Negative symptoms often include being emotionally flat or speaking in a dull, disconnected way. People with the negative symptoms may be unable to start or follow through with activities, show little interest in life, or sustain relationships. Negative symptoms are sometimes confused with clinical depression. People with the cognitive symptoms of schizophrenia often struggle to remember things, organize their thoughts or complete tasks.
Diagnosing schizophrenia is not easy. Sometimes using drugs, such as methamphetamines or LSD, can cause a person to have schizophrenia-like symptoms.
The difficulty of diagnosing this illness is compounded by the fact that many people who are diagnosed do not believe they have it. Lack of awareness is a common symptom of people diagnosed with schizophrenia and greatly complicates treatment.
While there is no single physical or lab test that can diagnosis schizophrenia, a health care provider who evaluates the symptoms and the course of a person's illness over six months can help ensure a correct diagnosis. The health care provider must rule out other factors such as brain tumors, possible medical conditions and other psychiatric diagnoses, such as bipolar disorder. To be diagnosed with schizophrenia, a person must have two or more of the following symptoms occurring persistently in the context of reduced functioning:.
Delusions or hallucinations alone can often be enough to lead to a diagnosis of schizophrenia. The literature on the role of medicines early in treatment is evolving, but we do know that psychotherapy is essential. People can describe symptoms in a variety of ways. How a person describes symptoms often depends on the cultural lens she is looking through. African Americans and Latinos are more likely to be misdiagnosed, potentially due to differing cultural perspectives or structural barriers.
Any person who has been diagnosed with schizophrenia should try to work with a health care professional that understands his or her cultural background and shares the same expectations for treatment. Successfully treating schizohprenia almost always improves these related illnesses. Search Close Menu. Sign In About Mental Illness. About Mental Illness Treatments.
About Mental Illness Research. Your Journey Individuals with Mental Illness. Your Journey Family Members and Caregivers. Positive symptoms are unusual thoughts, perceptions or distortion of normal functions. They include:. Negative symptoms relate to disruptions of normal emotions, motivation and drive. Symptoms to look for include:. Neurocognitive symptoms of schizophrenia are symptoms that have to do with the person's ability to think and reason. Some patients with schizophrenia also experience abnormal movements, such as twitching, repetitive gestures or catatonia for example, maintaining unusual positions or not moving or responding at all.
For reasons that are not understood, more severe forms of catatonia were more common before the availability of antipsychotic medications. On the other hand, certain motor movements, such as tremor, rigidity and restlessness, commonly occur as side effects to antipsychotic medications. Several subtypes of schizophrenia have been suggested, based on a person's range and intensity of symptoms.
There several recognized types of schizophrenia, including the following:. Although schizophrenia is usually a lifelong illness, some people develop all the symptoms of schizophrenia that resolve spontaneously. When the symptoms last less than one month, a diagnosis of brief psychotic disorder is given. When symptoms last less than six months, the diagnosis schizophreniform disorder is used. Unfortunately, schizophreniform disorder is rare, and most people progress to chronic schizophrenia.
The best treatment for any individual suffering from schizophrenia blends a combination of antipsychotic medications with psychosocial interventions. Psychosocial interventions include supportive psychotherapy, illness management skills, integrated treatment for any coexisting substance abuse, family participation in therapy and psychosocial and vocational rehabilitation.
People with schizophrenia who need a high degree of social services should receive assistance from an interdisciplinary treatment team. Antipsychotic medications for schizophrenia can eliminate or reduce the hallucinations and delusions of the disorder. These drugs, which help restore biochemical imbalances, may also help people regain their coherent thinking abilities. The older "conventional" or "typical" antipsychotic drugs were introduced in the s.
Over the years, studies have found that these drugs are very effective in treating acute episodes of delusions or hallucinations and can provide long-term maintenance and prevention of future schizophrenic relapses. However, these drugs can cause unpleasant side effects such as dry mouth, constipation, blurred vision and difficulty urinating. These types of side effects are called "anticholinergic.
These medications can also cause extrapyramidal side effects EPS , which affect how the body moves. For example, restlessness, tremors and slowing of normal gestures and movements can occur after days to weeks of treatment. Some patients report muscle spasms and cramps in the head and neck area, as well as stiff muscles throughout their body.
Tardive dyskinesia TD is a type of EPS that can occur after months or years of treatment with antipsychotic medications. The risk of TD increases the longer antipsychotic medications are taken. This condition is more common among older patients. It involves small involuntary movements of the fingers, tongue, lips, face or jaw. The symptoms tend to get worse and turn into thrusting and rolling motions of the tongue, lip smacking, grimacing or uncontrollable sucking motions.
Involuntary movements of the hands, feet, neck and shoulders can also occur. Tardive dyskinesia can be a permanent, irreversible side effect. These medications can also interfere with reproductive hormones, affecting a woman's menstrual cycles and fertility or causing breast enlargement, milk secretion or sexual side effects in both men and women.
Sedation and dizziness are also relatively common side effects. Because of the potential side effects associated with these medications, it is important that any medication regimen is tailored to the individual. You should work closely with your doctor to achieve the most benefit with the fewest problems from the medication. Sometimes adding another drug can help reduce certain antipsychotic-related side effects and possibly improve their effectiveness.
Examples of older "typical" antipsychotic medications include chlorpromazine Thorazine , haloperidol Haldol , perphenazine Trilafon and fluphenazine Prolixin.
Over the past 20 years, pharmaceutical manufacturers have introduced a newer generation of antipsychotic drugs known as novel or "atypical" antipsychotics. The major advantage of these medications is a decreased risk of some side effects, such as EPS.
These medications include clozapine Clozaril , olanzapine Zyprexa , quetiapine Seroquel , risperidone Risperdal , ziprasidone Geodon , paliperidone Invega and aripiprazole Abilify. Clozapine is unique in that it is the most effective antipsychotic medication and is not typically associated with EPS or TD. However, patients taking clozapine must be monitored closely with regular blood tests because the medicine can cause a blood disorder called agranulocytosis, a disorder in which there are an insufficient number of white blood cells.
Although it only occurs in a very small percentage of those taking clozapine, it can prove fatal if not caught and treated immediately. Studies find the atypical antipsychotics are about as effective as the older conventional medications but have fewer extrapyramidal side effects. It has also been suggested that the atypical antipsychotics may improve anxiety, depression and cognitive symptoms. As a result, these newer drugs have replaced older drugs as "first line" therapy in the United States.
However, this new generation of medications has its own potential side effects, including sedation, significant weight gain and sexual dysfunction. Some are associated with a higher incidence of diabetes or high cholesterol, particularly in those who gain weight. While they don't typically interfere with menstruation as much as the typical antipsychotics, there is little information about the safety or impact of antipsychotic treatment during pregnancy and breastfeeding.
If you are taking these medications and considering getting pregnant, talk to your health care professional first. Perhaps the biggest challenge facing people with schizophrenia and their families is the high rate at which many stop taking their medication.
Some stop treatment because they don't really believe they are ill. Others have such extreme disorganized thinking they can't remember to take their regular medication doses. Injectable medications that last for several weeks can sometimes help in these situations. Patients also stop taking their medication because of difficulties with side effects. Substance abuse can also interfere with the efficacy of the medication, influencing patients' compliance.
Finally, uninformed family members may suggest patients stop taking their medication because the symptoms seem to have disappeared. That's why it's important for a health care professional to stay involved in the treatment of someone with schizophrenia, even if they seem to be doing fine.
In unusual circumstances, electroconvulsive therapy ECT can be used to treat schizophrenia. During ECT, an electrical current passes through the patient's brain inducing a seizure. This treatment may be used if the person hasn't responded to antipsychotic medication or, in some circumstances, for those in catatonic states.
Once the delusions and hallucinations of schizophrenia subside, patients also can benefit from psychosocial therapies that help them improve their social skills and teach them how to live independently. These sessions can be provided in group, family or individual settings. Many therapists use behavioral learning techniques, including coaching, modeling and positive reinforcement, all of which can make a big difference in helping patients cope with other stresses in their lives that could contribute to relapses.
Psychoeducational family therapy is another segment of treatment that many psychiatrists see as necessary to help prevent relapses.
These family education training sessions teach family members and close friends how to recognize the early warning signs of a relapse and what to do before the situation worsens. Improving communication and problem-solving skills among family members and the person with schizophrenia can help reduce the potential for relapse. For individuals suffering from schizophrenia who need community services for support, clinical case managers can coordinate the necessary services and make sure medical and psychiatric treatments are addressed.
These case managers can also play a key role in crisis management if the person doesn't have a support network of family and friends. Review the following Questions to Ask about schizophrenia so you're prepared to discuss this important health issue with your health care professional.
For information and support on Schizophrenia, please see the recommended organizations, books and Spanish-language resources listed below. Fuller Torrey. Mueser, Ph.
The most lead-contaminated neighborhoods in cities are often the poorest and home to the highest percentage of nonwhite children. Your Health. Your Wellness. Your Care. Schizophrenia can occur at any age, but the average age of onset tends to be in the late teens to the early 20s for males and the late 20s to early 30s for females.
It is uncommon for schizophrenia to be diagnosed in a person younger than 12 or older than Research suggests that a combination of genetics, environmental factors, and brain chemistry contribute to the development of this mental disorder.
With the right treatments, you can manage your symptoms and live well. Schizophrenia is typically diagnosed between 16 and 30 years old or after the first episode of psychosis occurs. A person can experience prodromal schizophrenia symptoms for weeks or years before being diagnosed, because this first phase is so hard to distinguish from the normal ups and downs of puberty or other mental disorders like depression and anxiety.
There are a few theories about why schizophrenia tends to appear during late adolescence:. EOS is different from schizophrenia that develops before the age of 13, otherwise known as child-onset schizophrenia COS. COS is rare, affecting around one in 40, children. Late-onset schizophrenia LOS is schizophrenia diagnosed after the age of It typically develops during the menopausal years or between 44 and 49 years of age.
Furthermore, they could have been occurring to some degree for years before the person reached out for help, meaning the onset of symptoms may be quite difficult to accurately determine. For more mental health resources, see our National Helpline Database. The prodromal phase of schizophrenia can be particularly difficult to identify because it lacks the positive psychotic symptoms characteristic of active schizophrenia.
Children are more likely to experience auditory hallucinations than adults. Common early warning signs of schizophrenia include:. Early treatment usually involves medication, psychotherapy, and life skills training. Sometimes early treatment may start with a hospital stay if symptoms become severe enough that they threaten the safety of the child or adult and anyone else.
Some studies on the time between first episodes and schizophrenia diagnosis demonstrate the average is a year in developed countries and twice as long in developing countries. The researchers found that:. Schizophrenia typically appears in late adolescence and the early 20s. However, it can affect people of any age, and can also appear in your 40s, which is known as late-onset schizophrenia.
Paying attention to the early signs of schizophrenia can help you detect this mental disorder and get treated sooner, which have been linked to better outcomes.
So if you or a loved one is showing signs and symptoms of schizophrenia, talk to your medical or mental health provider. Effective treatment options are available, and even people with late-onset schizophrenia can find relief and regain a certain level of functioning.
You can also seek out support groups to meet others who are going through the same challenges, get support, and learn coping skills.
Your doctor will use the criteria in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition , to rule out other mental disorders and make a diagnosis.
They may also order blood or imaging tests to rule out physical conditions that could be causing your symptoms. A stressful or traumatic life event can also trigger a psychotic episode. Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life.
National Alliance on Mental Illness.
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