by Dr. Manura Nanayakkara

Created on: July 01, 2010   Last Updated: June 28, 2011

Schizophrenia is a serious mental illness. It is characterized by delusions and hallucinations. Around one third of patients can have a normal life, if adhered to doctors advice. Another one third will have some symptoms and functional deterioration, despite regularly taking drugs. Unfortunate last third of patients may not see any improvements in their symptoms. 

What causes schizophrenia?

Majority of patients don’t have structural abnormality in their brain. Therefore, it’s called a functional mental illness. However, there are biochemical changes like increased dopamine (a neurotransmitter) levels in the certain brain areas and changes in Glutamate neurotransmission in the brain (Stahl, 3rd). 

What are the symptoms of schizophrenia?

Symptoms usually start insidiously. Therefore, Schizophrenia should be suspected, when a normal individual (typically a teenager) suddenly withdrawn from society, shows reduced work/school performance, start to suspect others and start utter words to himself.

Symptoms are divided into positive, negative and cognitive. Main positive symptoms are delusions and hallucinations. Delusions are false beliefs patients have, which cannot be challenged by logical reasoning and beliefs that are out of keeping with patients cultural background.eg. It’s normal to have a belief of witchcraft in rural setting in India. But it’s certainly not, if one has a belief that Martians are controlling his thoughts.

Hallucinations are perceptions without stimulus. Patients usually get auditory, somatic, gustatory, and visual hallucinations. In Schizophrenia main form of hallucination is auditory. Other hallucinations are less common especially visual hallucinations. When there are visual hallucinations, the doctor investigates the patient extensively for other brain disorders.

 There are several types of auditory hallucinations that are characteristic of Schizophrenia. Most common are third person auditory hallucinations (two people talk to each other about the patient or one voice identifying the patient in third person e.g. He, she) and thought echo (hearing his own thoughts spoken loud).

Most common delusions that occur in schizophrenia are thought insertion (Patient believes other are inserting thoughts to his head), thought withdrawal (Other are withdrawing thoughts from the patient), Delusional perception (giving bizarre interpretation to normal perception .e.g. believing he is a homosexual person when he sees

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