Schizophrenia is a serious mental illness affecting a person’s thoughts and behaviours. It affects about 1% of the UK population with symptoms usually developing in early adulthood. The first indications that someone may be suffering from schizophrenia are usually delusions, hallucinations, disorganised speech, catatonia (strange behaviours such as walking in circles or sitting still for hours on end) and negative symptoms (such as showing no feelings or motivation). At least one of the first three in this list must be present and for a period of at least one month in order for a diagnosis of schizophrenia to be made.
There are several different types of schizophrenia which were re-defined in 2013 to give a more accurate and representative picture of a diagnosis of schizophrenia. Instead of being defined as several distinct conditions, schizophrenia is now diagnosed as one of several defined schizophrenia sub-types:
1. Paranoid-type characterised by frequent hallucinations and delusions.
2. Disorganised (or hebephrenic)-type – disorganised behaviour and non-sensical speech.
3. Catatonia-type – typified by extremes of movement – either excessive or very little. These symptoms, in particular, can sometimes be confused with other mental health conditions such as bipolar disorder and other mood disorders.
4. Undifferentiated-type – some paranoia or catatonia symptoms but which do not fit into the above categories.
5. Residual-type – several mild symptoms of schizophrenia, such as odd beliefs or odd perceptions, but none of the above most typical symptoms are present.
6. Cenesthopathic-type – unusual body sensations are experienced, such as the feeling that an area of the body is detached or being compressed or stretched or the sensation that a part of the body is hollow or open to the air.
7. Unspecified-type – where none of the above are diagnosed.
Only a psychiatrist can give an accurate and comprehensive diagnosis of schizophrenia. In some cases, a diagnosis may start off as a ‘psychotic disorder’ or ‘psychosis’ before symptoms are better understood and a more accurate diagnosis of schizophrenia is made.
The causes for schizophrenia are not known and there is unfortunately no known cure. Genetics, complications at birth, stress or stressful life events are thought to contribute to the development of schizophrenia and there is also a strong link between the prolonged use of strong cannabis and the development of schizophrenia. The condition can be successfully managed through the use of medication and therapies such as Cognitive Behavioural Therapy (CBT), art therapy and self-care and family therapies which can help both the sufferer and those close to them better understand and cope with the effects of the condition and enable both parties to enjoy normal and productive lives.
There has been some interesting work regarding high emotional expression (HEE) families and low emotional expression (LEE) families. Patients with schizophrenia who live in HEE families tend to relapse more frequently and need longer courses of treatment. Part of the treatment programme is to try and make high emotional families into a more relaxed, less critical and demanding groups of relatives, which leads to a reduction not only in the relapse rate, but also in the severity and length of the illness.
Some patients may be reluctant to take anti-psychotic medication in the form of tablets on a regular basis for their condition, and injections administered by a nurse every two to four weeks, depending on the medication, may be preferable for some.
For some patients with severe symptoms, it may be necessary to be treated in hospital, sometimes under a Section of the Mental Health Act. There are various types of sections which involve differing lengths of time. Usually, two doctors are required to complete the appropriate forms for the section, along with the nearest relative or an approved mental health practitioner or social worker.
Our consultant psychiatrists at Private Psychiatry have many years’ experience in diagnosing and helping those with schizophrenia manage their condition. For an appointment with one of our consultants, please contact us.