How Is Schizophrenia Diagnosed?
To diagnose schizophrenia, a trained mental health professional conducts a face-to-face clinical interview, asking detailed questions about family health history and the individual’s symptoms.
Though there isn’t a medical exam for schizophrenia, doctors typically order medical tests to rule out any health conditions or substance abuse that might mimic schizophrenia symptoms.
According to the DSM-IV-TR, the standard reference book mental health professionals use to help make diagnoses, medical conditions that can imitate symptoms of schizophrenia include: neurological conditions (e.g., Huntington’s disease, epilepsy, auditory nerve injury); endocrine conditions (e.g., hyper- or hypothyroidism); metabolic conditions (e.g., hypoglycemia); and renal (kidney) diseases.
What Treatments Exist for Schizophrenia?
Schizophrenia can be successfully managed with medication and psychotherapy. For the majority of schizophrenia sufferers, medication is highly effective in controlling symptoms. However, finding the right medication can take time; each medication affects each person differently. Patients typically try several medications before finding the best one for them.
It’s important to discuss the details of each medication’s risks and benefits with your doctor, take the medication as prescribed, and never stop taking your medication without first talking to your doctor.
What Kinds of Medications Are Used for Schizophrenia?
- Typical antipsychotics. Available since the mid-1950s, these older antipsychotics used to be the first line of treatment, because they successfully reduced hallucinations and delusions. These include: haloperidol (Haldol), chlorpromazine (Thorazine), perphenazine (Etrafon, Trilafon) and fluphenzine (Prolixin). Many patients stop taking their medication because of its extrapyramidal side effects. “Extrapyramidal” actions are those that affect movement, such as muscle spasms, cramps, fidgeting, and pacing. Taking typical antipsychotics long-term can cause tardive dyskinesia—involuntary, random movements of the body, such as facial grimacing and movements of the mouth, tongue, and legs. Because of these side effects, atypical antipsychotics largely have replaced traditional antipsychotics.
- Atypical antipsychotics. Developed in the 1990s, these medications have become the standard treatment for schizophrenia. That’s because they effectively control positive symptoms and help treat negative symptoms without the same side effects as traditional antipsychotics. They include: aripiprazole (Abilify), risperidone (Risperdal), olanzapine (Zyprexa), quetiapine (Seroquel), clozapine (Clozaril), olanzapine/fluoxetine (Symbyax), and ziprasidone (Geodon). Though they rarely cause extrapyramidal complications, each atypical antipsychotic comes with its own side effects. For instance, though effective and much cheaper than other atypicals, clozapine can cause agranulocytosis — a condition that leaves the bone marrow unable to produce enough white blood cells to fight off infection. The newer antipsychotics don’t cause agranulocytosis, but they do cause significant weight gain and increase the risk for diabetes, which can have serious health complications.
Psychotherapy
When combined with medication, psychotherapy can be a valuable tool in managing schizophrenia. Therapy facilitates medication adherence, social skills, goal setting, support, and everyday functioning. Different types of psychotherapy benefit patients in different ways.
Illness management helps patients become an expert on their disorder, so they learn more about their symptoms, the warning signs of a potential relapse, various treatment options, and coping strategies. The goal is for patients to be actively involved in their treatment.
Rehabilitation gives patients the tools to be independent and navigate everyday life by teaching them social, vocational, and financial skills. Patients learn how to manage money, cook, and communicate better. There are many different types of rehabilitation programs.
Cognitive-behavioral therapy helps patients develop techniques to challenge their thoughts, ignore the voices in their heads, and overcome apathy.
Family education provides families with the tools to help and support their loved one. Families gain a deeper understanding of schizophrenia and learn coping strategies and other skills to prevent relapses and bolster treatment adherence.
Family therapy aims to reduce familial stress by teaching relatives how to discuss problems immediately, brainstorm solutions and pick the best one. Families who participate in therapy significantly decrease the chances of their loved one relapsing.
Group therapy offers a supportive environment that fosters discussion of real-life problems and their solutions, encourages social interaction, and minimizes isolation.
Hospitalization
A person with schizophrenia might require hospitalization if he or she is experiencing severe delusions or hallucinations, suicidal thoughts, problems with substance abuse or any other potentially dangerous or self-harmful issues.
Learn more: Schizophrenia Treatment
What Do I Do Next?
Learning about schizophrenia is an important first step in finding help. If you would like to learn more about schizophrenia, check out LifeHelper’s guide to the disorder.
If you think you have schizophrenia (or your loved one might), the next step is to seek an evaluation by a trained mental health professional. To find a therapist near you, use LifeHelper’s therapist locator, ask your physician or consult a community mental health clinic for a referral.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Janicak, P.G., Marder, S.R., Tandon, R., Goldman, M. (2014). Schizophrenia Recent Advances in Diagnosis and Treatment. New York: Springer.
National Institute of Mental Health. (2018). Schizophrenia. Retrieved from https://www.nimh.nih.gov/health/publications/schizophrenia/index.shtml on February 27, 2018.
Olukayode, A. et al. (2014). The 4th Schizophrenia International Research Society Conference, 14-18 April 2014, Florence, Italy: A summary of topics and trends. Schizophrenia Research, 159, e1-22. doi: 10.1016/j.schres.2014.08.032
Simeone, J.C., Ward, A.J., Rotella, P., Collins, J. Windisch, R. (2015). An evaluation of variation in published estimates of schizophrenia prevalence from 1990-2013: A systematic literature review. BMC Psychiatry, 15.
For Further Information
National Alliance on Mental Illness (NAMI)
