commitment from patients. Patients or their family members must evaluate the targets of each treatment with regard to their specific needs before selecting the intervention approach.
Researching schizophrenia may provide you with a more comprehensive idea about the difficult times your loved one is going through. Avoid joking and applying stereotypes to mental illnesses.
Joining a support group formed by relatives of schizophrenia patients may offer you first-hand experiences on how to support your loved one. Meeting others who share similar experiences may also reduce your stress and anxiety when supporting your friend or family member who has schizophrenia.
Although patients with schizophrenia may not be able to communicate with you effectively, being there for your loved one can still provide emotional support for them.
In case of need for immediate support, please do not hesitate to reach out for professional help. Below is a list of hotlines with 24-hour support.
Hospital Authority E.A.S.Y. Programme
Hotline: 29 283 283
Available languages: Cantonese, English
The Samaritans
Hotline: 2896 0000
Available languages: English, Cantonese, Mandarin
Suicide Prevention
Hotline: 2382 0000
Available languages: Cantonese
The Samaritan Befrienders Hong Kong
Hotline: 2389 2222
Available languages: Cantonese
Patients with schizophrenia may see, hear, smell and feel objects or scenes that ordinary people do not experience, i.e. hallucinations. They may also experience delusions that are untrue beliefs, such as being persecuted by aliens or that they have supernatural powers.
Causes of schizophrenia can be divided into biological and social factors. Common factors include genetic influence, nervous system abnormality, substance abuse, stress and trauma.
People with schizophrenia should avoid the use of street drugs such as ecstasy, methamphetamine, cocaine, and marijuana as these may worsen the psychotic symptoms.
This article was independently written by Healthy Matters. It is informative only and not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be relied upon for specific medical advice.
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