Schizophrenia is the most common and well-known psychotic disorder, affecting approximately 1% of the world’s population.
However, although it is relatively well known, there are still a lot of mysteries and aspects to be investigated regarding this disorder. What? Why is this happening? And this is perhaps the most important question … does schizophrenia cure you?
What is schizophrenia? diagnostic criteria
Schizophrenia is a psychotic disorder characterized by the presence for more than six months of symptoms such as hallucinations (the most prototypical symptom, especially in the form of auditory hallucinations attributed to people or strangers) to oneself ), delusions and disorganized speech, and may also present with symptoms such as allergy and abulia, chaotic behavior and catatonia. These symptoms generally manifest themselves in the form of psychotic epidemics, and the disorder has different courses (with complete or partial remission, with progressive deterioration …), and generate significant interferences in the life of the subject in all or almost all of the home areas.
These symptoms are generally categorized into positive and negative, the former activating the subject or adding something to normal functioning (eg hallucinations and delusions) and the latter limiting them. Due to the decrease in faculties (case of allergy and poor speech and thought).
The existence of different subtypes was previously considered on the basis of the most characteristic symptoms, although in the latest version of the US Reference Manual, the DSM-5, it came to be viewed as a single diagnostic label.
What are its causes?
The causes of schizophrenia remain largely unknown to this day. The influence of genetic factors has been observed, which generate a vulnerability that predisposes (but does not necessarily generate) the disorder. The environment also has a great influence, with the interaction between the two factors that can trigger the disorder. Experiencing very stressful events or taking certain medications can increase and trigger outbreaks in people with this vulnerability.
People with schizophrenia often have peculiarities in the brain, some of which are directly associated with symptoms. Among them, the alteration of certain dopaminergic pathways, the mesolimbic pathway and the mesocortical pathway being the most closely related. In the mesolimbic tract, there is an excess of dopamine associated with the existence of positive symptoms, while a deficiency of this hormone in the mesocortical pathway is responsible for the negative symptoms. Knowledge of these brain disorders can and in fact is used in their treatment (especially medically and pharmacologically).
Currently, some authors propose the hypothesis that schizophrenia is the result of a problem in the process of neuronal migration, Of how neural interconnections develop throughout development.
Is there a cure?
Schizophrenia is a disorder currently considered chronic, and there is currently no cure. for this condition. However, it is treatable: there are treatments and therapies that control the symptoms and keep the patient stabilized, preventing the recurrence of more psychotic flare-ups and allowing them to lead normal lives.
However, treatment should be carried out continuously throughout the subject’s life. This last point is important to avoid relapses, which are generally frequent when subjects, already in good health, decide to stop being treated and medicated. In addition, continuous monitoring allows you to regulate or vary the intake of drugs, in cases where the prescribed drug is not effective or has excessive side effects.
However, it is also true that this disorder is not unknown to science, but there is still a long way to go when it comes to understanding it. As with other chronic disorders, both mental and organic, there is still a lot to analyze and discover, and it is possible that in the future a solution will be found which can be regarded as a cure as such. .
As we said, although schizophrenia is a treatable disorder without care at the moment, this treatment is carried out in a multidisciplinary way. The joint use of psychotherapy and psychotropic drugs is recommended.
1. Pharmacological and medical treatments
Pharmacologically, antipsychotics or neuroleptics are mainly used. The use of atypical drugs is especially recommended, as they can significantly reduce and control both positive and negative symptoms and do not have as many side effects as typical side effects. Pharmacological treatment should be continued throughout the life of the subject, as it prevents the onset of new psychotic attacks (although the type of drug in question, the dose and its level of effectiveness depend on the person).
Other types of medication, such as antidepressants, may need to be applied in cases where it is necessary for the symptoms presented.
As with other medical procedures, although it is not a widespread practice, different surgical techniques are being tested, such as the implantation of electrodes in certain areas of the brain (such as the nucleus accumbens).
2. Psychological treatments
At the psychological level, the treatments to be applied will depend on the problems manifested by the patient. One of the most fundamental aspects is to make the subject understand the need for continued treatment, as many affected people eventually give up the drug. Another fundamental aspect is psychoeducation both in the subject and in the immediate environment, so that it is understandable for the whole situation of the subject, which means for the patient, the need for treatment or aspects such as symptoms that may indicate the onset of a psychotic epidemic. Family and social support is essential both to continue treatment and to cope with the disorder (still strongly stigmatized).
Concentrating on the symptomatology itself, in the case of the presence of hallucinations can use the technique of focusing on the voices so that the subject gradually learns to attribute to himself and not to an external being . Cognitive restructuring is essential to fight against beliefs and illusions. It should always be borne in mind that this is real mental content for the patient, it is generally not advisable to use a direct confrontation. The form and content of his hallucinations and delusions have been explored. It is important to consider the meaning and provenance that the subject attributes to them, so that he can work on these aspects. Additionally, another therapy that generates positive results is acceptance and commitment therapy.
Social skills training or its integration into multimodal programs is highly recommended, as this is an area that tends to be unwelcome in patients with schizophrenia. Occupational therapy can also be helpful, especially in cases of cognitive impairment.
All of the treatments presented above, although they do not involve the treatment of schizophrenia, as we have said, they allow the patient to keep the disorder under control and lead a normal life.
- American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders. Fifth edition. DSM-V. Masson, Barcelona
- Vallina, O. and Lemos, S. (2001). Effective psychological treatments for schizophrenia. Psicothema, 13 (3); 345-364.