How to deal with family schizophrenia

Schizophrenia is a topic that, although most people have heard it, raises many questions. What are your main symptoms? How should the family cope with this disorder? How is the treatment? These are just some of the questions.

Marcia Morikawa, a psychiatrist at Albert Einstein Hospital, explains that schizophrenia can be defined as a chronic mental disorder, where the patient experiences psychotic, flare-ups throughout his life. "These symptoms are characterized by hallucinations, delusions, thought disruption and even bizarre behavior," he says.

The disease is multifactorial, ie it has a range of etiologies. There is a genetic coefficient, and the incidence of the disease in the general population is 1%. When a parent or sibling is affected by the disorder, the risk of developing schizophrenia rises to 10-20%. Among identical twins, the agreement is 50%, while among dizygotic twins, the incidence is 12%. If you are a grandparent, the risk is 3%. If both parents are schizophrenic, the risk of involvement increases to 40-50% ?, explains the psychiatrist.

It is known that there is a change in neurotransmitters, such as a central dopaminergic hyperfunction, but it is known that there are other neurotransmitters implicated in its genesis. Other factors that correlate with the possible onset of the disorder are situations of fetal stress, malnutrition of the fetus, which can occur due to illness during pregnancy, pregnancy complications and peripartum, such as extreme prematurity ?, adds Marcia.

Still according to the doctor, the psychological theories advanced in the 40's, that there would be a "schizophrenogenic" maternal behavior, have not been proven and are no longer considered as an etiological factor. Such theories attempted to show that certain patterns of maternal behavior, including hostility and rejection, appeared to be common in mothers of patients who developed schizophrenia. However, the lack of evidence led to their being discarded.

Schizophrenia Symptoms

The main symptoms of schizophrenia are organized between two major groups: positive and negative symptoms. Positive symptoms include hallucinations, which are unrealistic perceptions, which occur regardless of whether there are external stimuli. They can be visual, auditory (speaking to or about the person, as if commenting on one's actions, giving command commands, etc.), kinesthetic (body sensations, as if there were animals walking under the person's skin), olfactory (odor of perfumes or unpleasant smells) etc. ?, highlights Marcia.

Other positive symptoms are delusions, which are unrealistic and unremovable beliefs with religious mystical content. For example, that one has the power to bless and heal others, who carries God's message of persecution (as in the movie Brilliant Mind, where Russell Crowe's character believes there is a military plot against him, or when people They believe cameras have been installed to watch over him, which have poisoned his food), influence (in which one believes his body is commanded by another person / force), etc., ”adds the psychiatrist.

Negative symptoms, according to Marcia, are the least noticeable by the general population. They are associated with the flattening of affection, that is, with the affective apathy that we find in most patients. They end up having less initiative and appear to be more conforming to situations, with less resonance with environmental stimuli ?, he says.

According to the doctor, the age of onset of symptoms is earlier in men, occurring at young-adult age, around 20-25 years, and in women, later, occurring around 30-35 years.

5 Tips For Coping With Family Schizophrenia

Schizophrenia is a condition that inevitably affects the whole family. The tips below help you deal with it as best you can:

1. Find out about schizophrenia

"Family education about the nature of the disease and coping strategies can markedly decrease relapses and improve patients' quality of life," says Marcia.

In this sense, it is important that not only the parents, but everyone in the household (for those patients who have siblings, those who are married, etc.) are aware of this condition.

2. Keep in mind the symptoms of the disease.

? To deal with schizophrenia you need to know its symptoms, and what plasticity that individual presents when they will present a clinical decompensation.The family member has to learn to recognize what are the characteristics of that individual and his symptomatic presentation?

3. Intervene before the crisis is complete

The family member, knowing what the individual's own characteristics and symptomatic presentation are, will be able to identify the first signs of decompensation and may intervene before the psychotic manifestation is complete, explains psychiatrist Marcia.

4. Seek help and information from knowledgeable people

Looking for patient family associations, psychoeducational meetings on the subject, and talking to the patient's psychiatrist are the best ways to learn about the disease, without stigma and prejudice, to help the patient in their daily difficulties, such as adherence to the disease. medication, coping with symptoms, socializing, performing tasks etc ?, says Marcia.

5. Support the patient and get rid of any prejudice

It is a mistake to think that people with schizophrenia cannot live well among their family and friends. The psychiatrist explains that people with schizophrenia can get along with family and friends as well as the better their adherence to treatment, the support of family members, their psychoeducation and the lower the prejudice of those around them. "Stabilized patients can have a normal family life with their jobs and social network," he says.

Schizophrenia Treatment

Treatment of schizophrenia is based on lifelong control of symptoms using antipsychotic medications. There are typical antipsychotics, which are older medications, which are very effective for treating positive symptoms but have a higher profile of side effects. and atypical antipsychotics, with less extrapyramidal effects and more effective in treating negative symptoms of schizophrenia ?, highlights Marcia.

Once the disorder is diagnosed, the psychiatrist explains, continuous treatment is necessary as there is no cure for it yet. That is, if the use of medications is correct, there is control of the disease. If there is irregular use of medication, new decompensations will occur, similar to clinical treatments of extremely diverse pathologies such as diabetes, hypertension, hypothyroidism ?, says.

According to the doctor, the goals of treatment during the acute phase of treatment, when psychotic symptoms are present, are:

• Avoid damage to the patient;
• Control altered behavior;
• Reduce the severity of psychosis and associated symptoms (eg agitation, aggression, negative symptoms, affective symptoms).

During the stabilization phase, Marcia adds, the goals of the treatment are:

• Reduce stress on the patient;
• Provide support to minimize the likelihood of relapse;
• Improve patient adaptation to community life;
• Progressive reduction of symptoms;
• Consolidation of the remission;
• Promotion of the recovery process;
• Social reinsertion.

Schizophrenia Prevention

Marcia explains that the use of substances such as cannabis (genus of some of the most famous plants of which cannabis sativa, from which cannabis and hashish is produced), alcohol and other drugs, can lead to the onset of psychotic outbreaks, which can or not lead to installation of schizophrenic framework. "Thus, avoiding contact with these substances may decrease the chance of the predisposed individual to develop the disorder," he says.

Myths and Truths About Schizophrenia

1. MYTH: Most people with schizophrenia are violent or dangerous.

Marcia explains that most people in psychotic breakdown can have violent or dangerous behavior, depending on the person's delusional belief in that situation / moment, because their judgment skills are impaired. "However, patients with symptomatic control of the disease are no more violent than ordinary individuals we meet on the street around us," he says.

2. MYTH: Schizophrenia can be caused by parental neglect.

Marcia points out that the disorder is multifactorial and, despite having influence of the environment (including drugs, in this way), can not be triggered exclusively by parental behavior. "Studies with identical twins, adopted and raised in completely different environments, maintain the same incidence of diagnosis, proving that the genetic factor is much more important in the genesis of the disorder," adds the doctor.

3. MYTH: If the father has schizophrenia, the child will necessarily have too.

Marcia points out that if one parent has the disorder, the child's chance of developing schizophrenia is 10-20%.

4. MYTH: If a person has schizophrenia they need to stay in a mental hospital.

According to Marcia, there is the stigma of psychiatric hospitals.? The concept of? Asylum? is it prejudiced and does not correspond to the reality lived today ?, he says.

The psychiatrist explains that a schizophrenic patient, as well as a bipolar patient, a depressed patient or a dementia patient, can benefit from lifelong hospitalizations for very short periods of time to protect them from crisis, and for the adjustment of drug treatment.

However, it is extremely harmful for patients to stay away from their environment for a long time, in the old concept of psychiatric hospitalization; How harmful is it for a patient with asthma (who is also a chronic condition) who wants to stay in the hospital for fear of having shortness of breath at home?

5. MYTH: If a person has schizophrenia they can never work.

Patients who are stabilized, adhering to their treatment correctly, according to Marcia, can have a normal life. ? The focus of multidisciplinary treatment is to reinsert patients in society, in their daily life, so that they can work, date, marry, have fun ?, highlights.

6. MYTH: Schizophrenic people are lazy.

It is not correct to say that schizophrenic people are lazy. But Marcia explains that the negative symptoms, when present, make patients more apathetic and flattened (lack of enthusiasm, vitality). "However, the goal of treatment is to achieve remission of these symptoms, so that the patient can perform all their ordinary activities, with quality and well-being," he says.

7. TRUTH: There is no cure for schizophrenia.

One can, in fact, never be able to cure schizophrenia. However, Marcia points out, "there is treatment available with newer medications, with a lower profile of side effects, seeking symptomatic remission, so that the patient has fewer relapses, with higher quality of life, as well as a lower profile of residual and degenerative effects ?, concludes the psychiatrist.

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