Schizophrenia

What is schizophrenia?
Schizophrenia is a serious, long-term mental illness. It can make you lose touch with reality. You can usually keep the symptoms under control by taking medications. But you'll probably have some symptoms that don't go away. You will probably also have times when all your symptoms come back (doctors call this a relapse).
If you have schizophrenia, your brain works differently to other people's brains. This affects your thoughts, emotions and
the way you behave. You may go through periods when you find it hard to figure out what's really happening and what you are
imagining. Doctors call this psychosis.
If you have schizophrenia, you may lose touch with reality, and have beliefs that couldn't be true (delusions) and imaginary experiences that seem real (hallucinations).
- Schizophrenia symptoms can cause you problems because they make you behave differently from how you normally would.
- There is no cure for schizophrenia. But long-term treatment with antipsychotics can help control your symptoms.
Source:
Thornley B, Adams CE, Awad G.
Chlorpromazine versus placebo for those with schizophrenia (Cochrane review).
In: The Cochrane Library. Wiley, Chichester, UK.
1Source:
Joy CB, Adams CE, Lawrie SM.
Haloperidol versus placebo for schizophrenia (Cochrane review).
In: The Cochrane Library. Wiley, Chichester, UK.
2 - Being treated with antipsychotics allows many people with schizophrenia to lead independent lives.
- Antipsychotics all have side effects. But you can work with your doctor to try and stop side effects from becoming a problem.
To understand what happens in schizophrenia, it's useful to know how your brain works.
Your brain controls everything you do. Your brain allows you to think, to speak, to move your body and remember things. It's
also responsible for the things your body does automatically, such as breathing and digesting food.
Your brain is made up of billions of nerve cells that share information with each other. These cells are organized in chains. They are not actually joined together, but they
sit close to each other with a space between them called a synapse.
Nerve cells allow your brain to receive, process and send information.
- Tiny electrical signals travel from one nerve cell to the next with the help of chemicals called
neurotransmitters
Neurotransmitters are chemicals that help to carry messages between nerve cells. Serotonin, dopamine and noradrenaline are all neurotransmitters.neurotransmitters. - To reach nerve cells throughout your body, these electrical signals travel from your brain to your spinal cord. This is a tube of nerves that runs down your back from your brain. It sits inside the bones that make up your spine.
- Once an electrical signal reaches your spinal cord, it can then travel along nerves to your arms, legs and elsewhere in your body.
Other areas are responsible for matching up and comparing the information you receive from the outside world with your memories.
This is how we experience our moods and emotions, such as pleasure, fear or anger.
No one fully understands what causes schizophrenia. But you might find it helpful to know some of the theories that doctors
and researchers have about why people have schizophrenia.

Most people with schizophrenia can keep their symptoms under control with medication.
Doctors think that people with schizophrenia have different levels of neurotransmitters than other people.
3 Drugs can be used to change the levels of neurotransmitters in people's brains. Some of the drugs that work for schizophrenia
reduce the amount of the neurotransmitter
dopamine.
Source:
Mueser KT, McGurk SR.
Schizophrenia.
Lancet. 2004; 363: 2063.
Mueser KT, McGurk SR.
Schizophrenia.
Lancet. 2004; 363: 2063.
dopamine
Dopamine is a neurotransmitter, which is a chemical that helps messages pass between brain cells and other cells. Dopamine plays a role in your mood, and your physical movements.
Dopamine is a neurotransmitter, which is a chemical that helps messages pass between brain cells and other cells. Dopamine plays a role in your mood, and your physical movements.
Doctors also think that if you have schizophrenia, some parts of your brain are not working normally and that the different
parts can't communicate with each other properly.
4 Brain scans show that some people with schizophrenia have slightly different brains compared to people who don't have schizophrenia.
3
Source:
Andreasen NC.
Symptoms, signs and diagnosis of schizophrenia.
Lancet. 1995; 346: 477-481.
Andreasen NC.
Symptoms, signs and diagnosis of schizophrenia.
Lancet. 1995; 346: 477-481.
Source:
Mueser KT, McGurk SR.
Schizophrenia.
Lancet. 2004; 363: 2063.
Mueser KT, McGurk SR.
Schizophrenia.
Lancet. 2004; 363: 2063.
If parts of your brain can't communicate properly, or if some areas of your brain aren't working in the way they should, your
brain will have trouble dealing with information. When your brain can't deal with information properly, your understanding
of the world can change a lot. It may be hard to know what's real and what isn't. You may get symptoms like hearing voices
that aren't really there.
Your thoughts and emotions depend on what you think is happening around you. If you have schizophrenia it can have a big effect
on the way you think and the way you feel. Having schizophrenia can make you isolated and lonely. Some of the symptoms can
be very frightening. And it can be hard to get on with normal life when you have trouble working out what is real and what
isn't.
Before drugs called antipsychotics were introduced to treat schizophrenia in the 1950s, many people with schizophrenia spent
years in the hospital. However, with antipsychotics (and the other treatments now available that help people deal with schizophrenia),
most people can keep their symptoms under control most of the time. Now, with help, people with schizophrenia have a much
better chance of living active lives, outside the hospital.
5
Source:
Johnstone EC.
Schizophrenia: problems in clinical practice.
Lancet. 1993; 341: 536-538.
Johnstone EC.
Schizophrenia: problems in clinical practice.
Lancet. 1993; 341: 536-538.
It's very important to have good support from your doctors, and from friends and family. But schizophrenia puts a big strain
on the people who care for you. It can be hard to have good relationships with other people, because of the way schizophrenia
makes you feel and behave.
You may want to share the information on these pages with your close friends and family. It may help them to understand what
you're going through and why you behave the way you do.
There are a lot of myths and misunderstandings about schizophrenia. Some people think it means you have a split personality.
That isn't true. And, some people think having schizophrenia means you will behave in a violent or dangerous way. It's true
that some people may be violent when they are having schizophrenia symptoms. But most people with schizophrenia do not harm
other people.
6
Source:
Swanson JW, Swartz MS, Van Dorn RA, et al.
National study of violent behavior in persons with schizophrenia.
Archives of General Psychiatry. 2006; 63: 490-499.
Swanson JW, Swartz MS, Van Dorn RA, et al.
National study of violent behavior in persons with schizophrenia.
Archives of General Psychiatry. 2006; 63: 490-499.
These myths and misunderstandings can make life even more difficult for people with schizophrenia.
Doctors don't know for certain why some people have schizophrenia. But, if you have a close relative with schizophrenia, you
are more likely to have it yourself. Schizophrenia seems to run in families. But not everyone who has close relatives with
schizophrenia gets it themselves.
- If you don't have a relative with schizophrenia, your chances of getting it are 1 in 100.
Source:
Cannon M, Jones P.
Neuroepidemiology: schizophrenia.
Journal of Neurology, Neurosurgery, and Psychiatry. 1996;61:604-613.
7 - If you have a close relative (a parent, a brother or a sister) with schizophrenia, your chances of developing it yourself are about 1 in 10.
Source:
Cannon M, Jones P.
Neuroepidemiology: schizophrenia.
Journal of Neurology, Neurosurgery, and Psychiatry. 1996;61:604-613.
7 - The chances are even higher if you have an identical twin who has schizophrenia. If your twin has schizophrenia, the chances that you will have it are nearly 1 in 2.
Source:
Cannon M, Jones P.
Neuroepidemiology: schizophrenia.
Journal of Neurology, Neurosurgery, and Psychiatry. 1996;61:604-613.
7
genes
Your genes are the parts of your cells that contain instructions for how your body works. Genes are housed on chromosomes, structures that sit in the nucleus at the middle of each of your cells. You have 23 pairs of chromosomes in your normal cells, each of which has thousands of genes. You get one set of chromosomes, and all of the genes that are on them, from each of your parents.
Your genes are the parts of your cells that contain instructions for how your body works. Genes are housed on chromosomes, structures that sit in the nucleus at the middle of each of your cells. You have 23 pairs of chromosomes in your normal cells, each of which has thousands of genes. You get one set of chromosomes, and all of the genes that are on them, from each of your parents.
Some studies have shown that you may be more likely to get schizophrenia if you:
7
Source:
Cannon M, Jones P.
Neuroepidemiology: schizophrenia.
Journal of Neurology, Neurosurgery, and Psychiatry. 1996;61:604-613.
Cannon M, Jones P.
Neuroepidemiology: schizophrenia.
Journal of Neurology, Neurosurgery, and Psychiatry. 1996;61:604-613.
- Didn't get enough nutrients as you were growing in your mother's uterus
- Had a difficult birth. For example, if you didn't get enough oxygen while your mother was in labor
- Were slow to develop as a baby or young child. For example, if you learned to walk or talk later than expected
- Were born in a city, rather than the countryside
- Were born in winter or early spring
- Were born to a mother who had an infection like flu when she was pregnant
- Had parents who were immigrants
- Smoke a lot of marijuana.
Source:
Mueser KT, McGurk SR.
Schizophrenia.
Lancet. 2004; 363: 2063.
Mueser KT, McGurk SR.
Schizophrenia.
Lancet. 2004; 363: 2063.
Things that can bring on symptoms include:
3
Source:
Mueser KT, McGurk SR.
Schizophrenia.
Lancet. 2004; 363: 2063.
Mueser KT, McGurk SR.
Schizophrenia.
Lancet. 2004; 363: 2063.
- Being under lots of stress from studying or working, or because of family or relationship problems
- Being isolated, with little or no social support from friends and family
- Using drugs or alcohol
- Stopping your antipsychotics.
Sources for the information on this page:
- Thornley B, Adams CE, Awad G.Chlorpromazine versus placebo for those with schizophrenia (Cochrane review).In: The Cochrane Library. Wiley, Chichester, UK.
- Joy CB, Adams CE, Lawrie SM.Haloperidol versus placebo for schizophrenia (Cochrane review).In: The Cochrane Library. Wiley, Chichester, UK.
- Mueser KT, McGurk SR.Schizophrenia.Lancet. 2004; 363: 2063.
- Andreasen NC.Symptoms, signs and diagnosis of schizophrenia.Lancet. 1995; 346: 477-481.
- Johnstone EC.Schizophrenia: problems in clinical practice.Lancet. 1993; 341: 536-538.
- Swanson JW, Swartz MS, Van Dorn RA, et al.National study of violent behavior in persons with schizophrenia.Archives of General Psychiatry. 2006; 63: 490-499.
- Cannon M, Jones P.Neuroepidemiology: schizophrenia.Journal of Neurology, Neurosurgery, and Psychiatry. 1996;61:604-613.
This information was last updated on Nov 06, 2008
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© BMJ Publishing Group Limited 2009. All rights reserved.
© BMJ Publishing Group Limited 2009. All rights reserved.
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