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Help With Schizophrenia

Curated and updated for the community by APA

Schizophrenia is a chronic brain disorder that affects about one percent of the population. When schizophrenia is active, symptoms can include delusions, hallucinations, disorganized speech, trouble with thinking and lack of motivation. However, with treatment, most symptoms of schizophrenia will greatly improve and the likelihood of a recurrene can be diminished.

While there is no cure for schizophrenia, research is leading to innovative and safer treatments. Experts also are unraveling the causes of the disease by studying genetics, conducting behavioral research, and using advanced imaging to look at the brain’s structure and function. These approaches hold the promise of new and more effective therapies.

The complexity of schizophrenia may help explain why there are misconceptions about the disease. Schizophrenia does not mean split personality or multiple-personality. Most people with schizophrenia are not any more dangerous or violent than the general population. Most people with schizophrenia live with their family, in group homes or on their own.

Read more on symptoms & treatment

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Family to Family Training
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My friend with schizophrenia smokes marijuana and drinks a lot, it that related to the schizophrenia?

Substance abuse is a common problem in persons with schizophrenia, including tobacco, marijuana, alcohol and other drugs. Abuse has all the usual health-related problems, but the presence of schizophrenia complicates this issue. Patients may stop their antipsychotic medications if they believe it interferes with the marijuana or alcohol effect. Disorganized thinking and behavior may be made worse. Marijuana increases the risk of schizophrenia in vulnerable young people and may complicate the course of schizophrenia. Impaired cognition is common in schizophrenia and misused drugs adversely affect cognition, such as attention, memory, task orientation and the like. There are many good reasons to avoid substance misuse. More

Does everyone with schizophrenia need to take medication? Can therapy help someone with schizophrenia?

All persons with schizophrenia need drugs some of the time and most will do better with continued use of medication to help control symptoms and prevent relapse. But the drugs are not effective for all aspects of the illness. Cognitive behavioral therapy may help with certain symptoms and supportive psychotherapy can support personal strengths and improve quality of life. Vocational programs increase the chances of successful employment. Family psychoeducation can give patients and family members a better understanding of the disorder and what will be helpful. A relationship with a case worker may help with the problems of daily living and supportive psychotherapy may help. New treatments such as neuromodulation are being developed and drugs with novel mechanisms of action are being tested. 

So, yes, drug treatment is important, but many patients will not take medication continuously for long periods and many experience side effects that have to be addressed. An integrated, comprehensive approach works best. More

What are the first symptoms someone would notice if they had schizophrenia?

The earliest signs and symptoms come before a diagnosis can be certain. There is now a growing emphasis on identifying young people at high risk for a psychotic disorder and offering treatment and services in advance of a full psychotic experience. At this stage symptoms and signs include problems with personal relationships and school or work performance, experiencing odd phenomena such as hearing a voice or noise but being uncertain if it was really heard, or becoming excessively suspicious. Also, some people may develop a “loner” lifestyle, a sense that something is wrong and that one’s mind is playing tricks, and other things that mark a change in life course. These may are not always early schizophrenia symptoms, but it is a good time for clinical assessment and care in hopes of preventing a progression to a full first episode of psychosis.

At first episode of schizophrenia, common symptoms include paranoia, hearing voices or seeing visions, disorganization of thoughts and behavior, low motivation and reduced experience of pleasure, anxiety, fear, depression, sleep disturbance, social withdrawal and sometimes poor emotional control seen as anger and hostility.

All the signs and symptoms can occur at a mild level in people who are not ill. A diagnosis must look at the severity of the symptoms, their impact on function and resulting distress. It is critical to rule out other possible causes of these symptoms before a diagnosis of schizophrenia. More

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About the Expert:

William Carpenter Jr., M.D.
Professor of Psychiatry and Pharmacology
University of Maryland School of Medicine
Editor-in-Chief, Schizophrenia Bulletin
October 2020

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Myles’ Story

Myles was a 20-year old man who was brought to the emergency room by the campus police of the college from which he had been suspended several months ago. A professor had called and reported that Myles had walked into his classroom, accused him of taking his tuition money and refused to leave.

Read More 

Editor's Choice

OCT 14, 2020

Smartphone data can help spot schizophrenic episodes before they happen
Study Finds

Although mental health awareness is a major factor in society today, spotting the signs that someone is suffering is not always easy. Could a device most people use every day also alert someone when they are about to have a problem? Researchers at Cornell University say smartphone data can actually predict when patients with schizophrenia will have a relapse, even a month before an episode occurs. 

OCT 2, 2020

IBM joins NIH effort to diagnose schizophrenia using AI
Venture Beat

IBM today announced that, in collaboration with researchers from Harvard Medical School, Mount Sinai School of Medicine, Stanford University, and the Northern California Institute for Research and Education, it will undertake a new initiative funded by the U.S. National Institutes of Health to investigate whether AI can be used to better identify people at risk of developing schizophrenia. It’s a part of the multimillion-dollar, multiyear Accelerating Medicines Partnership (AMP) program, a collaboration between the National Institute of Health (NIH), the U.S. Food and Drug Administration (FDA), pharmaceutical companies, biotech firms, and nonprofit organizations to develop new diagnostics and therapies for patients.

SEPT 21, 2020

American Psychiatric Association Publishes Updated Practice Guidelines for the Treatment of Schizophrenia
Psychiatry Advisor

The new guidelines focus on evidence-based pharmacological and nonpharmacological treatments and also includes information on assessment and treatment planning. In December 2019, the American Psychiatric Association (APA) Board of Trustees approved updated practice guidelines for the treatment of schizophrenia. The last full APA practice guideline was published in 2004, with an update in 2009. The 2019 guidelines aim to improve care quality and treatment outcomes for patients with schizophrenia.

Resources

Additional Resources and Organizations

Physician Reviewed

Felix Torres, M.D., MBA, DFAPA
August 2020