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Definition[edit]

Schizophrenia is a mental disorder, characterized by abnormal behavior, strange speech, and a decreased ability to understand reality.[1]

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Symptoms[edit]

Other symptoms of schizophrenia can include false beliefs, unclear (or confused) thinking, and hearing voices that do not exist. There may also be reduced social engagement, and a lack of motivation.[1][2]

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Associated mental health disorders[edit]

People with schizophrenia can also have additional mental health problems, such as anxiety, depression, or substance-use disorders.[3]

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Onset of symptoms[edit]

These symptoms typically come on gradually in young adulthood, and in many cases, they never resolve.[2][4] Males are also more likely to be affected than females and, on average, experience more severe symptoms.[1]

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Cause[edit]

Even though a combination of genetic, and environmental factors play a role in the development of schizophrenia,[5] family genetics has the largest impact. For instance, the chances of someone acquiring the disease, if they have a parent, child or sibling who has it, is six-and-a-half percent.[6]

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Environmental factors[edit]

Despite the impact of genetics, roughly 20% of the risk of the disease comes from environmental factors. These factors include, being raised in a city, certain infections, the age of a person's parents, cannabis use during adolescence, and poor nutrition during pregnancy.[5][7]

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Genetic factors[edit]

The genetics of schizophrenia is equally complex. There are many rare genetic variants[8] known to be involved in schizophrenia, each with a small effect, and an unknown risk of transmission to children.[8][9]

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Diagnosis[edit]

Diagnosis is based on observed behavior, the person's reported experiences, and reports of others familiar with the person.[4] During diagnosis, a person's culture must also be taken into account.[4] As of 2013, there is no objective test.[4]

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Confusion with dissociative identity disorder[edit]

Schizophrenia does not imply a "split personality", or dissociative identity disorder. The two are often confused in public perception, but are separate illnesses.[6]

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Treatment[edit]

The mainstay of treatment is anti-psychotic medication, along with counselling, job training, and social rehabilitation.[1][5]

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Antipsychotic medication[edit]

When medication is used, it is unclear whether typical, or atypical anti-psychotics are better.[10]

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Additional medication[edit]

If a person's disease is not well controlled with anti-psychotics alone, then clozapine may also be tried.[5]

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Hospitalizations[edit]

In more serious situations, where there is a risk to themselves or others, involuntary hospitalization may be necessary. With modern treatments, admissions to hospital are now shorter, and less frequent than they once were.[11]

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Epidemiology[edit]

About 0.3 to 0.7% of people are affected by schizophrenia during their lifetimes,[12] and in 2013, there were an estimated 23.6 million cases globally.[13]

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Social effects[edit]

Unfortunately, few people with schizophrenia recover completely[4], and 50% will have a life-long impairment[14]. Because of this disability, social problems such as long-term unemployment, poverty, and homelessness, are common. [4][15]

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Prognosis[edit]

Schizophrenia also lowers life expectancy, [16] because of the increased risk of suicide.[12][17] In 2015, an estimated 17,000 people worldwide died from behavior related to, or caused by, schizophrenia.[18]

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References[edit]

  1. ^ a b c d "Schizophrenia Fact sheet N°397". WHO. September 2015. Archived from the original on 18 October 2016. Retrieved 3 February 2016.
  2. ^ a b "Schizophrenia". National Institute of Mental Health. January 2016. Archived from the original on 25 November 2016. Retrieved 3 February 2016.
  3. ^ Buckley PF, Miller BJ, Lehrer DS, Castle DJ (March 2009). "Psychiatric comorbidities and schizophrenia". Schizophrenia Bulletin. 35 (2): 383–402. doi:10.1093/schbul/sbn135. PMC 2659306. PMID 19011234.
  4. ^ a b c d e f American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington: American Psychiatric Publishing. pp. 101–05. ISBN 978-0-89042-555-8.
  5. ^ a b c d Owen MJ, Sawa A, Mortensen PB (July 2016). "Schizophrenia". Lancet. 388 (10039): 86–97. doi:10.1016/S0140-6736(15)01121-6. PMC 4940219. PMID 26777917.
  6. ^ a b Picchioni MM, Murray RM (July 2007). "Schizophrenia". BMJ. 335 (7610): 91–5. doi:10.1136/bmj.39227.616447.BE. PMC 1914490. PMID 17626963.
  7. ^ Parakh P, Basu D (August 2013). "Cannabis and psychosis: have we found the missing links?". Asian Journal of Psychiatry (Review). 6 (4): 281–7. doi:10.1016/j.ajp.2013.03.012. PMID 23810133. Cannabis acts as a component cause of psychosis, that is, it increases the risk of psychosis in people with certain genetic or environmental vulnerabilities, though by itself, it is neither a sufficient nor a necessary cause of psychosis.
  8. ^ a b Kavanagh DH, Tansey KE, O'Donovan MC, Owen MJ (February 2015). "Schizophrenia genetics: emerging themes for a complex disorder". Molecular Psychiatry. 20 (1): 72–6. doi:10.1038/mp.2014.148. PMID 25385368.
  9. ^ Schork AJ, Wang Y, Thompson WK, Dale AM, Andreassen OA (February 2016). "New statistical approaches exploit the polygenic architecture of schizophrenia--implications for the underlying neurobiology". Current Opinion in Neurobiology. 36: 89–98. doi:10.1016/j.conb.2015.10.008. PMC 5380793. PMID 26555806.
  10. ^ Kane JM, Correll CU (2010). "Pharmacologic treatment of schizophrenia". Dialogues in Clinical Neuroscience. 12 (3): 345–57. PMC 3085113. PMID 20954430.
  11. ^ Becker T, Kilian R (2006). "Psychiatric services for people with severe mental illness across western Europe: what can be generalized from current knowledge about differences in provision, costs and outcomes of mental health care?". Acta Psychiatrica Scandinavica. Supplementum. 113 (429): 9–16. doi:10.1111/j.1600-0447.2005.00711.x. PMID 16445476.
  12. ^ a b van Os J, Kapur S (August 2009). "Schizophrenia" (PDF). Lancet. 374 (9690): 635–45. doi:10.1016/S0140-6736(09)60995-8. PMID 19700006. Archived from the original (PDF) on 23 June 2013. Retrieved 23 December 2011.
  13. ^ Global Burden of Disease Study 2013 Collaborators (August 2015). "Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013". Lancet. 386 (9995): 743–800. doi:10.1016/S0140-6736(15)60692-4. PMC 4561509. PMID 26063472.
  14. ^ Lawrence RE, First MB, Lieberman JA (2015). "Chapter 48: Schizophrenia and Other Psychoses". In Tasman A, Kay J, Lieberman JA, First MB, Riba MB (eds.). Psychiatry (fourth ed.). John Wiley & Sons, Ltd. pp. 798, 816, 819. doi:10.1002/9781118753378.ch48. ISBN 978-1-118-84547-9.
  15. ^ Foster A, Gable J, Buckley J (September 2012). "Homelessness in schizophrenia". The Psychiatric Clinics of North America. 35 (3): 717–34. doi:10.1016/j.psc.2012.06.010. PMID 22929875.
  16. ^ Laursen TM, Munk-Olsen T, Vestergaard M (March 2012). "Life expectancy and cardiovascular mortality in persons with schizophrenia". Current Opinion in Psychiatry. 25 (2): 83–8. doi:10.1097/YCO.0b013e32835035ca. PMID 22249081.
  17. ^ Hor K, Taylor M (November 2010). "Suicide and schizophrenia: a systematic review of rates and risk factors". Journal of Psychopharmacology. 24 (4 Suppl): 81–90. doi:10.1177/1359786810385490. PMC 2951591. PMID 20923923.
  18. ^ GBD 2015 Mortality and Causes of Death Collaborators (October 2016). "Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet. 388 (10053): 1459–1544. doi:10.1016/s0140-6736(16)31012-1. PMC 5388903. PMID 27733281.