Schizophrenia | Diagnosis, Treatment, Predictors of Course & Outcome of chronic psychosis

Schizophrenia (Chronic Psychosis) Diagnosis, Treatment, Predictors of Course & Outcome
Schizophrenia is a serious mental illness that affects how a person thinks, feels, and behaves. People with schizophrenia may seem like they have lost touch with reality, which causes significant distress for the individual, their family members, and friends. If left untreated, the symptoms of schizophrenia can be persistent and disabling. However, effective treatments are available. When delivered in a timely, coordinated, and sustained manner, treatment can help affected individuals to engage in school or work, achieve independence, and enjoy personal relationships.
Two follow-up studies conducted by the World Health Organization, viz, International Pilot Study of Schizophrenia and Determinants of Outcome of Severe Mental Disorders, showed that the outcome of schizophrenia is better in Indian population.
Schizophrenia is a chronic brain disorder that affects 0.3 to 0.7% of the Indian population. When schizophrenia is active, symptoms can include delusions, hallucinations, disorganized speech, trouble with thinking and lack of motivation.
Schizophrenia is a syndrome with multifactorial etiology and unlike diseases (for example malaria, typhoid etc), it does not have a cure. The target of management is symptom resolution and prevention of relapse. Earlier the onset of intervention and shorter the duration of untreated psychosis (DUP); better the outcome
Schizophrenia is treatable and research is leading to innovative and safer treatments. Experts also are unraveling the causes of the disease by studying genetics, conducting behavioral research, and using advanced imaging to look at the brain’s structure and function. These approaches hold the promise of new, and more effective therapies.
Symptoms of schizophrenia usually first appear in early adulthood and must persist for at least six months for a diagnosis to be made. Men often experience initial symptoms in their late teens or early 20s while women tend to show first signs of the illness in their 20s and early 30s. More subtle signs may be present earlier, including troubled relationships, poor school performance and reduced motivation.
The symptoms of schizophrenia generally fall into the following three categories:
Psychotic symptoms
include altered perceptions (e.g., changes in vision, hearing, smell, touch, and taste), abnormal thinking, and odd behaviors. People with psychotic symptoms may lose a shared sense of reality and experience themselves and the world in a distorted way. Specifically, individuals typically experience:
Hallucinations, such as hearing voices or seeing things that aren’t there
Delusions, which are firmly held beliefs not supported by objective facts (e.g., paranoia - irrational fears that others are “out to get you” or believing that the television, radio, or internet are broadcasting special messages that require some response)
Thought disorder, which includes unusual thinking or disorganized speech
Negative symptoms
include loss of motivation, disinterest or lack of enjoyment in daily activities, social withdrawal, difficulty showing emotions, and difficulty functioning normally. Specifically, individuals typically have:
Reduced motivation and difficulty planning, beginning, and sustaining activities
Diminished feelings of pleasure in everyday life
“Flat affect,” or reduced expression of emotions via facial expression or voice tone
Reduced speaking
Cognitive symptoms
include problems in attention, concentration, and memory. For some individuals, the cognitive symptoms of schizophrenia are subtle, but for others, they are more prominent and interfere with activities like following conversations, learning new things, or remembering appointments. Specifically, individuals typically experience:
Difficulty processing information to make decisions
Problems using information immediately after learning it
Trouble focusing or paying attention
Family members and other significant people can help by first taking the individual with these symptoms to a mental health professional, for psychiatric consultation, as early as possible rather than taking them to faith healers. Early diagnosis and starting treatment can improve the prognosis.