Family doctor

Overview:

Schizophrenia is a serious and potentially debilitating mental illness. Schizophrenia is NOT the same as a "split personality". It is an illness affecting both thinking and emotion.

The illness is characterised by:

• Disorganised thinking, speech and behaviour
• Preoccupation
• Hallucinations
• Delusions
• Seemingly absent or inappropriate emotions

Schizophrenia usually first appears in adolescence or early adulthood.

There is an increased risk of self harm with schizophrenia. Violence towards others is less common but can also occur.

The causes of schizophrenia are not yet known but increased risk factors include a family history of mental illness, major life stressors and drug and alcohol abuse.

Schizophrenia affects about one percent of the population.

What is schizophrenia?

Schizophrenia is a mental illness which may cause psychosis (an inability to tell what is real from what is not).

It appears to be caused by a combination of genetic and environmental factors. Many sufferers of schizophrenia have, or have had difficulties with "street drugs" such as marijuana, glue or "hard drugs, such as LSD. Use of these drugs (and overuse of alcohol) are contributing factors in the appearance of psychotic episodes, but are probably only one factor in susceptible people.

Stressful life events may also play a precipitating role.

There are several subgroups of schizophrenia but all tend to share a core set of symptoms:

• Disordered thinking: inability to "think straight" leading to incoherent speech.
• Impaired emotional expression: either "flat", "blunted" emotions or expressions of emotions that others see as abnormal in the circumstances, such as giggling when talking about personal suffering.
• Hallucinations: most commonly, hearing voices, but visual and even tactile hallucinations can also occur with schizophrenia.
• Delusions: such as thinking that the TV can broadcast your thoughts or that you are being persecuted.
• Apathy: a lack of drive or interest in life. "Self-cares" like showering or washing and changing clothes may deteriorate. Food and fluid intake may decrease sufficiently to cause weight loss and physical illness.

How can schizophrenia be treated?

Although there is no "cure", most schizophrenia sufferers can have their illness substantially controlled using anti-psychotic drugs.

These can eliminate hallucinations and delusions and help patients to think more clearly and relate to people more effectively.

A "maintenance dose" is usually needed to lower the severity and frequency of relapses.

Modern anti-psychotic drugs are not only more effective than previously, but also have fewer and less severe side-effects.

Psychotherapy may also be useful, as are occupational therapy, regular routine and contact with society.

Education of both the patient and his/her family and supporters is vital as misunderstanding of the illness can further isolate the patient and thus exacerbate the illness. Understanding and involvement of the patient's family helps a lot in getting a better outcome.

Getting help for diagnosis and treatment:

See your GP or go straight to your local mental health team. Never delay seeking help if you have concerns, or concerns about a relative with the condition.

For education and family support and advice, contact The Schizophrenia Fellowship, Ph Auckland (09) 378 9134 or e-mail sfakl@xtra.co.nz, or the national office Ph (03) 366 1909 or e-mail Sfnat@voyager.co.nz.

The Mental Health Foundation of New Zealand, Ph Auckland (09) 630 8573, or Christchurch (03) 366 6936.