Some important facts:
- The World Health Organization estimates that 450 million people worldwide are affected by mental, neurological or behavioural problems at any time. It is estimated that 10 million Indians suffer from mental health problems.
- People with mental disorders are often subjected to social isolation, poor quality of life and increased mortality. These disorders are the cause of staggering economic and social costs.
- Cost-effective treatments exist for most disorders and, if correctly applied, could enable most of those affected to become functioning members of society.
- Barriers to effective treatment of mental illness include lack of recognition of the seriousness of mental illness and lack of understanding about the benefits of services. Policy makers, health and labour policies, and the public at large – all discriminate between physical and mental problems.
Research has shown that people with schizophrenia who attend structured psychosocial rehabilitation programs and continue with their medical treatment manage their illnesses the best. Richmond Fellowship Society (India) in all its branches follows a structured programme of psychosocial rehabilitation with our clients. Various professionally evaluated systems are adopted to provide proper care and services to the residents. Regular therapy sessions are conducted by trained counselors. Care givers meetings are held regularly. Psychiatrists, psychologists and other mental health professionals are invited to address such meetings.
The outlook for those suffering from this once dreaded disorder is better today than ever, and is actually better than for many other medical diseases.
- Schizophrenia is a medical illness and is acknowledged the world over by the experts, as a brain disorder. It distorts the senses, making it very difficult for the individual to distinguish between the real and not real.
- It normally occurs during the most productive ages – between 15 & 35 years – and can also affect children and the elderly. The usual age of onset is between 16 – 20 years.
- Schizophrenia can be treated successfully. With the drugs available today and if the treatment is started early, 80 per cent of the patients make steady recovery within 2 – 4 weeks and they can go back to their studies or jobs. The cost of drugs may be as low as Rs 2/- Rs 4/- per day in India.
- Schizophrenia is not infectious. It does not spread by talking to patients or eating and mixing with them. In fact these patients need affection.
- It is not true that the persons with schizophrenia will be violent. Violence/ disruptive behaviour are more frequently seen among normal people than with those suffering from schizophrenia. According to the Bureau of Police and Criminal record, the crimes committed by mentally ill patients are rare.
What are the symptoms of Schizophrenia?
The onset of schizophrenia is not sudden but gradual. There are several key symptoms through which schizophrenia can be diagnosed. Deterioration is usually observed in:
- Work or academic activities
- Relationships with others
- Personal care and hygiene
Delusions are patients fixed belief in something that is obviously untrue. They may believe that they are being persecuted, that people are conspiring against them at work or at home; they may suspect their spouse of infidelity and may take to watching them constantly; they may believe that their thoughts are being controlled by some external force, e.g. that a radio receiver is planted in their head. This belief will not be shaken by attempts to reason with them.
Hallucinations are imaginary voices which the patient hear and respond to. They are seen apparently talking to themselves in a disjointed way, often laughing, gesticulating or smiling. These voices can be distressing and can sometimes control the patients. Often, the patients see frightening figures and their fear may make it difficult for others to control them. They could even be driven to suicide.
Schizophrenia is often characterised by disturbances in thinking – this may be reflected in incoherent and irrelevant speech. The patients may also report that their thoughts are muddled, are withdrawn by somebody else or that other people get to know what they are thinking.
The patients may also believe that thoughts are inserted into their mind.Most common signs:-
- Deterioration of personal hygiene
- Social withdrawal, isolation and reclusiveness
- Irrational statements
- Sleeping excessively or inability to sleep
- Deterioration of social relationships
- Bizarre behavior
- Inability to concentrate or to cope with minor problems
- Extreme preoccupation with religion or with the occult
- Inability to express emotions
- Dropping out of activities
It is well known that schizophrenia can lead to shortcomings in intellectual functioning, such as lapses in attention, concentration, concept formation, reasoning and problem-solving. These shortcomings not only interfere with daily activities, but can also affect the patient’s performance at the workplace.
Treatment of schizophrenia:
Though the real cause or causes of schizophrenia remain unclear this has not prevented the development of safe and effective therapeutic interventions and treatments. The discovery of phenothiazenes in 1951 revolutionised treatment and outcomes, especially when drug therapy was instituted early in the disease. This breakthrough led to the closure of many large custodial mental hospitals in the western world. Treatment within the community became the norm and led to the development of general hospital psychiatry on a large scale. In the half century since, psychopharmacology has made rapid strides especially with the advent of Second Generation Anti-psychotics (SGAs) like Clozajnine, Risperidone, Olanzapine, Quetiapine, Ziprazidone, Aripiprazole and Amisulpiride. Relatively much safer and more patient-friendly with regard to their side-effect profile, most of these newer medications are taken once a day (usually at bedtime) and do not interfere with vocational or other activities. Cost wise also they are generally affordable. These medicines can cause weight to increase. This brings with it problems such as increased chances of diabetes and other metabolic illnesses. What causes schizophrenia? Schizophrenia has a biological basis in the form of disturbances in the brain structure and chemicals and functioning, but it manifestations are largely behavioural, with enormous social ramifications. Various hypotheses have been advanced to explain the causes of schizophrenia and a number of risk factors have been implicated, but the real cause or causes still remain unclear.
There is a strong evidence to suggest a genetic basis, though the exact location of the gene/genes and mode of transmission has not yet been determined. Schizophrenia does appear more regularly in some families. Then again, many people with schizophrenia have no family history of the illness.
Stress does not cause schizophrenia. However, it has been shown that stress makes symptoms worse when the illness is already present.
Drugs (including alcohol, tobacco and street drugs) themselves do not cause schizophrenia. However, certain drugs can make symptoms worse or trigger a psychotic episode if a person already has schizophrenia. Drugs can also create schizophrenia-like symptoms in otherwise healthy individuals.