Schizophrenia and Schizoaffective Disorder

 

Schizophrenia and Schizoaffective Disorder are very serious mental illnesses that can lead to suicide. A sobering vignette involves a decorated combat veteran who presented to the emergency room with a request for help with “the killing disease”. Initially, the triage nurse assumed the veteran was asking for help with PTSD. Eventually the patient was able to explain that it was his schizophrenic illness that was killing him.

Schizophrenia

Schizophrenia is a serious mental illness that affects about 1% of all adults. Finding the causes for schizophrenia proves to be difficult as the cause and course of the illness is unique for each person. Schizophrenia impairs a person’s ability to function to their potential when it is not treated. Unfortunately, no single, simple course of treatment exists. Research has linked schizophrenia to a multitude of possible causes, including aspects of brain chemistry and structure, as well as environmental causes including infection, and generally is associated with a state of inflammation in the nervous system.

Psychosis is a common symptom of schizophrenia. It might be a consequence of dysfunction of brain networks, or in other cases is actually an indication of {subacute} delirium. The hallucinations are probably related to dream-like material that penetrates consciousness.

Suicide is a serious risk for those with schizophrenia, occurring at a much higher rate than the general population. However, the risk of suicide can be reduced by effective treatment.

Unfortunately, the majority of those living with schizophrenia do not believe themselves to be ill and so they fight against treatment and medication.

Lack of awareness of illness (lack of insight) is called anosognosia. An everyday description of mental illness is “significant disturbance of insight and judgement”.

Clinical experience, and also the medical literature suggests about half of the people diagnosed with schizophrenia have positive outcomes when they receive appropriate treatment.

Schizoaffective disorder

Schizoaffective disorder is also a serious mental illness that affects about 1% of all adults. Schizoaffective disorder has features that resemble both schizophrenia and also serious mood symptoms. Schizoaffective disorder is thought to be between the bipolar and schizophrenia diagnoses as it has features of both.

Science

The illnesses are obviously “real” and a propensity to Schizophrenia-specturum illness appears to be heritable. The suffering is immense and bad outcomes are the norm instead of an exception. Sometimes QEEG or analysis of eye motion can help identify objective abnormalities. Structural brain imaging (by CT or MRI or old-school pneumoencephalography) does give us evidence for the assertion that these illnesses are brain disease.

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