Schizophrenia is a severe mental disorder in which patients misinterpret reality. The disease affects a person’s thoughts, actions and emotions. The disease requires lifelong treatment and is characterized by a wave-like course with periods of exacerbation and remission.
Contrary to popular belief, schizophrenia is not a dissociative (multiple) personality disorder or, simply put, a split personality. Schizophrenia implies a psychosis in which the patient cannot separate the real from the imaginary. Patients with this disease often lose touch with reality, immersing themselves in their own disordered and confusing world. A sudden change in personality and behavior in which the connection to reality is lost is called a psychotic episode.
Some facts
- The first manifestations of schizophrenia are often seen before the age of 20;
- schizophrenia is not a split personality;
- most schizophrenic patients are not violent;
- schizophrenic patients do not always need a long-term stay in a psychiatric hospital.
Symptoms of schizophrenia
The following symptoms are distinguished:
- Illusions, fantastic delusions. For example, such a patient believes that people around him hear his thoughts or put them into his head;
- Auditory, visual, gustatory and olfactory hallucinations. Voices in the patient’s head may comment on his behavior, insult him, or give commands. In addition, the person may see things, feel strange odors and taste in the mouth;
- Catatonia – the appearance of movement disorders. Catatonic stupor can also develop – immobility of the body with increased muscle tone;
- Lack of focus in actions;
- Rapid switching from one thought to another without maintaining a logical chain;
- Inability to make decisions;
- Forgetfulness, absent-mindedness.
- Violation of executive functions (memory impairment, slowing of psychomotor speed, decreased verbal fluency, violation of abstract thinking, etc.);
- Violation of the switchability of attention.
- Absence of emotions or a limited range of emotions;
- Detachment from family, friends, and society in general;
- Decreased energy and activity;
- Lack of motivation;
- Loss of pleasure or interest in life;
- Failure to maintain good hygiene.
Diagnosis of schizophrenia
The diagnosis of schizophrenia is made on the basis of identified positive symptoms in combination with negative symptoms, which have a protracted character – lasting at least 6 months.
The patient must have at least one of the following signs:
- Auditory pseudohalucinations;
- “Voices” in the head;
- Commenting hallucinations;
- Sensation of introduction of other people’s thoughts into the head or “stealing” of thoughts, interruption of thoughts;
- Incoherent or disconnected speech;
- Delirium of perception (the patient interprets certain events inadequately, in a way that is only understandable to him);
- Delusions of influence (the patient feels that someone is controlling him);
- Decreased social activity, autism;
- Emotional disturbances.
Schizophrenia can occur in the following forms:
- continuous
- recurrent
- episodic-progressive.
Modern treatment of schizophrenia during the onset period
The choice of treatment method and location depends on the specific clinical case.
- Psychosocial therapy. Although drug therapy is the main method of treatment for schizophrenia, various psychosocial methods enhance the effect of therapy and help with behavioral, psychological, and social problems. Through psychosocial therapy, patients can learn to cope with their symptoms, recognize the precursors of an attack. Psychosocial therapies include:
- rehabilitation, which focuses on improving social skills. We help patients with schizophrenia to function fully in society;
- cognitive remediation, which helps to compensate for problems with information processing, strengthen mental skills, attention, and memory;
- individual and group psychotherapy.
- Hospitalization. Most of our patients are treated on an outpatient or day hospital basis. Inpatient hospitalization may be required for:
- Patients with severe pathological behavior (aggression, risk of injury to self and others);
- patients with suicidal attempts;
- patients with acute affective reactions;
- patients with anorexia;
- shock therapy or treatment with high doses of psychotropic drugs.
- Electroconvulsive therapy. Electrodes are attached to the patient’s scalp to deliver small electrical shocks. The method was long considered inhumane due to the lack of anesthesia. Today, the procedure is performed under general anesthesia 2-3 times a week. The purpose of the procedure is to induce a controlled seizure. A course of procedures over time results in improved mood and thinking. It is believed that during seizures induced by electroconvulsive therapy there is a release of neurotransmitters in the brain.
Stabilizing treatment for schizophrenia
The stabilization phase covers the first 6 months or more after an exacerbation. The goal of stabilization treatment during this phase is to minimize the stress to which the body has been subjected and to prevent relapse. Doctors try to increase the patient’s adaptation to society and consolidate the remission period.
During the stabilization phase, the psychiatrist prescribes the same medications (maintenance therapy with neuroleptics) that the patient took during the exacerbation phase. Premature dose reduction or complete discontinuation of the medication may lead to relapse.
Treatment of schizophrenia with cytokines
Recently, there has been a growing body of incontrovertible evidence that immunologic dysfunction is a key element in the development of the disease. Cytokines are key mediators involved in the coordination of the immune system. This is why cytokine treatment may be a promising method in the future. Cytokines are used as injections or inhalations for five days. Inhalations are given daily for ten days, after that every three days for 3 months.
Stem cell treatment
Stem cell injections are performed in the hippocampus of the brain to regenerate neuronal cells. Such treatment is carried out only after the final control of the attack with stabilization of the patient’s condition and allows significantly prolonged remission.
Conclusion
Schizophrenia is a chronic mental illness that requires constant treatment and attention. Despite the complexity and diversity of treatment methods, including drug therapy, psychosocial approaches and modern innovative technologies, the main principle in treatment is a comprehensive approach that takes into account the individual characteristics of the patient. It is important to diagnose the disease in time and not to forget about the importance of social adaptation, rehabilitation and prevention of relapses. Modern methods, such as treatment with cytokines and stem cells, open new prospects for improving the quality of life of patients and prolonging remission.
