How many people have schizophrenia?
Prevalence of mental disorders
A 2005 review of prior surveys in 46 countries on the prevalence of schizophrenic disorders, including a prior 10-country WHO survey, found an average (median) figure of 0.4% for lifetime prevalence up to the point of assessment and 0.3% in the 12-month period prior to assessment. A related figure not given in other studies (known as lifetime morbid risk), reported to be an accurate statement of how many people would theoretically develop schizophrenia at any point in life regardless of time of assessment, was found to be "about seven to eight individuals per 1,000" (0.7/0.8%). The prevalence of schizophrenia was consistently lower in poorer countries than in richer countries (though not the incidence), but the prevalence did not differ between urban/rural areas or men/women (although incidence did).
Political abuse of psychiatry in the Soviet Union
On the covert orders of the KGB, thousands of social and political reformers—Soviet "dissidents"—were incarcerated in mental hospitals after being labelled with diagnoses of "sluggish schizophrenia", a disease fabricated by Snezhnevsky and "Moscow school" of psychiatry. American psychiatrist Alan A. Stone stated that Western criticism of Soviet psychiatry aimed at Snezhnevsky personally, because he was essentially responsible for the Soviet concept of schizophrenia with a "sluggish type" manifestation by "reformerism" including other symptoms. One can readily apply this diagnostic scheme to dissenters. Snezhnevsky was long attacked in the West as an exemplar of psychiatric abuse in the USSR. The leading critics implied that Snezhnevsky had designed the Soviet model of schizophrenia and this diagnosis to make political dissent into a mental disease. He was charged with cynically developing a system of diagnosis which could be bent for political purposes, and he himself diagnosed or was involved in a series of famous dissident cases, and, in dozens of cases, he personally signed a commission decision on legal insanity of mentally healthy dissidents including Vladimir Bukovsky, Natalya Gorbanevskaya, Leonid Plyushch, , and Pyotr Grigorenko.
Smoking cessation
Studies across 20 countries show a strong association between patients with schizophrenia and smoking. People with schizophrenia are much more likely to smoke than those without the disease.[1] For example, in the United States, 80% or more of people with schizophrenia smoke, compared to 20% of the general population in 2006.
Scientology and psychiatry
Scientology claims a worldwide membership of more than 8 million, the total of people who have taken the Scientology introductory course. The Church of Scientology claims 3.5 million members in the United States, though an independent survey has found the number of people in the United States would state their religion as 'Scientology' is close to 55,000. By comparison, the American Psychiatric Association and the American Psychological Association, which are composed of psychiatrists and psychologists, have 38,000 and 148,000 members respectively.
Pseudoneurotic schizophrenia
Pseudoneurotic schizophrenia is a postulated mental disorder categorized by the presence of two or more symptoms of mental illness such as anxiety, hysteria, and phobic or obsessive-compulsive neuroses. It is often acknowledged as a personality disorder. Patients generally display salient anxiety symptoms that disguise an underlying psychotic disorder.
Jeffrey Swanson
Swanson has co-authored over 200 papers on subjects such as the epidemiology of violence and mental illness, the effectiveness of community-based interventions for people with serious psychiatric disorders, such as schizophrenia, and causes of gun violence, as well as policies aimed at reducing it. In 1990, he led a study that found that, when excluding substance abusers, 33% of people with mental illness reported having behaved violently, as compared with only 15 percent of non-mentally-ill people. The same study found that substance abuse was a strong predictor of violence. This study has been criticized for overstating the connection between serious mental illness and violence. In 2015, he led a study that found that 8.9% of those interviewed, which would equate to roughly 22 million Americans, had both impulsive anger issues—meaning they developed "explosive, uncontrollable rage" when provoked—and easy access to guns in their homes. In 2016, he led a study analyzing data from two Florida counties that found that 72% of mentally ill people who committed suicide with a gun purchased it legally. Later that year, he published a study evaluating a 1999 Connecticut law allowing police to remove guns from people believed to be at risk of suicide. The study found that one suicide was prevented for every 10 to 20 guns seized under the law.
Scale for the Assessment of Negative Symptoms
Schizophrenia is a severe mental illness that is characterized by a range of behaviors including hallucinations and delusions. Hallucinations refer to disorders involving the sensory systems, and are most often manifested as seeing or hearing things (e.g., voices) that do not exist. Delusions include odd or unusual beliefs such as grandiosity or paranoia. Both hallucinations and delusions are inconsistent with reality. Other symptoms of schizophrenia include bizarre behavior, odd posture or movements, facial grimacing, loss of, or indifference to self-help skills (grooming, washing, toileting, feeding, etc.). Schizophrenia may also be marked by a host of social and communication deficits, such as social withdrawal, odd use of language, including excessive use of made up words (neologisms), incomprehensible combinations of words (word salad) or overall poverty of speech. There are several subtypes of schizophrenia, but generally speaking the symptoms are often classified into two broad categories: positive and negative symptoms. Positive symptoms refer to those behaviors or condition that are present in schizophrenia but that are not present under typical conditions (hallucinations, delusions). Negative symptoms refer to those behaviors that are conspicuous because of their absence (grooming, language, communication). Several measures or rating scales have been developed to assess the positive and negative aspects of schizophrenia.
Schizophrenia
Media coverage relating to violent acts by people with schizophrenia reinforces public perception of an association between schizophrenia and violence. In a large, representative sample from a 1999 study, 12.8% of Americans believed that those with schizophrenia were "very likely" to do something violent against others, and 48.1% said that they were "somewhat likely" to. Over 74% said that people with schizophrenia were either "not very able" or "not able at all" to make decisions concerning their treatment, and 70.2% said the same of money-management decisions. The perception of people with psychosis as violent has more than doubled in prevalence since the 1950s, according to one meta-analysis.
Evolutionary approaches to schizophrenia
Schizophrenia is a mental illness characterized by experiencing persistent hallucinations, delusions, paranoia, and thought disorder. These experiences are evident in multiple sensory modalities and include deviation in all facets of thought, cognition, and emotion. Compared to other psychological disorders like major depressive disorder (MDD) and generalized anxiety disorder (GAD), schizophrenia has significantly higher heritability. It has been found to present cross-culturally, and it almost always has 0.1% prevalence in a given population, although some studies have cast doubts on this. Schizophrenia has been hypothesized to be unique to human beings and existing for a long time.
Visual processing abnormalities in schizophrenia
Schizophrenia is a complex mental disorder with a heterogeneous set of symptoms. Scientists have identified visual processing abnormalities in this disorder by studying the behavior and physiology of subjects with schizophrenia, and have proposed this as a topic meriting further investigation. There is evidence that schizophrenia affects perception of contrast and motion, control of eye movements, detection of visual contours, and recognition of faces or facial expressions. The specificity of many visual processing abnormalities in schizophrenia is still an area of active debate within the scientific community.
Robin Murray
Professor Murray is part of The Psychosis Research Group at the Institute of Psychiatry, perhaps the largest (by number of papers produced per annum) in the world. It uses a range of methods to improve understanding and treatment of psychotic illnesses, particularly schizophrenia. Murray is ranked as one of the most influential researchers in psychiatry by Thomson Reuters' "Science Watch" and 3rd in schizophrenia research.
Paranoid schizophrenia
Paranoid schizophrenia is an illness that typically requires lifelong treatment with neuroleptics or 5-HT2A antagonists to allow someone to have a relatively stable and normal lifestyle. In order to be successfully treated, a person with schizophrenia should seek help from family or primary care doctors, psychiatrists, psychotherapists, pharmacists, family members, case workers, psychiatric nurses, or social workers, provided he or she is not unable to do so, due to many people with schizophrenia having the inability to accept their condition. Non-compliance with neuroleptics may also occur if the patient considers the side effects (such as extrapyramidal symptoms) to be more debilitating than the condition itself. The main options that are offered for the treatment of paranoid schizophrenia are the following: neuroleptics, psychotherapy, hospitalization, electroconvulsive therapy, and vocational skills training.
Causes of schizophrenia
Individual twin studies and meta-analyses of twin studies have estimated the heritability of risk for schizophrenia to be approximately 80% (this refers to the proportion of variation between individuals in a population that is influenced by genetic factors, not the degree of genetic determination of individual risk), but the heritability estimate varies from 41 to 87%. Concordance rates between monozygotic twins vary in different studies, approximately 50%; whereas dizygotic twins was 17%. 
Some twin studies have found rates as low as 11.0%–13.8% among monozygotic twins, and 1.8%–4.1% among dizygotic twins, however.
Schizophrenia
In the United States, the cost of schizophrenia—including direct costs (outpatient, inpatient, drugs, and long-term care) and non-health care costs (law enforcement, reduced workplace productivity, and unemployment)—was estimated to be $62.7 billion in 2002. The book and film "A Beautiful Mind" chronicles the life of John Forbes Nash, a mathematician who won the Nobel Prize for Economics and was diagnosed with schizophrenia.
LINGO1
Schizophrenia is a chronic, severe and disabling brain disorder.
Diagnosis of schizophrenia
Early-onset schizophrenia occurs from ages 20–30, late-onset occurs after the age of 40, and very-late-onset after the age of 60. It is estimated that 15% of the population with schizophrenia are late-onset and 5% very-late onset. Many of the symptoms of late-onset schizophrenia are similar to the early-onset. However, individuals with late-onsets are more likely to report hallucinations in all sensory modalities modalities, as well as persecutory and partition delusions. On the other hand, late-onset cases are less likely to present with formal thought disorder, affective symptoms. Negative symptoms and cognitive impairment are also rarer in very-late onset cases.
Auditory hallucination
In a study of 1,080 people with a schizophrenia diagnosis from seven different countries of origin, including Austria, Poland, Lithuania, Georgia, Pakistan, Nigeria and Ghana, researchers found that 74.8% of the total participants ("n" = 1,080) disclosed having experienced auditory hallucinations in the last year than any other hallucinations from the date of the interview. Further, the study found the highest rates of both auditory hallucinations and visual hallucinations in both of the West African countries, Ghana and Nigeria. In the Ghana sample, "n" = 76, auditory hallucinations were reported by 90.8% and visual hallucinations were reported by 53.9% of participants. In the Nigeria sample, "n" = 324, auditory hallucinations were reported by 85.4% and visual hallucinations were reported by 50.8% of participants. These findings are in line with other studies that have found that visual hallucinations were reported more in traditional cultures.
Theodore Lidz
Lidz did not consider schizophrenia to be a disease or an illness. He considered it to be a personality disorder which was a reaction to a sick organization. As psychiatric research on the causes of schizophrenia turned to patterns of genetic inheritance and functions of neurotransmitters, Lidz argued that family approaches remained more helpful to treatment and fought the classification of schizophrenia as an incurable, lifelong condition. He studied the creativity of many artists, religious leaders and even scientists who had schizophrenia for periods in their lives. While acknowledging that contemporary medications often alleviate some symptoms of schizophrenia, he emphasized the successes that he and others had achieved with psychotherapy. He viewed the common failure to offer long-term psychotherapy as a betrayal of patients with schizophrenia.
Fantasy (psychology)
In a study of eighty individuals diagnosed with schizophrenia, it was found one quarter of men who had committed a contact crime against women were motivated by sexually orientated fantasy (A.D. Smith 2008).
Schizophrenia and tobacco smoking
Studies across 20 countries show a strong association between schizophrenia and tobacco smoking, whereby people with schizophrenia are much more likely to smoke than those without the disease. For example, in the United States, 80% or more of people with schizophrenia smoke, compared to 20% of the general population in 2006.
History of schizophrenia
The word "schizophrenia" was coined by the Swiss psychiatrist and eugenicist Eugen Bleuler in 1908, and was intended to describe the separation of function between personality, thinking, memory, and perception. He formally introduced the term on 24 April 1908 in a lecture given at a psychiatric conference in Berlin and in a publication that same year. Bleuler later expanded his new disease concept into a monograph in 1911, which was finally translated into English in 1950.
Evolution of schizophrenia
Given the high numbers of individuals diagnosed with schizophrenia (nearly 1% of modern-day populations), it is unlikely that the disorder has arisen solely from random mutations. Instead it is believed that, despite its maladaptive nature, schizophrenia has been either selected for throughout the years or exists as a selective by-product.
Schizotypal personality disorder
Schizotypal personality disorder is widely understood to be a "schizophrenia spectrum" disorder. Rates of schizotypal personality disorder are much higher in relatives of individuals with schizophrenia than in the relatives of people with other mental illnesses or in people without mentally ill relatives. Technically speaking, schizotypal personality disorder may also be considered an "extended phenotype" that helps geneticists track the familial or genetic transmission of the genes that are implicated in schizophrenia. But there is also a genetic connection of STPD to mood disorders and depression in particular.
Evolutionary approaches to schizophrenia
Schizophrenia has raised a perplexing question for evolutionary psychologists and anthropologists. Why has such a debilitating disorder persisted for so long, with such frequency? This paradox has been referred to as the schizophrenia enigma, and many evolutionary models have been created to explain it.
Social construction of schizophrenia
Charities that disagree with the notion of the schizophrenia label in the U.K. include Mind (charity) and Rethink. Mind state on their website "Because of differences of opinion about schizophrenia, it's not easy to identify what might cause it." Mind have previously published an explanatory leaflet, prefaced by Michael Palin that gives a definition of schizophrenia as people 'who think outside the normal range of human experience'. The National Alliance on Mental Illness says:
Epigenetics of schizophrenia
There is a great deal of evidence to show that schizophrenia is a heritable disease. One key piece of evidence is a twin study that showed that the likelihood of developing the disease is 53% for one member of monozygotic twins (twins with same genetic code), compared to the 15% for dizygotic twins, who don't share the exact DNA. Others question the evidence of heritability due to different definitions of schizophrenia and the similar environment for both twins.
Schizophrenia
People with schizophrenia may have a high rate of irritable bowel syndrome, but they often do not mention it unless specifically asked. Psychogenic polydipsia, or excessive fluid intake in the absence of physiological reasons to drink, is relatively common in people with schizophrenia.
Schizophrenia is often described in terms of positive and negative (or deficit) symptoms. "Positive symptoms" are those that most people do not normally experience, but are present in people with schizophrenia. They can include delusions, disordered thoughts and speech, and tactile, auditory, visual, olfactory and gustatory hallucinations, typically regarded as manifestations of psychosis. Hallucinations are also typically related to the content of the delusional theme. Positive symptoms generally respond well to medication.
Prognosis of schizophrenia
Individuals with a diagnosis of schizophrenia are often the victims of violent crime—at least 14 times more often than they are perpetrators. Another consistent finding is a link to substance misuse, particularly alcohol, among the minority who commit violent acts. Violence by or against individuals with schizophrenia typically occurs in the context of complex social interactions within a family setting, and is also an issue in clinical services and in the wider community.
Lynn DeLisi
Lynn Eleanor DeLisi is an American psychiatrist known for her research on schizophrenia. She is an attending psychiatrist at the VA Boston Healthcare System and a professor of psychiatry at Harvard Medical School. She is the editor-in-chief of "Psychiatry Research" and the president of the Schizophrenia International Research Society. She was a co-founder of both the Schizophrenia International Research Society and the International Society of Psychiatric Genetics, and went on to serve as secretary of both organizations. She was one of two founding editors-in-chief of "Schizophrenia Research", which she founded with Henry Nasrallah in 1988. She is also the author of the best-selling book "100 Questions and Answers about Schizophrenia: Painful Minds". She was elected a fellow of the American Association for the Advancement of Science in 2014.
Diagnosis of schizophrenia
The diagnosis of schizophrenia is based on criteria in either the American Psychiatric Association's "Diagnostic and Statistical Manual of Mental Disorders", version DSM-5, or the World Health Organization's International Statistical Classification of Diseases and Related Health Problems, the ICD-10. Clinical assessment is performed by a mental health professional based on observed behavior, reported experiences, and reports of others familiar with the person. Symptoms associated with schizophrenia occur along a continuum in the population and must reach a certain severity and level of impairment before a diagnosis is made.
Schizophrenia
People with severe mental illness, including schizophrenia, are at a significantly greater risk of being victims of both violent and non-violent crime. Schizophrenia has been associated with a higher rate of violent acts, but most appear to be related to associated substance abuse. Rates of homicide linked to psychosis are similar to those linked to substance misuse, and parallel the overall rate in a region. What role schizophrenia has on violence independent of drug misuse is controversial, but certain aspects of individual histories or mental states may be factors. About 11% of people in prison for homicide have schizophrenia and 21% have mood disorders. Another study found about 8-10% of people with schizophrenia had committed a violent act in the past year compared to 2% of the general population.
Prognosis of schizophrenia
Schizophrenia is a major cause of disability. Approximately three quarters of people with schizophrenia have ongoing disability with relapses. Still some people do recover completely and additional numbers function well in society.
Diagnosis of schizophrenia
Estimates of the heritability of schizophrenia is around 80%, which implies that 80% of the individual differences in risk to schizophrenia is explained by individual differences in genetics. Although many genetic variants associated with schizophrenia have been identified, their effects are usually very small, so they are combined onto a polygenic risk score. These scores, despite accounting for hundreds of variants, only explain up to 6% in symptom variation and 7% of the risk for developing the disease. An example of a well-studied genetic biomarker in schizophrenia is the single nucleotide polymorphism in the HLA-DQB1 gene, which is part of the human leukocyte antigen (HLA) complex. A G to C replacement on position 6672 predicts risk of agranulocytosis, a side effect of clozapine that can be fatal.
E. Fuller Torrey
In the early 1970s, Torrey became interested in viral infections as possible causes of schizophrenia or bipolar disorder, particularly a parasite "Toxoplasma gondii" whose definitive host is the cat, but whose intermediate host can be any mammal, including humans. Up to one third of the world's human population is estimated to carry a Toxoplasma infection. Since then he has published, often with Robert Yolken, more than 30 articles on seasonal variation and possible infectious causes of schizophrenia, focusing especially on Toxoplasma gondii. He is involved in five or six ongoing studies using anti-Toxoplasmosa gondii agents (e.g. antibiotics such as minocycline and azithromycin) as an add-on treatment for schizophrenia. He believes that infectious causes will eventually explain the "vast majority" of schizophrenia cases. Some of his collaborators have disagreed with the emphasis he has placed on infection as a direct causal factor. Many of the research studies on links between schizophrenia and "Toxoplasma gondii", by different authors in different countries, are funded and supported by the Stanley Medical Research Institute. The hypothesis is not prominent in current mainstream scientific views on the causes of schizophrenia, although infections may be seen as one possible risk factor that could lead to vulnerabilities in early neurodevelopment in some cases.
Causes of schizophrenia
A particularly stable and replicable finding has been the association between living in an urban environment and the development of schizophrenia, even after factors such as drug use, ethnic group and size of social group have been controlled for. A recent study of 4.4 million men and women in Sweden found a 68%–77% increased risk of diagnosed psychosis for people living in the most urbanized environments, a significant proportion of which is likely to be described as schizophrenia.
Executive dysfunction
Schizophrenia is commonly described as a mental disorder in which a person becomes detached from reality because of disruptions in the pattern of thinking and perception. Although the etiology is not completely understood, it is closely related to dopaminergic activity and is strongly associated with both neurocognitive and genetic elements of executive dysfunction. Individuals with schizophrenia may demonstrate amnesia for portions of their episodic memory. Observed damage to explicit, consciously accessed, memory is generally attributed to the fragmented thoughts that characterize the disorder. These fragmented thoughts are suggested to produce a similarly fragmented organization in memory during encoding and storage, making retrieval more difficult. However, implicit memory is generally preserved in patients with schizophrenia.
Causes of schizophrenia
The rate of substance use is known to be particularly high in this group. In a recent study, 60% of people with schizophrenia were found to use substances and 37% would be diagnosable with a substance use disorder.
Schizophrenia
About 30 to 50 percent of people with schizophrenia fail to accept that they have an illness or comply with their recommended treatment. Treatment may have some effect on insight.
Prevalence of mental disorders
The World Health Organization has published worldwide incidence and prevalence estimates of individual disorders. Obsessive-compulsive disorder is two to three times as common in Latin America, Africa, and Europe as in Asia and Oceania. Schizophrenia appears to be most common in Japan, Oceania, and Southeastern Europe and least common in Africa. Bipolar disorder and panic disorder have very similar rates around the world.
Schizophrenics Anonymous
Schizophrenics Anonymous is a peer support group to help people who are affected by schizophrenia and related disorders including bipolar disorder, schizoaffective disorder, psychotic depression and psychosis.
Eating Disorders Coalition
The United States spends relatively little money on eating disorder-specific programs and research. For example, in 2006 the U.S. spent $21 million on eating disorders research for a population of 5-10 million sufferers. By comparison, in 2006 over $300 million ($USD) was spent on schizophrenia, which impacts approximately the same number of people as eating disorders.
Causes of schizophrenia
It is well established that obstetric complications or events are associated with an increased chance of the child later developing schizophrenia, although overall they constitute a non-specific risk factor with a relatively small effect. Obstetric complications occur in approximately 25 to 30% of the general population and the vast majority do not develop schizophrenia, and likewise the majority of individuals with schizophrenia have not had a detectable obstetric event. Nevertheless, the increased average risk is well-replicated, and such events may moderate the effects of genetic or other environmental risk factors. The specific complications or events most linked to schizophrenia, and the mechanisms of their effects, are still under examination.
Childhood schizophrenia
The grey matter in the cerebral cortex of the brain shrinks over time in people with schizophrenia; the question of whether antipsychotic medication exacerbates or causes this has been controversial. A 2015 meta-analysis found that there is a positive correlation between the cumulative amount of first generation antipsychotics taken by people with schizophrenia and the amount of grey matter loss, and a negative correlation with the cumulative amount of second-generation antipsychotics taken.
Schizophrenia disorders in children are rare. Boys are twice as likely to be diagnosed with childhood schizophrenia. There is often an disproportionately large number of males with childhood schizophrenia, because the age of onset of the disorder is earlier in males than females by about 5 years. People have been and still are reluctant to diagnose schizophrenia early on, primarily due to the stigma attached to it.
History of schizophrenia
According to E. Fuller Toddy and Robert H. Yolken, it was in 1939 that Hitler asked his private physician and his officials to draft a law that would allow the systematic killing of individuals with mental disorders, sticking to a claim that he had made shortly after assuming office in 1933: “it is right that the worthless lives of such creatures should be ended, and that this would result in certain savings in terms of hospitals, doctors and nursing staff.” In 1932 Berthold Kihn had estimated that mentally ill patients were costing Germany 150 million Reichsmarks per year.
Religion and schizophrenia
Schizophrenia is a complex psychotic disorder in which symptoms include emotional blunting, intellectual deterioration, social isolation, disorganized speech and behavior, delusions, and hallucinations. The causes of schizophrenia are unclear, but it seems that genetics play a heavy role, as individuals with a family history are far more likely to suffer from schizophrenia. The disorder can be triggered and exacerbated by social and environmental factors, with episodes becoming more apparent in periods of high stress. Neurologists have found that the schizophrenic brain has larger ventricles (fluid-filled cavities) compared to a well brain. This is hypothesized to be due to loss of nerve cells. Symptoms usually appear around the onset of early adulthood. It is rare for a child to be diagnosed with schizophrenia, in part because of the difficulty in establishing what erroneous thoughts and beliefs can be attributed to childhood development and which thoughts and beliefs can be attributed to schizophrenia. With psychiatric medication (usually antipsychotics) and therapy, individuals with schizophrenia can live successful and productive lives.
Anomalous experiences
Auditory hallucinations, and in particular the hearing of a voice, are thought of as particularly characteristic of people suffering from schizophrenia. However, normal subjects also report auditory hallucinations to a surprising extent. For example, Bentall and Slade found that as many as 15.4% of a population of 150 male students were prepared to endorse the statement "In the past I have had the experience of hearing a person's voice and then found that no one was there". They add: "no less than 17.5% of the [subjects] were prepared to score the item 'I often hear a voice speaking my thoughts aloud' as 'Certainly Applies'. This latter item is usually regarded as a first-rank symptom of schizophrenia ..."
Interpretation of Schizophrenia
"Interpretation of schizophrenia" is a 756-page book divided in 45 chapters. Arieti begins his book stating that it is difficult to define schizophrenia. He asks if schizophrenia is an illness and answers in the negative, since the disorder is not understood in classic Virchowian criterion of cellular pathology. Though those searching for a biological basis of schizophrenia far outnumber those undertaking psychological approaches, Arieti supports the minority view. He believes schizophrenia is an unrealistic way to represent both the self and the world and praises psychiatrist Adolf Meyer for stressing the importance of psychological factors in the etiology of schizophrenia. Arieti also mentions that Freud felt that in schizophrenia the patient's relationship with people is handicapped (an observation that resembles what presently is called "autism").
Schizophrenia Bulletin
Schizophrenia Bulletin is a peer-reviewed medical journal which covers research relating to the etiology and treatment of schizophrenia. The journal is published bimonthly by Oxford University Press in association with the Maryland Psychiatric Research Center and Schizophrenia International Research Society.
Effects of estrogen on schizophrenia
Genetic factors have much to do with developing schizophrenia. In fact the "heritability of schizophrenia is around 80%, and a first degree relative has a 5 to 10 fold increase in the risk of developing the disorder compared to the risk for the general population." It seems that individuals with schizophrenia inherit problems associated with dopamine in the brain. According to Answers.com, dopamine is a "neurotransmitter... essential to the normal functioning of the central nervous system." In the 1950s Arvid Carlsson "designated the molecule dopamine ... as a neurotransmitter". This led to the dopamine hypothesis of schizophrenia.
Personality disorder
Cluster A personality disorders are often associated with schizophrenia: in particular, schizotypal personality disorder shares some of its hallmark symptoms, e.g., acute discomfort in close relationships, cognitive or perceptual distortions, and eccentricities of behavior, with schizophrenia. However, people diagnosed with odd-eccentric personality disorders tend to have a greater grasp on reality than those diagnosed with schizophrenia. Patients suffering from these disorders can be paranoid and have difficulty being understood by others, as they often have odd or eccentric modes of speaking and an unwillingness and inability to form and maintain close relationships. Though their perceptions may be unusual, these anomalies are distinguished from delusions or hallucinations as people suffering from these would be diagnosed with other conditions. Significant evidence suggests a small proportion of people with Cluster A personality disorders, especially schizotypal personality disorder, have the potential to develop schizophrenia and other psychotic disorders. These disorders also have a higher probability of occurring among individuals whose first-degree relatives have either schizophrenia or a Cluster A personality disorder.
Some types of personality disorder were in previous versions of the diagnostic manuals but have been deleted. Examples include sadistic personality disorder (pervasive pattern of cruel, demeaning, and aggressive behavior) and self-defeating personality disorder or masochistic personality disorder (characterised by behaviour consequently undermining the person's pleasure and goals). They were listed in the DSM-III-R appendix as "Proposed diagnostic categories needing further study" without specific criteria. The psychologist Theodore Millon and others consider some relegated diagnoses to be equally valid disorders, and may also propose other personality disorders or subtypes, including mixtures of aspects of different categories of the officially accepted diagnoses.
Diseases of affluence
One in four people have experienced mental illness at one time in their lives and approximately 450 million people in the world currently have a mental illness. People that face poverty have more risks related to having a mental illness and also do not have as much access to treatment. The stressful events that they face, unsafe living condition and poor physical health lead to cycle of poverty and mental illness that is seen all over the world. India, China, and the United States are the countries with the highest levels of mental illnesses of anxiety, depression and schizophrenia according to WHO. The U.S. is reported to have the highest level of depression worldwide. In the U.S., approximately one in five adults has a mental illness or 44.7 million people. In 2016, it was estimated that 268 million people in the world had depression. The range of people that have depression by country is from 2% to 6% of the population with the United States, Greenland, and Australia having higher rates of depression. Anxiety disorders, such as generalized anxiety, Obsessive Compulsive Disorder, and Post Traumatic Stress Disorder impacted 275 million people around the world in 2016. The range of population impacted by anxiety disorders globally is from 2.5%-6.5%. Countries, such as the Australia, the United States, Brazil, Argentina, Iran, the United States and a number of countries in Western Europe appear to have a higher prevalence of anxiety disorders.
Theory of mind
Individuals with the diagnosis of schizophrenia can show deficits in theory of mind. Mirjam Sprong and colleagues investigated the impairment by examining 29 different studies, with a total of over 1500 participants. This meta-analysis showed significant and stable deficit of theory of mind in people with schizophrenia. They performed poorly on false-belief tasks, which test the ability to understand that others can hold false beliefs about events in the world, and also on intention-inference tasks, which assess the ability to infer a character's intention from reading a short story. Schizophrenia patients with negative symptoms, such as lack of emotion, motivation, or speech, have the most impairment in theory of mind and are unable to represent the mental states of themselves and of others. Paranoid schizophrenic patients also perform poorly because they have difficulty accurately interpreting others' intentions. The meta-analysis additionally showed that IQ, gender, and age of the participants does not significantly affect the performance of theory of mind tasks.
Interpretation of Schizophrenia
Since the 1980s, and into the beginnings of 21st century, biological psychiatric models of schizophrenia almost completely took over the psychiatric profession. Current research into the disorder focuses on neurobiology. Psychological approaches to schizophrenia like Arieti's are a rarity in the profession, although this structurally created circumstance neglects the obvious connection between psychological phenomena and neurotransmitter levels, which can be changed through certain practices, like Yoga, meditation, hyperventilation, sensory deprivation, sleep deprivation, among others.
Causes of schizophrenia
In 1956, Gregory Bateson and his colleagues Paul Watzlawick, Donald Jackson, and Jay Haley articulated a theory of schizophrenia, related to Laing's work, as stemming from double bind situations where a person receives different or contradictory messages. Madness was therefore an expression of this distress and should be valued as a cathartic and transformative experience. In the books "Schizophrenia and the Family" and "The Origin and Treatment of Schizophrenic Disorders" Lidz and his colleagues explain their belief that parental behaviour can result in mental illness in children. Arieti's "Interpretation of Schizophrenia" won the 1975 scientific National Book Award in the United States.
Social construction of schizophrenia
"Anti-stigma campaigns and the growing profile of mental health issues in recent years appear to have gone some way to changing views and dispelling misconceptions about mental illness. But with nine in ten people with mental health problems still experiencing stigma and discrimination, nearly sixty years after the Royal Commission’s optimistic assessment, there may still be some way to go in changing public attitudes".
Schizophrenia
Despite the prior belief that schizophrenia occurs at similar rates worldwide, its frequency varies across the world, within countries, and at the local and neighborhood level. This variation has been estimated to be fivefold. It causes approximately one percent of worldwide disability adjusted life years and resulted in 20,000 deaths in 2010. The rate of schizophrenia varies up to threefold depending on how it is defined.
Epidemiology of schizophrenia
The following tables record the age-standardised disability-adjusted life years rates per 100,000 inhabitants (recorded in 2004).
In 2010, there were approximately 397,200 hospitalizations for schizophrenia in the United States. About 88,600 (22.3%) were readmitted within 30 days.
Visual hallucinations in psychosis
Hallucinations in those with psychoses are often experienced in color, and most often are multi-modal, consisting of visual and auditory components. They frequently accompany paranoia or other thought disorders, and tend to occur during the daytime and are associated with episodes of excess excitability.
The DSM-V lists visual hallucinations as a primary diagnostic criterion for several psychotic disorders, including schizophrenia and schizoaffective disorder. The lifetime prevalence of all psychotic disorders is 3.48% and that of the different diagnostic groups are as follows: 0.87% for schizophrenia, 0.32% for schizoaffective disorder, 0.07% for schizophreniform disorder, 0.18% for delusional disorder, 0.24% for bipolar I disorder, 0.35% for major depressive disorder with psychotic features, 0.42% for substance-induced psychotic disorders, and 0.21% for psychotic disorders due to a general medical condition. Visual hallucinations can occur as a symptom of the above psychotic disorders in 24% to 72% of patients at some point in the course of their illness.
Not all individuals who experience hallucinations have a psychotic disorder. Many physical and psychiatric disorders can manifest with hallucinations, and some individuals may have more than one disorder that could cause different types of hallucinations.
E. Fuller Torrey
Although Torrey described family members as "surviving schizophrenia" in his book of that title, in 1997 he said the term "psychiatric survivor" used by ex-patients to describe themselves was just political correctness and he blamed them, along with civil rights lawyers, for the deaths of half a million people due to suicides and deaths on the street. His comments elicited a record number of letters in response, some in favour of Torrey but most against. The accusations have been described as inflammatory and completely unsubstantiated, and issues of self-determination and self-identity said to be more complex than Torrey realizes. In the same journal in 1999, Torrey and Miller of the Stanley Foundation Research Program argued for an incentivised schizophrenia treatment system backed by a credible threat of force, modeled on that used for the fatal infectious disease tuberculosis; replies criticized the logic of the analogy and resort to forced drugging rather than developing alliances and understanding, to which Torrey accused the director and members of MindFreedom International of living off federal funds while denying illness and not caring about the mentally ill on the streets and in prisons.
Schizophrenia
Estimates of the heritability of schizophrenia is around 80%, which implies that 80% of the individual differences in risk to schizophrenia is associated with genetics. These estimates vary because of the difficulty in separating genetic and environmental influences. The greatest single risk factor for developing schizophrenia is having a first-degree relative with the disease (risk is 6.5%); more than 40% of monozygotic twins of those with schizophrenia are also affected. If one parent is affected the risk is about 13% and if both are affected the risk is nearly 50%. Results of candidate gene studies of schizophrenia have generally failed to find consistent associations.
August Hoch
In 6 March 1913 Hoch introduced Eugen Bleuler's disease concept of schizophrenia to elite American alienists and neurologists for the first time during a meeting of the New York Psychiatrical Society. According to him, "all of them made a lot of fun at the term, but it is remarkable what one can get used to."
Schizophrenia Research Foundation
Schizophrenia Research Foundation (SCARF), is a non governmental, non profit organisation based in Chennai. Founded in 1984 by a group of philanthropists and mental health professionals led by M. Sarada Menon, a psychiatrist by profession. SCARF has established itself as a center of repute in rehabilitation and research in disorders of the mind. SCARF is one of the very few NGOs in the world to be named as a collaborating centre of the World Health Organization for mental health research and training.
SCARF has been involved in several studies conducted by the World Health Organisation. Some of its collaborating partners in mental health research are World Health Organization, World Psychiatric Association, Johns Hopkins University, King's College London, Oxfam, Indian Council of Medical Research, AIIMS, NIMHANS and TISS. Tamil Nadu MGR Medical University has approved SCARF as a centre for doctoral studies in 'Mental health and Social Sciences'.
Michael C. O'Donovan
Michael C. O'Donovan is a Scottish psychiatric geneticist who researches the genetics of schizophrenia. He is a clinical professor in the Division of Psychological Medicine and Clinical Neurosciences and the deputy director of the MRC Centre for Neuropsychiatric Genetics and Genomics at the Cardiff University School of Medicine in Cardiff, Wales. He also leads the Schizophrenia Group of the Psychiatric Genomics Consortium. Educated at Glasgow University, he also serves as Academic Psychiatry Lead for the Royal College of Psychiatrists in Wales. He was lead author of a 2014 study in "Nature" which identified over 100 genetic loci associated with an increased risk of schizophrenia. The study, the largest of its kind undertaken at the time, was covered extensively in the media. It was also praised by Thomas Insel, the then-director of the National Institute of Mental Health, who described the study as "a big step forward".
Epidemiology of schizophrenia
While it is claimed that schizophrenia occurs at similar rates worldwide, its prevalence and incidence varies across the world, within countries, and at the local and neighborhood level. It causes approximately 1% of worldwide disability-adjusted life years (DALYs). The rate of schizophrenia varies up to threefold depending on how it is defined.
Creativity and mental illness
People with schizophrenia live with positive, negative, and cognitive symptoms. Positive symptoms (psychotic behaviors that are not present in healthy people): hallucinations, delusions, thought & movement disorders. Negative symptoms (abnormal functioning of emotions and behavior): "flat affect", Anhedonia, reserved. Cognitive symptoms: problems with "executive functioning", attention, and memory. One artist known for his schizophrenia was the Frenchman Antonin Artaud, founder of the Theatre of Cruelty movement. In "Madness and Modernism" (1992), clinical psychologist Louis A. Sass noted that many common traits of schizophrenia – especially fragmentation, defiance of authority, and multiple viewpoints – happen to also be defining features of modern art.
Trauma model of mental disorders
From the 1940s to the 1970s prominent mental health professionals proposed trauma models as a means of understanding schizophrenia, including Harry Stack Sullivan, Frieda Fromm-Reichmann, Theodore Lidz, Gregory Bateson, Silvano Arieti and R.D. Laing. Based on their clinical work they theorised that schizophrenia appears to be induced by children's experiences in profoundly disturbed families and reflect victims attempts to cope with such families and live in societies that are inherently damaging to people's psychological well-being. In the 1950s Sullivan's theory that schizophrenia is related to interpersonal relationships was widely accepted in the United States. Silvano Arieti's book "Interpretation of Schizophrenia" won the American National Book Award in the field of science in 1975. The book advances a psychological model for understanding all the regressive types of the disorder.
Causes of schizophrenia
Schizophrenia is suggested to be a brain disorder rather than a mental illness. It is labeled as a mental illness because the symptoms align as such and the causes of the disorder are not completely known and understood. Psychiatrists R. D. Laing, Silvano Arieti, Theodore Lidz and others have argued that the symptoms of what is called mental illness are comprehensible reactions to impossible demands that society and particularly family life places on some sensitive individuals. Laing, Arieti and Lidz were notable in valuing the "content" of psychotic experience as worthy of interpretation, rather than considering it simply as a secondary and essentially meaningless marker of underlying psychological or neurological distress. Laing described eleven case studies of people diagnosed with schizophrenia and argued that the content of their actions and statements was meaningful and logical in the context of their family and life situations.
Mental health
A survey conducted by Australian Bureau of Statistics in 2008 regarding adults with manageable to severe neurosis reveals almost half of the population had a mental disorder at some point of their life and one in five people had a sustained disorder in the preceding 12 months. In neurotic disorders, 14% of the population experienced anxiety disorders, comorbidity disorders were the next common mental disorder with vulnerability to substance abuse and relapses. There were distinct gender differences in disposition to mental health illness. Women were found to have high rate of mental health disorders and Men had higher propensity of risk for substance abuse. The SMHWB survey showed low socioeconomic status and high dysfunctional pattern in the family was proportional to greater risk for mental health disorders. A 2010 survey regarding adults with psychosis revealed 5 persons per 1000 in the population seeks professional mental health services for psychotic disorders and the most common psychotic disorder was schizophrenia.
Memory disorder
Dementia refers to a large class of disorders characterized by the progressive deterioration of thinking ability and memory as the brain becomes damaged. Dementia can be categorized as reversible (e.g. "thyroid" disease) or irreversible (e.g. Alzheimer's disease). Currently, there are more than 35 million people with dementia worldwide. In the United States alone the number of people affected by dementia is striking at 3.8 million.
Prognosis of schizophrenia
The relationship between violent acts and schizophrenia is a contentious topic. Current research indicates that the percentage of people with schizophrenia who commit violent acts is higher than the percentage of people without any disorder, but lower than is found for disorders such as alcoholism, and the difference is reduced or not found in same-neighbourhood comparisons when related factors are taken into account, notably sociodemographic variables and substance misuse. Studies have indicated that 5% to 10% of those charged with murder in Western countries have a schizophrenia spectrum disorder.
Cognitive epidemiology
A recent study published in March 2015 edition of the American Journal of Psychiatry suggests that not only there is no correlation between high IQ and schizophrenia, but rather that a high IQ may be protective against the illness. Researchers from the Virginia Commonwealth University analyzed IQ data from over 1.2 million Swedish males born between 1951 and 1975 at ages 18 to 20 years old to investigate future risk of schizophrenia as a function of IQ scores. The researchers created stratified models using pairs of relatives to adjust for family clusters and later applied regression models to examine the interaction between IQ and genetic predisposition to schizophrenia. Results from the study suggest that subjects with low IQ were more sensitive to the effect of genetic liability to schizophrenia than those with high IQ and that the relationship between IQ and schizophrenia is not a consequence of shared genetic or familial-environmental risk factors, but may instead be causal.
Causes of schizophrenia
A 2003 study of over 50,000 Swedish conscripts found that there was a small but significant protective effect of smoking cigarettes on the risk of developing schizophrenia later in life. While the authors of the study stressed that the risks of smoking far outweigh these minor benefits, this study provides further evidence for the 'self-medication' theory of smoking in schizophrenia and may give clues as to how schizophrenia might develop at the molecular level. Furthermore, many people with schizophrenia have smoked tobacco products long before they are diagnosed with the illness, and a cohort study of Israeli conscripts found that healthy adolescent smokers were more likely to develop schizophrenia in the future than their nonsmoking peers.
History of schizophrenia
A detailed case 1809 report by John Haslam concerning James Tilly Matthews, and a separate account by Philippe Pinel also published in 1809, are often regarded as the earliest cases of schizophrenia in the medical and psychiatric literature. The Latinized term "dementia praecox" entered psychiatry in 1886 in a textbook by asylum physician Heinrich Schüle (1840-1916) of the Illenau asylum in Baden. He used the term to refer to hereditarily predisposed individuals who were "wrecked on the cliffs of puberty" and developed acute dementia, while others developed the chronic condition of hebephrenia. Emil Kraepelin had cited Schüle's 1886 textbook in the 1887 second edition of his own textbook, Psychiatrie, and hence was familiar with this term at least six years before he himself adopted it. It later appeared in 1891 in a case report by Arnold Pick which argued that hebephrenia should be regarded as a form of dementia praecox. Kraepelin first used the term in 1893. In 1899 Emil Kraepelin introduced a broad new distinction in the classification of mental disorders between "dementia praecox" and mood disorder (termed manic depression and including both unipolar and bipolar depression). Kraepelin believed that "dementia praecox" was caused by a lifelong, smoldering systemic or "whole body" process of a metabolic nature that would eventually affect the functioning of the brain in a final decisive cascade. Hence, he believed the entire body—all the organs, glands and peripheral nervous system—was implicated in the natural disease process. Although he used the term "dementia," Kraepelin seemed to use the term synonymously with "mental weakness," mental defect," and "mental deterioration," but distinguished it from other uses of the term dementia, such as in Alzheimer's disease, which typically occur later in life. In 1853 Bénédict Morel used the term "démence précoce" (precocious or early dementia) to describe a group of young patients who were suffering from "stupor". It is sometimes argued that this first use of the term signals the medical discovery of schizophrenia. However, Morel employed the phrase in a purely descriptive sense and he did not intend to delineate a new diagnostic category. Moreover, his traditional conception of dementia differed significantly from that employed in the latter half of the nineteenth-century. Finally, there is no evidence that Morel's "démence précoce" had any influence on the later development of the "dementia praecox" concept by either Arnold Pick or Emil Kraepelin.
Glutamate carboxypeptidase II
Schizophrenia is a mental disorder that affects 1% of people throughout the world. It can be modeled by PCP in laboratory animals, and it has been shown that mGluR agonists have reduced the effects of the drug. NAAG is, such, an mGluR agonist. Thus, inhibition of the enzyme that reduces NAAG concentration, NAAG peptidase, could provide a practical treatment for reduction of schizophrenic symptoms.
Schizophrenia
Late adolescence and early adulthood are peak periods for the onset of schizophrenia, critical years in a young adult's social and vocational development. In 40% of men and 23% of women diagnosed with schizophrenia, the condition manifested itself before the age of 19. The most general symptoms of schizophrenia tend to appear between ages 16 and 30. The onset of the disorder is usually between ages 18 and 25 for men and between 25 and 35 for women. To minimize the developmental disruption associated with schizophrenia, much work has recently been done to identify and treat the prodromal (pre-onset) phase of the disorder, which has been detected up to 30 months before the onset of symptoms. Those who go on to develop schizophrenia may experience transient or self-limiting psychotic symptoms and the non-specific symptoms of social withdrawal, irritability, dysphoria, and clumsiness before the onset of the disease. Children who go on to develop schizophrenia may also demonstrate decreased intelligence, decreased motor development (reaching milestones such as walking slowly), isolated play preference, social anxiety, and poor school performance.
Comparison of bipolar disorder and schizophrenia
Bipolar I disorder and schizophrenia each occur in approximately 1% of the population; schizoaffective disorder is estimated to occur in less than 1% of the population.
Social construction of schizophrenia
"He first advanced the term schizophrenia in 1908 in a paper based on a study of 647 Burghölzli patients. He then expanded on his paper of 1908 in Dementia Praecox oder Gruppe der Schizophrenie…Bleuler is credited with the introduction of two concepts fundamental to the analysis of schizophrenia: autism, denoting the loss of contact with reality, frequently through indulgence in bizarre fantasy; and ambivalence, denoting the coexistence of mutually exclusive contradictions within the psyche."
Schizophrenia Research
Schizophrenia Research is a peer-reviewed medical journal covering research on the cause, clinical diagnostics, and treatment of schizophrenia. It is an official journal of the Schizophrenia International Research Society and was established in 1988. The editors-in-chief are Henry Nasrallah (University of Cincinnati) and Lynn DeLisi (Harvard Medical School). According to "Schizophrenia Research"'s original mission statement, the journal is aimed at
Sarnoff A. Mednick
In a 2008 reassessment of the High Risk sample by Leigh Silverton and Sarnoff A. Mednick (supported by a grant to Silverton from the American Foundation for Suicide Prevention) Silverton, Mednick, Holst and John showed a very relative rate of suicide in those at high risk for schizophrenia. They also showed that although those with schizophrenia may drift into lower social class regions, those of higher social class "origins" develop schizophrenia suicide at a higher rate than those from lower social classes. The authors reasoned the although schizophrenia may largely be a brain disease, the response to cognitive impairments caused by the disorder may be harder for those from a higher initial social classes and therefore higher self-expectations.
Epigenetics of schizophrenia
The epigenetics of schizophrenia is the study of how the inherited epigenetic changes is regulated and modified by the environment and external factors, and how these changes shape and influence the onset and development of, and vulnerability to, schizophrenia. Epigenetics also studies how these genetic modifications can be passed on to future generations. Schizophrenia is a debilitating and often misunderstood disorder that affects up to 1% of the world's population. While schizophrenia is a well-studied disorder, epigenetics offers a new avenue for research, understanding, and treatment.
Karl Bowman
Karl Bowman read his article "The Modern Treatment of Schizophrenia" at the New York Academy of Medicine in New York on February 17, 1939. During his reading, Bowman stated, "over one half of the population of State Hospitals" consisted of patients diagnosed with schizophrenia. He claimed that this psychological disorder did not shorten the lifespan of the patient, but resulted in the deterioration of the patient's brain. In his article, Bowman addresses many different methods that were used throughout history to help treat schizophrenia. For example, fever therapy consisted of inducing a fever in the patient using various methods, such as the malaria virus, but did not produce effective results in the treatment of schizophrenia. Sleep therapy was carried out using sleep-inducing substances such as marijuana, opium, and somnifen. Bowman also addresses stimulus therapy; this method had only temporary effects. Bowman recommended the insulin method as effective, with longer-lasting effects and more indications of long-term improvement. Bowman was optimistic about schizophrenia patients whose conditions had improved or had been cured and also about future treatment methods for schizophrenia patients.
Self-transcendence
People with schizophrenia tend to have poorer self-rated quality of life compared to the general population. A study of individual differences in people with schizophrenia found that higher scores on self-transcendence and self-directedness and lower scores on harm avoidance were associated with better self-ratings of quality of life. The authors suggested that this finding accords with previous studies finding that spirituality in people with schizophrenia is associated with better adjustment to illness.
List of people with schizophrenia
This is a list of people, living or dead, accompanied by verifiable source citations associating them with schizophrenia, either based on their own public statements, or (in the case of dead people only) reported contemporary or posthumous diagnoses of schizophrenia. Remember that schizophrenia is an illness that varies with severity.
Social cue
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM), schizophrenia is a psychological disorder, which has to include two out of the five symptoms listed below: 
Schizophrenic people find it hard to pick up on social cues. More specifically, people with schizophrenia are found to have deficits in emotional facial recognition, social knowledge, empathy, and non verbal cues, and emotional processing. Most of these aspects are part of a category called social cognition. However, most tasks that are related to social cognition involve emotional processing, empathy, and social norms knowledge. When dealing with facial expression recognition, recent research has found that people with this disorder are unable to recognize facial expressions that exhibit negative emotions, including fear, sadness, anger, and disgust. As a result, Schizophrenic people have trouble comprehending situations that involve different types of empathy, especially situations that require empathy for pain.
Mind-blindness
People with schizophrenia also show deficits associated with mind-blindness. However, there is an ongoing debate as to whether individuals with schizophrenia have an impaired ToM leading to mind-blindness or display an exaggerated ToM. Unlike autism, schizophrenia is a late onset condition. It is speculated that this difference in the condition may account for differences seen in the ToM abilities. Brain lesion studies show that there are differences seen in the laterality of brain that account for mind-blindness. It is unknown whether the ToM in schizophrenia deteriorates in the affected person as the condition progresses.
Schizophrenia
Schizophrenia has great human and economic costs. It results in a decreased life expectancy by 10–25 years. This is primarily because of its association with obesity, poor diet, sedentary lifestyles, and smoking, with an increased rate of suicide playing a lesser role. Antipsychotic medications may also increase the risk. These differences in life expectancy increased between the 1970s and 1990s.
Schizophrenia is a major cause of disability, with active psychosis ranked as the third-most-disabling condition after quadriplegia and dementia and ahead of paraplegia and blindness. Approximately three-fourths of people with schizophrenia have ongoing disability with relapses and 16.7 million people globally are deemed to have moderate or severe disability from the condition. Some people do recover completely and others function well in society. Most people with schizophrenia live independently with community support. About 85% are unemployed. Some evidence suggests that paranoid schizophrenia may have a better prospect than other types of schizophrenia for independent living and occupational functioning. In people with a first episode of psychosis a good long-term outcome occurs in 42%, an intermediate outcome in 35% and a poor outcome in 27%. Outcomes for schizophrenia appear better in the developing than the developed world. These conclusions have been questioned.
There is a higher than average suicide rate associated with schizophrenia. This has been cited at 10%, but a more recent analysis revises the estimate to 4.9%, most often occurring in the period following onset or first hospital admission. Several times more (20 to 40%) attempt suicide at least once. There are a variety of risk factors, including male gender, depression, and a high intelligence quotient.
Schizophrenia and smoking have shown a strong association in studies worldwide. Use of cigarettes is especially high in those diagnosed with schizophrenia, with estimates ranging from 80 to 90% being regular smokers, as compared to 20% of the general population. Those who smoke tend to smoke heavily, and additionally smoke cigarettes with high nicotine content. Some propose that this is in an effort to improve symptoms. Among people with schizophrenia use of cannabis is also common.
History of schizophrenia
Both Rüdin's and Kallmann’s theories coincided with the growing interest in the idea of Rassenhygiene or “race hygiene”. The eugenics movement had gained great strength in the United States and Britain. Following suit, in 1933 Rüdin became a guiding force in the passage of Germany’s first compulsory sterilization laws known as “the law for the prevention of progeny with hereditary defects” which would target individuals with mental retardation, schizophrenia, manic-depressive disorder, epilepsy, Huntington chorea, hereditary blindness and deafness, hereditary alcoholism and “grave bodily malformation.” It is suggested by the limited data available that of the 400,000 (1% of the entire population) that were sterilized, 132 000 were sterilized for schizophrenia.
Schizophrenia
In 2000, the World Health Organization found the percentage of people affected and the number of new cases that develop each year is roughly similar around the world, with age-standardized prevalence per 100,000 ranging from 343 in Africa to 544 in Japan and Oceania for men, and from 378 in Africa to 527 in Southeastern Europe for women. About 1.1% of adults have schizophrenia in the United States.
Sluggish schizophrenia
Because of diagnoses of sluggish schizophrenia, Russia in 1974 had 5–7 cases of schizophrenia per 1,000 population, compared to 3–4 per 1,000 in the United Kingdom. In the 1980s, Russia had three times as many schizophrenic patients per capita as the USA, twice as many schizophrenic patients as West Germany, Austria and Japan, and more schizophrenic patients than any Western country. The city with the highest diagnosed prevalence of schizophrenia in the world was Moscow.
Schizophreniform disorder
Schizophreniform disorder is a type of mental illness that is characterized by psychosis and closely related to schizophrenia. Both schizophrenia and schizophreniform disorder, as defined by the "Diagnostic and Statistical Manual of Mental Disorders" (DSM-IV-TR), have the same symptoms and essential features except for two differences: the level of functional impairment and the duration of symptoms. Impairment in social, occupational, or academic functioning is usually present in schizophrenia, particularly near the time of first diagnosis, but such impairment may or may not be present in schizophreniform disorder. In schizophreniform disorder, the symptoms (including prodromal, active, and residual phases) must last at least 1 month but not more than 6 months, while in schizophrenia the symptoms must be present for a minimum of 6 months.
Schizophrenia
People with schizophrenia may experience hallucinations (most reported are hearing voices), delusions (often bizarre or persecutory in nature), and disorganized thinking and speech. The last may range from loss of train of thought, to sentences only loosely connected in meaning, to speech that is not understandable known as word salad. Social withdrawal, sloppiness of dress and hygiene, and loss of motivation and judgment are all common in schizophrenia.
Bicameralism (psychology)
Jaynes notes that even at the time of publication there is no consensus as to the cause or origins of schizophrenia. Jaynes argues that schizophrenia is a vestige of humanity's earlier bicameral state. Recent evidence shows that many schizophrenics do not just hear random voices but experience "command hallucinations" instructing their behavior or urging them to commit certain acts.
Religion
Hallucinations and delusions related to religious content occurs in about 60% of people with schizophrenia. While this number varies across cultures, this had led to theories about a number of influential religious phenomenon and possible relation to psychotic disorders. A number of prophetic experiences are consistent with psychotic symptoms, although retrospective diagnoses are practically impossible. Schizophrenic episodes are also experienced by people who do not have belief in gods.
Social construction of schizophrenia
In Japan "In order to contribute to reduce the stigma related to schizophrenia and to improve clinical practice in the management of the disorder, the Japanese Society of Psychiatry and Neurology changed in 2002 the old term for the disorder, "Seishin Bunretsu Byo" ("mind-split-disease"), into the new term of "Togo Shitcho Sho" ("integration disorder")…Eighty-six percent of psychiatrists in the Miyagi prefecture found the new term more suitable to inform patients of the diagnosis as well as to explain the modern concept of the disorder." 
The Japanese society of psychiatry and neurology report:
"This change is making psychoeducation much easier and is being useful to reduce misunderstandings about the illness and to decrease the stigma related to schizophrenia. The new term has been officially accepted by the Japanese medicine and media and is being adopted in the legislation in 2005."
Paul E. Meehl
Meehl was elected president of the American Psychological Association in 1962. In his address to the annual convention, he presented his comprehensive theory about the genetic causes of schizophrenia. This conflicted with the prevailing notion that schizophrenia was primarily the result of a person’s childhood rearing environment. Meehl argued schizophrenia should be considered a genetically-based neurological disorder manifesting via complex interactions with personal and environmental factors. His reasoning was shaped by the writings of psychoanalyst Sandor Rado as well as the behavioral genetics findings at the time. He proposed that existing psychodynamic theory about schizophrenia could be meaningfully integrated into his neurobiological framework for the disorder.
Meehl hypothesized the existence of an autosomal dominant “schizogene” widespread throughout the population, which would function as a necessary, but not sufficient, condition for schizophrenia. The schizogene would manifest on the cellular level throughout the central nervous system and should be observed as a functional control aberration called “hypokrisia.” Cells exhibiting hypokrisia should contribute to a characteristic pattern of impaired integrative signal processing across multiple neural circuits in the brain, which Meehl termed “schizotaxia.” In response to typical rearing environments and social reinforcement schedules, this neural aberration should invariably lead to a collection of observable behavioral tendencies called “schizotypy.” Schizotypy indicators would include neurological soft signs, subtle differences in language usage (“cognitive slippage”), and effects on personality and emotion. Meehl believed many people in society exhibit signs of schizotypy as a result of the schizogene without showing signs of schizophrenia. Schizophrenia would only occur when individuals are carrying other non-specific genetic risk factors (“polygenic potentiators”) relevant for traits such as anhedonia, ambivalence, and social fear. These additional traits would be more likely expressed under stress (e.g., trauma) and inconsistent social schedules from parents. Given these combinations of conditions, decompensation from schizotypy to schizophrenia would result.
Self-awareness
Schizophrenia as a disease state is characterized by severe cognitive dysfunction and it is uncertain to what extent patients are aware of this deficiency. Medalia and Lim (2004), investigated patients’ awareness of their cognitive deficit in the areas of attention, nonverbal memory, and verbal memory. Results from this study (N=185) revealed large discrepancy in patients’ assessment of their cognitive functioning relative to the assessment of their clinicians. Though it is impossible to access ones’ consciousness and truly understand what a schizophrenic believes, regardless in this study, patients were not aware of their cognitive dysfunctional reasoning. In the DSM-5, to receive a diagnosis of schizophrenia, they must have two or more of the following symptoms in the duration of one month: delusions*, hallucinations*, disorganized speech*, grossly disorganized/catatonic behavior and negative symptoms (*these three symptoms above all other symptoms must be present to correctly diagnose a patient.) Sometimes these symptoms are very prominent and are treated with a combination of antipsychotics (i.e. haloperidol, loxapine), atypical antipsychotics (such as clozapine and risperdone) and psychosocial therapies that include family interventions and socials skills. When a patient is undergoing treatment and recovering from the disorder, the memory of their behavior is present in a diminutive amount; thus, self-awareness of diagnoses of schizophrenia after treatment is rare, as well as subsequent to onset and prevalence in the patient.
Causes of schizophrenia
People with schizophrenia tend to smoke significantly more tobacco than the general population. The rates are exceptionally high amongst institutionalized patients and homeless people. In a UK census from 1993, 74% of people with schizophrenia living in institutions were found to be smokers. A 1999 study that covered all people with schizophrenia in Nithsdale, Scotland found a 58% prevalence rate of cigarette smoking, to compare with 28% in the general population. An older study found that as much as 88% of outpatients with schizophrenia were smokers.
Oneirophrenia
Oneirophenia and schizophrenia are often confused although there are distinct differences between the conditions. Oneirophrenia has some of the characteristics of simple schizophrenia, such as a confusional state and clouding of consciousness, but without presenting the dissociative symptoms which are typical of that disorder. Oneiophrenia often begins with the inability to focus on things while schizophrenia frequently starts with a traumatic event. Persons affected by oneirophrenia have a feeling of dream-like derealization which, in its extreme form, may progress to delusions and hallucinations. Therefore, it is considered a schizophrenia-like acute form of psychosis which remits in about 60% of cases within a period of two years. It is estimated that 50% or more of schizophrenic patients present oneirophrenia at least once.
Lieber Institute for Brain Development
The Lieber Institute was started in 2010 by Steve and Connie Lieber along with Milton and Tamar Maltz—both families have children with schizophrenia. Psychiatrist Daniel R. Weinberger is the CEO. Having gathered over 2,000 brains for research purposes, the institute has the largest collection of post-mortem brains diagnosed with post-traumatic stress disorder. These brains are used to study the biological basis for mental illnesses. In one study of post-mortem brains, LIBD researchers found that patients with schizophrenia had high levels of DNA methylation in brain regions associated with risk for schizophrenia. They are also developing a drug to prevent post-traumatic stress disorder.
Psychosis
Auditory hallucinations, particularly experiences of hearing voices, are the most common and often prominent feature of psychosis. 
Up to 15% of the general population may experience auditory hallucinations. The prevalence in schizophrenia is generally put around 70%, but may go as high as 98%. During the early 20th century auditory hallucinations were second to visual hallucinations in frequency, but they are now the most common manifestation of schizophrenia, although rates vary throughout cultures and regions. Auditory hallucinations are most commonly intelligible voices. When voices are present, the average number has been estimated at three. Content, like frequency, differs significantly, especially across cultures and demographics. People who experience auditory hallucinations can frequently identify the loudness, location of origin, and may settle on identities for voices. Western cultures are associated with auditory experiences concerning religious content, frequently related to sin. Hallucinations may command a person to do something which may be dangerous when combined with delusions.
Schizophrenia
The term schizophrenia is commonly misunderstood to mean that affected persons have a "split personality". Although some people diagnosed with schizophrenia may hear voices and may experience the voices as distinct personalities, schizophrenia does not involve a person changing among distinct, multiple personalities; the confusion arises in part due to the literal interpretation of Bleuler's term "schizophrenia" (Bleuler originally associated schizophrenia with dissociation, and included split personality in his category of schizophrenia). Dissociative identity disorder (having a "split personality") was also often misdiagnosed as schizophrenia based on the loose criteria in the DSM-II. The first known misuse of the term to mean "split personality" was in an article by the poet T. S. Eliot in 1933. Other scholars have traced earlier roots. Rather, the term means a "splitting of mental functions", reflecting the presentation of the illness.