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Dealing with schizophrenia poses significant challenges

Schizophrenia is perhaps the most severe and disabling of all the clinical mental disorders.

It is a disorder that involves psychosis – a loss of contact with reality – in which symptoms like hallucinations and delusions markedly distort perception.

People with hallucinations see and/or hear things that are not real. Delusions cause people to believe things that are not true – that they are being unfairly persecuted or that they are a divine deity (Jesus Christ or Buddha), for example.

“Schizophrenia is probably the most devastating and destructive mental illness,” Dr. Joseph Antonowicz, medical director of behavioral health services for the UPMC Altoona Regional Health System, said. “It takes people’s lives away from them, more so than a lot of the other (mental disorders), and it’s a lot harder to treat.

“Schizophrenia isn’t just hallucinations or delusions,” Antonowicz added. “It attacks many different aspects of one’s life – how you think, what makes sense to you, what is important to you. It just distorts everything.”

In any given year, 2.5 million American adults suffer from schizophrenia, a biologically-based brain disorder that in all of its various forms, affects 1 percent of the population.

Symptoms and types of schizophrenia include: paranoid schizophrenia, which is characterized by delusions of being persecuted unfairly; disorganized schizophrenia, which is characterized by erratic speech and/or behavior; catatonic schizophrenia, which is characterized either by complete immobility or frenzied movement.

Along with delusions and/or hallucinations, other symptoms of schizophrenia may include social withdrawal, loss of appetite, a lack of attention to personal hygiene and self-care, flat or emotionless affect, inappropriate affect and a sense of being controlled by outside forces.

The delusions and hallucinations experienced by a person suffering from schizophrenia can be particularly troublesome, according to Denis Navarro, retired outpatient supervisor/clinical specialist at the UPMC Altoona Regional Health System, who still does consulting work at UPMC.

“Hallucinations and delusions of reference – the idea, for example, that the television set is talking to you – are the worst (symptoms),” Navarro said. “And command hallucinations are the scariest. That’s where people believe that they are being directed to do something, and it usually isn’t good.”

The bad news about schizophrenia is that, without proper and adequate treatment, it is the most disruptive, disabling and even deadliest of mental disorders.

Untreated or inadequately-treated schizophrenia can leave individuals with an increased risk for suicide, homelessness, chronic disability, substance abuse or early death stemming from poor self-care.

Although the overwhelming majority of people with schizophrenia are not a danger to others, the delusions and hallucinations caused by the disorder can drive a very small minority of afflicted people to violent behavior.

Psychiatric treatment is essential for people with schizophrenia.

The good news about schizophrenia is that with adequate, appropriate treatment that often involves psychosocial rehabilitation, as well as psychiatric intervention and medication, the prognosis for controlling the disease can be quite good.

“The best outcome for the treatment of schizophrenia is with medication and certain types of psychotherapy that is really aimed at helping people with the disorder become more functional with things like social-skills training,” Antonowicz said.

Coming?Wednesday: A look at obsessive-compulsive disorder (OCD).

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