Schizophrenia

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    Overview

    Schizophrenia is a disease of the brain affecting a person's thought, perceptions, emotions movement and behavior. It does not mean that a person has a "split personality". Schizophrenia affects about one in every 100 people. More than 2 million Americans have schizophrenia in a given year. The illness affects men and women with equally. In men it usually appears between ages 15 to 25, and in women, usually between ages 25 to 35. The symptoms and long lasting pattern of schizophrenia often cause a high degree of disability. It has been estimated that the financial cost of the illness in the United States exceed that of all cancers combined. 33 to 50 percent of homeless Americans are reported to have schizophrenia.

    Although there is no cure, schizophrenia is highly treatable and there is much hope for patients and their families. New discoveries in treatment have led to new and safer medications with fewer side effects. 


     

    Cause

    The exact cause for schizophrenia is not known. Bad parenting or personal weakness is not the cause. Research into the cause has pointed to several possibilities. Schizophrenia does run in families and scientists studying genetic factors have found that it is likely that multiple genes are involved. It is likely, but not yet certain that there is an imbalance of the chemicals in the brain that allow communication between the nerve cells. Other researchers called Neurobiologists have found that schizophrenia may be a developmental disorder that means that neurons (brain cells) and/or their connections may not have formed properly before birth. Infection, poor nutrition, and hypoxia (not enough oxygen) during pregnancy are possible causes. Immune and viral causes of schizophrenia have also been proposed, although the research data to support these causes is weak. 


     

    Symptoms

    The symptoms of schizophrenia vary from person to person. Symptoms may appear all at once, or develop slowly over months or years and can come and go in cycles. A person who has schizophrenia may have some, all, or combination of the following mental, emotional, and/or behavior symptoms:

      Distorted Perceptions of Reality
      People with schizophrenia may perceive the world and reality very differently from the reality seen and shared by others around them. Because of this, they may feel frightened, anxious, and confused.

      Hallucinations
      Hallucinations are perceptions that are experienced by a person but are not real. They can occur in any form of the five senses including sound, sight, touch, taste, and smell. The most common type of hallucination is hearing voices that other people do not hear. The voices may say things about the person, have a conversation, warn of real or imagined dangers, or give orders to say or do something.

      Delusions
      Delusions are false ideas or beliefs, which do not make sense. An example could include a person who thinks that people are cheating on him, poisoning him, spying and /or are a part of a conspiracy against him. A person with delusions may believe that he or she is a famous or important person. Sometimes a person can have a belief, which is bizarre, such as believing that an alien is controlling their behavior with electronic waves, or that people on the T.V. are talking to them.

      Disordered Thinking and Speech
      Schizophrenia often affects a person's ability to "think straight" so their thinking and speech are confused. Thoughts may come and go quickly, there may be difficulty concentrating, and connecting thoughts logically becomes very difficult. A person may move from one topic to another not making any sense and may even make up his own words or sounds. Because of the disordered thinking a person may do poorly in school and/or may have difficulty performing in their job. He or she may also withdraw from social situations, related to difficulties in communicating with others.

      Changes in Emotional Expression, Behavior, and Personality
      A person with schizophrenia may show very little emotion, speak in a monotone voice, and have very little motivation. He or she may spend days doing nothing at all including not taking care of his or her hygiene and appearance. One may notice that inappropriate feelings are expressed such as the person not caring about something important. Irrational, angry, or fearful responses toward loved ones may be common and hence cause much family concern. Strange body positioning, bizarre behavior, and extreme preoccupation with religion or the occult may occur. There may also be a change in a person's sleep pattern, usually difficulty with sleeping.

     


     

    When to Seek Help or Call Doctor

    If you or a loved one experiences several of the symptoms described above for more than two weeks, seek help. If you or a loved one verbalizes or tries to act on suicidal or violent thoughts, seek help immediately. Emergency help may be necessary. Please see resourses listed below. 


     

    What Happens

    When it is determined that a person requires help for the symptoms listed above, sometimes hospitalization is needed. This so a thorough mental and physical exam and tests can be performed to determine what is going on and begin treatment. Approximately a third of people with schizophrenia will recover completely. Another third will have symptoms of psychosis in several episodes during their lives and have some lesser symptoms in-between these episodes. The last third will have psychotic symptoms throughout their lives. The outlook for people with schizophrenia has improved with new medications developed over the past 25 years. Although there is no cure, many people with the illness improve enough to lead independent and fulfilling lives. 


     

    Common Concerns

    Is a person more likely to become violent if they have schizophrenia?
    Most people with schizophrenia are not violent and most violent crimes are not committed by people with schizophrenia. If a person had a criminal record before becoming ill or is abusing drugs or alcohol, he or she may be more prone to violence. But this is also the case in people who do not have any mental illness. If the person stops taking their medication and has symptoms of paranoia and delusions, he or she may be more prone to violence at that time.

    What About Suicide?
    People with schizophrenia have a higher rate of suicide than the rest of the population and so it is a serious concern. Anyone who tries to commit suicide or threatens to do so needs professional help immediately.

    Does having schizophrenia mean that you cannot work, go to school or pursue your own interests?
    No, as stated before, with treatment, symptoms may be lessoned or be eliminated, allowing a person to lead an independent and fulfilling life. This illness can be disabling though, with the desire to be independent and "normal" being an ongoing or intermittent struggle. 


     

    Exam & Tests

    A complete physical and mental examination will be done if you or a loved one is evaluated in a hospital. Blood tests and tests for drugs and alcohol will be done. Other tests may include a CAT scan or MRI of the brain. These are special x-rays of the brain to determine any abnormalities. An EEG test may also need to be performed and this test measures the brain waves to see if there is any seizure activity or neurological problem. 


     

    Treatment Overview

    The antipsychotic drugs are the best treatment now available for people with schizophrenia. These drugs do not cure or guarantee that there will not be any further episodes of psychosis. They can help most of the symptoms of schizophrenia most of the time. A trained mental health professional licensed to prescribe medications will need to determine the choice and dose of medication. There are two major types of antipsychotic medication, the typical or conventional antipsychotics and the new generation also known as atypical antipsychotics. A list of commonly prescribed antipsychotic medications brand and generic names is listed below.

     

      Brand Name Generic Name
    Typical antipsychotics Haldol haloperidol
    Loxitane loxapine
    Mellaril thioridazine
    Moban molindone
    Navane thiothixene
    Prolixin fluphenazine
    Serentil mesoridazine
    Thorazine chlorpromazine
    Trilafon perphenazine



      Brand Name Generic Name
    Atypical Antipsychotics Clozaril clozapine
    Geodon ziprasidone
    Risperdal risperidone
    Risperdal risperidone
    Seroquel quetiapine
    Zyprexa olanzapine



    If you would like more information about the medications above or any other medication, please click on the patient/consumer medication education web site listed below under 'resources'.

    In addition to medication, treatment also includes services for recovery and rehabilitation. This may include employment, housing and case management programs. Self-help groups can provide information and much support for people with mental illness. Therapy/counseling and crisis intervention services would also be included in the treatment of schizophrenia. 


     

    Resources on the Internet

      National Alliance for the Mentally Ill (NAMI)
      Phone: 1-800-950-6264 or (703) 524-7600
      Internet: http://www.nami.org

      National Alliance for Research on Schizophrenia and Depression (NARSAD)
      Phone: 1-800-829-8289 or (516) 829-0091
      Internet: http://www.narsad.org

      National Institute of Mental Health (NIMH)
      Phone:301-443-4513
      Internet: http://www.nimh.nih.gov

      National Mental Health Association (NMHA)
      Phone:1-800-969-6642 or (703) 684-7722
      Internet: http://www.nmha.org

      National Mental Health Consumers' Self-Help Clearinghouse
      Phone: 1-800-553-4539 or (215) 751-1810
      Internet: http://www.mhselfhelp.org

      Pharmacology Online web site:

     


     

    Community Resourses and Services

    Emergency Services and Hotlines:

    Suffolk County Mental Health Information Hotline
    (Located at Pilgrim Psychiatric Center, 24 Hour Hotline)
    952-3333
    Suicide, Suffolk County Mental Health Information Hotline 952-3333
    Response (Includes Suicide Hotline) 751-7500
    Islip hotline 277-4700
    Mobile Crisis Team (for Suffolk County)
    Located at Pilgrim Psychiatric Center, 10 am - 8 pm, 7 days/week
    952-3333
    Mobile Geriatric Team and Referrals at Pilgrim 952-3333
    Geriatric Community Services and Referrals, Patchogue 475-7108
    Sagamore Mobile Crisis Unit (will go to School/Home) 673-7701
    East and west End Teams, Children up to age 18 11 am - 7 pm Mon. - Fri.
    (Call Mental Health Hotline, after hours)
    Stony Brook University Medical Center And Medical Center
    CPEP - Comprehensive Psychiatric Emergency Program 444-6464
    All Ages, 24 Hours a Day 444-6365
    Emergency Room (Medical) 444-2465
    Psychiatric Unit, Adult 444-1051
    Psychiatric Unit, Children Ages 5-12 444-1251
    Nassau University Medical Center
    Emergency 516-572-0123
    ER 516-572-3311
    Mobile Crisis Unit 516-572-6419
    Psychiatric Unit 516-572-6115, 516-572-6116
    Children Crisis Team (Will go to School/Home) 516-681-0364
    Crisis Residence at Pilgrim Psychiatric Center
    Suffolk County/Nassau County
    Admitted 7 Days a Week, 24 Hours a day (17 beds for Out-Patients)
    761-2928, 761-2929
    Assisted Outpatient Treatment (AOT - Law) 853-6205, 853-3108
    Medication Info Pharmacy Director, 8-4:30 pm at Pilgrim PC 761-3515
    Out-patient or Emergency 761-3018, 952-3333
    DSS-Dept. of Soc. Services Emer. Medical (Medicaid) Medication 854-9100
    Voucher & Emer. Housing - Commissioner's Response Unit 854-9935
    Drug/Alcohol Abuse, Phoenix House 306-5724, 306-5710
    Suffolk County Mental hygiene Services, Alcohol & Substance Abuse 853-8500
    Family Crisis Support Group 941-3969, 476-9477, (516) 694-7327
    Ambulance Operator
    Escorted Police, or call local precinct 911


     

    For additional information, please call (631) 444-4000.