SCHIZOPHRENIA

any of a group of severe mental disorders that have in common such symptoms as hallucinations, delusions, blunted emotions, disordered thinking, and a withdrawal from reality. Schizophrenics display a wide array of symptoms, but four main types of schizophrenia, differing in their specific symptomatology as follows, are recognized by some authorities. 1. The simple or undifferentiated type of schizophrenic manifests an insidious and gradual reduction in his external relations and interests. His emotions lack depth, his ideation is simple and refers to concrete things, and there is a relative absence of mental activity, a progressive lessening in the use of inner resources, and a retreat to simpler or stereotyped forms of behaviour. 2. The hebephrenic or disorganized type of schizophrenic displays shallow and inappropriate emotional responses, foolish or bizarre behaviour, false beliefs (delusions), and false perceptions (hallucinations). 3. The catatonic type is characterized by striking motor behaviour. The patient may remain in a state of almost complete immobility, often assuming statuesque positions. Mutism (inability to talk), extreme compliance, and absence of almost all voluntary actions are also common. This state of inactivity is at times preceded or interrupted by episodes of excessive motor activity and excitement, generally of an impulsive, unpredictable kind. 4. The paranoid type, which usually arises later in life than the other types, is characterized primarily by delusions of persecution and grandeur combined with unrealistic, illogical thinking, often accompanied by hallucinations. These different types of schizophrenia are not mutually exclusive, and schizophrenics may display a mixture of symptoms that defy convenient classification. There may also be a mixture of schizophrenic symptoms with those of other psychoses, notably those of the manic-depressive group. Hallucinations and delusions, although not invariably present, are often a conspicuous symptom in schizophrenia. The most common hallucinations are auditory: the patient hears (nonexistent) voices and believes in their reality. Schizophrenics are subject to a wide variety of delusions, including many that are characteristically bizarre or absurd. One symptom common to most schizophrenics is a loosening in their thought processes; this syndrome manifests itself as disorganized or incoherent thinking, illogical trains of mental association, and unclear or incomprehensible speech. Schizophrenia crosses all socioeconomic, cultural, and racial boundaries. The lifetime risk of developing the illness has been estimated at about 8 per 1,000. Schizophrenia is the single largest cause of admissions to mental hospitals and accounts for an even larger proportion of the permanent populations of such institutions. The illness usually first manifests itself in the teen years or in early adult life, and its subsequent course is extremely variable. About one-third of all schizophrenic patients make a complete and permanent recovery, one-third have recurring episodes of the illness, and one-third deteriorate into chronic schizophrenia with severe disability. Various theories of the origin of schizophrenia have centred on anatomical, biochemical, psychological, social, genetic, and environmental causes. Despite much research, no single cause of schizophrenia has been established, or even identified. There is strong evidence that genetic inheritance often plays a role in the disease, and researchers continue to search for the presence of biochemical abnormalities in the brains of people suffering from schizophrenia. Stressful life experiences may trigger the disease's initial onset. There is no cure for most patients with chronic schizophrenia, but the disease's symptoms can in many cases be effectively treated by antipsychotic drugs given in conjunction with psychotherapy and supportive therapy. See also psychosis.