SCHIZOPHRENIC patients, along with their families, carry a heavy emotional burden because of the myths and stigmas attached to the condition. Not only are they incorrectly described as persons with a ‘split personality’, but often people with schizophrenia are also considered dangerous.
“This is not the case,” stresses Dr Kerryn Armstrong, a psychiatrist at the Akeso Clinic, Milnerton. “One of the biggest myths about schizophrenia is that all people with schizophrenia are dangerous. It is also a myth that all schizophrenic people are the same. In fact, people with schizophrenia experience a wide range of symptoms with diverse presentations. Another myth is that people with schizophrenia cannot be treated and belong in institutions – schizophrenia can be successfully managed with medication and psychosocial rehabilitation therapies, allowing patients to lead meaningful lives in their communities,” Armstrong points out.
“Schizophrenia is a psychiatric disorder characterised by chronic or recurrent psychosis. It is commonly associated with impairments in social and occupational function and is among the most disabling and economically costly medical disorders. The World Health Organization ranks schizophrenia as one of the top ten illnesses contributing to the global burden of disease.
“The disorder results from a complex interaction between genetic and environmental factors. Risk factors include family history of schizophrenia, pregnancy and birth complications, greater paternal age, late winter/early spring birth and growing up in an urban environment. Armstrong explains. “There is also strong evidence for genetic risk involved in schizophrenia.”
According to Dr Armstrong, symptoms usually become evident in the late teens or early twenties, ranging from late childhood right through to the seventies. Patients may present personality changes, become withdrawn or suspicious and show perplexity or depressive symptoms. Hallucinations, delusions, disorganised speech, bizarre or catatonic behaviour and mood and anxiety symptoms are all considered characteristic symptoms of schizophrenia.
In addition to these characteristic symptoms, individuals with schizophrenia also demonstrate impairment in a range of cognitive abilities, according to Dr Armstrong. “These include deficits in attention and concentration, processing speed, learning and memory, reasoning function, verbal skills and social cognition. They are also at increased risk of physical ill health, with schizophrenia being associated with medical disorders including diabetes, hyperlipidaemia and hypertension. The life expectancy of people with schizophrenia is decreased by more than a decade compared to the general population, with excess medical mortality largely related to heart disease.”
“Approaches aimed at preventing schizophrenia in those at high risk are still being investigated,” says Dr Armstrong. “As for treatment, a biopsychosocial approach should be employed in managing patients with schizophrenia.
“Antipsychotic medication should be prescribed to treat psychotic episodes and prevent future relapses. A choice of agent and route of administration should be made in conjunction with the patient and their family, taking into account considerations such as the side-effects of different agents, co-morbid medical conditions, drug interactions, insight into condition and compliance. Psychoeducation for the patient and family is crucial, with ongoing psychosocial support and psychological interventions such cognitive behavioural therapy tailored to individual patients’ needs.”
“Most treated patients still require ongoing social and occupational support and many may remain chronically ill, either with relapsing/remitting course or progressive deterioration,” she concludes.
Feel free to visit www.akeso.co.za or contact them on 011 447 0268 for further information on psychiatric, psychological or addictive conditions. In the event of a psychological crisis, please call 0861 4357 87 for assistance.
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