Schizophrenia, a brain disease, is seen in 4 out of every 1000 people. Schizophrenia, which is found in 12 million men and 9 million women all over the world, is thought to be present in more than 300 thousand people in Turkey.
Every year, April 11 is commemorated as the "World Day Against Schizophrenia".
The disease progresses with deterioration in thoughts and emotional, behavioral and cognitive changes. Although the onset and course of the disease may vary in each patient, it has a chronic course, like high blood pressure diabetes, with periods of exacerbation. Beginning; While it can last for many years with silent symptoms such as introversion and depression, it can also begin suddenly within days of a stressful period with symptoms such as doubt, hearing voices, and insomnia.
Positive symptoms: Unreal thoughts and hallucinations
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The first is the presence of delusions (unreal thoughts) and hallucinations (such as hearing non-existent voices, seeing images, smelling or touching something bad), which are called "positive symptoms". Among the positive symptoms; Thinking that he is being followed, believing that he will be harmed by a person or group, delusions that his thoughts can be read or that he is being directed, and hearing the voices of people or religious entities who comment or speak ill of him are common. It is not necessary for every patient to have all these symptoms at the same time. In addition, these symptoms may not last throughout the disease, they occur during the 'flare-up' periods of the disease and can be relieved with treatments.
Dullness in facial expression, withdrawal from people and reluctance are observed
The second group of symptoms is 'negative symptoms'. Negative symptoms are similar to depression. These are symptoms such as a decrease in the person's gestures and facial expressions, dullness in facial expressions, low motivation, lack of interest in social activities, inability to start a task, reluctance, lack of pleasure, decrease in speech, and moving away from people.
Third group of symptoms: Disorganization
The other is the third group of symptoms, called 'disorganization', also called disorganized speech and behavior in Turkish. group of this There are symptoms such as switching from topic to topic while talking, giving inappropriate answers, dressing strangely, decreasing self-care, shouting, swearing, or not moving, not speaking, not reacting at all, which we call 'catatonia'. Schizophrenia is divided into various types according to the presence of symptoms and the course of the disease. The patient may consult a doctor with many different symptoms. Again, the response to treatment, the patient's social, occupational, family functionality and course may vary greatly from person to person.
The target of treatment is; The aim is to soothe disease symptoms, reduce stressors, treat comorbid diseases such as depression, and increase family, social and professional functionality. It also includes educating the family about the disease and providing psychological support. Medications are important in treatment; antidepressants, mood stabilizers and anxiolytic drugs can be used, especially antipsychotic group drugs. Long-acting antipsychotics in depot form may be preferred. The physician decides on the treatment individually for the patient. It is selected taking into account the type, course, severity of the disease, and drug side effects. A frequently wondered question about drug use is how long it will be used. Drug treatments must be uninterrupted, use may be required for many years and sometimes for life. With regular outpatient clinic follow-ups, response to the medication, side effects, blood values, blood pressure, pulse and weight are monitored at regular intervals. Drug treatments are mandatory. Psychotherapy is one of the treatment options along with medication treatments. Individual therapies and group therapies are helpful. Art and occupational therapies, called occupational therapy, are also used in treatment during outpatient or clinical hospitalizations in community mental health centers. The treatment of the disease is in society, the goal is to avoid clinical hospitalizations and periods of increased disease symptoms, which we call exacerbations, as much as possible. Clinical hospitalizations are made, as in other diseases, if the patient is at risk of suicide or harm and refuses to use medication. ECT treatment can be used to quickly relieve symptoms in patients at risk during clinical hospitalizations.
Family support is of great importance
Families should first and foremost be knowledgeable about the course of the disease, symptoms of the disease, medications used, and correct approaches. They can get help from the patient's psychiatrist or therapist on this issue. They need to support the patient regarding regular doctor's examination follow-ups and medication use, and if necessary, take responsibility in this regard. Family comes to the fore in facilitating socialization and supporting patients in acquiring hobbies in patients with introversion and reluctance. It is important for them to be understanding during periods of exacerbation of the disease, not to criticize the symptoms of the disease, and to approach them in a way that inspires confidence. It should not be forgotten that the patient has characteristics, life and privacy outside of the disease. First of all, it is important for families to stay away from stigmatizing attitudes and to inform the environment about this issue.
The biggest problem in schizophrenia: Stigma and prejudices
Contrary to popular belief, the rate of violence and crime in schizophrenia patients is not higher than in the general population; It has even been reported that they commit fewer crimes. Self-harm and death by suicide are more common. From time to time we come across false news about this in the media; People who mistreat animals and commit violence against people are called 'schizophrenia'. This type of news affects both our patients and their families very negatively. The disease mostly causes alienation from people and introversion, and unfortunately, this is also caused by social prejudices and stigma. Some patients with schizophrenia (such a period does not occur in every patient) may experience periods called 'exacerbations' in which the tendency to cause harm increases, mostly when the patient remains untreated; Thought disorders may occur due to doubts, fears that his family will kill him, that they are devils, or hearing voices commanding him to kill. As mental health professionals, our most important duty is to prevent stigma and prejudice, which are the biggest problems in schizophrenia.
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