Types
Some researchers believe schizophrenia is an isolated disorder, while others believe it is a syndrome (a set of symptoms) based on numerous underlying diseases. Subtypes of schizophrenia have been proposed to classify patients into more uniform groups; however, in the same patient, the subtype can vary over time. For this reason, the subdivision into paranoid, hebephrenic, catatonic, or undifferentiated schizophrenia has been ruled out in international classifications of psychiatric illnesses.
Currently, there is a potential to assess and differentiate the disorder that depends on the predominance of positive or negative symptoms and all of the above, to measure the intensity of each of these symptoms using questionnaires and scales. This allows the patient to be evaluated at various times in their evolution and the effectiveness of the treatments.
Diagnosis
for the diagnosis of schizophrenia, there is no definitive diagnostic test. Instead, the psychiatrist makes the diagnosis based on an evaluation of the patient’s family history and disease symptoms.
To diagnose schizophrenia, symptoms must last for at least six months and be associated with significant impairment in work, school, or social development. Information from family, friends, or teachers is important in establishing when the disease started.
The physician must discover the possibility that an affective disorder causes the patient’s psychotic symptoms. Laboratory tests are often performed to rule out substance abuse or an underlying neurological or endocrine disruption that may have some features of psychosis. These disorders include brain tumours, temporal lobe epilepsy, autoimmune diseases, Huntington’s, liver diseases, and adverse drug reactions.
Treatments
Pharmacological treatment of schizophrenia is fundamentally based on the use of antipsychotic drugs. Two types are distinguished:
The classics: chlorpromazine, haloperidol or thioridazine.
Atypicals: clozapine, risperidone, olanzapine, ziprasidone, or quetiapine
Both groups have in common the ability to correct neurotransmitter imbalances, especially dopamine, and relieve positive symptoms. However, atypical antipsychotics have a special ability to achieve the imbalance of the neurotransmitter serotonin. The effectiveness of this type of drug on negative symptoms has been associated with this. In addition, they also have the advantage of producing fewer side effects.
Treatment with electroshock may be indicated in specific cases, such as when the drug treatment has a poor response, with a serious risk of suicide or aggression towards others. However, despite its bad press, the current application conditions of electroshock make it a safe and very effective procedure.
Antipsychotic treatments have allowed, in most cases, the patient with schizophrenia to live in the community. Therefore, it is extremely important to take advantage of this possibility and combine pharmacological treatment with a series of measures to keep the patient busy and active.
These measures constitute what is called psychosocial therapy. In addition to individual psychological therapy, group psychotherapy can be very useful, as well as occupational workshops or mental health day centres, depending on the severity of each case.
A healthy conversation between a schizophrenia patient and the doctor can be an important therapeutic tool. The doctor can teach you to live with the pathology and to use your different psychological resources and those of others -family, friends, support-to get closer to those around you.
On the other hand, the psychiatrist tries to discuss and inform both the patient and the relatives about the symptomatic characteristics of the disease and help them to distinguish how they have manifested themselves in their particular case, to prevent or intervene in case of an exacerbation. The psychiatrist must also inform the psychiatrist about antipsychotic treatments, their effects and advantages, and possible adverse effects.
In addition, the psychiatrist must help the patient and those close to them to achieve adequate communication in the family environment. Other individual psychotherapy techniques, such as those of a psychoanalytic type, do not seem effective in schizophrenia.
Forecast
The prognosis of this pathology depends on each case. In most patients, symptoms improve with pharmacological treatment. When the symptoms are abandoned, they usually reappear.
Contrary to popular belief, many patients can lead a normal life despite being a disorder with great potential for causing disability. However, many false beliefs about this disorder still contribute to stigmatising those suffering from it. For example, most people with schizophrenia are not dangerous or violent; neither are they homeless individuals nor live in psychiatric residences. As a result, much more life is integrated into the community and their families, and a significant percentage of work.
complications
- Experts note that people with schizophrenia are at increased risk of:
- Problems with alcohol and drug consumption increase the chances that the symptoms will reappear.
- Develop other diseases due to an inactive lifestyle.
- Have side effects from medications.
- Suicide.
