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Schizophrenia occurs in all societies, and one in 100 people will be diagnosed with schizophrenia at some time in their lives. It is the most common among all the psychotic illnesses. Most researchers and clinicians agree that schizophrenia is a biopsychosocial disorder.

This means that syndrome of schizophrenia has a biological basis and that in patients who eventually develop the illness this biological predisposition has interacted with psychosocial stressors.


What are the symptoms of Schizophrenia?

Schizophrenia affects the way people think, behave and react when they are influenced by its active symptoms. Schizophrenic symptoms can be divided into three categories: positive symptoms, disorganized symptoms, and negative symptoms.

  1. Positive symptoms: This refers to having symptoms that ordinarily should not be there. Positive symptoms are sometimes called psychotic symptoms since the patient has lost touch with reality in certain important ways. Some of the positive symptoms are:
    • Delusions: A false/unreal belief that people with schizophrenia sometimes have. Their belief may be that people are reading their thoughts, that someone is plotting against them, or that they can control other people’s minds.
    • Hallucinations: This refers to hearing, seeing, smelling, or feelings that are not there.
  2. Disorganized symptoms:
    • Thought and speech: People with schizophrenia sometimes have trouble communicating in coherent sentences or carrying on a conversation.
    • Behaviour: Schizophrenia can cause people to move more slowly, repeat rhythmic gestures, or make ritualistic movements.
    • Perceptions: People with schizophrenia sometimes have a hard time making sense of everyday sights, sounds, and feelings. Their perception of what is going on around them may be distorted so that ordinary things appear distracting or frightening. They may be extra-sensitive to background noises and colors and shapes.
  3. Negative symptoms: Negative refers to a lack of certain characteristics that should be there. The symptoms are not as dramatic as positive symptoms, but they can interfere significantly with the person’s functioning.
    • Flat/blunted emotions: schizophrenia can make people with it have difficulties to express their emotions clearly. They may speak in a monotone or show little expression on their faces.
    • Lack of motivation/energy: People with schizophrenia may seem to lack energy and have trouble starting projects or following through with things. At the extreme, they may have to be reminded to do simple things like taking a bath or changing clothes.
    • Lack of interest: People with schizophrenia may not take much pleasure or interest in the things around them, even things they used to find enjoyable. They may feel that it is not worth the effort to get out and do things.
    • Limited speech: Their speech is brief and lacks content. They often have trouble carrying on a continuous conversation or saying anything new.


Discovering the Illness

Schizophrenia usually develops in the teens or early adulthood. When the illness first attacks a person, there are changes experienced by him/her or observed by his/her relatives.

These changes may be gradual for some people and sudden and acute for others. The changes may include trouble sleeping, suspicion, fear, and a decrease in general functioning (e.g. having problems in studying, keeping a job, taking care of themselves and relating with others).

Stress in studies or a breakdown in relationships do not cause the illness, these are merely precipitating factors.


How is Schizophrenia treated?

Symptoms of schizophrenia can come and go. They are active in a psychotic episode and require acute treatment. Acute treatment is aimed at ending the current acute psychotic episode.

It may include hospitalization.

When the symptoms are mostly controlled, maintenance treatment is continued on a long term basis to improve functioning and prevent future psychotic episodes.

The person may or may not have persistent symptoms during this phase of maintenance treatment. Successful treatment involves the use of medication, psychotherapy and rehabilitation.

  1. Anti-psychotic medication: Medication is necessary in both the acute and maintenance treatment phase. During the acute phase, medications help relieve the acute psychotic symptoms. After the acute phase, ongoing anti-psychotic medication greatly reduces the chance of relapse. Medication may cause side effects. It is important to discuss medication with the doctor who prescribes it.
  2. Psychotherapy: It helps persons with schizophrenia learn about their illness and develop coping skills, and have emotional support.
  3. Psychosocial rehabilitation: It aims to enhance the abilities of persons with mental illness in their daily living.


What is the outcome?

The course of schizophrenia varies from one patient to another. It is a chronic illness and complete cure (i.e. no need to take medication) is rare. About 25% of schizophrenic patients have complete remissions, about 10% remain severely psychotic, and others are with minor residual symptoms or alternate between impairment and acute psychotic lapses.

There are enormous variables that affect the outcome of the illness, such as functioning before the onset of the illness, type of symptoms, familial and sociocultural context.


What can a person with Schizophrenia do to manage his/her illness?

  1. Comply with medication or other treatment
  2. Understanding the illness
  3. Monitor his/her mental condition
  4. Strive for her/his recovery
  5. Have hope
  6. Join a peer support group


What can families and friends do to help?

  1. Help the patient find appropriate treatment
  2. Encourage the patient to comply with treatment Cooperate with professionals (such as doctor, social worker) offering treatment
  3. Learn to recognize warning signs of relapse
  4. Learn to handle crisis
  5. Understand the patient and set appropriate expectations
  6. Attend family support group


Where do you get help when you or your family members appears to have Schizophrenia?

  1. Ask your family doctor to refer you for help. Approach social services and health agencies for information.
  2. Contact Hong Fook’s intake staff at 416-493-4242 X 0 or other community service agencies
  3. Contact the Metro Integrated Community Crisis Program at 416-289-2434 when in crisis situation
  4. Contact nearby emergency departments