Schizophrenia is one of the most costly mental disorders, both for patients and their families and for society. More hospital beds are occupied by people with schizophrenia than by people with any other mental disorder, with the exception of the cognitive disorders (delirium and dementia). Because Schizophrenia, like dementia, is usually chronic or recurring, cases tend to accumulate. One theory is that schizophrenia is caused by an imbalance of neurotransmitters in the brain, and that medications for psychoses  work by correcting this imbalance. Antipsychotic medications have helped, and many people with Schizophrenia function well between acute episodes. There are at least 2,000,000 people with Schizophrenia in the U.S. 

For any diagnosis of Schizophrenia (types are listed below), the symptoms must generally be present for at least a month, and must be severe enough to be a cause for clinical concern. The symptoms must also not be better accounted for by other problems, such as drug abuse, toxins, or medical conditions.

Schizophrenia was named by Bleuler; the name replaced the earlier "dementia praecox," which meant early dementia. Schizophrenia, by which Bleuler meant "shattered personality," was a more accurate term, but it confused many people, who thought it meant split personality (a name that would fit dissociative disorders better). Schizophrenic dementia does, indeed, occur earlier on the average than do most cases of dementia; the symptoms of Schizophrenia most often are manifested in adolescence or early adulthood, although late-onset Schizophrenia has been observed in people over 65.

The symptoms of Schizophrenia are often divided into two classes, the positive symptoms like delusions and hallucinations, and the negative symptoms like social withdrawal and flattened affect. The negative symptoms are more difficult to detect because they are exaggerations of normal dimensions of personality; the positive symptoms are more bizarre. The prognosis is better for patients whose symptoms are positive, arise quickly, and occur against a background of better adjustment prior to showing symptoms of Schizophrenia.

Traditionally, it was believed that psychotherapy was not useful for Schizophrenia. Anti-psychotic medications are a critical part of therapy, but there is growing recognition that group therapy, cognitive behavioral therapy, and perhaps other types of individual therapy, may also be helpful. One important consideration is keeping patients on their medical regime, and all types of psychotherapy may have a useful role in doing so. In addition, the patient is likely to need more help than others in developing social and occupational skills, and even informal group participation is probably helpful in that regard. A recent study indicates that schizophrenics have a type of memory defect that is likely to make them forget to take their medication, and to make them think they have taken it when they haven't. The web site, http://www.biomedcentral.com/1471-244X/3/9/, presents the study in full, and is available free to the public.  It would probably be a good idea for family members to monitor schizophrenic relatives to keep them on their medication regimes. 

There are many subtypes of Schizophrenia, each with a somewhat different set of most prominent symptoms. The disorders cannot be classified according to their causes, as in some other disorders, because Schizophrenia's causes are largely unknown and may or may not be different for the different sets of symptoms. DSM-IV identifies four main types of Schizophrenia besides a "residual" type, and listing the main features of each type is a good way to introduce the full set of symptoms of Schizophrenia. 

For all types, at least one of their important areas of functioning must have suffered because of the disease, and signs of disturbance must have been present for at least 6 months. 

Paranoid Schizophrenia

The first subtype is Paranoid Schizophrenia. For these patients the primary symptoms are delusions or frequent auditory hallucinations. The delusions of Schizophrenia are likely to be bizarre, but in Paranoid Schizophrenia the delusions tend to be less bizarre and to be related to the content of the person's hallucinations. The most frequent auditory hallucinations are of people holding conversations; simpler hallucinations, as of buzzing sounds, are of less concern. The person with Paranoid Schizophrenia retains better organization and has few, if any, of the symptoms that are most characteristic of the other subtypes. Persecutory delusions may lead to danger to themselves or others. 

Disorganized Schizophrenia

The second subtype is Disorganized Schizophrenia. People with this subtype manifest disorganized speech (no, or very little, consistent thematic structure, "word salad," with loose associations between words, ranging to speech that is incomprehensible), disorganized behavior, and flat affect (little variation in emotions). What affect they have may be inappropriate and not related to the context of their speech. Their behavior may so lack goal-directness that they are unable to care for themselves. 

Catatonic Schizophrenia

The third subtype is Catatonic Schizophrenia. These patients manifest  waxy flexibility, stupor, or rigidity, so that their abnormality is overtly expressed and obvious to onlookers. They are very negativistic and may resist all instructions or attempts to move them or change their posture. They may assume bizarre postures and make stereotyped movements, and their speech may be echolalic (repeating what they just heard). Their delusions are likely to be bizarre; an example might be that their body has been taken over by Martians who are procreating inside them. 

Undifferentiated Schizophrenia

The fourth type is "Undifferentiated"; it does not meet the criteria for any of the preceding three types, but does meet the criteria for Schizophrenia. These include the presence of two or more of the following symptoms: delusions, hallucinations, disorganized speech, disorganized or catatonic behavior, and negative symptoms (flattened affect, lack of volitional behavior, or illogical thinking). In the undifferentiated type, none of these symptoms are sufficiently prominent relative to the others to justify a more specific diagnosis.

Learn about rehabilitation of persons with Schizophrenia and other severe mental illnesses.

Read about one case of Schizophrenia.

Find information on medication for Schizophrenia.

Find information on how to help a loved one with Schizophrenia.

Visit this healthinmind page if you are interested in learning about side effects of medication for Schizophrenia on movement.

The following books might be helpful:

Surviving Schizophrenia : A Manual for Families Consumers and Providers by E. Fuller Torrey

Coping With Schizophrenia : A Guide for Families by Kim Tornval Mueser