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Schizophrenia is a psychotic brain disorder characterized by distortions in the way a person perceives reality, thinks, acts, expresses emotions and relates to others. According to the World Health Organization, an estimated 24 million people worldwide suffer from schizophrenia; it affects about seven people per thousand of the adult population, mostly in the age group 15-35 years¹. Approximately 260,000 people with schizophrenia were treated every day in 1999 in Japan, and 202,012 were admitted to a mental hospital in 2002².

The symptoms of schizophrenia can be classified into three categories³ Positive symptoms include unusual thoughts or perceptions, such as hallucinations, delusions, thought disorder and movement disorder. Negative symptoms are characterized by a loss or decrease in the ability to speak, express emotion, initiate plans or find pleasure in everyday life. Cognitive symptoms include problems with attention, memory and the functions that enable us to plan and organize. There are four basic subtypes of schizophrenia⁴. In paranoid schizophrenia, patients are preoccupied with delusions of being persecuted or punished. However, their thinking, speech and emotions may remain reasonably normal. In disorganized schizophrenia, patients are often confused and incoherent, with jumbled speech, and their behavior may be emotionless or inappropriate. They often demonstrate disorganized behavior that may disrupt their ability to perform daily activities. In catatonic schizophrenia, patients are immobile and unresponsive. They may also have peculiar movements or display bizarre postures. Undifferentiated schizophrenia is diagnosed when the patient's symptoms do not clearly represent one of the other subtypes.

Schizophrenia varies in severity from person to person. Psychotic episodes occur when a person loses touch with reality, causing a sudden change in personality and behavior. Some people have only one psychotic episode, while others may experience many episodes, although it is possible for them to lead relatively normal lives between episodes. The symptoms of schizophrenia seem to worsen and improve in cycles (relapses and remissions)⁵.

Part two of this article will describe schizophrenia's potential causes and treatments.

Discussion questions

1. Please summarize the article. What is the main point of the article?
2. What is schizophrenia?
3. How many people suffer from schizophrenia?
4. What are the symptoms of schizophrenia?
5. What are the subtypes of schizophrenia?

References:

1. Schizophrenia. World Health Organization (Accessed 26 June 2007)
2. Sato M. Renaming schizophrenia: a Japanese perspective. World Psychiatry. 2006 February; 5(1): 53-55. (Accessed 26 June 2007)
3. Schizophrenia. U.S. National Institutes of Mental Health. (Accessed 26 June 2007)
4. Mental health: Schizophrenia. WebMD. (Accessed 26 June 2007)
5. Mental health: Schizophrenia. WebMD. (Accessed 26 June 2007)