Schizophrenia is a mental illness, affects approximately 1 percent of the adult population. The disease primarily manifests in adolescence, or early adulthood and the exact cause of its origin is not known. It is very difficult to accurately define schizophrenia, personally I would describe it as overall impaired thinking and perception of reality.


The cause of schizophrenia is not known. It seems to be a complex disease that develops due to certain genetic condition and influences of the external environment. These effects include chronic stress, tragic events and usage of addictive drugs and medications from the group of antipsychotics. The basis of schizophrenia is assumed to be an imbalance of neurotransmitters within the brain. The neurotransmitters are substances that allow the transmission of neuroelectric impulses among the neurons.


The manifestations of schizophrenia may be very variable and the disease has many subtypes according to the symptoms. The most typical form is the paranoid schizophrenia, when the individual suffers from paranoid delusions. The victim has feeling of a danger, that someone threatens his life or steals his ideas. Certain types of schizophrenia cause flattening of the emotions, inadequate emotional reactions, inactivity and loss of social interest. A special form of schizophrenia known as the “flexibilitas cerea” affects the momentum and causes complete immobility and waxy stiffness, i.e. the victim is completely immobile, but parts of his body will remain in the exact position, in which they are placed by another person.


Regardless of the type of schizophrenia, the disease disrupts the social relationships and untreated patient loses more or less the rational ability to communicate with other individuals and becomes unable to work in a team. Sometimes, schizophrenia may be associated with aggressive behavior and the patients may harm themselves or other individuals. Patients with schizophrenia have a higher risk of suicide attempts.


The diagnosis of schizophrenia is confirmed by a psychiatrist according to the patient’s symptoms. There is no objective examination to establish the diagnosis – all blood tests and imaging methods are more or less normal. In addition to the diagnosis, the psychiatrist may determine the type of schizophrenia and decide between the outpatient and inpatient treatment. However, the assessment of whether the patient is dangerous is sometimes very difficult.


If possible, the treatment is rather outpatient. Modern medicine uses a combination of antipsychotics and various non-pharmacological methods. Antipsychotics are a rich group of drugs that are designed to alter the balance of neurotransmitters in the brain and thereby attenuate the schizophrenic symptoms. It should be noted that regular use of medication can have great effect, but many patients do not cooperate and do not take the medication regularly, which causes repeated worsening of the symptoms. The non-pharmacological treatment includes various forms of psychotherapy and the improvement of social and communication skills of the patient (occupational therapy, family therapy).


As a complement to the issue of antipsychotic treatment, I have written a short article about the neuroleptic malignant syndrome, which can be caused by antipsychotics.


Jiri Stefanek, MD  Author of texts: Jiri Stefanek, MD
 Sources: basic text sources