Schizophrenia

What is schizophrenia?

Schizophrenia is a serious mental health condition that affects how a person thinks, feels, and behaves. People with schizophrenia may experience persistent delusions (firmly held beliefs despite contrary evidence) and hallucinations (most often hearing voices that aren't there). They may have difficulty organising their thoughts or feel that their feelings, actions, or thoughts are being controlled by others. Schizophrenia can make everyday life — work, studies, relationships, self-care — very difficult.

Schizophrenia affects about 24 million people worldwide (WHO) — roughly 1 in 300. It is one of the most stigmatised mental health conditions. Globally, more than two in three people with psychosis do not receive the specialist mental health care they need.

When does schizophrenia start?

Symptoms usually begin between the ages of 16 and 30. Men often develop symptoms at a younger age than women. It is uncommon to develop schizophrenia after the age of 45.

What are the symptoms of schizophrenia?

Symptoms fall into three groups:

• Psychotic symptoms (also called "positive" symptoms): hallucinations (hearing or seeing things that are not there), delusions (false, unshakeable beliefs), disorganised thinking and speech, and unusual movements.
• "Negative" symptoms: reduced ability to show emotions, low motivation, social withdrawal, and difficulty experiencing pleasure. These can look like depression.
• Cognitive symptoms: trouble concentrating, making decisions, using new information, and working memory. These often have the biggest effect on long-term daily functioning.

What causes schizophrenia?

No single cause is known. Schizophrenia is understood to arise from a combination of genes, brain biology and chemistry, and environmental factors including severe stress or substance use. It is not caused by bad parenting or weak character.

How is schizophrenia treated?

Schizophrenia cannot be cured, but with treatment many people live meaningful, productive lives. In fact, at least 1 in 3 people with schizophrenia can achieve full recovery (WHO). Treatment usually involves:

• Antipsychotic medicines — the mainstay of treatment. They control the psychotic symptoms. Medicines take time to work, and people may need to try more than one. Do not stop taking them without talking to your doctor — stopping abruptly can trigger relapse.
• Psychotherapy — including cognitive behavioural therapy (CBT), which helps manage the impact of symptoms.
• Family education and support — because schizophrenia affects families too, and family involvement improves outcomes.
• Rehabilitation and skills training — supported employment, day programmes, and practical help with daily living.
• Community care — in India, the District Mental Health Programme (DMHP) offers free consultation, some medicines, and follow-up at government hospitals in most districts.

Schizophrenia is a long-term condition. Ongoing treatment and support make the difference between relapse and stability.