Schizophrenia is an extremely complex mental disorder: a biochemical imbalance in the brain is believed to cause symptoms. Recent research reveals that schizophrenia may be a result of faulty neuronal development in the fetal brain, which develops into full-blown illness in late adolescence or early adulthood. A simple explanation of how the brain works helps us to define schizophrenia. There are billions of nerve cells in the brain. Each nerve cell has branches that transmit and receive messages from other nerve cells. The nerve endings release chemicals, called neurotransmitters, which carry the messages from the end of one nerve branch to the cell body of another. In the brain afflicted with schizophrenia, something goes wrong in this communication system.

The disorder may develop so gradually that it is undetectable in the person for a long time, or it may have a very sudden onset with rapid development. It most commonly strikes between the ages of 15 and 25 years. Schizophrenia does not discriminate. It is found world wide, affecting men and women, people of all races, cultures and social classes. In Canada one in every one hundred persons is diagnosed with this disorder; over three hundred thousand people in all. To a large extent, genes control the activity of neurotransmitters, and there is very strong evidence indicating that genes are involved in causing schizophrenia. No definite schizophrenia genes have been found yet. However, researchers have identified several regions on the chromosomes where schizophrenia genes are likely to be. There are potential environmental contributors to the development of schizophrenia as well. Although the evidence to date is inconclusive, prenatal or perinatal trauma, season and place of birth, and viral infections may contribute to the development of this disease. It should be noted that while stress and/or drug abuse do not cause schizophrenia, these factors very often trigger or worsen symptoms that are already present. The precise cause of schizophrenia remains unknown. Changes in key brain functions, such as perception, emotions, and behavior, indicate that the brain is the biological site of schizophrenia. Some researchers suspect neurotransmitters (the substances through which cells communicate) may be involved. There may be changes in dopamine, serotonin, or other neurotransmitters. The limbic system (an area of the brain involved with emotion), the thalamus (which coordinates outgoing messages), and several other brain regions may also be affected.

Just as other illnesses have signs or symptoms, so does schizophrenia. Persons with schizophrenia will display symptoms as they struggle to discern reality from their own perceptions. The symptoms of schizophrenia are classified into four categories: positive symptoms, negative symptoms, cognitive symptoms and emotional symptoms. Positive symptoms (sometimes called psychotic symptoms) refer to symptoms that appear; negative symptoms refer to elements that are taken away from a person.

Positive symptoms can include:
   - Delusions
   - Hallucinations
   - Disorganized behavior
   - Changes in sensitivity

Negative symptoms can include:
   - Loss of interest in daily activities
   - Lack of energy

Cognitive symptoms can include:
   - Lack of energy
   - Poor concentration
   - Thought disorder

Emotional symptoms can include:
   - Depression
   - Blunted emotions.

Currently, there is no method for preventing schizophrenia and there is no cure. Minimizing the impact of disease depends mainly on early diagnosis and, appropriate pharmacological and psychosocial treatments. Hospitalization may be required to stabilize ill persons during an acute episode. The need for hospitalization will depend on the severity of the episode. Mild or moderate episodes may be appropriately addressed by intense outpatient treatment. A person with schizophrenia should leave the hospital or outpatient facility with a treatment plan that will minimize symptoms and maximize quality of life.

A comprehensive treatment program can include:
   - Antipsychotic medication
   - Education & support, for both ill individuals and families
   - Social skills training
   - Rehabilitation to improve activities of daily living
   - Vocational and recreational support
   - Cognitive therapy.

Treated?
Medication is one of the cornerstones of treatment. Once the acute stage of a psychotic episode has passed, most people with schizophrenia will need to take medicine indefinitely. This is because vulnerability to psychosis doesn’t go away, even though some or all of the symptoms do. In North America, atypical or second generation antipsychotic medications are the most widely used. However, there are many first-generation antipsychotic medications available that may still be prescribed. A doctor will prescribe the medication that is the most effective for the ill individual.

Currently, the following atypical medications are available in Canada:
   - CLOZAPINE [Clozaril]
   - OLANZAPINE [Zyprexa]
   - RISPERIDONE [Risperdal]
   - QUETIAPINE [Seroquel]

For more information please visit www.schizophrenia.ca

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