What you should know about Schizophrenia

Schizophrenia is not related to situations of low schooling or childhood traumas, and of course there are no guilty of their appearance.

Schizophrenia is a chronic psychiatric disease characterized by a set of symptoms, positive and negative, which make each patient manifest in a specific way, with a very specific signs and symptoms. Due to the variability between patients, this disease requires individualized treatment and follow-up.

In its beginnings it was called ‘precocious dementia’, to later acquire the name that today partially defines the disease: ‘schizo’ and ‘frenetic’, or divided mind.

There is no symptom completely characteristic of schizophrenia, it is accepted that they present alterations of perception in the form of hallucinations, of reality in the form of delusions, of thinking with very weak reasonings, of motivation and judgment. It also adds a disorganization of thought and behavior. it is considered that the psychotic patient is a subject with difficulties in the structuring of thought and a marked deterioration of the capacity for decision making, which presents a great difficulty to control their emotionality and, due to this, or together with it, deficit in your relationship with other people.

The main factors involved in the onset and development of schizophrenia are:

• Genetic predisposition: the presence of the disease in parents or close relatives (uncles, cousins, grandparents, etc.) is a factor that increases the possibility of occurrence in children.
• Alterations during pregnancy or birth: anoxia (lack of oxygen in the fetus during pregnancy or childbirth), viral infections, trauma, etc.
• Morphological, functional or biochemical alterations in the brain: in this section, the habitual consumption of toxic substances and exposure to certain toxic and environmental stressors plays a fundamental role.
• Family and social factors: although they are not universally accepted, they are always referred to as possible influencing elements in the development of the disease or rather as triggers of outbreaks.
• Non-compliance with the treatment once the disease is diagnosed: it supposes a high risk of the appearance of relapses.

Depending on the signs and symptoms that prevail in the patient and the way they manifest, schizophrenia can be of the following types:

• Paranoid: alterations of thought and perception, with delusions and hallucinations. Delusions of jealousy or persecution are frequent. The patient hears unreal voices that command him. It is the most frequent type of schizophrenia.
• Hebephrenic: emotional alterations with strange and inappropriate affective manifestations.
• Catatonic: affects mainly the habitual motor activity of the patient with stupor (decrease of intellectual activities with air of absence or indifference) or agitation. They can remain hours with rigid attitudes or move to a degree of intense excitement.
• Simple: affects the will and personality with withdrawal, poor ideas and decrease in impulses.
• Depression after schizophrenic: it is a form of depression that happens as a result of a schizophrenic outbreak, where symptoms of this may remain, but not be predominant.
• Residual schizophrenia: it is usually equivalent to the stable phase after having suffered several acute outbreaks, predominantly negative symptoms such as behavioral inhibition, with deterioration of the image in terms of hygiene or social behavior.
• Undifferentiated schizophrenia: it is an undifferentiated form, since it meets the criteria of the disease, but no subtype is distinguished based on its symptoms.

The positive and negative symptomatology do not refer to symptoms that improve or worsen the prognosis of schizophrenia, nor influence positively or negatively in the patient’s daily life.

Positive symptoms of schizophrenia are considered to be the set of signs and symptoms that provoke in the patient situations of excitation, alterations in perception, delirious behaviors, while negative symptoms are considered those that cause a situation of emotional flattening in the schizophrenic. or null communication, disconnection of the environment, etc.

Both blocks of symptoms of schizophrenia are counterproductive for the patient and require control so that he can lead an adequate life.

Positive symptoms:

Are the behaviors, perceptions and pathological ideas present in the patient that do not appear in the general population. The patient lives in his new and own reality (he does not invent things, but he has a totally altered perception of reality). At this time the patient is not aware of his illness, so a drastic confrontation with him is not recommended, questioning his ideas. These symptoms are:

• Delirious ideas: the patient believes that a series of things are happening that are not really happening.
• Sensory hallucinations: alterations of perception without an external stimulus that occasions. In general, they are usually of an auditory nature (voices, sounds …), although they can also be visual, olfactory … Sometimes violent acts can be perpetrated towards others or towards themselves.
• Extravagant behavior: product of those delusional ideas and sensory alterations. They do not usually have a specific purpose. The patient may present hyperemotivity, histrionics, etc.
• Disorganized thinking: the patient is not able to organize and expose their thinking in an organized way, which manifests itself in an unconnected language and with an erratic message.

Negative symptoms:

• Anhedonia: loss of interest in those things that previously interested and liked the patient.
• Apato-bulimia: loss or absence of initiative to start tasks or purposes and carry them out.
• Social isolation: decreased interest in social activities and requiring relationships with other people. The patient tends to perform solitary activities.
• Flat affect: reduction or, in severe cases, absence of expression and emotional response. It is reflected in actions such as facial mutism (no gesticulation with the face before stimuli), spontaneous decrease of the movements, absence of visual contact, decrease of the oral message and tone of voice (the patient keeps a low tone of voice and Express with few words) with slowness or blocking of conversation, etc.

Schizophrenia is an extremely complex treatment due to the combination of different factors that have a great influence on its evolution, such as the complexity and severity of the psychotic disorder, and the biological, environmental and psychosocial components.

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