Schizophrenia belongs to a group of illnesses known as psychotic disorders, where people may hear or see things that aren’t real, hold strong beliefs that don’t match reality, or have difficulties expressing emotions.
One of the most common features of schizophrenia is experiencing hallucinations, such as hearing voices that do not exist or seeing people or objects that are not real.
Another typical sign of psychosis is when a person interprets everyday events as being directly connected to them. For example, they may firmly believe that a television broadcaster is speaking to them personally.
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Forms of Schizophrenia
Schizophrenia can take different forms, each characterized by specific symptoms or patterns of behavior. The most common types include:
Paranoid schizophrenia
is marked primarily by delusions and hallucinations. People with paranoid schizophrenia often feel watched or influenced by others. It is the most frequent type and typically appears between the ages of 15 and 25.
Hebephrenic schizophrenia
is characterized by a noticeable emotional flatness or inappropriate emotional reactions that do not match the situation. This may lead to unusual behavior. Disorganized thinking is also a typical feature of this type, which usually begins between the ages of 15 and 25.
Catatonic schizophrenia
is a rarer form, recognizable by abnormal movements. Affected individuals may show aimless agitation or complete physical rigidity. This form also often begins between the ages of 15 and 25.
It is important to note that the boundaries between these types are not always clear-cut, and symptoms can overlap across the different forms.
Positive and Negative Symptoms of Schizophrenia
The symptoms and course of schizophrenia vary greatly from one person to another, but with the right help, most people can learn to manage their symptoms and lead meaningful lives.
The symptoms of schizophrenia Schizophrenia can manifest in varying ways and follow very different courses. In its development one differentiates so-called “positive” and “negative” symptoms.
Positive Symptoms
Positive symptoms are disturbances that appear as an “addition” to a person’s own personality. These may include delusional beliefs; for example, a person might feel they are a famous figure, believe themselves to be a god or religious figure, or think they are being monitored or spied upon.
Hallucinations also belong to this category: a person may lose touch with reality, seeing, hearing, feeling, tasting, or smelling things that do not exist. Often they hear imaginary voices giving commands.
Disorganized behavior in schizophrenia occurs, where the individual experiences movements that cause fear or tension and may act impulsively or become angry without obvious reason. Speech disturbances are common, such as abrupt shifts of topic, inventing words and sounds, or repeating words and ideas.
Negative Symptoms
Negative symptoms refer to the loss of normal emotional and social abilities. A person may appear withdrawn, show little facial expression, or lose interest in everyday activities. They might have trouble feeling joy, expressing affection, or participating in social life. Such symptoms can make daily functioning challenging and often last longer than the more dramatic positive symptoms.
Can schizophrenia Be Cred?
Schizophrenia is not curable in the sense of permanently eliminating its causes. However, the concept of “recovery” allows patients to define what healing means to them. For some, recovery may include living with or accepting the presence of voices rather than eliminating them entirely. Classical ideas of cure may become secondary if both doctor and patient agree that a different definition of healing – one focused on quality of life – is more appropriate. What matters most is that individuals receive the treatment and support they need to live well despite their condition.
How Schizophrenia Is Treated
Although schizophrenia is a chronic condition, it can be successfully managed. The main goal of treatment is to reduce symptoms, prevent relapses, and help the person live as independently and actively as possible.
The therapy of schizophrenia starts with the assessment of the patient’s current state. Many affected individuals face risks like losing their jobs or housing. In such cases, social support systems are crucial.
Medication is a central part of treatment. The main medications used for the treatment of schizophrenia are so-called antipsychotics, which block dopamine receptors and help relieve symptoms. Antipsychotic medication, especially with atypical antipsychotics, is consistent with current common practice.
Psychotherapy is beneficial for almost all patients with schizophrenia, though not always in the form of traditional weekly sessions. Many need more flexible arrangements, such as access to a therapist when fears or delusional beliefs intensify.
Treatment with Antipsychotic Medication
Especially during an acute psychotic phase, a psychiatrist will prescribe antipsychotics, formerly known as “neuroleptics.” These chemical substances influence neurotransmitter metabolism, primarily dopamine, but also serotonin and other transmitters. They suppress psychotic positive symptoms such as hallucinations, delusions, and disorganized thinking through the inhibition of internal and external stimuli.
Nowadays “atypical” second-generation antipsychotics are frequently used. Substances from this group (e.g., risperidone, clozapine, olanzapine, amisulpride, quetiapine, ziprasidone, aripiprazole) show fewer motor side effects than many classic antipsychotics. However, each antipsychotic may trigger specific side effects, which must be recognized by the treating physician.
Dosage Adjustment
Even at optimal dosage, a significant improvement of psychotic symptoms usually occurs only after several weeks. Once symptoms decrease, the dose is gradually reduced in small steps. If the symptoms have entirely subsided, a maintenance dose should be given for 1 to 2 years as prevention.
Relapse Prophylaxis
Studies show that without medication there is a very high risk of relapse, which protective medications (“relapse prophylaxis”) can considerably reduce. In patients with multiple relapses, antipsychotics may be taken for 3-5 years after the acute phase, and in chronic cases, even lifelong. In general the pharmacotherapy must be strictly monitored—regarding effect, tolerability, and regular intake.
Patient’s Compliance
Compliance, i.e., that the patient accepts the treatment and takes their medication according to the doctor’s instructions, is a key factor in a successful outcome. The prerequisite is that the patient trusts the doctor and feels taken seriously and understood.
A particular problem in acute schizophrenic phases can be the lack of insight into the illness. When there is self- or external endangerment, hospitalization in a “protected” ward becomes unavoidable, and—under certain legal conditions—treatment against the patient’s will may be required.
Psychotherapy and Sociotherapy
Psychotherapeutic and sociotherapeutic measures can begin once the willingness of the person with schizophrenia to cooperate increases. Psychotherapy focuses in particular on processing the experience of illness, mastering existing life problems, and supporting the individual in finding themselves, recognizing reality, and coping with it.
Teaching about the illness is especially important in treatment and demonstrably improves patient compliance. This so-called psychoeducation is usually delivered in group therapy.
Sociotherapeutic measures aim to prevent social consequences within the family, living environment, work, and community life. The care offerings include occupational and activity therapies, structuring of daily routines, and vocational rehabilitation measures. Involvement of the family and the entire social environment plays a crucial role. Comprehensive education about the condition and communication training are essential therapy components since acceptance and understanding by relatives as well as a stable social network help prevent relapse.
Cognitive Rehabilitation
Many patients continue to suffer from cognitive impairments after the psychotic symptoms have subsided, particularly deficits in attention, working memory, and planning ability. These can be treated with the help of cognitive remediation or cognitive rehabilitation.
These are various training measures, based on behavioral therapy, aimed at improving cognitive functions. Treating these cognitive limitations is of enormous importance, not only as the basis for better social integration but also for improving insight into the illness and thereby the therapeutic alliance and medication intake. Relationship and functional ability in various social roles can also be improved in this way.
Other psychological training programs build on the cognitive training and also train social perception, verbal communication, social skills, and interpersonal problem-solving.
Psychiatrist in India for Treatment of Schizophrenia. Summary
Schizophrenia is a complex mental health condition that can deeply affect the way a person thinks, feels, and behaves, often losing touch with reality.
Treatment of schizophrenia largely follows established clinical standards and scientific evidence. Most patients begin treatment with medication and continue with psychotherapy and social rehabilitation. Some may start their treatment in a hospital during an acute phase and later continue on an outpatient basis.
If you want to treat schizophrenia, the first step is to find a psychiatrist experienced in the treatment of schizophrenia.