- [Instructor] Schizophrenia
is a disorder of the brain.
What it is absolutely not,
it has nothing to do with
multiple personalities.
When we think about the brain, we think
about things that can cause schizophrenia
and there are likely to
be many different causes,
but we know that it's
likely to be a combination
of genetics and environmental
causes that will be at play,
and when I say environmental,
that may include things
like the experience in the womb
and also growing up,
childhood experiences,
so it's really a combination
of these two big factors
that leads to abnormalities in the brain,
and these abnormalities
in the brain can actually
be picked up by some of the
tests that we have today.
Some of our brain imaging
tests can show some
abnormal changes in some
individuals with schizophrenia.
We know that some of
the neurotransmitters,
the brain chemicals, are also
abnormal in schizophrenia.
In particular, there is a
neurotransmitter called dopamine
that is often thought to
be too high or elevated
in certain parts of the
brain in schizophrenia,
and quite a number of the medicines I use
to treat schizophrenia, the
anti-psychotic medicines,
aim to work against dopamine.
Unfortunately, brain scans,
measuring neurotransmitters,
none of these tests ever
diagnose schizophrenia.
Schizophrenia is actually diagnosed
based on a clinical interview,
and that means taking a history,
hearing from the patient or their family
exactly what's been happening over time,
and also observing the patient.
Well, why would we observe the patient?
Because we know that these
brain changes may actually
cause changes in how a patient behaves.
Their behavior may be altered,
and we can further break this down
into changes in the way they think
and changes in the way they
act, and we think about ways
that people with schizophrenia
may think differently.
We start to think about
having abnormal beliefs,
something that we actually call delusions,
and they may also happen
to see and hear things that
aren't there, something that
we refer to as hallucinations.
Now, people can have
delusions and hallucinations
in other conditions, but these are
some of the symptoms of schizophrenia.
Also, the way that they
act may be different.
They may isolate themselves socially.
They may be somewhat disorganized
or somewhat confused in their actions,
especially to people looking
at them from a distance.
They may have something
that we call a flat affect,
and that basically means they
lack emotions on their face.
This is by no means an exhaustive list,
but we can start to see
that the way that they think
and the way that people
with schizophrenia act,
there's a lot of changes
here that people would
start to feel maybe abnormal or different.
Now, let's think a little more
widely about schizophrenia.
How common is this condition?
Well, we know that
approximately one percent
of people have schizophrenia.
The exact number is actually
a little bit less than that
in the US; it's actually 0.7%,
and we know that males
are typically affected
as much as females, and we know
that this is a condition
that affects people
between the age of 16 and 30.
Although it can happen in childhood
and in older individuals, this
is the most common age group,
with males being affected at
a younger age than females.
When we think about schizophrenia,
we should also think about the fact
that there is something
called the prodrome
and the prodrome
represents a period of time
before schizophrenia, the
symptoms are fully present,
but it's actually a kind of deterioration
in a person's behavior and functioning.
Things are starting to go downhill
and in the prodrome,
typically what may happen is
that people will start to demonstrate
some of the signs of schizophrenia,
but what you will notice is
their academic or schoolwork
may suffer, and I say schoolwork
because if you think about
between 16 and 30, and if
the prodrome precedes that,
you're talking about individuals
that are often still in
the educational system,
but if they're working,
the work can suffer.
Also, their relationships may suffer.
They may exhibit some paranoia
or suspiciousness towards other people.
Some of their thoughts may be
that people are working against them,
so they may develop some
of these delusional ideas
and they may start to act differently.
The prodrome then often
leads to schizophrenia
and we know that if
somebody has schizophrenia,
they are at risk of having
lots of different consequences.
For example, they're at
a higher risk of suicide,
a higher risk of being homeless,
and a higher risk of being
in prison or in jail.
So these are some basics to think about
when we start to hear
the word schizophrenia.
Schizophrenia is a brain disorder
that's neurodevelopmental,
a combination of genetics and environment,
and we can notice that there's differences
in brain scans and neurotransmitters,
but it's really diagnosed
on clinical interview
and it affects how people think and act.
It's preceded by this prodrome period
where we notice a decrease in functioning
and schizophrenia has
a lot of repercussions.
It stops people engaging in
society, results in higher rates
of suicide, homelessness
and incarceration.
