Schizophrenia (cont.)
When does it start and who gets it?
Psychotic symptoms (such as hallucinations and delusions) usually emerge in men
in their late teens and early 20s and in women in their mid-20s to early 30s.
They seldom occur after age 45 and only rarely before puberty, although cases of
schizophrenia in children as young as 5 have been reported. In adolescents, the
first signs can include a change of friends, a drop in grades, sleep problems,
and irritability. Because many normal adolescents exhibit these behaviors as
well, a diagnosis can be difficult to make at this stage. In young people who go
on to develop the disease, this is called the "prodromal" period.
Research has shown that schizophrenia affects men and women equally and occurs
at similar rates in all ethnic groups around the world.
Are people with schizophrenia violent?
People with schizophrenia are not especially prone to violence and often
prefer to be left alone. Studies show that if people have no record of
criminal violence before they develop schizophrenia and are not substance
abusers, they are unlikely to commit crimes after they become ill. Most
violent crimes are not committed by people with schizophrenia, and most
people with schizophrenia do not commit violent crimes. Substance abuse
always increases violent behavior, regardless of the presence of
schizophrenia (see sidebar). If someone with paranoid schizophrenia becomes
violent, the violence is most often directed at family members and takes
place at home.
What about suicide?
People with schizophrenia attempt suicide much more often than people in the
general population. About 10 percent (especially young adult males) succeed.
It is hard to predict which people with schizophrenia are prone to suicide, so
if someone talks about or tries to commit suicide, professional help should be
sought right away.
| Substance abuse Some people who abuse drugs show symptoms similar
to those of schizophrenia, and people with schizophrenia may be mistaken for
people who are high on drugs. While most researchers do not believe that
substance abuse causes schizophrenia, people who have schizophrenia abuse
alcohol and/or drugs more often than the general population.
Substance abuse can reduce the effectiveness of treatment for
schizophrenia. Stimulants (such as amphetamines or cocaine), PCP, and
marijuana may make the symptoms of schizophrenia worse, and substance abuse
also makes it more likely that patients will not follow their treatment
plan.
Schizophrenia and
nicotine
The most common form of substance abuse in people with schizophrenia is an
addiction to nicotine. People with schizophrenia are addicted to nicotine at
three times the rate of the general population (75-90 percent vs. 25-30
percent).
Research has revealed that the relationship between smoking and
schizophrenia is complex. People with schizophrenia seem to be driven to
smoke, and researchers are exploring whether there is a biological basis for
this need. In addition to its known health hazards, several studies have
found that smoking interferes with the action of antipsychotic drugs. People
with schizophrenia who smoke may need higher doses of their medication.
Quitting smoking may be especially difficult for people with
schizophrenia since nicotine withdrawal may cause their psychotic symptoms
to temporarily get worse. Smoking cessation strategies that include nicotine
replacement methods may be better tolerated. Doctors who treat people with
schizophrenia should carefully monitor their patient's response to
antipsychotic medication if the patient decides to either start or stop
smoking.
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Next: What causes schizophrenia? »
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