Schizophrenia

Symptoms of schizophrenia may be positive or negative. What does that mean?

​

Positive Symptoms 

These are psychotic symptoms not usually seen in otherwise healthy people. It is where patients "lose touch" with some aspects of reality. Examples of "positive" symptoms:

• Hallucinations
  These usually involve seeing or hearing things that don't exist. While hallucinations can be in any of the five senses, it is most common to hear voices.

• Delusions
  These are false beliefs out of touch with reality. For example, you believe that you're being harmed or harassed; you have exceptional ability or fame; another person is in love with you; or a major catastrophe is about to occur. This happens to most people with schizophrenia.

• Disorganized speech
  Incoherence or frequent derailment of thought; causes impairment of effective communication and replies in conversations may be partially or completely unrelated. Occasionally, speech may include putting together meaningless words that can't be understood.

• Extremely disorganised or abnormal motor behaviour
  This may show in a number of ways, from childlike silliness to unpredictable agitation. Behaviour isn't focused on a goal, so it's hard to do tasks. It can include resistance to instructions, inappropriate or bizarre posture, a complete lack of response, or useless and excessive movement.

​

Negative symptoms

Refers to a reduced ability to function normally due to disruptions to normal emotions and behaviours. Includes:

• “Flat affect” (reduced expression of emotions via facial expression or voice tone)

• Reduced feelings of pleasure in everyday life

• Difficulty beginning and sustaining activities

• Reduced speaking

Schizophrenia requires lifelong treatment, even after symptoms have long subsided. An experienced psychiatrist usually leads a team of psychologists, social workers, psychiatric nurses and case managers to coordinate the care of the patient. 

​

Medications

As with any mental illness, medication like antipsychotics, anti-depressants and anti-anxiety drugs are the cornerstone of treatment. As these drugs come with their own side effects, administration of the drugs highly depends on the individual's willingness to cooperate with treatment.

​

Antipsychotics

Antipsychotics may be categorised into 3 types: first-generation antipsychotics, second-generation antipsychotics and long-acting antipsychotics. 

Second-generation antipsychotics are largely preferred as there is minimal risk of serious side effects such as a movement disorder caused by first-generation psychotics. Long-acting antipsychotics are administered every 2 to 4 weeks as an intramuscular or subcutaneous injection. If someone has a preference for fewer pills, this option will be helpful for adherence.

​

Psychosocial Interventions

Once psychosis recedes, it is important to keep up with psychosocial interventions such as:

• Individual therapy - ​​​Helps normalize thought patterns. Patients also learn to cope with stress and identify early warning signs of relapse to manage their illness.

• Social skills training - Focuses on improving communication, social interactions and the ability to partake in daily activities.

• Family therapy - Provides support and education to families dealing with schizophrenia.

• Vocational rehabilitation and supported employment - Helps people with schizophrenia prepare for, find and keep jobs.

​

Hospitalization

This is to ensure the safety, proper nutrition, adequate sleep and basic hygiene of patients who are experiencing severe symptoms.

​

Electroconvulsive Therapy

This is an alternative for patients who remain unresponsive towards drug therapy.