Schizophrenia is a severe, chronic mental disorder that affects an individual s ability to think and make decisions, as well as relationships and emotions. The illness is characterized by experiences or unrealistic thoughts, disorganized behaviour and speech, reduced participation in routine activities. A person diagnosed with schizophrenia also experiences difficulty concentrating and memorizing things.

Schizophrenia does not have a definite cure. However, psychological rehabilitation can help the patient manage the symptoms of the illness, and improve the quality of life. This is where psychosocial therapy steps in.

Rehabilitation Psychology for Schizophrenia

Rehabilitation Psychology is a speciality of Psychology that utilizes psychological skills, knowledge, and theories to evaluate and treat people diagnosed with disabilities and chronic health issues in order to maximize functional ability, independence, social participation, and overall health.

A rehabilitation psychologist individualizes services to address different patients with varying health conditions. In order to meet this goal, the discipline adopts a holistic approach and considers individuals within a broad social context.

Different Treatment Approaches

Rehabilitation psychology follows these techniques to address mental disorder like schizophrenia in people  

Individual Psychotherapy   a psychologist/therapist teaches the patient how to deal with their behaviours and thoughts. Patients learn more about the ailment and its effects   and how to distinguish between what is real and what is not. The therapy may also help them manage day-to-day life.

Cognitive Behaviour Therapy   CBT can help the patient change the way they think or behave. A psychologist can show them how to deal with hallucinations and voices. After a couple of CBT sessions, you may be able to identify what triggers psychotic episodes   delusions and hallucinations   and prevent or reduce them.

Cognitive Enhancement Therapy   CET teaches individual ways to recognize triggers, social cues better, and improve memory and attention, and the ability to organize thoughts. The therapy combines group sessions and computer-based brain training.

Social Skills Training aimed towards improving social interactions and communication
Rehabilitation procedures such as problem-solving support and job counselling

Even if the above techniques are able to improve the condition, a schizophrenic person will likely need to continue with special care and education on how to become part of the community. 




How Effective Is Rehabilitation Psychology In Managing Schizophrenia?

When you hear the word  schizophrenia , the first thing that comes to mind are those serial killers shown on the TV or you call it split personality. But that is not the true meaning of it. It is not split personality or some kind of violent illness. Schizophrenia is a severe chronic mental illness which makes it difficult to differentiate between what is real and what is false.

As this is a mental illness, you will not be able to see any changes physically. You need to understand the symptoms of schizophrenia in order to know if a person is suffering from this problem. There are different kinds of symptoms that are used for diagnosing schizophrenia, but they all differ from person to person. Also, the symptoms that you see now, may not be seen later as the disease progresses. There are different types of schizophrenia and each has different symptoms.

Here is a list of the different types of schizophrenia and the most predominant and significant symptoms of each type.

Paranoid Schizophrenia: People suffering from paranoid schizophrenia are characterized by strong auditory hallucinations and of being persecuted. However, they are very normal and function normally. But they are not ready to discuss their feelings openly and the symptoms are not observable. Other symptoms include anger, hostility and disorganized speech.
Disorganized Schizophrenia: As the name suggests, people with disorganized schizophrenia exhibit disorganized thoughts. Delusions and hallucination may not be seen in this type of schizophrenia. The behavior of the affected person is quite disorganized or it is difficult to understand what they are saying. In fact, some emotions exhibited by the affected person are hard to understand or they are not at all relevant to the current situation. Their daily routine and activities will also be affected.
Catatonic Schizophrenia: People with catatonic schizophrenia are characterized by increased or decreased movement. This symptom actually varies from person to person. Some people stay at a place for a long time without any kind of movement and some people keep moving for hours and do not stop. They do not speak for hours and sometimes they keep repeating the same thing over and over again. This has to be treated immediately as they will not be able to manage even their daily routine with this kind of behavior.
Undifferentiated Schizophrenia: Undifferentiated schizophrenia is a condition where the symptoms do not fall into any of the above three types. You will also be able to observe hallucinations, delusions, anger, disorganized speech or catatonic behavior.
Residual Schizophrenia: As the name suggests, it is the residue of schizophrenia behavior, but it is less severe as compared to the past. Delusions, hallucination and disorganized speech may still be present but compared to the past, the patient would be doing better. 

Schizophrenia - 5 Types & Their Signs!

Schizophrenia is a brain disorder that affects how a person sees the world. Schizophrenia makes it difficult for you to distinguish between what is real or unreal. It can stop you from thinking clearly, handling your emotions properly or functioning in a normal way. However, one can manage schizophrenia effectively. The best way is to recognise the signs and symptoms that one might be having. Here is how you can recognise the symptoms of schizophrenia:

Delusions: A delusion is an idea that a person might have despite there being obvious evidence that it is not true or does not exist. These are extremely common in schizophrenia and occur in ninety percent of the people with this disorder. These delusions can be of many types:
Delusion of persecution: When a person believes that someone is out to get them.
Delusion of reference: a very neutral environmental event tends to have a personal meaning to them. They might think that a person on the TV or a billboard is trying to send a message specifically for them.
Delusion of control: In this, a person believes that his or her actions are being controlled from the outside.
Hallucinations: These are sensations or sounds that a person experiences as real when they only exist in that person s mind. Visual hallucinations are relatively more common. These are only meaningful to the person who is experiencing them. These voices or visuals are usually horrific, vulgar, abusive or critical. They tend to increase in intensity when the person is alone.
Disorganized speech: People who suffer from this order have a hard time maintaining or concentrating on certain thoughts. They may start sentences and forget what they were talking about. They might even go off track in the middle of conversations. People with this disorder usually say illogical things and speak incoherently. A patient may also make up words or phrases that only have a meaning to them.
Disorganized symptoms: A person is unable to take care of himself or herself or their work. They face a decline in their overall daily functioning and their behaviours are bizarre and may have no purpose. People with this disorder cannot control their impulses.
Negative symptoms: This refers to the absence of behaviours that usually appear normal to other people. These include lack of expressing oneself emotionally, lack of interest or enthusiasm. These also include speech difficulties or abnormalities as well as their lack of interest in the world.
Schizophrenia can be caused due to many reasons. These include lack of oxygen during birth, exposure to a virus during infancy, physical or sexual abuse, depression, hereditary components or enlarged brain ventricles. This disorder can affect a patient s mental as well as physical health and can endanger the people around them as well as their relationships. Hence, the signs and symptoms should be recognised as early as possible in order to get the right kind of treatment.

Schizophrenia - How To Recognize The Signs?

Schizophrenia has been recognized as a mental disorder that combines symptoms like hallucinations with distorted thinking and others like fright and severe paranoia. This condition is one that gets progressively worse over time and leads to delusional thinking. Oversleeping and complaining of fatigue are usually the earliest signs of this condition's onset. Eventually, it becomes a debilitating factor in the life of the patient, who will not be able to function in a normal way due to the severe symptoms.

Read on to know more about the types and causes of this condition:

Genetic Causes: Schizophrenia may be caused due to genetic factors and it may be a learned or inherited disorder. It is known to affect patients who have a parent or a sibling who may have suffered from this condition. Yet, one must also remember that Schizophrenia can only be influenced by genetics, and not determined by the same.
Environmental Causes: When there has been an exposure to a viral infection during the pre natal stage, the patient is susceptible to this condition. Also, it may affect children who have been subject to the loss of a parent or separation at an early age. Physical and emotional abuse in one's childhood may also bring on this condition. Low level of oxygen at the time of birth is one of the causes of this condition in many patients.
Anomalies in Brain Structure: When the brain ventricles of the patient are enlarged, he or she may be prone to this condition. Also, anomalies in the temporal lobes and amygdala have links with the onset of this condition.
Types: A wide variety of mental and medical conditions can manifest with psychotic symptoms that must be considered in the differential diagnosis of schizophreniform disorder. These include psychotic disorder due to another medical condition or its treatment; delirium or major neurocognitive disorder; substance/medication-induced psychotic disorder or delirium; depressive or bipolar disorder with psychotic features; schizoaffective disorder; other specified or unspecified bipolar and related disorder; depressive or bipolar disorder with catatonic features; schizophrenia; brief psychotic disorder; delusional disorder; other specified or unspecified schizophrenia spectrum and other psychotic disorder; schizotypal, schizoid, or paranoid personality disorders; autism spectrum disorder; disorders presenting in childhood with disorganized speech; attention-deficit/hyperactivity disorder; obsessive-compulsive disorder; posttraumatic stress disorder; and traumatic brain injury.
Since the diagnostic criteria for schizophreniform disorder and schizophrenia differ primarily in duration of illness, the discussion of the differential diagnosis of schizophrenia also applies to schizophreniform disorder. 

Brief psychotic disorder. Schizophreniform disorder differs in duration from brief psychotic disorder, which has a duration of less than 1 month.

Residual Schizophrenia is a condition where the patient does not experience the various debilitating symptoms of the condition, and is on the road to recovery. Yet, even in this type of Schizophrenia, the patient will not really show any interest in life and the activities around him or her. Finally, the last type of Schizophrenia is Schizoaffective Disorder which is characterised by the symptoms of Schizophrenia as well as the symptoms of major mood disorders. When combined, this condition can lead to major complications and complex behavior.

A patient suffering from this condition will need to see a mental health specialist like a psychiatrist or a psychologist on an immediate basis. The treatment will be carried out on a long term basis for the results to start appearing.

Schizophrenia - Know the Causes Behind it

Neurological disorders are an enigmatic bunch. There are various ongoing researches to identify the exact cause and how to treat them. While some argue that schizophrenia is a chronic brain disorder, others do not agree with it and debate that the origin is yet to be identified and the factors which produce it are yet to be identified.

Factors supporting it to be a brain disease are listed below.

Scan images (MRI and PET scans) of people who have had schizophrenia are different and have a reduced volume of grey matter, especially in the frontal and temporal lobes. In some people, this loss could be as high as 25%. Serial images have shown that the loss begins in the outer (parietal) region and gradually spreads to the rest of the brain. There is a strong correlation between the extent of this grey matter loss and the severity of the symptoms more the loss, worse the symptoms. Severe symptoms include hearing voices, psychotic thoughts, delusions, hallucinations and severe depression. This grey matter reduction does not depend on whether the person has undergone treatment or not for the condition. 

The counter argument is that grey matter loss is not seen in patients with schizophrenia alone. A number of neurological disorders, including normal ageing, manifest as grey matter loss on the scan images. Also, another consoling news is that this grey matter loss is completely reversible.

The way neurotransmitters respond to stimuli in people with schizophrenia is also slightly different. There are two variations to this debate: that schizophrenia is caused by excessive amounts of dopamine or increased sensitivity to dopamine. There are two proofs for this hypothesis first, dopamine suppressants are useful as antipsychotic drugs and secondly drugs which produce the same effect as dopamine can cause hallucinations similar to those seen in schizophrenics. There could be other neurotransmitters involved too, but the dopamine connection is more strongly established.

The electrical activity of the brain as seen in EEG is very different and abnormal in schizophrenic people. This reduced brain activity is another indication of the fact that schizophrenia is another brain disorder. There is also a strong genetic component to schizophrenia. Family history correlation is also very strong. The correlation extends to the point that where there is a neurologic disorder in the first-degree relatives, the chances of developing schizophrenia is increased.

There are specific genes, mutations of which are also attributed to schizophrenia. While the risk factors are in place (as mentioned above), the environmental conditions (brain infections, head trauma, family/social stressors and toxins can all lead to the manifestation of the symptoms. With medications and support therapy, both prevention and symptom management are possible.

Schizophrenia - Is It Really a Brain Disease?

Schizophrenia affects over 1% of the world s population and affects the way a person thinks, feels and behaves. In most cases, it is diagnosed when a person is between the ages of 16 to 25. This condition can be hereditary and is said to affect men more often than women. Schizophrenia is characterized by an inability to distinguish between real and imaginary which can lead to delusions, social withdrawal, hallucinations and other forms of social and occupational dysfunction.

Schizophrenia affects different people in different ways. On the basis of the type of symptoms exhibited, this disease has been categorized into 5 sub types. These are:

Paranoid schizophrenia: This type of schizophrenia is characterized by delusions and hallucinations that may make the person exhibit paranoid behaviour. These people often feel like they are being watched or followed and may have delusions of grandeur. They may also get angry quickly on minor issues and show signs of anxiety and hostility.
Disorganized schizophrenia: In such cases, the person may behave in ways that are difficult to understand or speak in broken sentences and have difficulty structuring a sentence. They may also display inappropriate behaviour and react in ways not suitable to the occasion. People suffering from disorganized schizophrenia may also neglect their personal hygiene.
Catatonic schizophrenia: People suffering from catatonic schizophrenia may swing between immobility and periods of rapid movement. They may stay quiet for hours or talk rapidly repeating everything they hear. These people have a high risk of harming themselves as they are usually unable to look after themselves and complete daily activities.
Undifferentiated schizophrenia: People suffering from this type of schizophrenia exhibit behaviour that fits into more than one type of schizophrenia. From time to time they may have hallucinations, suffer from delusions or display catatonic behaviour and disorganized behaviour or speech.
Residual schizophrenia: Even though a person may not be currently showcasing any signs of schizophrenia, they are said to have residual schizophrenia. Such people need to have had at least one schizophrenic episode. These people may exhibit symptoms later or be in complete remission.
With schizophrenia, an early diagnosis can make treatment easier and hence if you notice anyone exhibiting signs of schizophrenia, you must advise them to seek medical help immediately. Schizophrenia cannot be cured but it can be managed with a combination of typical or atypical medication and cognitive therapy. The latter can be in the form of self-help groups, housing and employment programs, counselling and therapy. 

Types Of Schizophrenia - How Can They Be Dealt With?

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