Schizophrenia: definition, causes, symptoms, diagnosis and treatment

By Cristiano Antonino Last updated Jun 14, 2023

Schizophrenia comes from the Greek and literally means “separate mind”: those affected struggle to distinguish reality from imagination

It is a psychiatric disorder that seriously compromises self-perception.

In addition to negatively affecting social relationships and the performance of normal daily activities.

This disease also affects perception, memory, attention, learning and emotions.

A schizophrenic subject may, for example, hear voices that others do not hear, believe that others are able to read his mind.

Schizophrenia even leads to the belief that others are conspiring to do harm.

Similar thoughts can frighten the person and consequently induce a state of strong agitation.

The social implications of schizophrenia

Typically, many people with schizophrenia struggle to find work and are unable to fend for themselves on their own.

The family nucleus is generally heavily involved and forced to deal with a heavy load of anxiety and worry.

Schizophrenia also leads to fear of social stigma.

Schizophrenia usually occurs between the ages of 18 and 28 in similar percentages in men and women

In the latter it appears at an older age, with an average delay of 3-4 years compared to the male sex.

The onset can occur suddenly, or be preceded by a phase in which the person withdraws into himself.

In this period, typically, interest in the surrounding world gradually decreases, friendships and romantic relationships are interrupted for no reason, work is lost or school is stopped.

Early diagnosis is essential, as prompt treatment has been shown to affect the course of the disease.

Unfortunately in many cases the first signs are difficult to distinguish from an ordinary adolescent crisis.

Add to this the fact that people with schizophrenia are unable to recognize themselves as sick.

For them, the reality in which they live is much more vivid and sensible than the one in which the rest of the world is immersed.

The treatment of schizophrenia follows three main paths: pharmacological therapies, individual and group psychotherapies.

The latter are rehabilitation interventions to help patients recover the social skills lost during the pathology.

According to the WHO, about one-third of patients with schizophrenia can make a full recovery.

Another 30% must continue the therapy and in any case experience a negative impact on the social sphere, while the remaining 30% experience a chronic disease.

Symptoms

The symptoms generated by schizophrenia are typically divided into:

positive disorders, i.e. identified by psychotic behavior not recognizable in healthy people. These are symptoms that can occur intermittently, and the intensity of which will also depend on whether or not you are taking a therapy
negative disorders, represented by the loss of faculties present before the onset of the disease. Generally these symptoms are more difficult to recognize and can be mistaken for depression or other pathological symptoms.

Positive disturbances

The positive symptoms of schizophrenia include:

hallucinations, which can involve hearing, vision, smell, taste and touch. However, auditory hallucinations occur more frequently: voices talking to each other or commenting on the person’s actions. Through magnetic resonance imaging of the brain, it was discovered that the brain mistakes the voices generated internally, through the imagination, for real voices coming from the external environment and heard through the ear
delusions, such as delusions of persecution and grandeur (for example, thinking you are a famous historical figure)

Other symptoms that may be classified as positive or, according to other classification schemes, in a third category called disorganization, include:

inability to organize one’s thinking in a logical way
bizarre and disorganized behavior; people with schizophrenia may behave inappropriately or become very agitated in seemingly unwarranted ways. They may also feel that their thoughts are being controlled by another person.

Negative disturbances

The negative symptoms of schizophrenia usually appear within a few years of the first acute episode of the illness. The schizophrenic person tends to lose interest in the surrounding world. The subject tends to decrease his social relationships more and more, up to complete isolation.

As a rule, these complaints appear gradually and worsen slowly.

They can contemplate:

apathy, in many cases it is necessary to encourage and induce sick people to perform even simple activities such as taking care of personal hygiene
emotional flattening
impoverishment of language
inability to make decisions
difficulty staying focused
lack of interaction with the interlocutor

Negative disorders are more difficult to identify as they have a slow and gradual course.

Especially at the beginning they can be confused with a normal adolescent crisis.

In schizophrenia there may also be thought disturbances and evident cognitive limitations, with particular reference to memory, attention and the ability to solve problems.

Causes of schizophrenia

Schizophrenia is believed to have a multifactorial genesis.

Several elements combine to create the conditions for the appearance and development of the disease.

Among these factors we can recognize heredity, events that occurred during the period of pregnancy, alterations of biochemical processes of the organism, viral infections.

In particular, it is noted that:

difficult deliveries increase the risk of occurrence by two or three times. It is thought that this may be due to the fact that the fetal brain is damaged during its development
infectious agents may favor the onset of the disease. If, for example, the flu virus is contracted during the first trimester of pregnancy, the risk of schizophrenia increases approximately sevenfold. Although according to the studies carried out, it would seem more the antibody response, instead of the infection, to cause brain damage
genetics plays an important role. Some studies have shown that the probability of developing the disease is ten times higher among relatives than among the general population. In schizophrenia there appear to be multiple genes involved, each of which exerts a small effect acting in conjunction with epigenetic and environmental factors. At least seven genes appear to be implicated in schizophrenia.

Basically it can be hypothesized that these elements represent the foundation of a certain personal predisposition to develop the disease.

In the event that, in the course of the life of predisposed people, further traumatic or, in any case, negative events should occur, schizophrenia could arise.

Possible trigger factors include:

situations of high psychological stress (such as bereavement, job loss, divorce)
heavy use of certain drugs, especially some types of cannabis, cocaine, LSD or amphetamines.