Schizophrenia, a psychiatric disorder that can start at a young age and significantly impair a person's functionality, is characterized by impaired thinking, emotional, behavioral and cognitive changes. Emphasizing the importance of family support in schizophrenia, which has many symptoms such as hearing voices and seeing images that are not there, decreased speech, withdrawal from people, dullness in facial expression, decreased self-care, swearing, shouting or not speaking and not moving, Assoc. Prof. Emre Tolun Arıcı said, "Our most important task is to prevent stigmatization and prejudice, which is the biggest problem in schizophrenia." Arıcı noted that current treatment methods increase the possibility of schizophrenia treatment.
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Schizophrenia, a brain disease, is seen in 4 out of every 1000 people. Schizophrenia, which is found in 12 million men and 9 million women worldwide, is thought to be present in more than 300 thousand people in Turkey.
Every year, April 11th is commemorated as the "World Day Against Schizophrenia".
Psychiatry Specialist Assist. Assoc. Prof. Emre Tolun Arıcı from Üsküdar University NP Feneryolu Medical Center made important evaluations about schizophrenia.
"Schizophrenia is a psychiatric disorder that starts at a young age, can be seen in every society and sociocultural level, and can significantly impair the functionality of the person," said Asst. Assoc. Prof. Emre Tolun Arıcı,
"The disease progresses with deterioration in thoughts, emotional, behavioral and cognitive changes. Although the onset and course of the disease may vary in each patient, it has a chronic course like blood pressure diabetes with periods of exacerbation in between. The onset can last for many years with silent symptoms such as introversion and depression, or it can start suddenly with symptoms such as suspicion, hearing voices, insomnia within days after a stressful period."
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"We can talk about 3 main symptom groups in schizophrenia," said Arıcı and continued his words as follows:
Positive symptoms: Unrealistic thoughts and hallucinations
The first is the presence of delusions (unrealistic thoughts) and hallucinations (such as hearing voices, seeing images, smelling or touching things that are not there), which are called "positive symptoms". Among the positive symptoms, it is common to think that one is being followed, to believe that one will be harmed by a person or a group, to have delusions that one can read one's thoughts, that one is being manipulated, and to hear the voices of people or religious entities commenting or speaking badly about oneself. Not all patients necessarily have all these symptoms at the same time. In addition, these symptoms may not persist throughout the disease, but may occur during the so-called 'exacerbation' periods of the disease and may subside with treatment.
Dullness in facial expression, withdrawal from people and reluctance
The second group of symptoms are 'negative symptoms'. Negative symptoms are similar to depression. They include a decrease in the person's gestures and facial expressions, dullness in facial expression, low motivation, lack of interest in social activities, inability to start a task, reluctance, lack of enjoyment, decreased speech, and withdrawal from people.
Third group of symptoms: Disorganization
The other is the third group of symptoms called 'disorganization', also called disorganized speech and behavior in Turkish. In this group, there are symptoms such as moving from topic to topic while talking, giving inappropriate answers, dressing strangely, decreased self-care, shouting, swearing or not moving at all, not speaking, not reacting, which we call 'catatonia'. Schizophrenia is divided into various types according to the presence of these symptoms and the course of the disease, and the patient may present to the doctor with very different symptoms. Again, the response to treatment, the patient's social, occupational and familial functionality and prognosis can vary greatly from person to person."
Current treatments increase the possibility of cure in schizophrenia
"Today, the increase in the options used in treatment and the use of new drugs have increased the possibility of treatment," said Asst. Assoc. Prof. Dr. Arıcı,
"The goal of treatment is to alleviate the symptoms of the disease, reduce stressors, treat comorbid conditions such as depression, and improve familial, social and occupational functioning. It also includes educating the family about the illness and providing psychological support. Medications are important in treatment, mainly antipsychotic group drugs, antidepressants, mood stabilizers and anxiolytic drugs can be used. Long-acting antipsychotics may be preferred in depot form. The physician decides on the treatment individually. It is selected by taking into consideration the type, course, severity and side effects of the disease. A common curiosity about the use of medication is how long it will be used, drug treatments should be uninterrupted, long years and sometimes lifelong use may be required. Response to medication, side effects, blood values, blood pressure, pulse rate and weight are monitored at regular outpatient clinic follow-ups. Drug treatments are mandatory. Psychotherapy is one of the treatment options along with medication. Individual and group therapies are useful. In community mental health centers, art and occupational therapies called occupational therapy are also used during outpatient or clinical hospitalizations. The treatment of the disease is in the community, and the goal is to avoid clinical hospitalizations and exacerbations, which are periods of increased symptoms of the disease. Clinical hospitalizations are made when the patient is at risk of suicide or self-harm and refuses to take medication. ECT treatment can be used to quickly relieve symptoms in patients at risk during clinical hospitalizations."
Family support is of great importance
Psychiatry Specialist Asst. Assoc. Prof. Emre Tolun Arıcı from Üsküdar University NP Feneryolu Medical Center stated that family support is very important in schizophrenia as in many psychiatric diseases and concluded his words as follows
"Families should be knowledgeable about the course of the disease, symptoms, medications used, correct approaches, and they can get help from the patient's psychiatrist or therapist in this regard. They should support the patient regarding regular medical examination follow-ups and medication use, and if necessary, they should take responsibility in this regard. The family comes to the forefront in facilitating socialization and supporting patients in acquiring hobbies in patients where withdrawal and reluctance are at the forefront. During periods of exacerbation of the disease, it is important that they are understanding, do not criticize the symptoms of the disease, and approach in a way that inspires confidence. It should not be forgotten that the patient has characteristics, life and privacy outside the disease. Above all, it is important that families stay away from stigmatizing attitudes and inform the environment about this issue.
The biggest problem in schizophrenia: Stigmatization and prejudices
Contrary to popular belief, patients with schizophrenia are not more likely to commit violence and crimes than the general population; in fact, it has been reported that they commit fewer crimes. Self-harm and death by suicide are more common. From time to time, we come across false news in the media; people who mistreat animals and inflict violence on people are called 'schizophrenic'. This kind of news affects both our patients and their families very negatively. The disease causes more isolation and withdrawal from people, and unfortunately, social prejudices and stigmatization also cause this. In some patients with schizophrenia (not all patients have such a period), there may be periods called 'exacerbation' in which the tendency to harm increases, mostly when the patient is left untreated; thought disorders may be due to doubts, doubts that his family will kill him, that they are the devil, or hearing voices ordering him to kill. As mental health professionals, our most important task is to prevent stigmatization and prejudices, which are the biggest problem in schizophrenia."
