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Central nervous system
Schizophrenia is a mental illness that affects about one in a hundred people. It occurs equally in men and women and most frequently first affects those between late teens and early twenties.
It appears that several different things may contribute to schizophrenia, rather than it being due to just a single cause. About 1 in 10 people with schizophrenia have a parent with the illness, and although there is no direct link, it would appear that the person’s genetic make-up makes them more susceptible to things that trigger the illness. In others, brain damage caused during childbirth or through a viral infection during pregnancy may be responsible for the illness.

External factors that may trigger an episode of schizophrenia include stressful life events and drug or alcohol misuse. There is now strong evidence to suggest that smoking cannabis, particularly the more potent variety known as skunk, doubles the risk of someone developing schizophrenia, especially if the drug is smoked during the person’s teenage years or is smoked regularly.
The symptoms of schizophrenia can be divided into two groups - positive and negative.

Positive symptoms include hallucinations, the most common of which are hearing voices. A person with schizophrenia will hear his own thoughts as if they have been spoken out loud by someone else. Other hallucinations will include sensations of smell, sight, size or touch, but there is nothing physical to account for them. A person who experiences hallucinations will naturally attempt to find an explanation for what is happening and these explanations appear to the outside world as delusions. Other positive symptoms include thought disorders, restlessness, irrational behaviour and mood swings.

Negative symptoms include slowness to move, think, speak or react. The person may lack concentration, emotion and motivation and becomes socially withdrawn.

Positive and negative symptoms can occur together, separately or alternately. Positive symptoms tend to be associated with sudden onset or acute schizophrenia; negative symptoms tend to be associated with long-lasting or chronic schizophrenia.

Of those people who develop schizophrenia, one in every five will get better within five years of symptoms first appearing; three in every five show improvement but occasions when symptoms get worse; a further one in five continue with symptoms that are poorly controlled.

Schizophrenia is also associated with other risks. Premature death from natural and cardiovascular causes is two to three times higher in people with schizophrenia than that in the general population. A person with schizophrenia may also experience depression and may attempt suicide. Approximately 30-40% of people with schizophrenia attempt suicide sometime during their life. One out of every 10 people succeeds.
The earlier that schizophrenia is treated, the better. Starting treatment early has been shown to help people lead a more normal life, enabling them to work and live independently, reducing the need for intensive support and lowering the risk of suicide.

The main aim of treatment is to reduce the effects that symptoms have on the person’s life. Medicines are available that reduce hallucinations and delusions, increase motivation and help the person think more clearly. The drugs used are called ‘neuroleptics’ or ‘anti-psychotics’ and are given in the form of capsules, tablets, syrups or injections.

The earliest anti-psychotics to be used are often referred to as ‘typical anti-psychotics’ and include drugs such as chlorpromazine, haloperidol, flupentixol and zuclopenthixol. These drugs work by lowering the action of one of the brain’s chemical messengers called dopamine. Use of this type of medicine sometimes causes symptoms similar to Parkinson’s disease such as stiffness and shakiness.

The more recently discovered anti-psychotics are often referred to as ‘atypical anti-psychotics’ and include drugs such as amisulpride, aripiprazole, clozapine, olanzapine, quetiapine, paliperidone and risperidone. These drugs affect brain chemical messengers other than dopamine and are less likely to produce Parkinson’s disease-like symptoms. These drugs may also be better than typical anti-psychotics at controlling negative symptoms of schizophrenia.

Everyone will respond differently to anti-psychotic medicines and it may take some time to find the most suitable medicine at the correct dose.

Non-drug treatments such as counselling and cognitive behavioural therapies are often used together with drug treatment. These methods help the person recognise and cope with their symptoms.
When to see your pharmacist
Many of the medicines used for the treatment of schizophrenia cause side effects or can interact dangerously with other medicines being taken at the same time. Talk to your pharmacist if you are worried about side effects, and always let your pharmacist know what medicines you are receiving for schizophrenia when purchasing over the counter medicines or health care supplements.
When to see your doctor
If you think you or a relative has any of the symptoms of schizophrenia you should see your doctor. If symptoms have come on suddenly, your doctor may prescribe medicines to control the symptoms. You or the person affected will probably be referred to a psychiatrist or a community mental health team for a full assessment of the illness and to allow appropriate treatment to be given.
Living with schizophrenia
Receiving a diagnosis of schizophrenia can affect the way you feel, behave and interact with friends, family and colleagues. Perhaps one of the most frightening aspects of having a mental health problem is that you will experience some kind of impact on everyday life and you may feel that you lack control over your life. Make sure you find out as much information about your condition as you can so that you can begin to understand how it affects you and your family.

Join one of the self-help groups in your area (see Further Information section below). Self-help groups provide an important opportunity for you and your family to share experiences and ways of coping, and to support each other.

Look after yourself. Your physical health is as important as your mental health. Do not skip meals and make sure that what you eat provides a well balanced diet. This is particularly important if you live alone and there is nobody to prepare and cook your meals for you.

Take regular outdoor exercise.

Try to avoid stressful situations. Lear relaxation techniques. Focus on the positive things and do not let things get on top of you. If you feel down, let friends and family know how you feel.

If you need practical help with work, housing, legal or financial matters, start by referring to Rethink’s and Mind’s websites (see Further Information section below).
Useful Tips
  • Do not neglect your physical health
  • Eat a healthy, well-balanced diet
  • Exercise regularly
  • If you think you are putting on weight, cut back on high fat foods and reduce the amount of sugar you eat
  • Try and reduce stress; learn relaxation techniques
  • Get enough rest and sleep
  • Turn to your family and friends for support
Further information
Rethink, the leading national mental health membership charity, works to help everyone affected by severe mental illness recover a better quality of life. Its aim is to make a practical and positive difference by providing hope and empowerment through effective services, information and support.

Mind is the leading mental health charity for England and Wales. It campaigns to create a society that promotes and protects good mental health for all, a society where people with experience of mental distress are treated fairly, positively and with respect. A fundamental part of Mind's work is provided through a network of over 180 Local Mind Associations (LMAs) running around 1,600 services across England and Wales. Services include supported housing, crisis helplines, drop-in centres, employment and training schemes, counselling and befriending.

Both Rethink’s and Mind’s website provide useful information about schizophrenia and offer practical guidance to help cope with the social, occupational and welfare needs of people affected by schizophrenia.

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Tel: 0845 456 0455
Advice and Information Service: 020 7840 3188 (Mon - Fri 10:00 - 13:00)

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Infoline: 0300 123 3393

Reviewed on 6 June 2011