What is Schizophrenia? Symptoms, Causes, and Risk Factors

Schizophrenia is a chronic and disabling mental illness that impacts one’s perceptions and interactions. Everyday life becomes a challenge due to its debilitating symptoms, and it can be just as distressing for family and friends. Fortunately, those who receive treatment can often achieve independence in their daily activities, enjoy personal relationships, and continue going to school and engaging in work.

Prevalence

In 2020, researchers estimated that this chronic neurological brain disorder affected 1.1% of the population, approximately 2.8 million adults in the United States aged 18 or older. While schizophrenia is less common than some other mental disorders, worldwide it is one of the top 15 leading causes of disability.

Other facts about schizophrenia's prevalence include:

• Almost 49% of this illness goes untreated.
• Twenty-four million people or 1 in 300 individuals (32%) are affected by schizophrenia worldwide.
• The overall prevalence rate is 1 in 222 people (0.45%) among adults. Those with schizophrenia have a higher rate of suicide than the general population with the highest risk in the early phases of the illness.

Positive symptoms

“Positive“ symptoms are signs the individual has lost touch with reality and include distorted or exaggerated ideas or perceptions.

Symptoms include:

Delusions

A belief or altered sense of reality. A person may have an irrational belief that people on TV are sending special messages to them, or they believe they are God. Hearing voices is most frequent.

Hallucinations

Hearing, seeing, feeling, tasting, or smelling something that is not there.

Confusion and disorganized thoughts

Those with schizophrenia lose the ability to sort out and interpret incoming sensations and information and respond appropriately. They may have a hard time following a conversation or responding in a way that makes sense. They may have unusual or illogical thoughts and trouble putting cohesive thoughts together. They may stop in the middle of a sentence; speech may be irrelevant to the topic, or they may make up words that have no meaning.

Lack of concentration

An inability to focus or follow along with books or TV shows.

Movement changes

Sometimes, they may be agitated and jumpy, while other times they sit perfectly still, in a catatonic state, for hours.

Negative symptoms

“Negative” symptoms refer to disruptions with normal emotions and behaviors, leading to decreased mental function surrounding thoughts, actions, and perceptions.

Symptoms can include:

• A flattening effect: Little to no emotions in their facial expression or a dull tone of voice is displayed.
• Reduced energy and decreased motivation.
• A decrease in pleasure: Those with schizophrenia experience less joy and satisfaction in everyday activities.
• Difficulty starting and sustaining, such as successfully having daily conversations.
• Avoiding social interactions or being socially awkward.
• Engaging only in passive activities.
• An inability to perform daily activities, such as planning and sticking to activities, such as grocery shopping.

Many with schizophrenia have problems with cognitive activities ranging from subtle to severe. These problems can include problems with their:

• Attention span
• Working memory
• Learning, verbal, and visual memory
• Processing speed, which is the ability to use newly-learned information
• Executive functioning, the ability to reason, problem-solve, and make decisions

Types of Schizophrenia

There are several subtypes of schizophrenia. These include:

Paranoid schizophrenia

One of the most common forms is characterized by delusions, hallucinations, disorganized speech, behavioral problems, and difficulty focusing and comprehending.

Hebephrenic schizophrenia

Symptoms include disorganized thinking and speech, and forgetfulness. Others include difficulty making sense of sounds, sights, and feelings, writing to an extreme extent without any meaning, repeating gestures and movements, such as pacing, problems with decision-making, slowing of movement, and inappropriate emotional responses. Hallucinations and delusions are not present with this form of the disorder.

Undifferentiated schizophrenia

Occurs when a person with schizophrenia has features from more than one kind of schizophrenia. An example would be a combination of hallucinations and slow movements.

Residual schizophrenia

This involves an individual who once had schizophrenia but now has only minor symptoms to a lesser degree. This form has an absence of normal behavior or negative symptoms such as lack of emotion, fatigue, speaking less, and withdrawal from social activities. Other characteristics include loss of interest or a lack of pleasure in life, lack of motivation, and poor grooming and hygiene habits.

Catatonic schizophrenia

The hallmark characteristic is mutism, which is the refusal or unwillingness to speak. It also may feature a stupor type of state, bodily rigidity, and a tendency for limbs to stay in the same position as placed. This can last for hours or even days if left untreated.

Simple schizophrenia

This version's negative symptoms, including poor memory, concentration, and hygiene, in addition to slow movements, are most noticeable in the early stages of the disorder and continue to worsen. There are rarely positive symptoms.

Cenesthopathic schizophrenia

The primary symptom is experiencing unusual body sensations.

Unspecified schizophrenia

Schizophrenia is diagnosed but doesn't fall into one of the listed categories.

Risk factors

Researchers have yet to determine the precise cause of schizophrenia. There are several risk factors linked to the illness, including:

Genetics

Schizophrenia can be hereditary, although one family member having it does not automatically mean others also will. One of the most significant risk factors, researchers have yet to link a specific gene to the illness.

Environment

Living in stressful or dangerous surroundings, poverty, and exposure to nutritional issues or viruses before birth can play a role in causing the disorder.

Brain chemistry

Differences in the size of brain areas and connections within these areas demonstrate a difference between people with and without schizophrenia. Structural and chemical changes may be present.

Other risk factors include drug abuse during adolescence and young adulthood, an older father, immune system abnormalities, and complications during birth and pregnancy.

Getting help

For those seeking help to treat schizophrenia, many programs and services are available to help. Resources include:

• The National Alliance on Mental Illness (NAMI). This organization has an information helpline (800-950-NAMI), treatment programs, and referral services.
• The Treatment Advocacy Center.
• Your healthcare provider.
• Support groups through psychiatric hospitals, clinics, and colleges.

If you or a loved one are showing signs of schizophrenia, it’s important to seek help to receive a diagnosis and treatment options.