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By Dr Dulcy Rakumakoe

Chief Executive Officer

Understanding Schizophrenia and It’s impact

Symptoms of schizophrenia include seeing or hearing things that are not there and having difficulty organising thoughts.

Schizophrenia is a mental health illness in which people have an abnormal way of interpreting reality.
This leads to a combination of hallucinations, delusions, and extremely disordered thinking and behaviour that impairs daily functioning. It is a chronic condition where treatment is taken for life. It is important to start treatment early so that one can still function in society.]

When the individual poses a danger to themselves or others, immediate referral for hospitalisation may be needed. You can contact your hospital, the police or social workers for assistance. Suicidal ideations are common in people with schizophrenia.

Picture: iStock
Picture: iStock

Treatment compliance and symptom variability

You cannot prevent schizophrenia, but once treatment has been started, you need to be compliant with it to prevent relapses or worsening of symptoms.

Symptoms can vary in type and severity over time, with periods of worsening and remission of symptoms. Some symptoms may always be present. In men, symptoms typically start in the early to mid-20s. In women, typically in the late 20s.

It’s uncommon for children to be diagnosed with schizophrenia and rare for those older than age 45.

It’s not known what causes schizophrenia, but researchers believe a combination of genetics, brain chemistry and environment contribute to development of the disorder. Neuroim – aging studies show differences in the brain structure and central nervous system of people with schizophrenia. While researchers aren’t certain about the significance of these changes, they indicate that schizophrenia is a brain disease.

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Picture: iStock
Picture: iStock


Symptoms of schizophrenia involve a range of problems with how you think, how you behave and how you feel. They may include:

  • Delusions. These are false beliefs that are not based on anything real or any evidence.
  • Hallucinations. These usually involve seeing or hearing things that do not exist. Hallucinations can be in any of the senses, but hearing voices is the most common.
  • Disorganised thinking (speech). This is inferred from disorgasnised speech. Effective communication can be impaired, and answers to questions may be partially or completely unrelated. This may be manifested by putting together words that don’t make any sense.
  • Extremely disorganised or abnormal motor behaviour. This may show in a number of ways, from childlike silliness to unpredictable agitation. Behaviour isn’t focused on a goal, so it’s hard to do tasks. Behaviour can include resistance to instructions, inappropriate or bizarre posture, a complete lack of response, or useless and excessive movement.
  • Negative symptoms. This refers to reduced or lack of ability to function normally. For ex[1]ample, the person may neglect personal hygiene or appear to lack emotion (doesn’t make eye contact, doesn’t change facial expressions or speaks in a mono[1]tone). Also, the person may lose interest in everyday activities, socially withdraw or lack the ability to experience pleasure.

Risk factors

There is no specific known cause of schizophrenia but certain factors seem to increase the risk of developing or triggering schizophrenia , including:

  • Family history of schizophrenia
  • Some pregnancy and birth complications, such as malnutrition or exposure to toxins or viruses that may impact brain development
  • Substance abuse (marijuana, drugs and alcohol) during teen years and young adulthood.


Left untreated, schizophrenia can result in severe problems that affect every area of life. Complications that it may cause or be associated with include:

  • Suicide, suicide attempts and thoughts of suicide.
  • Anxiety disorders and obsessive-compulsive disorder (OCD)
  • Abuse of alcohol or other drugs, including nicotine.
  • Inability to work or attend school.
  • Financial problems and homelessness.
  • Social isolation
  • Health and medical problems
  • Aggressive behaviour

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Picture: iStock
Picture: iStock


Firstly the doctor will rule out other causers of psychosis like medical or other mental health disorders, substance abuse or medication side effects. Also head trauma history will need to be excluded. This will involve doing:

  • History and physical examinations
  • Blood and urine tests and screenings.
  • Imaging studies, such as an MRI or CT scan. Then the doctor or mental health professional will check mental status by observing appearance and demeanour and asking about thoughts, moods, delusions, hallucinations, substance use, and potential for violence or suicide. This also includes a discussion of family and personal history. Using the above, an accurate diagnosis will be reached.


Schizophrenia requires lifelong treatment, even when symptoms have subsided. Medications and psychosocial therapy can help manage the condition. In some cases, hospitalisation may be needed. It is a multidisciplinary team that includes psychiatrist, psychologist, social worker and a case manager.

Picture: iStock
Picture: iStock


Medications are the cornerstone of schizophrenia treatment, and antipsychotic medications are the most commonly prescribed.

They’re thought to control symptoms by affecting the brain neurotransmitter dopamine. The goal of treatment with antipsychotic medications is to effectively manage signs and symptoms at the lowest possible dose.

The psychiatrist may try different drugs, different doses or combinations over time to achieve the desired result.

Other medications may also help, such as antidepressants or anti-anxiety drugs. It can take several weeks to notice an improvement in symptoms. Because medications for schizophrenia can cause serious side effects, people with schizophrenia may be reluctant to take them.

Willingness to cooperate with treatment may affect drug choice. For example, someone who is resistant to taking medication consistently may need to be given injections instead of taking a pill.

Your doctor is the best person to guide you and your support structure about the benefits and side effects of any medication and what is to be expected.

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