Schizophrenia

Author: 
Adoptive Families Association of BC
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Definition
A severe chronic disease of the brain characterized by the occurrence of hallucinations, an inability to distinguish between reality and delusion, and emotional and social withdrawal.

Causes
The causes of schizophrenia are not yet known, although scientific research is progressing rapidly. Like many illnesses, schizophrenia tends to run in families, so risk is increased  if a family member has it – much like heart disease or breast cancer. However, heredity is not the whole story. Even with identical twins there is only a 30-40% chance that if one twin acquires the illness, the other will get it too.     

Substance abuse often coincides with schizophrenia but it does not cause the disease,  as some people used to believe.

Characteristics
Schizophrenia is a complex illness with varying intensities and symptoms. However, good modern treatment is available, and it works. Because of this, many people with schizophrenia can now lead relatively normal lives in the community. Medication usually helps relieve the more vivid symptoms of the illness such as hallucinations, but troublesome cognitive deficits remain. People with schizophrenia may be extremely intelligent, but they often have difficulty with organizing, planning, prioritizing, and decision-making, as well as with short term memory. Early intervention and treatment –including understanding specific cognitive deficits and providing necessary supports – definitely improve patient outcomes. The common age of onset for schizophrenia is 15–24. However there are cases of childhood schizophrenia, although symptoms may look slightly different.

Schizophrenia Symptoms in Teens and Young Adults

  • Hallucinations: Hearing, seeing, tasting, feeling or smelling something that is not there (e.g., hearing voices.)
  • Delusions: For instance, a belief that others can see and/or control their thoughts, and are plotting to harm them
  • Disorganized speech and behaviour; often illogical or bizarre, sometimes frightening to an observer
  • Becoming fearful and withdrawing from social contact
  • Inability to think logically or rationally
  • Erratic emotions such as crying or laughing inappropriately; or the opposite - complete emotional “flattening” and detachment
  • Difficulties sleeping
  • Loss of interest in personal hygiene

As a result of living with untreated hallucinations and delusions, people with  schizophrenia may appear:

  • Distant or preoccupied
  • Unaware of those around them
  • Agitated and unable to calm themselves
  • Frightened, confused, or paranoid

In contrast to common belief, people with schizophrenia are not prone to violent behaviour. Most individuals would prefer to retreat from society rather than confront it. Substance abuse increases the risk of violent behavior but it has the same effect on those who do not suffer from schizophrenia. 

 Schizophrenia in Children

  • Hearing voices, seeing things that aren’t there
  • Idea that others are plotting to harm them
  • May become fearful and withdraw from social contact
  • Difficulty in social relationships; suddenly becoming shy
  • Confused thinking, strange ideas
  • Inability to distinguish reality from delusion
  • Behaving younger than they actually are

The occurrence of schizophrenia before adolescence is rare, but it does happen.  Psychosis usually develops gradually in children, while some adults appear to  have a sudden onset. An outgoing child may slowly begin to withdraw or another child may begin to share strangely bizarre ideas.

Treatment for children with schizophrenia is the same as for adults except that children are more susceptible to side effects of medications.

Treatment
Since the cause of the schizophrenia is unknown, treatment is focused on reducing or eliminating symptoms. Effective  treatment includes antipsychotic medications plus psychosocial rehabilitation and other necessary supports.

Antipsychotic medications can be very effective for hallucinations and delusions, but they are not a “cure”. Current  drugs do not help with the serious cognitive deficits that are part of the disease. Psychosocial rehabilitation such as cognitive enhancement therapy, individual counselling, self-help groups, family education, and supported education and employment programs are focused on helping the patient with these more subtle symptoms ¾ allowing them to maintain their lives and their relationships with the least possible amount of interruption in spite of their illness.

Complications
People suffering from schizophrenia can have many difficulties interacting with society. These include:

  • Inability to function in the classroom or school.
  • Lack of organizational skills to manage  normal tasks of daily living.
  • Loss of relationships.
  • Having to deal with stigma associated with the disease. 

Additional complications associated with schizophrenia can be unwanted side effects from medications.  Older medications caused dry mouth, muscle spasms, drowsiness, restlessness and blurred vision, and long-term use sometimes led to permanent movement disorders (tardive dyskinesia.) Modern medications are much better tolerated, but may still produce unwanted side effects such as weight gain or elevated hormone levels.


This resource is by no means intended as a substitute for a doctor's advice or diagnosis. Any concerns you may have with regard to your child's health and development should be discussed with a professional in an appropriate field.