Falsehoods Vs. Facts About Schizophrenia: What Science Says About This Disorder
Schizophrenia may be among the most well-known forms of mental illness, but it also tends to be one of the most frequently misunderstood. Stereotyped images of people with this condition have spread widely through popular culture, often leading to the proliferation of inaccurate and stigmatizing ideas. This article will review the facts about schizophrenia and challenge some of the most potentially damaging misconceptions.
Although it can be considered a relatively rare mental health condition, schizophrenia may affect millions of people around the world. Its characteristic symptoms typically include disorganized thoughts and behavior, distorted perceptions of reality, and challenges with directing and controlling one’s actions. It can lead to a variety of negative life outcomes, often resulting in part from the discriminatory and exclusionary actions of other people. In many cases, individuals can manage symptoms of schizophrenia with proper treatment, which usually includes a combination of therapy and medication.
Defining the disorder: Facts about the schizophrenia spectrum
Schizophrenia can take a variety of different forms and may have wide-ranging impacts on an individual’s thoughts, perceptions, and behaviors.
Schizophrenia can involve both “positive” and “negative” symptoms
Some symptoms of schizophrenia can produce major changes in perception and erratic, unpredictable behavior. These are usually classified as positive symptoms and can involve things like:
- Hallucinations (sensory perceptions of things that aren’t there)
- Delusions (persistent, false ideas about the world or the thoughts and intentions of others)
- Disorganized speech (difficulty holding a coherent conversation or expressing understandable ideas)
- Disorganized behavior (actions that don’t seem to serve a logical purpose and may seem startling and strange to others)
While positive symptoms may be the most noticeable signs of schizophrenia, this mental disorder can also involve negative symptoms, meaning the absence of certain behaviors and abilities generally found in healthy people. Negative symptoms can include the following:
- Avolition (little interest in pursuing any particular action or activity)
- Anhedonia (lack of pleasure or satisfaction in activities)
- Asociality (diminished ability to socialize or lack of interest in interacting with others)
- Alogia (limited vocabulary and tendency to speak only briefly, if at all)
- Blunted affect (reduced emotional responses)
For some people with schizophrenia, negative symptoms may persist even after positive symptoms have been managed by medication. This can present a serious challenge to healthy functioning for these individuals.
Schizophrenia may also involve cognitive impairments
Along with disordered patterns of thinking, individuals with schizophrenia can also experience deficits in various cognitive functions. These may include impaired working memory, difficulties with focus and attention, slower mental processing, difficulty understanding social relationships, and challenges with decision-making and behavior control.
Cognitive impairments may emerge early in life, even before other symptoms of schizophrenia become apparent.
A schizophrenia diagnosis requires positive symptoms
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), a person can only be diagnosed with schizophrenia if they exhibit some combination of delusions, hallucinations, and disorganized speech. Someone with only negative symptoms would not meet the diagnostic criteria.
Is schizophrenia rare? Facts about prevalence and impact
Many people may be unclear about how widespread schizophrenia is and which populations are at greatest risk of developing this disorder.
Schizophrenia affects approximately one in 300 people
The World Health Organization (WHO) estimates that around 24 million people, or 0.32% of the general population, live with schizophrenia. This condition seems to be more common in adulthood, with many people experiencing the onset of core symptoms only after adolescence.
Schizophrenia may differ based on gender
While there don’t appear to be differences in the prevalence of schizophrenia between the sexes, research suggests that men and women tend to develop schizophrenia at different points in their lives.
Based on estimates from the National Institute of Mental Health, the most common age of onset among men tends to be between adolescence and early adulthood. For women, the peak occurrence is usually in their early 20s to early 30s. There may be another, much smaller “peak” around age 45.
Some clinical features of the disorder may also differ based on sex. Men with schizophrenia seem to be more prone to negative symptoms and co-occurring substance use disorders, while women may be more likely to present with positive symptoms.
Schizophrenia diagnosis may vary by race
There’s some evidence that the prevalence of schizophrenia may vary based on ethnic background. Black Americans are roughly twice as likely to be diagnosed with psychotic illnesses, including schizophrenia, as white individuals. Latinos may also have higher-than-average rates of diagnosis.
The reasons behind these disparities are unclear. The genetic risk factors for schizophrenia aren’t fully understood, and some of them may be more prevalent in certain populations. However, many researchers have presented evidence that racial bias may influence evaluations of psychotic symptoms, potentially leading to the overdiagnosis of psychotic conditions in minority groups.
Socioeconomic and environmental factors may also partly explain this discrepancy. A systematic review published in 2021 noted that people impacted by structural discrimination may be more likely to develop psychotic symptoms because they experience more frequent and severe psychological stress.
People with other mental illnesses may be at higher risk of schizophrenia
Many kinds of mental health conditions overlap or co-occur, and schizophrenia is no exception. Research suggests that about one in three people with schizophrenia also have at least one other psychiatric diagnosis.
The disorders that most commonly appear alongside schizophrenia usually include the following:
- Substance use disorders
- Bipolar disorder (BD)
- Personality disorders
- Depressive disorders
- Obsessive-compulsive disorder (OCD)
The presence of multiple mental health disorders can often complicate schizophrenia treatment and increase the likelihood of negative outcomes for the people affected.
Where does schizophrenia come from? Facts about schizophrenia risks and causes
Although the causes of schizophrenia aren’t yet fully understood, researchers have uncovered a variety of likely risk factors that are beginning to shed light on how this disease may develop.
Schizophrenia may be affected by many different genes
Heritability studies have shown that schizophrenia likely has a significant genetic component, with a family history of the disease constituting the largest known risk factor. However, the exact genes responsible haven’t yet been pinpointed.
Emerging research indicates that this condition may not be explained by just one or two genes. Instead, it may involve many different genetic variants affecting the formation of the nervous system. This suggests that schizophrenia could be understood in part as a developmental brain disorder.
Life circumstances may also play a role in the development of schizophrenia
Not everyone with a high genetic risk for schizophrenia will experience symptoms of the disease. Other factors that can influence the odds of developing psychosis include those listed below:
- Childhood trauma or bullying
- Complications during gestation and birth
- Advanced paternal age
- Migration from country of origin
- Unstable or dangerous environment during childhood
- Living in an urban environment
- Substance misuse (previously referred to as substance abuse) and use of high-potency cannabis at an early age
Common misconceptions about schizophrenia
Certain widespread misunderstandings about schizophrenia can make life more difficult for those affected.
Misconception #1: Schizophrenia means having multiple personalities
Perhaps because the word “schizophrenia” comes from Greek roots meaning “split mind,” many people believe that schizophrenia involves a single individual switching between two or more “identities” with distinct patterns of speech and behavior. However, this is not a known feature of schizophrenia and tends to be more characteristic of dissociative identity disorder.
Misconception #2: Most people with schizophrenia are dangerous
While they’re often depicted in the media as impulsively and unpredictably aggressive, most people with schizophrenia do not exhibit violent behavior. Some schizophrenic symptoms, such as delusions of persecution, can increase the risk of violence compared to the general population. When people with this condition do commit violent acts, they’re usually more likely to direct them toward family members and other close acquaintances rather than strangers.
Misconception #3: Those with schizophrenia can’t live normal lives
Many people assume that an individual with schizophrenia will be permanently unable to integrate into society and will have to be hospitalized. However, the symptoms of this condition can often be controlled using antipsychotic medications, and psychosocial interventions, such as supported employment, can help individuals live stable and fulfilling lives in the community.
Misconception #4: Schizophrenia involves hearing hostile voices
Auditory hallucinations can be a common symptom of schizophrenia, and there’s a widespread perception that people with this disorder usually hear threatening, critical, or antisocial voices that instruct them to commit harmful acts. However, researchers have found evidence that cultural expectations may play a significant role in the content of hallucinations, with people in non-Western cultures often reporting hearing mostly positive things from hallucinatory voices.
Getting effective treatment may make a difference
Schizophrenia can lead to a variety of negative outcomes, including social isolation, greater risk of physical illnesses, and excess early mortality. However, with proper treatment, many people with this disorder can achieve significant improvement.
Pharmacological treatments may be one viable option. Research suggests that long-lasting injections of antipsychotic medications can be especially effective at controlling psychotic symptoms and improving patient outcomes. Always speak to your doctor or psychiatrist regarding medication options.
Psychotherapy may also help people with schizophrenia, particularly when combined with medication.
There’s also some evidence that group psychotherapy can improve negative symptoms, which are often resistant to pharmacological interventions.
Online therapy could be a good option for those whose symptoms or life circumstances make it difficult to attend in-person meetings regularly. The ability to receive therapy at home might reduce these challenges considerably, although individuals currently experiencing acute psychotic or positive symptoms may require in-person care.
Emerging research suggests that online interventions can be helpful for people living with schizophrenia. For example, a 2016 paper reported that an internet therapy program based on cognitive-behavioral therapy (CBT) could reduce depression and improve positive symptoms of this disorder.
Takeaway
Schizophrenia is a serious mental health disorder whose causes still aren’t fully understood. It often involves positive and negative symptoms, as well as cognitive impairments. A common misconception about schizophrenia may be that individuals living with this disorder cannot live normal lives, but in reality, many of schizophrenia’s debilitating symptoms can be effectively treated with a combination of medication and psychosocial interventions.
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