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Schizophrenia is characterized by delusions (false beliefs) and hallucinations (perceiving something that isn't there.) One percent of adults, or more than 2 million Americans every year, develop schizophrenia. Men usually develop it earlier than women, but it affects both sexes with equal frequency. Schizophrenia occurs rarely in children- approximately 1 in 40,000 children develop schizophrenia.
People with psychosis may hear "voices" or have strange and illogical ideas (for example, thinking that others can hear their thoughts, or are trying to harm them, or that they are the President of the United States or some other famous person). They may get excited or angry for no apparent reason, or spend a lot of time by themselves, or in bed, sleeping during the day and staying awake at night. The person may neglect appearance, not bathing or changing clothes, and may be hard to talk to--barely talking or saying things that make no sense. They often are initially unaware that their condition is an illness.
Distorted Perceptions of reality
People with schizophrenia often perceive the world differently than others. Delusions, hallucinations and other symptoms of psychosis can cause people with schizophrenia to behave differently and can be very confusing or frightening. People with schizophrenia might seem to be distracted, seem anxious, or respond to something that isn't there.
Hallucinations and Illusions
Hallucinations are perceptions that occur without connection to an appropriate source. Although hallucinations can occur in any sensory form – auditory (sound), visual (sight), tactile (touch), gustatory (taste), and olfactory (smell) – hearing voices that other people do not hear is the most common type of hallucination in schizophrenia. Voices may describe the patient's activities, carry on a conversation, warn of impending dangers, or even issue orders to the individual. Illusions, on the other hand, occur when a sensory stimulus is present but is incorrectly interpreted by the individual.
Delusions
Delusions are false personal beliefs that are not subject to reason or contradictory evidence. For example, patients suffering from paranoid-type symptoms – roughly one-third of people with schizophrenia – often have delusions of persecution, or false and irrational beliefs that they are being cheated, harassed, poisoned, or conspired against. These patients may believe that they, or a member of the family or someone close to them, are the focus of this persecution. In addition, delusions of grandeur, in which a person may believe he or she is a famous or important figure, may occur in schizophrenia. Sometimes the delusions experienced by people with schizophrenia are quite bizarre; for instance, believing that a neighbor is controlling their behavior with magnetic waves; that people on television are directing special messages to them; or that their thoughts are being broadcast aloud to others.
Disordered Thinking
Schizophrenia often affects a person's ability to “think straight.” Thoughts may come and go rapidly; the person may not be able to concentrate on one thought for very long and may be easily distracted, unable to focus attention. People with schizophrenia may not be able to sort out what is relevant and what is not relevant to a situation. The person may be unable to connect thoughts into logical sequences, with thoughts becoming disorganized and fragmented. This lack of logical continuity of thought, termed “thought disorder,” can make conversation very difficult and may contribute to social isolation. If people cannot make sense of what an individual is saying, they are likely to become uncomfortable and tend to leave that person alone.
Emotional Expression
People with schizophrenia often show “blunted” or “flat” affect. This refers to a severe reduction in emotional expressiveness. A person with schizophrenia may not show the signs of normal emotion and may withdraw from other people.
While schizophrenia sometimes begins as an acute psychotic episode in young adults, it emerges gradually in children, often preceded by developmental disturbances, such as lags in motor and speech/language development. Such problems tend to be associated with more pronounced brain abnormalities. The diagnostic criteria are the same as for adults, except that symptoms appear prior to age 12, instead of in the late teens or early 20s.Children with schizophrenia often see or hear things that don't really exist, and harbor paranoid and bizarre beliefs. For example, they may think people are plotting against them or can read their minds. Other symptoms of the disorder include problems paying attention, impaired memory and reasoning, speech impairments, inappropriate, or flattened, expression of emotion, poor social skills, and depressed mood. Such children may laugh at a sad event, make poor eye contact, and show little body language or facial expression.
Treatments that help young patients manage their illness have improved significantly in recent decades. As in adults, antipsychotic medications are especially helpful in reducing hallucinations and delusions. The newer generation "atypical" antipsychotics, such as olanzapine and clozapine, may also help improve motivation and emotional expressiveness in some patients. However, even with these newer medications, there are side effects. Children and adults with schizophrenia can often greatly benefit from other kinds of treatment. Because this disorder generally strikes in adolescence and early adulthood, it can be difficult for people with schizophrenia to engage socially, to complete their education, to find partners, and to do all of the things that other people their age are doing and learning. Addressing these specific concerns through individual and family therapy, support groups, advocacy, mental health education, job counseling, and intervention in schools can all help a person in recovery from schizophrenia.
