Schizophrenia is a long-term mental illness that affects how a person thinks, perceives and relates to other people. It typically begins between the late teens and the mid-thirties and affects a little under 1 in 100 people over a lifetime.
It does not mean a split personality, and most people who have it are not violent. With continued treatment and support many people recover substantially, study, work and live independently, although relapses are common when treatment is interrupted. Care is long term and works best when it is close to home and family.
Symptoms
- Hearing voices or other hallucinations
- Fixed false beliefs, such as being watched or persecuted
- Disorganised speech or thinking that is hard to follow
- Withdrawal from friends, study or work
- Loss of motivation and reduced emotional expression
- Difficulties with attention, memory and planning
- Neglect of self-care and disturbed sleep
- Limited awareness of being unwell
Causes and risk factors
There is no single cause. Genetic vulnerability is important: the risk is about 10 percent with an affected parent or sibling, though most patients have no family history. Complications in pregnancy and birth, childhood adversity, migration and urban upbringing, and heavy cannabis use in adolescence, particularly high-potency types, each increase the risk. The illness involves changes in dopamine and glutamate signalling in the brain. It is not caused by poor parenting or personal weakness.
How it is diagnosed
- Psychiatric assessment: The diagnosis rests on an interview, observation over time and information from the family. Symptoms must persist, usually for at least 1 to 6 months depending on the classification used.
- Physical examination and blood tests: Blood count, thyroid, glucose, vitamin B12, and screening for infection and drugs, to exclude medical causes.
- Brain MRI or EEG: Used when the presentation is unusual, for example sudden onset, later age, seizures or neurological signs. No scan can diagnose schizophrenia.
- Assessment of risk and substance use: Covers suicide risk, self-neglect, and use of cannabis, stimulants and alcohol.
- Baseline physical health measures: Weight, waist, blood pressure, lipids, glucose and ECG before antipsychotic treatment begins.
Treatment options
- Antipsychotic medication: The foundation of treatment. The choice is made jointly and weighs benefit against side effects such as weight gain, sedation, stiffness and raised prolactin. It usually needs to be continued long term.
- Long-acting injections: Given every 2 weeks to every 3 or 6 months. They reduce relapse when taking daily tablets is difficult.
- Clozapine: The most effective option when two other antipsychotics have not worked. It requires regular blood count monitoring.
- Psychological therapies: Cognitive behavioural therapy for psychosis and family intervention reduce distress and relapse.
- Early intervention and rehabilitation: Coordinated teams, supported employment and education, social skills training and help with housing.
- Physical health care: Support for stopping smoking and for diet and exercise, with yearly metabolic checks.
- Electroconvulsive therapy: Used occasionally for catatonia or for illness that has not responded to medication.
When it is urgent
Thoughts of suicide or of harming others, voices commanding harm, refusal of food or drink, severe agitation or a rigid, mute state require immediate help. Call the local emergency number or go to the nearest emergency department. High fever with muscle stiffness in someone taking an antipsychotic is also a medical emergency.
Travelling to Türkiye for treatment
Travelling abroad for the treatment of schizophrenia is rarely advisable. Care depends on a continuing relationship with a local team, on the person's own language, on family involvement and on the mental health law of the home country. Travel during an acute episode is unsafe, and admission against a person's will cannot be arranged across borders. What can reasonably be offered is a second-opinion consultation on diagnosis or medication, in person or online, when the person is stable and willing, with a written report for the treating psychiatrist. Never stop or change medication for a trip. Carry enough supply, together with a letter listing the medicines.
Send your reports, scans and a short history and a Clinic-Y coordinator replies within 24 hours with suitable teams and written, all-inclusive proposals side by side. Reviewing your case is free.
الأسئلة المتكررة
Can schizophrenia be cured?
There is no cure at present. Symptoms can be controlled and many people achieve a lasting recovery with continued treatment.
How long does medication need to be taken?
After a first episode, at least 1 to 2 years is generally advised. After relapses, long-term treatment is usual. Any reduction should be gradual and supervised.
Does cannabis cause it?
Heavy use in adolescence raises the risk in vulnerable people and worsens the course of established illness. Stopping improves the outlook.
How can the family help?
By learning about the illness, keeping communication calm, supporting treatment, knowing the early warning signs of relapse and looking after their own wellbeing.