"It is essential that parents, teachers, community groups and the general public make conscious efforts to move past fears and misconceptions." George Wilson, M.D.
By: Lorraine Seabroook with Dr. George Wilson
Unless you know someone who suffers with schizophrenia, you may have just a passing knowledge of this mental health condition. Many physicians and researchers are hoping to change the public’s perception, increase understanding and reduce stigmatization.
According to the National Institute of Mental Health (NIMH), schizophrenia is a chronic, severe, and disabling brain disease that affects approximately 1 percent of the population, or more than 2 million Americans, in any given year. The condition affects both genders equally, although the disorder typically appears earlier in a man’s life (teens/early 20s) than in woman’s (20s/early 30s).
George Wilson, M.D., psychiatrist at Princeton House Behavioral Health, part of the Princeton Healthcare System, wants you to know that you can play a significant role in helping people with schizophrenia by educating yourself about the condition and doing your part to reduce the stigma associated with it.
Dr. Wilson explains that it is essential that parents, teachers, community groups and the general public make conscious efforts to move past the fears and misconceptions behind the stigma so that they can assist young people at risk for developing the illness. All too often, teachers miss early warning signs out of ignorance and family members may ignore symptoms or delay treatment out of fear.
However, early intervention can make all the difference in the lives of those who are developing schizophrenia; without prompt and effective treatment, the illness leads to deterioration of brain functions with resulting mental and emotional disturbances which adversely affect all aspects of the person over a lifetime.
At the turn of the 20th century, schizophrenia was first identified as premature onset dementia due to an unknown medical illness. As more research was conducted and treatments were developed, schizophrenia came to be understood as a brain disease with a strong genetic vulnerability which is triggered by a variety of physical or psychological stresses.
Unfortunately, later in the 20th century, the new field of psychoanalysis mistakenly described schizophrenia as a reaction to early childhood loss or deprivation, and the responsibility was inappropriately attributed to the patient’s mother. This misconception caused undue distress to patients and families and it delayed effective treatment for some patients.
In the past three decades, psychiatry and psychology have returned to a biological model of etiology for schizophrenia and changed the practice of therapy to a rehabilitation model.
Exactly what causes schizophrenia is unknown, but it is known that schizophrenia runs in families. Psychiatrists know that genetic factors create a predisposition to developing the condition, and it appears likely that multiple genes are involved. Because multiple genes are involved, the condition cannot yet be predicted and no biological test or genetic map is yet available to confirm the disease or the risk of developing it.
Those with the highest risk are identical twins; if one twin develops schizophrenia, the other twin has at least a 50 percent chance of also developing it. If a parent has schizophrenia, the child has about a 15 percent chance. By comparison, about 1 percent of the general population is considered at risk.
The facts about genetic transmission, especially with identical twins, show that the genetic vulnerability is only half the explanation. Other influences such as intrauterine infection or malnutrition, perinatal complications, and childhood infections appear to be involved in some cases, and other as yet-undiscovered stresses are involved in other cases. The NIMH notes that people who have a close relative with schizophrenia are more likely to develop the disorder than are people who have no relatives with the illness.
Those who experience the onset of symptoms of schizophrenia describe hearing voices, believe that their minds and thoughts are being controlled by others, find themselves unable to discern what is real and what is unreal, and may feel that others are conspiring to harm them.
These psychotic symptoms of the acute phase of schizophrenia often result in confusing and bizarre changes in behavior such as disorganized or incomprehensible speech, odd mannerisms, severe anxiety, or accusations toward others based on paranoid ideas known as delusions. However, other less obvious symptoms such as withdrawal from family, social isolation from friends, depression, or loss of interest in school and work usually precede the acute psychotic symptoms by weeks or months.
Dr. Wilson lists the following signs that parents and teachers should be aware of:
* Preoccupation with excessively abstract thoughts or with ideas of the occult or magic;
* Suspiciousness and distrustfulness;
* Development of irritability and anger outbursts;
* Identification by peers as being strange, and
* A tendency to pay more attention to internal thought processes than other people or external situations.
A history of mental illness in the extended family may provide an additional clue to the diagnosis. If these signs appear, parents must take immediate action and not chalk up these changes to adolescent behavior. These early signs of schizophrenia may appear to overlap with symptoms of bipolar disorder, which also begins in adolescence and even in pre-teens.
For bipolar children, mood swings are the predominant issue and they are less likely to have bizarre thought processes and can usually maintain better contact with family or peers. Likewise, substance abuse may mimic symptoms of both schizophrenia and bipolar disorder, and treatment of addiction may be needed before an accurate diagnosis is made.
Recent research, conducted initially in Great Britain and now in the United States, shows that it is good practice to focus on children whose parents, grandparents or siblings have schizophrenia and to look for precursor symptoms or behavioral changes. When these signs are present in adolescents and early teens, treatment with low-dose antipsychotic medication can prevent development of the acute psychotic phase, which can avoid the progression of the disease and its serious emotional and social consequences.