What is schizophrenia?
Schizophrenia is a chronic, severe, and disabling brain disorder
that has affected people throughout history. About 1 percent of
Americans have this illness.1
People with the disorder may hear voices other people don't hear.
They may believe other people are reading their minds, controlling
their thoughts, or plotting to harm them. This can terrify people
with the illness and make them withdrawn or extremely agitated.
People with schizophrenia may not make sense when they talk. They
may sit for hours without moving or talking. Sometimes people with
schizophrenia seem perfectly fine until they talk about what they
are really thinking.
Families and society are affected by schizophrenia too. Many
people with schizophrenia have difficulty holding a job or caring
for themselves, so they rely on others for help.
Treatment helps relieve many symptoms of schizophrenia, but most
people who have the disorder cope with symptoms throughout their
lives. However, many people with schizophrenia can lead rewarding
and meaningful lives in their communities. Researchers are
developing more effective medications and using new research tools
to understand the causes of schizophrenia. In the years to come,
this work may help prevent and better treat the illness.
does schizophrenia start and who gets it?
Schizophrenia affects men and women equally. It occurs at similar
rates in all ethnic groups around the world. Symptoms such as
hallucinations and delusions usually start between ages 16 and 30.
Men tend to experience symptoms a little earlier than women. Most
of the time, people do not get schizophrenia after age 45.3
Schizophrenia rarely occurs in children, but awareness of
childhood-onset schizophrenia is increasing.4,5
It can be difficult to diagnose schizophrenia in teens. This is
because the first signs can include a change of friends, a drop in
grades, sleep problems, and irritability—behaviors that are common
among teens. A combination of factors can predict schizophrenia in
up to 80 percent of youth who are at high risk of developing the
illness. These factors include isolating oneself and withdrawing
from others, an increase in unusual thoughts and suspicions, and a
family history of psychosis.6 In young people who develop the
disease, this stage of the disorder is called the "prodromal"
Experts think schizophrenia is caused by several factors.
Genes and environment. Scientists have long known that
schizophrenia runs in families. The illness occurs in 1 percent of
the general population, but it occurs in 10 percent of people who
have a first-degree relative with the disorder, such as a parent,
brother, or sister. People who have second-degree relatives
(aunts, uncles, grandparents, or cousins) with the disease also
develop schizophrenia more often than the general population. The
risk is highest for an identical twin of a person with
schizophrenia. He or she has a 40 to 65 percent chance of
developing the disorder.15
We inherit our genes from both parents. Scientists believe several
genes are associated with an increased risk of schizophrenia, but
that no gene causes the disease by itself.16 In fact, recent
research has found that people with schizophrenia tend to have
higher rates of rare genetic mutations. These genetic differences
involve hundreds of different genes and probably disrupt brain
Other recent studies suggest that schizophrenia may result in part
when a certain gene that is key to making important brain
chemicals malfunctions. This problem may affect the part of the
brain involved in developing higher functioning skills.18 Research
into this gene is ongoing, so it is not yet possible to use the
genetic information to predict who will develop the disease.
Despite this, tests that scan a person's genes can be bought
without a prescription or a health professional's advice. Ads for
the tests suggest that with a saliva sample, a company can
determine if a client is at risk for developing specific diseases,
including schizophrenia. However, scientists don't yet know all of
the gene variations that contribute to schizophrenia. Those that
are known raise the risk only by very small amounts. Therefore,
these "genome scans" are unlikely to provide a complete picture of
a person's risk for developing a mental disorder like
In addition, it probably takes more than genes to cause the
disorder. Scientists think interactions between genes and the
environment are necessary for schizophrenia to develop. Many
environmental factors may be involved, such as exposure to viruses
or malnutrition before birth, problems during birth, and other not
yet known psychosocial factors.
How is schizophrenia
Because the causes of schizophrenia are still unknown, treatments
focus on eliminating the symptoms of the disease. Treatments
include antipsychotic medications and various psychosocial
Antipsychotic medications have been available since the
mid-1950's. The older types are called conventional or "typical"
antipsychotics. Some of the more commonly used typical medications
Perphenazine (Etrafon, Trilafon)
One of these medications,
clozapine (Clozaril) is an effective medication that treats
psychotic symptoms, hallucinations, and breaks with reality. But
clozapine can sometimes cause a serious problem called
agranulocytosis, which is a loss of the white blood cells that
help a person fight infection. People who take clozapine must get
their white blood cell counts checked every week or two. This
problem and the cost of blood tests make treatment with clozapine
difficult for many people. But clozapine is potentially helpful
for people who do not respond to other antipsychotic
Other atypical antipsychotics were also developed. None cause
agranulocytosis. Examples include.
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