3.2iii Mental health disorders: Psychosis

A Family Guide to Concurrent Disorder: Part I - What are concurrent disorders?

Outline - Chapter 3: Mental health problems

• Why do people develop mental health problems?
• Mental health disorders
  • Anxiety
  • Mood
  • Psychosis
  • Impulsivity
• Personality disorders

In this section:

• Schizophrenia

A psychotic disorder is a severe medical illness that disturbs the way a person acts, thinks, sees, hears or feels, and makes it difficult or impossible for him or her to distinguish between what is real and what is not.

Symptoms of psychosis may be either positive (something “added to” the person, something that is not always present) or negative (something “taken away” or “missing from” the person).

Schizophrenia

Prevalence

About one per cent of the population will develop schizophrenia at some point during their life.

Symptoms

Early warning signs of schizophrenia include:

• withdrawal from regular activities and from family and friends
• problems concentrating
• lack of energy
• confusion
• sleep problems
• unusual speech, thoughts or behaviour (e.g., a person may become intensely preoccupied with religion or philosophy).

This early phase can last weeks or months.

The seriousness of symptoms and chronic nature of schizophrenia can often cause a high degree of disability. Coping can also be difficult for family members who remember the person before the illness.

Positive symptoms (symptoms that appear in a person) include:

• Delusions: A delusion is a false or irrational personal belief. About one-third of people with schizophrenia experience delusions. These can include feelings of being persecuted, cheated or harassed, as well as delusions of grandeur (a false idea of oneself, e.g., as being famous).
• Hallucinations: A hallucination occurs when a person hears, sees, tastes or experiences something that is not really there. Hearing voices is the most common hallucination.
• Disordered thoughts: A person’s thoughts may become unconnected, so that conversations no longer make sense. Their thoughts may come and go and they may not be able to focus for long on one thought. This is called thought disorder. It can contribute to a person’s isolation.
• Cognitive difficulties: A person may have problems with memory, concentration and understanding concepts.
• Decline in social or occupational functioning: A person may have problems with work or school, or have trouble taking care of him- or herself.
• Disorganized behaviour: A person may seem agitated for no particular reason.

People with schizophrenia often have negative symptoms (elements that are taken away from a person) that include a “blunted affect” or “flat affect.” This means they find it hard to show or express feelings. They may feel empty. A person with schizophrenia may appear extremely apathetic, have reduced motivation and withdraw socially.

Course

Men and women are equally likely to develop schizophrenia. However, men tend to have their first episode in their late teens or early twenties. With women, the onset is usually a few years later. In most cases, the illness can start so gradually that people will start to have symptoms, but they and their families may not be aware of the illness for a long time.

Symptoms of schizophrenia tend to vary in intensity over time. Some people have a mild form, and may only have symptoms for a few short periods during their lives. Others experience symptoms almost all the time, and may need to spend time in a hospital to protect themselves or others.

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