Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Because the causes of schizophrenia are still unknown, treatments focus on
eliminating the symptoms of the disease. Treatments include antipsychotic
medications and various psychosocial treatments.
Antipsychotic medications
Antipsychotic medications have been available since the mid-1950's. The older
types are called conventional or "typical" antipsychotics. Some of the more
commonly used typical medications include:
Schizophrenia, also sometimes colloquially called split personality disorder, is a
chronic, severe, debilitating mental illness that affects about 1% of
the population, more than 2 million people in the United States alone.
With the sudden onset of severe psychotic symptoms,
the individual is said to be experiencing acute schizophrenia.
Psychotic means
out of touch with reality or unable to separate real from
unreal
experiences.
There is no known single cause of schizophrenia. As
discussed later,
it appears that genetic factors produce a vulnerability to
schizophrenia, with environmental factors contributing to
different
degrees in different individuals.
There are a number of various treatments for schizophrenia.
Given the
complexity of schizophrenia, the major questions about this
disorder (its cause or causes, prevention, and treatment) are unlikely
to be
resolved in the near future. The public should beware of
those offering
"the cure" for (or "the cause" of)
schizophrenia.
Schizophrenia is one of the psychotic mental disorders and is characterized
by symptoms of thought, behavior, and social problems.
Symptoms of schizophrenia may include delusions, hallucinations, catatonia,
negative symptoms, and disorganized speech or behavior.
There are five types of schizophrenia based on the kind of symptoms the
person has at the time of assessment: paranoid, disorganized, catatonic,
undifferentiated, and residual.
Children as young as 6 years of age can be found to have all the symptoms of
schizophrenia as their adult counterparts and to continue to have those symptoms
into adulthood.
Although the term schizophrenia has only been in used since 1911, its
symptoms have been described throughout written history.
Schizophrenia is considered to be the result of a complex group of genetic,
psychological, and environmental factors.
Health-care practitioners diagnose schizophrenia by gathering comprehensive
medical, family, mental-health, and social/cultural information.
The practitioner will also either perform a physical examination or request
that the individual's primary-care doctor perform one. The medical examination
will usually include lab tests.
In addition to providing treatment that is appropriate to the diagnosis,
professionals attempt to determine the presence of mental illnesses that may
co-occur.
People with schizophrenia are at increased risk of having a number of other
mental-health conditions, committing suicide, and otherwise dying earlier than
people without this disorder.
Medications that have been found to be most effective in treating the
positive symptoms of schizophrenia are first- and second-generation antipsychotics.
Psychosocial interventions for schizophrenia include education of family
members, assertive community treatment, substance-abuse treatment, social-skills
training, supported employment, cognitive behavioral therapy, and weight
management.
Cognitive remediation, peer-to-peer treatment, and weight-management interventions remain the focus topics for research.
What is schizophrenia?
Schizophrenia, also sometimes colloquially called split personality disorder, is a
chronic, severe, debilitating mental illness that affects about 1% of
the population, corresponding to more than 2 million people in the United
States alone. Other statistics about schizophrenia include that it affects men
about one and a half times more commonly than women. It is one of the
psychotic mental disorders and is characterized by symptoms of thought,
behavior, and social problems. The thought problems associated with
schizophrenia are described as psychosis, in that the person's thinking is
completely out of touch with reality at times. For example, the sufferer may
hear voices or see people that are in no way present or feel like bugs are
crawling on their skin when there are none. The individual with this disorder
may also have disorganized speech, disorganized behavior, physically rigid or
lax behavior (catatonia), significantly decreased behaviors or feelings, as well
as delusions, which are ideas about themselves or others that have no basis in
reality (for example, the individual might experience paranoia, in that he or she thinks others are plotting against
them when they are not).
What are the different types of schizophrenia?
There are five types of schizophrenia, each based on the kind of symptoms the
person has at the time of assessment.
Paranoid schizophrenia: The individual is preoccupied with one or more
delusions or many auditory hallucinations but does not have symptoms of
disorganized schizophrenia.
Disorganized schizophrenia: Prominent symptoms are disorganized speech and
behavior, as well as flat or inappropriate affect. The person does not have
enough symptoms to be characterized as suffering from catatonic schizophrenia.
Catatonic schizophrenia: The person with this type of schizophrenia
primarily has at least two of the following symptoms: difficulty moving,
resistance to moving, excessive movement, abnormal movements, and/or repeating
what others say or do.
Undifferentiated schizophrenia: This is 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 type of
schizophrenia.
Residual schizophrenia: While the full-blown characteristic positive
symptoms of schizophrenia (those that involve an excess of normal behavior, such
as delusions, paranoia, or heightened sensitivity) are absent, the sufferer has
a less severe form of the disorder or has only negative symptoms (symptoms
characterized by a decrease in function, such as withdrawal, disinterest, and
not speaking).
Depression is an illness that involves the body, mood, and thoughts and affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. The principal types of depression are major depression, dysthymia, and bipolar disease (also called manic-depressive disease).
Alcoholism is a disease that includes alcohol craving and continued drinking despite repeated alcohol-related problems, such as losing a job or getting into trouble with the law.
Suicide is the process of intentionally ending one's own life. Approximately 1 million people worldwide commit suicide each year, and 10 million to 20 million attempt suicide annually.
Bipolar disorder (or manic depression) is a mental illness characterized by depression, mania, and severe mood swings. Treatment may incorporate mood stabilizer medications, antidepressants, and psychotherapy.
Dissociative identity disorder (formerly known as multiple personality disorder or split personality disorder) is a mental illness in which a person has at least two distinct personalities. Symptoms and signs include lapses in memory, feeling unreal, blackouts in time, hearing voices in their head that are not their own, not recognizing themselves in the mirror, and finding items in one's possession but not recalling how they were acquired. Treatment usually involves psychotherapy, medications, and sometimes hypnosis.
Drug addiction is a chronic disease that causes drug-seeking behavior and drug use despite negative consequences to the user and those around him. Though the initial decision to use drugs is voluntary, changes in the brain caused by repeated drug abuse can affect a person's self-control and ability to make the right decisions and increase the urge to take drugs. Drug abuse and addiction are preventable.
Antisocial personality disorder (ASPD) has many symptoms, signs, and causes. Therapy is one treatment option for antisocial personality disorder. It is closely related to other personality disorders (PD), such as borderline personality disorder and narcissistic personality disorder.
Psychotic disorders are a group of serious illnesses that affect the mind. Different types of psychotic disorders include schizophrenia, schizoaffective disorder, schizophreniform disorder, brief psychotic disorder, shared psychotic disorder, delusional disorder, substance-induced psychotic disorder, paraphrenia, and psychotic disorders due to medical conditions.
Schizoaffective disorder is a mental illness that features schizophrenia and a mood disorder, either major depression or bipolar disorder. Symptoms include agitation, suicidal thoughts, little need for sleep, delusions, hallucinations, and poor motivation. Treatment may involve psychotherapy, medication, skills training, or hospitalization.
Mental illness is any disease or condition affecting the brain that influence the way a person thinks, feels, behaves, and/or relates to others. Mental illness is caused by heredity, biology, psychological trauma and environmental stressors.
Compulsive gambling is a disorder that affects millions in the U.S. Symptoms and signs include a preoccupation with gambling, lying to family or loved ones to hide gambling, committing crimes to finance gambling, and risking importance relationships and employment due to gambling. Treatment may incorporate participation in Gamblers' Anonymous, psychotherapy, and medications like carbamazepine, topiramate, lithium, naltrexone, antidepressants, clomipramine, and fluvoxamine.
About 5 million children and adolescents in the U.S. suffer from a serious mental illness such as eating disorders, anxiety disorders, disruptive behavior disorders, pervasive development disorders, elimination disorders, learning disorders, schizophrenia, tic disorders, and mood disorders. Symptoms of mental illness include frequent outbursts of anger, hyperactivity, fear of gaining weight, excessive worrying, frequent temper tantrums, and hearing voices that aren't there. Treatment may involve medication, psychotherapy, and creative therapies.
Brief psychotic disorder is a short-term mental illness that features psychotic symptoms. There are three forms of brief psychotic disorder. The first occurs shortly after a major stress, the second has no apparent trauma that triggers the illness, and the third is associated with postpartum onset. Symptoms include hallucinations, delusions, unusual behavior, disorientation, changes in eating and sleeping, and speech that doesn't make sense. Treatment typically involves medication and psychotherapy.
Factitious disorders are conditions in which people pretend to have physical or mental illnesses when they aren't sick. These people may lie about or fake symptoms to obtain the sympathy and attention given to people who are genuinely ill. Symptoms of factitious disorders include dramatic, inconsistent medical history, the presence of many surgical scars, and a history of seeking treatment at many different hospitals.
During the ECT procedure, an electric current is passed through the brain to
produce controlled convulsions (seizures).
Why is electroconvulsive therapy performed?
ECT is useful for certain patients with significant depression,
particularly for those who cannot take or are not responding to antidepressants,
have severe depression, or are at a high risk for suicide. ECT often is
effective in cases where antidepressant medications do not provide sufficient
relief of symptoms.
How does electroconvulsive therapy work?
This procedure probably works by a
massive neurochemical release in the brain due to the controlled seizure. Highly
effective, ECT relieves depression within 1 to 2 weeks after beginning
treatments. After ECT, some patients will continue to have maintenance ECT,
while others will return to antidepressant medications.
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