Schizophrenia is a mental disorder that is characterized by severe disturbances of thought, perception, feeling, and behavior. Mental health professionals classify it as a psychotic disorder, defined as being out of touch with reality and unable to separate real from imaginary experiences. Acute schizophrenia is marked by severe psychotic symptoms, which may include hallucinations, delusions, irrational acts, and bizarre behavior. Some people have only one such episode, while others have experienced many throughout their lives, sometimes interspersed with relatively normal periods. Still others suffer chronic recurrences without ongoing treatment. About 200,000 new cases are diagnosed in the United States each year. The disease affects about I percent of the population from all economic, racial, and cultural groups, with men and women affected equally Its cause is unknown, but researchers believe that a combination of inherited and environmental factors are involved.
Diagnostic Studies And Procedures
Since many patients with schizophrenia think, feel, and act quite normal much of the time, it is often hard to establish a diagnosis. In the active phase of the disease, at least two of the following symptoms must be present for most of the time for at least one month: delusions, hallucinations, disorganized speech or behavior, catatonic behavior, and a flat or abnormal facial expression. A medical history is important in determining if the patient has become withdrawn and dysfunctional suddenly or over a period of time. Tests might include psychological and neurological studies, a blood work up, and CT scans or MRI to rule out a brain tumor.
Hospitalization is often needed for an initial episode or severe relapse. Long¬term hospitalization is uncommon, but a few patients may require it. The mainstays of treatment are anti¬psychotic medications, or neuroleptics. These drugs, which include chlorpromazine , haloperidol (Haldol), thiothixene, prochlorperazine , loxapine (Loxitane), and clozapine, do not cure the condition, but they do enable most patients to think more clearly and rationally Antipsychotic drugs unfortunately have a number of adverse side effects, some of which can be eliminated by lowering the dosage. If this is not possible, some of the side effects can be controlled with other medications. Long term use, however, can lead to tardive dyskinesia, a disorder in which involuntary movements occur, most often of the mouth, lips, and tongue. Electroconvulsive therapy is rarely used to treat schizophrenia but may be helpful if a severe depression accompanies or triggers a psychotic episode. Lobotomy, a brain operation once used for severe chronic schizo phrenia, is no longer advocated.