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Schizophrenia: An Overview

Schizophrenia is a serious brain disorder that distorts the way a person thinks, acts, expresses emotions, perceives reality, and relates to others. People with schizophrenia -- the most chronic and disabling of the major mental illnesses -- often have problems functioning in society, at work, at school, and in relationships. Schizophrenia can leave its sufferer frightened and withdrawn. It is a life-long disease that cannot be cured but usually can be controlled with proper treatment.

Contrary to popular belief, schizophrenia is not a split personality. Schizophrenia is a psychosis, a type of mental illness in which a person cannot tell what is real from what is imagined. At times, people with psychotic disorders lose touch with reality. The world may seem like a jumble of confusing thoughts, images, and sounds. The behavior of people with schizophrenia may be very strange and even shocking. A sudden change in personality and behavior, which occurs when schizophrenia sufferers lose touch with reality, is called a psychotic episode.

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Working With Schizophrenia

You may think holding down a job is too much for someone with schizophrenia. But with treatment, many people can -- and should -- stay in the game. "People feel better about themselves if they're doing something productive," says Steven Jewell, MD, associate professor of psychiatry at Northeast Ohio Medical University. "It's critical to recovery to move forward with your life, whether it's at school or at work." Jewell advocates a team approach to providing patients the treatment, skills, and support...

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Schizophrenia varies in severity from person to person. Some people have only one psychotic episode while others have many episodes during a lifetime but lead relatively normal lives between episodes. Still other individuals with this disorder may experience a decline in their functioning over time with little improvement between full blown psychotic episodes. Schizophrenia symptoms seem to worsen and improve in cycles known as relapses and remissions.

Schizophrenia is a term given to a complex group of mental disorders. However, different types of schizophrenia may have some of the same symptoms. There are several subtypes of schizophrenia based on symptoms:

  • Paranoid schizophrenia: People with this type are preoccupied with false beliefs (delusions) about being persecuted or being punished by someone. Their thinking, speech, and emotions, however, remain fairly normal.
  • Disorganized schizophrenia: People with this type often are confused and incoherent and have jumbled speech. Their outward behavior may be emotionless or flat or inappropriate, even silly or childlike. Often they have disorganized behavior that may disrupt their ability to perform normal daily activities such as showering or preparing meals.
  • Catatonic schizophrenia: The most striking symptoms of this type are physical. People with catatonic schizophrenia are generally immobile and unresponsive to the world around them. They often become very rigid and stiff and unwilling to move. Occasionally, these people have peculiar movements like grimacing or assume bizarre postures. Or, they might repeat a word or phrase just spoken by another person. At times, the opposite may be true and these individuals appear to engage in restless ongoing activity with no specific purpose or desired outcome (for example, walking a straight line over and over; repeatedly jumping in place). People with catatonic schizophrenia generally go back and forth between more sedentary behaviors and the restless, purposeless behaviors and are at increased risk of malnutrition, exhaustion, or self-inflicted injury.
  • Undifferentiated schizophrenia: This subtype is diagnosed when the person's symptoms do not clearly represent one of the other three subtypes.
  • Residual Schizophrenia: In this type of schizophrenia, the severity of schizophrenia symptoms has decreased. Hallucinations, delusions, or other symptoms may still be present but are considerably less than when the schizophrenia was originally diagnosed. In addition, there must still be evidence of the disturbance as indicated by the presence of some negative symptoms (for example, inexpressive faces, blank looks, monotone speech, seeming lack of interest in the world and other people, inability to feel pleasure).

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