Schizophrenia

Schizophrenia or psychosis is a chronic mental illness that evolves into outbreaks with intervals of apparent normality. It is a relatively rare disease, but in many cases it can present serious characteristics. In this disease, the patient has a disorder of the interpretation of reality, whereby:

• Perceive things that are not there (hallucinations) and / or
• Misinterprets reality (delusion)

Thus, schizophrenia is characterized by an abnormal connection of the patient with reality; In this disease, the patient presents a disorganization of thought that makes him think and act in an abnormal and disorganized way.

How is it produced?

Characteristic differences have been found in the concentration of some neurotransmitters in certain areas of the brain in schizophrenic patients, which could be the origin of disorganized thinking in these patients.

This condition has no known cause, although some risk factors for suffering from it have been determined:

• Family factors: unstructured families, with little affection and excessive criticism towards their children, ambiguity in rewards and punishments; They are families in which the children can hardly mature in an autonomous and safe way: in this typology of families the incidence of schizophrenia is more important than in families with different characteristics.
• The use of hallucinogenic drugs
• Severe neurological diseases
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• Poor social insertion and deficit of social relations

Symptoms

Generally, the first schizophrenic outbreak occurs during adolescence or early youth. Late-onset cases also occur, but are less frequent. The onset may appear as a decrease in the patient's intellectual or school performance, which adds to it a loss or abandonment of social relationships. The patient usually presents what are known as positive symptoms, which include hallucinations and / or delusions:

• Hallucinations: the patient perceives stimuli that do not exist (hears unknown voices or voices of people who are not present, sees things that do not exist, etc.).
• Delusions: the patient interprets the real events in an abnormal way, very often as if they were against him (paranoia or delusional disorder); Thus, he can be convinced that television talks about him or talks to him, that all the people who pass by on the street look at him or watch him or threaten him, etc.

Typically, the patient is convinced that what he sees, hears or interprets is reality, and it is very difficult to make him think that he is in error. For this reason, schizophrenia is a disorder of the interpretation of reality, which is distinguished from other mental illnesses that occur with hallucinations in which the patient understands that the hallucinatory content does not exist and is a hallucination, and in which the structure of the thought remains intact.

The negative symptoms that patients with schizophrenia present usually affect the social sphere and the personal sphere:

• Difficulty expressing emotions.
• Suspicion or a feeling of threat (paranoia or delusional disorder).
• Limited language in the content, both in words and in conversation topics.
• Social isolation, which appears in a progressive way.

The patient with schizophrenia is rarely dangerous, and generally does not pose a danger to other people. Generally, schizophrenia or psychosis usually presents three stages or phases:

• Prodrome phase: the patient begins to present the first personality changes, gradually abandons social relationships, withdraws, is irritable and passive.
• Psychotic phase: in this phase is where the typical clinic of loss of contact with reality takes place. Delusions and hallucinations and alterations of thought, language and behavior appear.
• Residual phase: in this phase the patient does not present the typical positive symptoms, but appears withdrawn, with poor language, with very few social relationships and strange thoughts and behaviors.

Diagnosis

The diagnosis of schizophrenia is clinical, and no markers have been described in the complementary examinations that can help the diagnosis. In any case, a physical examination and some analytical and radioimaging examinations are recommended in cases in which the possibility of drug addiction, structural pathology, or intercurrent diseases is suspected. There are tests and diagnostic criteria defined for this disease that assess the diagnosis and evolution of patients. Some factors, if present, are considered to be a poor prognosis for the effectiveness of the treatment:

• Family history of close relatives with schizophrenia.
• Early onset with no apparent precipitating factors.
• Bad social adaptation and definitive loss of social relationships.
• Association with other neurological or psychiatric diseases.
• Prolonged clinic, long evolution of the outbreaks, frequent relapses.

Treatment

The treatment of schizophrenia is carried out through specific drugs that try to compensate for imbalances in the patient's brain neurotransmitters. Psychotherapy is also usually necessary and convenient as an adjunct to drug therapy. However, and due to the destructuring of thinking characteristic of this disease, the patient often does not want to go to the professional and / or does not follow the appropriate treatment. For this reason, continuous monitoring and the collaboration of the patient's family and relatives are usually essential for the long-term maintenance of the patients' balance.

Precautionary measures

The prevention of schizophrenia is very difficult, although the avoidance of external factors that may contribute to the onset of the disease can be recommended: maintaining the structure and balance and behavior of social relationships, avoiding the consumption of drugs, narcotics and psychotropic drugs in an inappropriate way.