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Help With Schizophrenia

Curated and updated for the community by APA

Topic Information

Schizophrenia is a chronic brain disorder that affects about one percent of the population. When schizophrenia is active, symptoms can include delusions, hallucinations, trouble with thinking and concentration, and lack of motivation. However, when these symptoms are treated, most people with schizophrenia will greatly improve over time.

See definition, symptoms, & treatment

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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 appears to increase 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.

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 not be 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, 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. 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
May 2015

Patient Stories
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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.

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Editor's Choice

DEC 19, 2018

A Unmet Needs and Challenges in Managing Schizophrenia

MD Magazine

The treatment of schizophrenia is a complex challenge, and I think there are many unmet needs. We have a number of patients who don’t respond adequately to the treatments that we use. There are a lot of relapses and hospitalizations that occur, which we could avoid. In addition, there are many patients who still have difficulty functioning, in terms of psychosocial and vocational abilities, so we need to do more, in terms of helping people get back to work or back to school or back to being a homemaker—whatever it is that they choose to do. Many of our patients still need a lot of help in achieving those goals.

DEC 19, 2018

Studies aim to improve cognition, reduce weight gain in schizophrenia

Medical Xpress

Aerobic exercise can improve the size and function of the brain, and now investigators want to know if it can also improve cognitive function in patients with schizophrenia who struggle with memory and attention problems. "We want to mitigate the modifiable risk factors that these patients have in abundance," says Dr. Joseph McEvoy. 

DEC 19, 2018

Hallucinations and voices: What it's really like to live with schizophrenia

Metro

Schizophrenia is often confused with dissociative identity disorder. But they couldn’t be more different. In DID, the mind creates multiple personalities to deal with trauma. Many people assume this is a symptom of schizophrenia, meshing together the idea of schizophrenia with having ‘multiple personalities’. The conditions are actually very different. In schizophrenia, no identities are created. Common symptoms are delusions, hearing voices, and hallucinating.

Resources

Additional Resources and Organizations

Physician Reviewed

Ranna Parekh, M.D., M.P.H.
July 2017