Mental Health and Illness - Schizophrenia

Schizophrenia generally presents itself in adolescence. The effects begin slowly and, initially, often are mistaken for the normal behavioral changes of adolescence. People with schizophrenia experience hallucinations—seeing, hearing, tasting, or feeling things that are not present—paranoia, and delusions, for example, believing that they are being controlled by forces considered totally implausible by their culture's standards, such as a teddy bear or a pet. Erratic behaviors and social isolation are hallmarks of the illness, as are hearing voices and responding to situations inappropriately or with flat affect (without any emotion at all). People with schizophrenia may speak incoherently or show loosening of associations in their speech—jumping from subject to subject with no apparent connecting thread.

In 2001 the NIMH reported that 2.2 million Americans (about 1 percent of all people older than age eighteen years) suffered from schizophrenia and similar disorders. Table 8.1 shows the estimated prevalence of schizophrenia among Americans age eighteen to fifty-four. The precise causes of schizophrenia are unknown. Researchers think that genetic susceptibility is a risk factor for schizophrenia because an individual with a parent or sibling who has schizophrenia has a 10 percent chance of developing the disease, compared to the 1 percent chance of an individual with no family history. A prenatal developmental problem or a combination of genetic, developmental, and environmental factors also might cause it. Although physical and emotional stress can aggravate symptoms of schizophrenia, they do not cause the disease.

Imaging studies of the brain have revealed abnormal brain development in children who have schizophrenia, and imaging studies of adults with the disease have found enlargement of the ventricles of the brain. Some studies suggest that the brain of a person with schizophrenia manufactures too much dopamine, a chemical vital to normal nerve activity. Conventional drug treatment focuses on blocking dopamine receptors in the brain, but not all people with schizophrenia respond to treatment; it also can produce serious side effects. Newer antipsychotic medications used to treat the disorder, such as risperidone, have fewer side effects than previously used medications. Patients who take these medications must be monitored closely for serious side effects such as loss of the white blood cells that fight infection.