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Schiophernial

 

Introduction

Schizophrenia is a serious mental disorder in which people interpret reality abnormally. Schizophrenia may result in some combination of hallucinations, delusions, and extremely disordered thinking and behavior that impairs daily functioning, and can be disabling. People with schizophrenia require lifelong treatment. Early treatment may help get symptoms under control before serious complications develop and may help improve the long-term outlook.

Symptoms

A variety of issues with behavior, emotions, and thinking (cognition) are present in schizophrenia. Although there are many different signs and symptoms, they typically involve delusions, hallucinations, or slurred speech and indicate a reduced capacity for function. Symptoms may include:

Delusions. These are erroneous notions that are not supported by reality. For instance, you feel threatened or harassed; you are the target of certain gestures or remarks; you are famous or gifted; you are in love with someone else; or a serious disaster is about to happen. The majority of those with schizophrenia experience delusions.

Thinking inefficiently (speech). Disorganized speech implies disorganized thought. Answers to questions may be partially or entirely unconnected, which might hinder effective communication. Rarely, speaking may include stringing together incomprehensible words, a practice known as word salad.This may manifest in a variety of ways, ranging from naiveté to irrational agitation. Because behavior isn’t goal-focused, tasks are challenging to complete. Behavior can include resistance to instructions, inappropriate or bizarre posture, a complete lack of response, or useless and excessive movement.

Over time, symptoms can change in type and severity, with periods when they get worse and times when they go away. Some symptoms might be present at all times.

In men, schizophrenia symptoms typically start in the early to mid-20s. In women, symptoms typically begin in the late 20s. It’s uncommon for children to be diagnosed with schizophrenia and rare for those older than age 45

Symptoms in teenagers:

Schizophrenia symptoms in teenagers are similar to those in adults, but the condition may be more difficult to recognize. This might be partially explained by the fact that some of the initial signs of schizophrenia in teens are also present in regular adolescent growth, such as:

  • Isolation from loved ones and friends
  • A drop in performance at school
  • Trouble sleeping
  • Irritability or depressed mood
  • Lack of motivation

Causes:

It’s not known what causes schizophrenia, but experts believe that a mix of genetics, brain chemistry and environment contributes to development of the condition. Problems with some naturally occurring brain chemicals, particularly neurotransmitters termed dopamine and glutamate, may lead to schizophrenia. Studies on neuroimaging reveal that schizophrenia patients have different central nervous system and brain structures. These alterations suggest that schizophrenia is a brain disorder, yet scientists are unsure of their relevance.

Diagnosis :

Diagnostic criteria for schizophrenia. A doctor or mental health professional may use the criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published

Schizophrenia must be ruled out along with other mental illnesses, and its symptoms must not be brought on by substance abuse, medication, or a physical ailment. The process of determining a schizophrenia diagnosis may involve. Physical exam. This may be done to help rule out other problems that could be causing symptoms and to check for any related complications.

Tests and screenings. These may include tests that help rule out conditions with similar symptoms, and screening for alcohol and drugs. The doctor may also request imaging studies, such as an MRI or CT scan.

Psychiatric evaluation. A doctor or mental health professional checks mental status by observing appearance and demeanor and asking about thoughts, moods, delusions, hallucinations, substance use, and potential for violence or suicide. This also includes a discussion of family and personal history.

Treatment:

Even after the symptoms of schizophrenia have subsided, treatment is still necessary for life. The condition can be managed with medical care and psychosocial therapy. In some cases, hospitalization may be needed. A psychiatrist experienced in treating schizophrenia usually guides treatment. The treatment team also may include a psychologist, social worker, psychiatric nurse and possibly a case manager to coordinate care. The full-team approach may be available in clinics with expertise in schizophrenia treatment.

Medications:

Medications are the cornerstone of schizophrenia treatment, and antipsychotic medications are the most commonly prescribed drugs. They’re thought to control symptoms by affecting the brain neurotransmitter dopamine. The goal of treatment with antipsychotic medications is to effectively manage signs and symptoms at the lowest possible dose. The psychiatrist may try different drugs, different doses or combinations over time to achieve the desired result. Other medications also may help, such as antidepressants or anti-anxiety drugs. It can take several weeks to notice an improvement in symptoms.

Second-generation antipsychotics

These newer, second-generation medications are generally preferred because they pose a lower risk of serious side effects than do first-generation antipsychotics. Second-generation antipsychotics include:

  • Aripiprazole (Abilify)
  • Asenapine (Saphris)
  • Brexpiprazole (Rexulti)
  • Cariprazine (Vraylar)
  • Clozapine (Clozaril, Versacloz)
  • Iloperidone (Fanapt)
  • Lurasidone (Latuda)
  • Olanzapine (Zyprexa)
  • Paliperidone (Invega)
  • Quetiapine (Seroquel)
  • Risperidone (Risperdal)
  • Ziprasidone (Geodon)

Long-acting injectable antipsychotics

Some antipsychotics may be given as an intramuscular or subcutaneous injection. They are usually given every two to four weeks, depending on the medication. Ask your doctor about more information on injectable medications. This may be an option if someone has a preference for fewer pills and may help with adherence.

Common medications that are available as an injection include:

  • Aripiprazole (Abilify Maintena, Aristada)
  • Fluphenazine decanoate
  • Haloperidol decanoate
  • Paliperidone (Invega Sustenna, Invega Trinza)
  • Risperidone (Risperdal Consta, Perseris)

Psychosocial interventions

Once psychosis recedes, in addition to continuing on medication, psychological and social (psychosocial) interventions are important. These may include:

  • Individual therapy.Psychotherapy may help to normalize thought patterns. Also, learning to cope with stress and identify early warning signs of relapse can help people with schizophrenia manage their illness.
  • Social skills training.This focuses on improving communication and social interactions and improving the ability to participate in daily activities.
  • Family therapy.This provides support and education to families dealing with schizophrenia.
  • Vocational rehabilitation and supported employment.This focuses on helping people with schizophrenia prepare for, find and keep jobs.

Most individuals with schizophrenia require some form of daily living support. Many communities have programs to help people with schizophrenia with jobs, housing, self-help groups and crisis situations. A case manager or someone on the treatment team can help find resources. With appropriate treatment, most people with schizophrenia can manage their illness.

Hospitalization

During crisis periods or times of severe symptoms, hospitalization may be necessary to ensure safety, proper nutrition, adequate sleep and basic hygiene.

Electroconvulsive therapy

For adults with schizophrenia who do not respond to drug therapy, electroconvulsive therapy (ECT) may be considered. ECT may be helpful for someone who also has depression.

Conclusion

Schizophrenia is a serious mental disorder in which people interpret reality abnormally. Schizophrenia may result in some combination of hallucinations, delusions, and extremely disordered thinking and behavior that impairs daily functioning, and can be disabling. People with schizophrenia require lifelong treatment.

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