A psychiatric condition characterized by misinterpretations of reality.

The schizophrenic patient may (amongst other things):

Any delusion suspected of being part of the diagnosis of schizophrenia must be a belief that is not compatible with the culture from which the patient came from.

Schizophrenics are also usually very disorganized. Whilst a paranoid schizophrenic might do something like the stabbing on E.R. some time ago, it's highly unlikely (imho) that a real schizophrenic would be able to commit premeditated murder.


Update (July 3, 2000):
From Harrison's online, chapter 385: Mental disorders:

Schizophrenia is characterized by perturbations of language, perception, thinking, social activity, affect, and volition, but there are no pathognomonic features. The syndrome commonly begins in late adolescence, has an insidious onset, and, classically, a poor outcome, progressing from social withdrawal and perceptual distortions to a state of chronic delusions and hallucinations.

The term "Schizophreniform disorder" is used to describe patients who meet the symptom description of schizophrenia but not the duration requirements (at least six months). Prognosis depends on the response to antipsychotic medication rather than the severity of symptoms.

Schizophrenia is supposedly present in 0.85% of people worldwide and there is a 1-1.5% lifetime risk of developing schizophrenia. Risk factors for developing schizophrenia are a family history of schizophrenia, developmental problems and being born in winter. If one of your parents had schizophrenia, your risk of developing schizophrenia jumps to about 6.6%. Two parents makes it about 40%. Having an identical twin who develops schizophrenia puts you at nearly 50% risk of developing it yourself.

From Harrison's online again,

The societal costs of schizophrenia are substantial. An estimated 300,000 episodes of acute schizophrenia occur annually, resulting in the use of 25 percent of all U.S. hospital beds and 20 percent of all Social Security days, with total direct and indirect economic costs approximating $33 billion.
alex.tan's writeup is a good description of the scientifically accepted definition, but I find the scientifically accepted definition to be quite silly. First of all, there are many people who demonstrate one or more of the symptoms listed above, who are as sane or many times more sane than the average person. To wit:
  • It is very possible, through many scientifically normal means, to have control over people's minds. See religion, mind cracking, mind hacking, advertising.
  • "believe that there are special personal messages for them in newspapers or on the radio or television."
    Has anyone ever dedicated a song to you?
  • "believe that he/she has a special link to God or indeed IS God."
    This is practically the most often quoted maxim from the more spiritually advanced people on the planet: "Thou art God." In fact, many of them see it as crazy to believe that you are not God.

So what distinguishes a schizophrenic, someone who has a mental illness, from someone who is, to coin a phrase, radically sane?

Here's the way I see it. Let's use the metaphor of a house for the mind -- a common dream metaphor. A mentally normal person stays inside the house all the time -- they see themselves as defined by their ego, the house. The very sane, the spiritually advanced or gifted, are capable of leaving the house and returning. They acknowledge and identify with more than their ego. But in a schizophrenic person, there is something wrong with the house. Sometimes it has completely collapsed, sometimes it's just the equivalent of a window left open in a storm. And the things that lie outside the house -- visions, godforms, archetypes can enter their consciousness without their control or consent.

A famous story about a mystic and a schizophrenic sums it up. The mystic went to visit the schizophrenic in the asylum.

Mystic: "So, they tell me you think you are Jesus."
Schizophrenic: "YES!!! I AM THE WAY!! I AM THE TRUTH!!"
M: "Well, I happen to think that I am Jesus, and most of my friends think they are Jesus too. We like being Jesus together. What do you think of that?"
S: "NO!! I, AM JESUS!! NO ONE ELSE!! YOU DON'T UNDERSTAND!!"
M: "Well, I guess that's why you're in here, and we're out there."

It's an extreme example of a schizophrenic patient -- not all people diagnosed with schizphrenia behave like this. (Thank you, Trip Technician, for pointing that out -- my bad.) But it shows what I mean, more generally, about mental illness and sanity.

See The Pre/Trans Fallacy for more discussion of this apparent paradox.

BTW, schizophrenia is NOT multiple personality disorder.

Voices aren't always the end-all; schizophrenics have extraordinarily active imaginations, and sometimes entire worlds go through their heads. I have little formal training in this kind of thing, but what I do know is that our world is extremely stressful for them; there's just too much input, and lots of schizophrenics attempt to filter and categorize all of it.

Most require medication, although certain individuals can be placed in low stress environments (rural farms without machinery were the location in the case study I read) and be fine. Later stages of schizophrenia ofern include something referred to as "posing", where they will stay in a single pose for long periods of time, their attention consumed completely by events in their own heads.

Not a lot is known about schizophrenia, and there are lots of theories about where it comes from and what causes it (including a recent idea that it can be contracted as a viral zoonosis from domestic cats).

artfuldodger's comments are interesting, but I get an impression he's oversimplifying the issues on schizophrenia. I am schizophrenic, but don't think I am crazy. There is more subtlety to the issue than simple generalisations can cover. I once thought I was Jesus, and actually anticipated his anecdote in my personal diary, writing that perhaps "being Jesus" could be a group state. Another time I made friends with someone who believed they were God, and we had a great laugh together, both being aware of the contradictions and subtleties of the relationship.

The portrayal of the schizophrenic as inflexible and bigoted in believing he is Jesus is a bit of a stereotype, and the mystic is so wise and wonderful isn't he ? artfuldodger seems here to back up the notion that all incarceration of schizophrenics is justified, when imho our societies are rigidly intolerant of mental "differentness", incarceration being often unnecessary. There is too much theoretical speculation about this illness with few people making the effort to find and talk to people who actually suffer from it. (Yes, I can talk).

Imagine not being able to trust your own mind; what it tells you; your own thoughts, or what voices in your head say. Or imagine not being able to control parts of your own body. These are two horrifying but true examples of schizophrenia.

While mental illnesses probably started in prehistory we don't have earlier information previous to the Middle Ages. This is when they would herd people with mental illnesses on ships, then not too much later they put them into asylums. One hospital known for housing the mentally retarded was in England; called the Bethlem Hospital. That's where the word "bedlam" came from, meaning noisy confusion. The first record of someone possibly having schizophrenia was back in the 1400's when King Henry VI had a psychotic breakdown and had symptoms like that of a person with schizophrenia.

On average schizophrenia affects the same amount of men and women but tends to be more serious and show up at an earlier age in men. The most common age of onset is late-teens to early twenties for men and twenties to late thirties for women. Developing schizophrenia after age 40 is very uncommon.

Schizophrenia shows up in all races and cultures all over the world. But lower averages of people in tropical Africa have schizophrenia and higher averages of people have it in Scandinavia and Ireland. Approximately 1 out of every 100 people in the U.S. will be diagnosed with it in their lifetime. That's about 1.2 million people just in the U.S. who currently have it; which is about 118 people diagnosed with it every day.

Schizophrenia is a psychiatric disorder in which previously normal cognitive abilities and behaviors become disturbed. There are three basic kinds of schizophrenia:

  1. Disorganized Schizophrenia- lack of emotion, disorganized speech
  2. Catatonic Schizophrenia- waxy flexibility, reduced movement, rigid posture, sometimes too much movement
  3. Paranoid Schizophrenia- strong delusions or hallucinations

The effects interfere with a person's ability to think clearly, manage emotion, make decisions, and relate to others. More specifically it's manifested either by delusions, hallucinations, and unusual or disorganized behavior or by marked lack of activity, loss of interest or unresponsiveness.

Prognosis is not positive for diagnosed patients but taking medication does appear to improve the long-term prognosis.

Schizophrenia can effect anyone at any point in life but it is more likely in those who are genetically predisposed to it. Experts are not completely sure how, but it is inherited. The possibility of developing it with two parents, neither of whom carries the disease, is 1 percent. With one parent carrying schizophrenia the chance of developing it is 13 percent. With both parents carrying the disease it is about 35 percent.

The main cause for schizophrenia is, as of yet, unknown. However there are four current theories on the cause of schizophrenia: the Dopamine Hypothesis, the NMDA Receptor Hypothesis, the Single-Carbon Hypothesis, and the Membrane Hypothesis. Currently there is no cure for this illness, however it can be treated with =Antipsychotic drugs (developed in the 1950's) such as Thorazine, Stelazine, or Loxapine, which reduce the symptoms. The drugs work by correcting imbalances in the chemical makeup of the patients' brain. There are, however, 6 side effects of Antipsychotic drugs:

  1. Parkinson's disease
  2. Dystonia
  3. Restlessness
  4. Tardive dyskinesia
  5. Weight gain
  6. Skin problems
. About 25-40% of patients who take Antipsychotic medications for several years develop these side effects. About 80% of those who stop taking their medications after an acute episode will relapse within a year.

It is important to treat this disease at the earliest age possible to help avoid a slower and less complete recovery, increased risk of depression and suicide, strain on relationships, and interference with social development.

Studies show that after 10 years of treatment, one fourth of those with schizophrenia have recovered completely, one fourth have improved considerably and one fourth have improved somewhat. 15% have not improved and 10% are dead.

There is several ways to reduce the risk of developing schizophrenia. Because heredity plays a part, offspring are less likely to get it if neither parent carries it. My sources disagree with whether the early environment of children is also a factor. If upbringing is a factor, then a child, who has a severe trauma or (especially) a number of them are at higher risk of developing schizophrenia. Psychiatric examination is recommended as a child, an adolescent, a young adult, and an adult. There is also critical prevention, which means helping someone in a crisis that may likely lead to schizophrenic behavior especially if it's carried in his or her genes. Individuals with schizophrenia die at a younger age than the typical population and suicide is the number one greatest cause, with a 10-13% rate, for premature death among the schizophrenic.

To diagnose schizophrenia an individual must have loss-of-reality symptoms for at least six months. It's critical a doctor ensure that other problems that mimic schizophrenia, such as manic depressive episodes, delusional disorder, or personality disorders (schizotypal, schizoid, paranoid personality disorder) are ruled out.

Node your homework!

Schizophrenics are neither blessed nor crazy as they’ve often been believed throughout history. They are people whose minds are filled with uncontrollable, torturing thoughts and whose lives are filled with fear and loneliness.

Experts estimate that about one percent of people in the world suffer from some form of this disease. Gender and race seems to make little difference in who is stricken with this. It usually begins in a person’s teens or early adulthood and usually lasts a lifetime.

Schizophrenics live in a world of horrible confusion in which imaginings and reality become so intertwined that they cannot distinguish between them. Life becomes a dream, day and night, with no hope of escape by simply “waking up.” For many the world seems to be full of critics, persecutors and even assassins. Some believe themselves to possess fantastic mental and physical powers. They often develop anxiety and abnormal eating and sleeping habits. Their existence is lonely, despairing, and often exhausting. Sufferers often become distant and retreat from society. Many schizophrenic’s thoughts turn to suicide as the only escape. Suicide attempts are extraordinarily high among schizophrenics the death rate is chilling.

Treatment of this disorder is complicated by the fact that it appears in many different forms with many different symptoms. Drugs that help some patients have no effect or cause complicated side effects on others. Also a drug that works this month for a particular patient may not work next month.

Schizophrenia has often been thought of as split personality. It was believed that there are two or more people living in one body. Often one of the personalities was thought of as good and the other bad. The DSM-IV does not use this term because the term is far too simplistic to truly describe this complex disorder. Schizophrenia is so complex that no detailed definition of it seems to apply clearly to every person who suffers from the disorder.

Though it is commonly referred to as a disease, it is better thought of as what doctors call a syndrome. A syndrome is a collection of symptoms that are likely to show up together but do not have a single, easily identifiable cause.

Schizophrenia is not preventable. It has been called “youth’s greatest disabler.” It usually begins between the ages of 16 and 30 but has been diagnosed in children as young as 5. The illness can begin later in life, but it is unusual to see preliminary symptoms after the age of 40.

Unlike a mentally well person who enjoys an entertaining escape by choice, then decide when it’s time to return to reality, the schizophrenic does not have control over when they will or will not retreat from reality. There are few anchors to reality. Fantasy and reality merge constantly and the sufferer cannot separate the two.

To cope, a schizophrenic person often tries to withdraw from reality. This results in utter loneliness. Meanwhile, the fantasy world into which the person tries to escape may be anything but pleasant. As the victim struggles to determine what in life is real they become confused and exhausted. They have fragmented thoughts and feel physically fatigued.

The schizophrenic person is constantly confused and anxious, though withdrawn and often quiet. The schizophrenic person may ignore his or her surroundings and sit completely still and silent for hours. At other times, he or she may be in a frenzy of activity even when most people around them are sleeping. There are times between when the person just seems blank. They speak in a monotone and display neither sadness, joy, nor any other emotion.

While speaking their thought process may become fragmented. Do to this distraction the speaker may be unable to finish expressing even a simple idea. She or he may be unable to connect logical causes and reactions. Hearing of a tragedy may make the person laugh while a joke may make the person feel sad.

Schizophrenia was not given its name until the 20th century. It has affected people throughout history, however, in practically every society. The Swiss psychiatrist Eugen Bleuler first used the word “schizophrenia” in 1911 but many years passed before the term was clearly defined. Earlier in the 19th century, the disorder was known as dementia praecox.

In schizophrenics suicide attempts are usually not triggered by the victim’s imaginary voices or delusions. Instead, they usually happen during cycles when the disorder has eased somewhat. When the individual is able to understand the depth of the problem, he or she is likely to feel depressed and hopeless.

Researchers have reported that people with psychological disorders, including schizophrenia, are no more prone to violence than the general population. In fact, schizophrenics are far more likely to withdraw into their private worlds than to commit public acts of violence.

Unlike some mental disorders, schizophrenics do not have long periods of normality to look forward to. In most cases of schizophrenia the problems are ongoing, and medication must be taken for the long term.

Due to the person being unable to concentrate and to make quick well-thought out decisions, school work, specific tasks, or on the job duties may be unusually difficult. Schizophrenics are often friendless because ordinary conversation, expressing their feelings, and other social interaction can be so difficult for them.

Fortunately this disease does not get worse with age. Patients can hope for successful treatment even later in life.

There are no genetic or chemical tests to prove that a person has schizophrenia. Some symptoms of schizophrenia lasts as little as a month while others last for six months or more at a time.

There are many dysfunctions that can be caused by schizophrenia. There can be problems with concentration and reasoning, emotional upsets, halting or nonsensical speech, or an apparent attitude of carelessness or lack of attention.

There are two categories of symptoms of schizophrenia. Positive and negative. Positive symptoms of schizophrenia are hallucinations and delusions. The negative symptoms of schizophrenia are not as obviously alarming as the positive ones but can be a serious indicator of unhealthiness. Once common negative symptom is affective flattening. The schizophrenic may look dazed, not make eye contact, or not respond to communication. Another symptom is a poverty of speech, which is called Alogia. When questioned the schizophrenic may give short, and sometimes meaningless answers. Avovition is the inability to initiate and persist in goal-directed activities. The person may sit for long periods of time and show no interest in participation in anything.

Families of schizophrenics must learn to deal with many issues. Some of these issues are: denial, grief, fear, guilt, exhaustion, anger and bitterness, loss of control, marital problems, and loss of place in the community.

Overcoming the stigma associated with schizophrenia is especially difficult for the sufferer due to the hallucinations and delusions.

Many things have been identified as triggering symptoms of schizophrenia. These include street drugs, heavy consumption of alcohol, nicotine and excessive amounts of caffeine, over-the-counter medications, and life stresses.

Several types of medication have been used to treat schizophrenia. Some are pills, others are injected. Antipsychotics have become increasingly prescribed. These include Thorazine, Mellaril, Haldol, Clozaril, and Risperdal. It is usually vital that patients continue to take it regularly. As many as 80% of patients who stop taking their antipsychotic medication suffer relapses of the disease within two years. Only about 40% of those who continue to take the medication have relapses during that period. Although medication and other forms of treatment can help restore a normal, peaceful state of mind, they cannot make up for the person’s loss of social development. Chances today of schizophrenics being able to live normal, happy lives are much higher than they were in the past. As many as 25% now recover almost completely and close to 50% can expect at least a partial recovery.

Family members can be the most helpful thing to a schizophrenic. Family members can be life savers in many ways. Healthy family environment can significantly help bring about stabilization of the ill person’s condition and can help decrease the chance of traumatic relapses.

Family members are usually the first to observe the schizophrenic symptoms. According to the British Columbia Schizophrenia Society there are many early warning signs that can appear in various combinations.

  • Declining interest in sports, school, etc in which the person was once devotedly involved.
  • Ending of longtime friendships
  • Difficulty concentrating
  • Neglect of personal hygiene
  • Poor eating habits and dramatic weight change
  • Depression or apparent lack of emotion
  • Inexplicable glee or silliness
  • Odd physical expressions and behavior
  • Blank stares

At first schizophrenics often resist evaluation. Family or close friends must take the initiative in addressing the problem and trying to persuade the individual to seek medical help. Once a person is evaluated and stabilized the family can help ensure that the patient follows the prescribed treatment. Family can also make sure the schizophrenic receives balanced meals and regular exercise and gets rest. Loved ones are also very important in building the person’s confidence and encouraging independence. It is important however that they do not pressure the individual. They must be careful not to judge or criticize the person’s actions or progress.

Familiar, predictable routines are important. Loved ones must be consistent in their actions and attitudes when relating to the troubled relative. It is important for the ill person to remain relaxed and calm at all times. A schizophrenic, like every other human being, has a need for privacy that should be respected. Loved ones should be available for them but not intrusive. The most important thing when dealing with a schizophrenic is patience. There is no quick recovery from this disease.

A friend is an invaluable thing to a schizophrenic. The friend needs to be sympathetic and patient as well as realistic. When a schizophrenic is obviously deluded it is important for the persons supporters not to go along with the fantasy. The best response is to point out delicately the difference between what the sufferer perceives and what the supporter sees. The friend should explain that he has a different understanding of the situation while assuring the schizophrenic that what they are trying to express is understood. A friend can help the individual by helping them to focus on completing school assignments or maintaining job performance.

The World Schizophrenia Fellowship is one of many groups dedicated to helping those with this disease and those close to them. It is located at 238 Davenport Rd. P.O. Box 118 Toronto, Ontario M5R 1J6 Canada and can be found on the web at http://www.origo.com/wsf/

Source: Schizophrenia: Losing Touch with Reality By Daniel E. Harmon

It could happen to you, your best friend, or anyone. It is a disease that causes hallucinations, delirium, and distorts the senses. People who have this disease can’t trust their senses, and it is very difficult for them to tell what’s real and what’s not. This disease usually strikes down young between the ages of 16 and 25, when they are in their prime. This disease is called schizophrenia and it is a very real and very scary mental disease with treatment available.

What causes schizophrenia? Scientists believe that schizophrenia is caused by a neurochemical imbalance. Studies are being conducted on three different neurotransmitters; dopamine, serotonin, and norepinephrine. Neurotransmitters they direct communication between brain cells. Using different medical scanning techniques (PET scans), scientists are able to see what areas of the brain are activated during certain activities. They found that people with schizophrenia have problems directing activity in different parts of their brains. They also found that schizophrenic people have an irregular pattern of brain cells. This can mean that either this is “caused” before birth or that this indicates a predisposition to the disease later in life. However, scientists still haven’t found a gene that they believe causes schizophrenia. But, it is widely believed that there is a genetic inheritance present.

Schizophrenia is different for every person. Someone might have only one episode their entire life. Some might have more frequent episodes, but lead perfectly normal lives in between. Others could have frequent, persistent, and severe episodes all their lives. People who have this disease can go through personality changes. For example, they might withdraw from society or have inappropriate emotions (laugh at something sad, cry at something funny, etc). One of the most profound changes is the change in thought and rationalization. They might start having delusions with no logical reasons. They might also have hallucinations, like hearing voices. Other symptoms can seem unrelated unless they occur at the same times. Such as depression, inappropriate laughter, hyper activity, inactivity, drug or alcohol abuse, self mutilation, or rigid stubbornness.

In the early 40s and 50s, schizophrenia was treated with electroconvulsive shock therapy (aka ECT or just "shock therapy") or insulin shock therapy. However, these treatments were abandoned in favor of medication. Different antipsychotic medications have been used to treat the disease. Up until more recently, the most popular medications were Thorazine, Mellaril, Modecate, Prolixin, Navane, Stelazine, and Haldol. However, these medications can have many different side effects.

The more popular drugs today include Risperidone, Clozapine, Olanzapine, and Quetiapine. These medications have fewer side effects then the older ones. Risperidone (Risperdal) is now seen as one of the first lines of defense for newly diagnosed patients. Clozapine (Clozaril) is popular because 1/3 of patients with treatment resistant schizophrenia show improvement with this drug. Olanzapine (Zyprexa) is another very promising drug showing good signs of efficiency with a low rate of side effects. Quetiapine (Seroquel) is a more recent drug with a high efficiency rate and low side effect rate similar to Olanzapine. While these drugs are better than the older ones, side effects still exist and patients must be closely monitored to ensure proper treatment.

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