What is schizophrenia?

Schizophrenia is such a complex condition that few generalisations hold true for all people diagnosed as schizophrenic.

Acute schizophrenics may suffer psychotic symptoms when they are completely unable to separate reality from unreal experiences. They may view the world as highly distorted, changeable and lacking reliable landmarks.

Some patients may only have one psychotic episode, and others may have many episodes during a lifetime, but lead relatively normal lives during interim periods.

Patients with chronic schizophrenia often do not fully recover normal functioning and may require long-term treatment, generally including medication, to control the symptoms.

Some chronic schizophrenic patients may never be able to function without assistance of one sort or another.

The first psychotic symptoms of schizophrenia are often seen in the teens or twenties in men and in the twenties or early thirties in women.

Schizophrenia can be confused with other mental disorders, such as manic-depression and with physical illnesses.

What are the symptoms?

Schizophrenia can cause a huge variety of symptoms, and a sufferer may exhibit very different behaviour at different times.

A person with schizophrenia may feel anxious and confused. A sufferer may seem distant, detached, or preoccupied. Sometimes they may sit motionless and silent for hours.

Alternatively, a schizophrenic may move about constantly, always occupied, wide awake, vigilant, and alert. Prolonged extremes of depression and elation are not uncommon.

Some schizophrenics experience hallucinations. The most common form of hallucination is the hearing of voices.

Schizophrenics also suffer from delusions - false or irrational beliefs. Some can be quite bizarre, for instance that people on television are broadcasting the sufferer's thoughts aloud to other people.

Paranoid schizophrenics believe they are being persecuted.

Often a schizophrenic patient's thinking is affected by the disorder. The person may not be able to think straight, or to concentrate.

People with schizophrenia also have trouble expressing their emotions. They may appear inconsistent, manic or emotionally stunted.

Are people with schizophrenia likely to be violent?

Christopher Clunis: a rare case of a violent schizophrenic

Although news and entertainment media tend to link mental illness and criminal violence, studies show that mentally ill people are no more prone to violence than the general public.

Most schizophrenic individuals are not violent; more typically, they prefer to withdraw and be left alone.

Some acutely disturbed patients may become physically violent, but such outbursts have become relatively infrequent following the introduction of more effective treatments.

What causes schizophrenia?

There is no known single cause of schizophrenia. It appears that genetic factors produce a vulnerability to schizophrenia, with environmental factors contributing to different degrees in different individuals.

No specific gene has yet been found; no biochemical defect has been proven responsible; and no specific stressful event seems sufficient, by itself, to produce schizophrenia.

However, it is thought that a chemcial imbalance in the neurotransmitters - substances that allow communication between nerve cells - is involved in the development of schizophrenia.

How is schizophrenia treated?

Antipsychotic drugs - neuroleptics - are the best treatment now available. They do not cure schizophrenia but they have greatly improved the outlook for individual patients.

These medications reduce the psychotic symptoms of schizophrenia, such as hallucinations and delusions, and usually allow the patient to function more effectively and appropriately.

Patients vary a great deal in the amount of drug needed to reduce symptoms without producing troublesome side effects.

In the last eight years, five new types of anti-psychotic drugs have been introduced in the UK.

However, a survey of 60 health authorities in November 1998 found that 45% did not fund clozapine, 57% did not pay for olanzapine and 58% did not fund resperidone in their hospitals.

Psychosocial treatment can be used to help schizophrenics with psychological, social and occupational problems, which are often a major source of concern even when a patient is free of psychotic symptoms.

These include rehabilitation programmes, individual psychotherapy and therapy with other members of the family or in groups.

More radical treatment such as electroconvulsive therapy and brain surgery are only used in very exceptional circumstances.

What is the outlook?

The outlook for people with schizophrenia has improved over the last 25 years.

Although no totally effective therapy has yet been devised, many schizophrenic patients improve enough to lead independent, satisfying lives.

A review of almost 2,000 patients' life histories suggests that 25% achieve full recovery, 50% recover at least partially, and 25% require long-term care.

Is help available?

The National Schizophrenia Fellowship is based at 30 Tabernacle Street, London EC2A 4DD. Helpline number: (020) 8974 6814.

This page contains basic information. If you are concerned about your health, you should consult a doctor