10 Warning signs of schizophrenia as identified by family members

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1.  Deterioration of personal hygiene
2.  Sleeping excessively or inability to sleep
3.  Unexpected hostility
4.  Extreme preoccupation with religion or with the occult
5.  Dropping out of activities- or out of life in general
6.  Inappropriate laughter
7.  Shaving head or body hair
8.  Staring without blinking - or blinking incessantly
9.  Peculiar use of words
10. Sensitivity and irritability when touched by others

When someone is experiencing psychotic symptoms such as hallucinations, delusions, or grossly disorganized behavior, they are said to be in the acute or active stage of schizophrenia. The active phase indicates full development of the disorder. When patients are in the active phase, they appear psychotic. Their behavior may become so extreme or bizarre that hospitalization is necessary. Once a patient is brought to medical attention, a mental health professional will observe the patient, question the patient, and question the patient’s family members if they are available.

Patterns of Illness

Schizophrenia patients may follow one of several trajectories after experiencing their first acute episode of the illness. About 35 percent of patients have an extremely severe form of the illness and experience multiple episodes interspersed with periods of increasing functional impairment. Approximately one-third of patients experience several psychotic episodes with no impairment between.

About 20 percent of patients have only one psychotic episode and return to their normal level of functioning, and 10 percent have multiple episodes of schizophrenia that are followed by moderate functioning between episodes. Unfortunately, suicide is not uncommon in patients with schizophrenia. Approximately 15 percent of patients successfully commit suicide, often because they hear a voice telling them to do so.

Heather Barnett Veague, Ph.D.
Heather Barnett Veague attended the University of California, Los Angeles, and received her Ph.D. in psychology from Harvard University in 2004. She is the author of several journal articles investigating information processing and the self in borderline personality disorder. Currently, she is the Director of Clinical Research for the Laboratory of Adolescent Sciences at Vassar College. Dr. Veague lives in Stockbridge, Massachusetts, with her husband and children.

References

1. National Alliance on Mental Illness, "About Mental Illness." Available online. URL: http://www.nami.org/template.cfm?section=By_Illness. Accessed February 22, 2007.
2. American Experience, "People and Events: Recovery from Schizophrenia." Available online. URL: http://www.pbs.org/wgbh/amex/nash/ peopleevents/e_recovery.html. Accessed February 22, 2007.
3. John F. Nash Jr., "Autobiography." Availalable online. URL: http://nobelprize.org/economics/ laureates/1994/nash-autobio.html. Accessed May 10, 2007.
4. Sylvia Nasar, A Beautiful Mind. New York: Simon and Schuster, 1998, 335.
5. American Experience,"Transcript." Available online. URL: http://www.pbs.org/wgbh/amex/nash/filmmore/pt.html. Accessed February 22, 2007.
6. See note 2.
7. Robert L. Spitzer et al., eds., DSM-IV-TR Casebook: A Learning Companion to the Diagnostic and Statistical Manual of Mental Disorders. 4th ed., Text Revision. (Washington, DC: American Psychiatric Publishing, 2004), 189 - 90.
8. H. Hafner et al., "The Influence of Age and Sex on the Onset and Early Course of Schizophrenia." British Journal of Psychiatry 162 (1993): 80 - 86.
9. E. Fuller Torrey, Surviving Schizophrenia: A Manual for Families, Consumers and Providers, 3rd ed. New York: Harper Perennial, 1995, p. 79.
10. G.A. Fava and R. Kellner, "Prodromal Symptoms in Affective Disorders." American Journal of Psychiatry 148 (1991): 828 - 830.
11. British Columbia Schizophrenia Society, "Basic Facts about Schizophrenia," Available online. URL: http://www.mentalhealth.com/book/ p40-sc02.html#Head_4. Downloaded on November 13, 2006.
12. Quoted in J.N. Butcher, S. Mineka, and J.M. Hooley, Abnormal Psychology. Pearson: Boston, 2004.
13. Harrison et al., "Recovery from Psychotic Illness: A 15- and 25-year International Follow-up Study." British Journal of Psychiatry 178 (2001): 506 - 517.
14. N.C. Andreasen, "The Role of the Thalamus in Schizophrenia." Canadian Journal of Psychiatry 42 (1997): 27 - 33.
15. J. Hooley and S. Candela, "Interpersonal Functioning in Schizophrenia." In Oxford Textbook of Psychopathology, edited by T. Million, P.H. Blaney, and R.D. Davis. New York: Oxford University Press, 1999.
16. J.D. Hegarty et al., "One Hundred Years of Schizophrenia: A Meta Analysis of the Outcome Literature." American Journal of Psychiatry 151, no. 10 (1994): 1409 - 1416.
17. E.Q. Wu et al., "The Economic Burden of Schizophrenia in the United States in 2002." Journal of Clinical Psychiatry 66, no. 9 (2005): 1122 - 1129.
18. C. Wallace, P.E. Mullen, and P. Burgess, "Criminal Offending in Schizophrenia over a 25-year Period Marked by Deinstitutionalization and Increasing Prevalence of Comorbid Substance Use Disorders." American Journal of Psychiatry, 161 (2004): 716 - 727.
19. Suicide and Mental Health Association International, "NARSAD Publishes Top 10 Myths About Mental Illness Based on Nationwide Survey." Available online. URL: http://suicideandmentalhealth associationinternational.org/factsmythsment.html. Accessed February 22, 2007.

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