The W.H.O. has identified Schizophrenia as one of the 10 most debilitating diseases affecting human beings.

Also called ‘thought disorders,’ these conditions may interfere with the individual’s ability to think clearly, distinguish their symptoms from reality, manage emotions, make decisions and relate to others.

Types of Schizophrenia and Psychotic Disorders

Schizophrenia and Psychotic Disorders include:

Schizophrenia – Contrary to media portrayals, schizophrenia is not a split personality nor is it multiple personalities.

People with schizophrenia are not continually incoherent or psychotic. The disease usually involves a constellation of what are called positive and negative symptoms that occur along with impaired social or occupational functioning.

Many individuals with schizophrenia experience periods where positive symptoms increase excessively and then remit, while others may experience ongoing moderate or severe symptoms. These are called psychotic episodes or relapses.

Positive symptoms include thoughts or behaviors that are ordinarily absent in the general population. Negative symptoms refer to the absence of thoughts or behaviors that are ordinarily present in people in the general population.

Positive Symptoms

  • Catatonic behavior:
    
Generally involves a marked reduction in motion, as though the person is unaware of surroundings. The person may appear to have a very rigid posture.
  • Delusion:
    A firmly held erroneous belief and/or misinterpretation of perceptions or experiences. For example, the person may believe that he or she has certain powers or that someone is attempting to harm him or her.
  • Disorganized behavior:
    Behaviors which may appear bizarre, silly or unusual. The person may experience difficulty completing tasks, following through with things and actions may suggest that the person is responding to internal cues such as hallucinations.
  • Disorganized thinking:

    Generally evidenced by the person’s manner of speech (such as incoherent, tangential, or loosely associated speech).
  • Hallucination:
    
A distorted or exaggerated sensory perception. The individual may hear internal voices or experience other sensations not connected to an obvious source.

Negative symptoms

  • Alogia/Poverty of Speech or Content of Speech:
    
The individual generally speaks very little. When he/she speaks, the content appears slowed or blocked and may consist of ’empty’ responses.
  • Anhedonia:

    Refers to reduced or no pleasure in things he/she used to enjoy.
  • Avolition/Apathy:
    
The appearance of reduced or no motivation toward goals. May appear as disinterest.
  • Inattention:
    
The person distracts easily and, therefore experiences difficulty completing tasks.
  • Reduced facial expression (also called affect):

    To the extent that the intensity and range of the person’s expression (including facial expression, eye contact, body tone, etc.) appears flat or blunted.

Schizophreniform Disorders – Schizophreniform is often a pre-diagnosis to schizophrenia. It is characterized by positive symptoms and negative symptoms of schizophrenia. By definition, schizophreniform lasts longer than one month but no longer than six months.

Medication is the most important part of treatment, as medications can reduce and/or eliminate the symptoms. Other treatments, such as therapy to assist with coping skills and case management to assist with living skills, finances and housing, may also be beneficial.

Schizoaffective

  • Depression:
    
Such as serious loss of interest, chronic sadness, sleep or eating disturbance, difficulty concentrating
  • Mania:
    
Serious mood swings and distractibility; excessive, compulsivity (such as compulsive talking, spending); agitation; reduced sleep; racing thoughts
  • Schizophrenia:
    
Hallucinations, delusions, unusual behaviors, limited emotional reactions, appearances of apathy, poverty of speech/thought

Schizoaffective disorder is a very difficult condition to diagnose because it involves a combination of different symptoms. The person first may be misdiagnosed as having schizophrenia or bipolar disorder because both of those diagnoses can also include symptoms from the other disorder. The essential feature for schizoaffective disorder is the presence of psychosis after the mood is stabilized (in other words, psychosis that occurs during mania is not a schizoaffective disorder).

Treatment of schizoaffective disorder often requires a combination of antipsychotic, antidepressant, and anti-anxiety medications, along with counseling and other treatments generally provided for each of those conditions.

Psychotic Disorders

  • Brief psychotic disorder is typically preceded by a stressful event or trauma and involves the short term presence of psychotic symptoms lasting under one month. Because the diagnosis is short term, the prognosis is very good.
  • Shared psychotic disorder is a very rare condition involving shared delusions between two or more people who are typically involved in long-term relationships. With this disorder, a person believes a delusion of someone close to them.

Aside from the delusion, the individual affected by this condition appears to have otherwise normal thoughts and behaviors. This disorder is often best treated by counseling, along with separation from the affected individual.

Delusional Disorders – Delusional disorder is a psychiatric condition marked by the presence of a delusion or delusions where the person does not show evidence of other mental illnesses. Types of delusional disorders may include:

  • Erotomanic/erotomania:
    
A delusion that another person is in love with the individual.
  • Grandiose:

    A delusion of inflated importance, worth, power, knowledge, identity or special relationship.
  • Jealous:
    
Delusion that the individual’s sexual partner is unfaithful (see delusional jealousy).
  • Persecutory Type:

    Delusion that the person (or someone to whom the person is close) is being malevolently treated in some way.
  • Somatic Type:

    Delusions that the person has some physical defect or general medical condition (for example, see delusional parasitosis).

A diagnosis of ‘mixed type’ or ‘unspecified type’ may also be given if the delusions fall into several or none of the above categories.

Treatment for Schizophrenia and Psychotic Disorders

Most people with psychotic disorders experience at least one relapse after their first actively psychotic episode. When an acute episode of psychosis occurs, psychiatric hospitalization often is required in combination with (antipsychotic) medications.

Outpatient treatments are generally required to help the person with a psychotic disorder monitor their symptoms. Case management services also are often needed to assist with daily living skills, financial management and housing.

Therapy can help the individual learn better coping skills and improve social and occupational skills.

Medications are often the most crucial aspects of treatment. Over recent years, there have been many advances in medication.

Unfortunately, many people with psychotic disorders may stop treatment because of medication side effects, disorganized thinking or because they feel the medication is no longer working.