Schizophrenia

Schizophrenia is a cognitive brain disorder that affects how people think and act. It is characterized prominently by psychosis which is characterized primarily by auditory and visual hallucinations. Schizophrenia affects 1 percent of the population worldwide and generally develops in the early to mid-twenties in both males and females.

Sovereign Health of Arizona offers a mental health treatment program for patients who live with schizophrenia to help them reclaim control of their lives.

Symptoms and Diagnosis of Schizophrenia

The clinical symptoms of schizophrenia can be divided into four categories:

  • Positive symptoms – Psychotic symptoms, such as hallucinations, delusions, and disorganized speech and behavior
  • Negative symptoms – Decreased emotions, flat affect, loss of interest, and lack of speech.
  • Cognitive symptoms – Deficits in working memory and attention and in executive functions, such as the ability to organize. A deficit in interpersonal skills.
  • Mood symptoms – Depression and emotionally labile and instable.

To make a clinical diagnosis, the individual must have experienced at least two of the following symptoms:

  • Delusions
  • Hallucinations
  • Disorganized speech
  • Disorganized or catatonic behavior
  • Negative symptoms

Additionally, at least one of the symptoms must be the presence of delusions, hallucinations or disorganized speech. Hallucinations are defined as a sensory experience that does not persist outside of the minds. The most common types of hallucinations in schizophrenia are auditory and visual. Delusions are false realistic beliefs. For example, an individual with schizophrenia may believe that are an astronaut.

Continuous signs of the disturbance must persist for at least 6 months, during which the patient must experience at least 1 month of active symptoms. If symptoms are present for less than this duration, other related disorders should be considered such as schizophreniform disorder and schizoaffective disorder. Schizophreniform disorder has the same symptoms and diagnostic criteria except the duration of symptoms are less than six months but longer than one month.

Schizoaffective disorder is a mood disorder such as depression or bipolar disorder in addition to schizophrenia symptoms. A brief psychotic disorder is characterized by the same symptoms of schizophrenia but occurs less than one month in duration.

Brain Imaging for Schizophrenia

Although there are rarely physical symptoms and diagnosis is based on clinical findings, some studies have found that brain changes occur in schizophrenia. People with schizophrenia have been known to have MRI findings that include enlarged ventricles, smaller brain volumes and changes in their hippocampus. Additionally, neurotransmitters such as dopamine are affected in this disorder. It has been established that both and increase and a depletion of dopamine can cause positive symptoms and negative symptoms respectively. These MRI findings and neurotransmitter findings are more for research purposes than for clinical diagnosis. As the diagnosis and workup does not usually involved brain imaging.

Treatment for Schizophrenia

The mainstay treatment approach for schizophrenia primarily includes pharmacologic agents known as antipsychotics. There are first-generation and second-generation antipsychotics. These medications take time to work and many of them carry side effects. It is important for patients to be advised off all the risks and benefits before initiating therapy. First-generation agents include chlorpromazine, fluphenazine, haloperidol, thiothixene, perphenazine and loxapine. They act primarily to decrease the positive symptoms of schizophrenia. First-generation agent side effects include extra-pyramidal effects which are included below:

  • Akathisia – inner restlessness
  • Dystonia – muscle cramps and spasms
  • Hyperprolactinemia – results in galactorrhea, gynecomastia, and osteoporosis
  • Neuroleptic malignant syndrome (NMS)
  • Parkinsonism
  • Tardive dyskinesia (TD) – involuntary and repetitive movements

Second-generation antipsychotic agents are also used to treat positive symptoms and have less extra-pyramidal side effects however they usually result in weight gain. These agents include asenapine, clozapine, lurasidone, olanzapine, quetiapine, risperidone and ziprasidone.

Often, patients may use drugs or alcohol in an attempt to self-medicate and treat their undesirable symptoms. This may lead to substance abuse, and addiction and patients can be diagnosed with co-occurring disorders which are characterized by at least one mental health disorder in addition to at least one substance abuse disorder.

Schizophrenia Treatment at Sovereign Health of Arizona

Sovereign Health of Arizona works diligently to treat individuals who have been diagnosed with schizophrenia, schizoaffective and schizophreniform disorders. We provide evidence-based therapeutic approaches including psychotherapy such as cognitive behavioral therapy as well as pharmacologic therapy. For more information on our treatment programs, contact our 24/7 helpline.

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