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Schizophrenia - Ready reckoner for early diagnosis

Schizophrenia is the most serious psychiatric disorder. It alters and gradually destroys all the psychological faculties of the mind. Although the word schizophrenia means split personality the disease actually causes splintering of all mental functions like attention/concentration, process and content of thinking, feelings, volition, perception and behaviour.

The attention span of the patients gradually shrinks and they find it difficult to complete the tasks needed concentrated activity. The thoughts of the patients of schizophrenia become very personalized, delusional in nature. They are suspicious, have ideas of reference i.e. whatever happens in their surroundings has a special meaning for them. Their talk eventually becomes irrelevant and even incoherent. The patients lack the capacity to relate to people emotionally in a positive way. They become hostile, guarded or openly aggressive. Love and affection loose their meaning. They lack ambition, motivation and future perspective.

They have perceptual disorders like hallucinations like hearing voices, which are not there or seeing images which nobody is perceiving. Some patients might stop eating as they ‘see’ insects or snakes crawling in the food served to them.

The alteration of behaviour involves gradual withdrawal from human interaction. The patients stop socializing and the withdrawal can be so severe as to finally confine the patient to one corner in one posture. The patients can be very impulsive and are likely to get aggressive without any provocation. This happens in response to their weird ways of thinking.

Only at times the onset of schizophrenia is sudden with florid symptoms like aggressive behaviour, paranoid thoughts and hallucinations. The onset of schizophrenia is commonly gradual. Altered behaviour, irritability, falling academic grades during late teens or during early adulthood should alert the family towards the possibility of a diagnosis of schizophrenia. Denial of the symptoms and explanations for the altered behaviour like generation gap, peer group pressure or stress of studies etc. only result in delay in starting the treatment. It is important to remember that earlier the treatment is started in schizophrenia the better is the outcome.

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