Schizophrenia Personality Disorder

Schizophrenia is a chronic, disabling disease of the brain.  Schizophrenia affects men and women in equal numbers.  However, the disorder is diagnosed earlier in men, usually in the late teens or early twenties.  Women are typically diagnosed in their late twenties to early thirties.

Signs and Symptoms

Individuals with schizophrenia often experience symptoms such as hearing voices not heard by other people, or believing that others can read their minds, control their thoughts, and may be plotting to harm them. These symptoms may be so terrifying to the individual that they withdraw from society.  The speech and behavior of schizophrenics can often be disorganized.  This tangential “all over the place” quality can be incomprehensible and frightening to people around them.  There is no cure for schizophrenia.  Treatment can ease some of the symptoms, but the vast majority of individuals with schizophrenia continue to experience some symptoms in varying degrees throughout their lives.  It is rare but not impossible that someone with schizophrenia recovers completely. This usually occurs, if it does, much later in life.

The early signs of schizophrenia may appear as confusing changes in an individual’s behavior. When the onset is sudden and the symptoms are severe and of a psychotic nature, it is referred to as an “acute” phase of schizophrenia.  Psychosis is a common condition in schizophrenia.  It is a state of mental impairment marked by hallucinations, disturbances of sensory perception, and/or delusions that are strongly held and defended which result from an inability to separate real from unreal experiences. Less obvious symptoms which are perhaps due in part to the psychosis are; social isolation, withdrawal, unusual speech, odd thinking, and shocking behavior.  These symptoms may occur before psychosis or during.  It can be very difficult for loved ones to cope with the effects of schizophrenia because they remember how alive, vital and well adjusted the person was before the onset of the disease.

Some people have only one psychotic episode.  Other people may have many psychotic episodes during their lifetime.  Some individuals can lead relatively normal lives during the episodes. Chronic schizophrenia is a continuous, recurring pattern of the disease.  Individuals with chronic schizophrenia often do not fully return to normal functioning.  They typically require long-term treatment and medication to manage the symptoms.

• Paranoid-type schizophrenia is marked by delusions (usually persecutory) and auditory hallucinations. However, intellectual functioning and expression of emotion remain relatively normal. Individuals with paranoid schizophrenia sometimes appear angry, aloof, anxious, and irritable.
• Disorganized-type schizophrenia is marked by speech and actions that are difficult for others to understand.  They exhibit a flat affect or inappropriate emotions.  For example they may laugh at something like a car driving by or at something not at all related to what is taking place at the moment.  They have trouble with normal activities such as cooking, care for a home and hygiene.
• Catatonic-type schizophrenia is marked by disturbances of physical movement.  Individuals with catatonic schizophrenia may hold themselves completely still like a frozen statue or in contrast, flail all over the place. They may be silent for hours, or they may repeat sentences or words over and over.   This behavior also impairs their ability to care for themselves.
• Undifferentiated-type schizophrenia (or not otherwise specified) is marked by some of symptoms seen in each of the above types but not enough of any one of them to meet the criteria for one particular type of schizophrenia.
• Residual-type schizophrenia is much like is sounds, left over schizophrenia. It is characterized by a past history of at least one episode of schizophrenia. But to meet the criteria of residual-type the individual must currently have no symptoms (delusions, hallucinations, disorganized speech or behavior).  This may be a transition period between episodes or it may be a remission.

Treatment

Antipsychotic drugs are often quite effective in treating certain symptoms of schizophrenia, particularly hallucinations and delusions.   Unfortunately, drugs are not as helpful with other symptoms such as motivation and emotional expression.  Keeping individuals with schizophrenia involved with treatment and medication compliant is a challenge.  Even on medication their affect range remains limited and relationships difficult to maintain.