Schizophrenia

• Have a close family member with the condition;
• Have older parents;
• Are exposed to certain viruses or malnutrition before birth, and;
• Use drugs such as cannabis and lysergic acid diethylamide (LSD).

Methods for diagnosis

The diagnosis of schizophrenia will usually be made by a psychiatrist after asking specific questions and from your medical history. If your doctor suspects that you have schizophrenia, they may conduct some tests to rule out other conditions that could be causing your symptoms. This may include a blood test, or take images of your brain using magnetic resonance imaging (MRI) or a computerised tomography (CT) scan.

As there is no specific test that can confirm schizophrenia, a diagnosis is usually made on the basis of symptoms. People diagnosed with schizophrenia will typically have at least two of the following symptoms that last for a period of six months or longer:

• Delusions;
• Hallucinations;
• Disorganised behaviour;
• Disorganised speech;
• Social withdrawal;
• Memory problems, and;
• Suicidal thoughts and self-harm.

Schizophrenia can be similar to symptoms of other conditions, such as bipolar disorder, psychotic depression, substance abuse, personality disorder, and adult ADHD.

Types of treatment

If you have schizophrenia, it is likely that you will need lifelong treatment to keep your symptoms under control. The most effective treatment is usually a combination of medication, psychosocial treatments and self-help resources.

Medication

Some antipsychotic medications, such as haloperidol and chlorpromazine, may be prescribed if you are experiencing delusions or hallucinations, while other antipsychotics, such as clozapine or amisulpride, may be prescribed to treat symptoms including social withdrawal and difficulty expressing emotions. Other commonly used antipsychotic medications include risperidone and quetiapine.

Antipsychotic medications may also be prescribed to manage the condition in the long-term and prevent symptoms from returning. For individuals with symptoms that are particularly difficult to manage and/or have suicidal thoughts, a particular antipsychotic medication called clozapine may be trailed.

All antipsychotics are used cautiously, given the potential for side effects. These include movement disorders resembling Parkinson's disease (known as extrapyramidal symptoms), weight gain and metabolic syndrome, and heart disease (which is further increased by the high incidence of cigarette smoking among individuals with schizophrenia). Clozapine has the potential for other side effects, such as lowering the white cell count and increasing the risk of serious infections (known as agranulocytosis), and causing heart failure. Prior to commencing antipsychotic medications, and as part of ongoing monitoring, your doctor will conduct various tests, such as weight and waist circumference measurements, examination of the nerves, blood tests, electrocardiography (ECG) and occasionally echocardiography. These tests are used to identify side effects early and allow change in medication to prevent long-term complications.

Psychosocial treatments

In addition to taking medication, some people with schizophrenia may benefit from psychosocial treatments to help them overcome problems with motivation, day-to-day activities, relationships and communicating. Psychosocial treatments for schizophrenia include:

Individual psychotherapy

Individual psychotherapy, which is sometimes referred to as 'talking therapy', involves meeting regularly with a therapist to discuss your thoughts and feelings and any problems that you may be having. Talking about your symptoms may help in telling the difference between what is real and what is not.

Talking therapy can provide ways of managing the symptoms of schizophrenia. 

Rehabilitation

There are rehabilitation programs available for people with schizophrenia. These programs are designed to help people affected by the condition to find a job, manage their money and teach them how to interact with people.

Family education

People with schizophrenia generally make a better recovery with support from family or friends. There are services available to support and educate family and friends caring for someone with schizophrenia. For example, these services may teach family members why it is important that their loved one takes their prescribed medications and how to provide a safe and caring environment.

Prognosis

If left untreated, schizophrenia can affect many aspects of everyday life and make it difficult to function normally. People with schizophrenia may also develop violent behaviour and depression, which can often lead to family conflicts and difficulty with keeping a job.

The outlook for people with schizophrenia is improving. Although there is no cure, there are treatments available that are effective at reducing the symptoms. Generally, the earlier the condition is diagnosed and treated, the better the outcome. Many people with the disease improve enough to lead normal lives in their communities.

Prevention

There is no exact way to prevent schizophrenia. Recognising the condition and getting treatment early may help to control the symptoms before they become too serious. If you have an increased risk of schizophrenia, avoiding illegal drug use, reducing stress, getting enough sleep and starting treatment as soon as possible may help minimise symptoms, or prevent them from becoming worse.