Schizophrenia
EDP column by Dr Ketan Dhatariya

“My 19 year old son has just been diagnosed with schizophrenia. What is this?"

Schizophrenia comes from the Greek for ‘split mind’. It is a long term psychiatric condition that is reasonably common. Over a lifetime, there is a 1 in 100 chance of being diagnosed with this condition, and this can be higher if there is someone in the family who already has it.

The condition is associated with disordered thinking, and the individual may experience hallucinations or delusions. Hallucinations are the experience of some sort of sensation (for example a sight, smell or sound) without anything being present. An example of this is hearing voices. Delusions are defined as ‘fixed, false beliefs out of keeping with cultural or religious upbringing’.

Schizophrenia is a diagnosis made on the basis of several symptoms being present. These can be of hallucinations or delusions, or what is known as ‘thought disorder’. This is sometimes called ‘knights move thinking’, after the chess piece, where there may be a tenuous link between various thoughts, but these may not be obvious to the listener. Other examples of thought disorder are when words get regularly jumbled up – a ‘word salad’, or when spoken language speeds up – so called ‘pressure of speech’.

The other kinds of symptoms relate to the effect they have and are divided into ‘negative’ or ‘positive’ symptoms. ‘Negative’ symptoms include social withdrawal, lack of motivation, a tendency to be depressed, lack of speech, and so forth. ‘Positive’ symptoms include the delusions, hallucinations or the disordered thought. There are currently no specific tests that can be done to diagnose the condition, but several things may make a person more prone to developing the condition. These include genetic factors, ad I have mentioned, but also environmental factors, such as substance abuse, such as glue sniffing, drug use, and so on. Living in an environment of ‘high expressed emotion’ has also been shown to predispose to the development of schizophrenia. This means that having a constant environment filled with ‘negative’ emotions – often unintentionally found in a family, or in the work environment – such as high levels of critical comments, hostility, authoritarian and intrusive or controlling attitudes.

There is no cure for this condition, but there are lots of treatments. Several new drugs have become available over the past few years and, when used in combination with psychotherapy, keep people well and able to live relatively normal lives.

Over time, studies have shown that about a third of people make a full recovery, about a third show improvement but not a full recovery, and a third remain unwell.

As always, if you remain concerned, go and talk to your GP to get more information.


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