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Schizophrenia Information

  • Schizophrenia is a psychiatric diagnosis that describes a mental disorder characterized by impairments in the perception or expression of reality and by significant social or occupational dysfunction. A significant number of persons that have experienced being diagnosed do not consider it to be an impairment...
  • A person experiencing untreated schizophrenia is typically characterized as demonstrating disorganized thinking, and as experiencing delusions or auditory hallucinations. Although the disorder is primarily thought to affect cognition, it can also contribute to chronic problems with behavior and emotion. Due to the many possible combinations of symptoms, there is ongoing and heated debate about whether the diagnosis necessarily or adequately describes a disorder, or alternatively whether it might represent a number of disorders. For this reason, Eugen Bleuler deliberately called the disease "the schizophrenias", plural, when he coined the present name.

    Diagnosis is based on the self-reported experiences of the patient, in combination with secondary signs observed by a psychiatrist, clinical psychologist or other competent clinician. There is no objective biological test for schizophrenia, though studies suggest that genetics, neurobiology and social environment are important contributing factors. Current research into the development of the disorder often focuses on the role of neurobiology, although a reliable and identifiable organic cause has not been found. In the absence of objective laboratory tests to confirm the diagnosis, some question the legitimacy of schizophrenia's status as a disease.

    Patients diagnosed with schizophrenia are highly likely to be diagnosed with other disorders. The lifetime prevalence of substance abuse disorders is typically around 40%. Comorbidity is also high with clinical depression, anxiety disorders, social problems, and a generally decreased life expectancy is also present. Patients diagnosed with schizophrenia typically live 10-12 years less than their healthy counterparts, owing to increased physical health problems and a high suicide rate.

    The first line pharmacological therapy for schizophrenia is usually the use of antipsychotic medication. The concept of 'curing' schizophrenia is controversial as there are no clear criteria for what might constitute a cure, although some criteria for the remission of symptoms have recently been suggested. Therefore, antipsychotic drugs are only thought to provide symptomatic relief from the positive symptoms of psychosis. The newer atypical antipsychotic medications (such as clozapine, risperidone, olanzapine, quetiapine, ziprasidone and aripiprazole) are usually preferred over older typical antipsychotic medications (such as chlorpromazine and haloperidol) due to their favorable side-effect profile. Compared to the typical antipsychotics, the atypicals are associated with a lower incident rate of extra pyramidal side-effects (EPS) and tardive dyskinesia (TD) although they are more likely to induce weight gain and so increase risk for obesity-related diseases. It is still unclear whether newer drugs reduce the chances of developing the rare but potentially life-threatening neuroleptic malignant syndrome (NMS). While the atypical antipsychotics are associated with less EPS and TD than the conventional antipsychotics, some of the agents in this class (especially olanzapine and clozapine) appear to be associated with metabolic side effects such as weight gain, hyperglycemia and hypertriglyceridemia that must be considered when choosing appropriate pharmacotherapy.

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