- [Instructor] Schizophrenia is a disorder of the brain.
What it is absolutely not,
it has nothing to do with multiple personalities.
When we think about the brain, we think
about things that can cause schizophrenia
and there are likely to be many different causes,
but we know that it's likely to be a combination
of genetics and environmental causes that will be at play,
and when I say environmental, that may include things
like the experience in the womb
and also growing up, childhood experiences,
so it's really a combination of these two big factors
that leads to abnormalities in the brain,
and these abnormalities in the brain can actually
be picked up by some of the tests that we have today.
Some of our brain imaging tests can show some
abnormal changes in some individuals with schizophrenia.
We know that some of the neurotransmitters,
the brain chemicals, are also abnormal in schizophrenia.
In particular, there is a neurotransmitter called dopamine
that is often thought to be too high or elevated
in certain parts of the brain in schizophrenia,
and quite a number of the medicines I use
to treat schizophrenia, the anti-psychotic medicines,
aim to work against dopamine.
Unfortunately, brain scans, measuring neurotransmitters,
none of these tests ever diagnose schizophrenia.
Schizophrenia is actually diagnosed
based on a clinical interview,
and that means taking a history,
hearing from the patient or their family
exactly what's been happening over time,
and also observing the patient.
Well, why would we observe the patient?
Because we know that these brain changes may actually
cause changes in how a patient behaves.
Their behavior may be altered,
and we can further break this down
into changes in the way they think
and changes in the way they act, and we think about ways
that people with schizophrenia may think differently.
We start to think about having abnormal beliefs,
something that we actually call delusions,
and they may also happen to see and hear things that
aren't there, something that we refer to as hallucinations.
Now, people can have delusions and hallucinations
in other conditions, but these are
some of the symptoms of schizophrenia.
Also, the way that they act may be different.
They may isolate themselves socially.
They may be somewhat disorganized
or somewhat confused in their actions,
especially to people looking at them from a distance.
They may have something that we call a flat affect,
and that basically means they lack emotions on their face.
This is by no means an exhaustive list,
but we can start to see that the way that they think
and the way that people with schizophrenia act,
there's a lot of changes here that people would
start to feel maybe abnormal or different.
Now, let's think a little more widely about schizophrenia.
How common is this condition?
Well, we know that approximately one percent
of people have schizophrenia.
The exact number is actually a little bit less than that
in the US; it's actually 0.7%,
and we know that males are typically affected
as much as females, and we know
that this is a condition that affects people
between the age of 16 and 30.
Although it can happen in childhood
and in older individuals, this is the most common age group,
with males being affected at a younger age than females.
When we think about schizophrenia,
we should also think about the fact
that there is something called the prodrome
and the prodrome represents a period of time
before schizophrenia, the symptoms are fully present,
but it's actually a kind of deterioration
in a person's behavior and functioning.
Things are starting to go downhill
and in the prodrome, typically what may happen is
that people will start to demonstrate
some of the signs of schizophrenia,
but what you will notice is their academic or schoolwork
may suffer, and I say schoolwork because if you think about
between 16 and 30, and if the prodrome precedes that,
you're talking about individuals
that are often still in the educational system,
but if they're working, the work can suffer.
Also, their relationships may suffer.
They may exhibit some paranoia
or suspiciousness towards other people.
Some of their thoughts may be
that people are working against them,
so they may develop some of these delusional ideas
and they may start to act differently.
The prodrome then often leads to schizophrenia
and we know that if somebody has schizophrenia,
they are at risk of having lots of different consequences.
For example, they're at a higher risk of suicide,
a higher risk of being homeless,
and a higher risk of being in prison or in jail.
So these are some basics to think about
when we start to hear the word schizophrenia.
Schizophrenia is a brain disorder that's neurodevelopmental,
a combination of genetics and environment,
and we can notice that there's differences
in brain scans and neurotransmitters,
but it's really diagnosed on clinical interview
and it affects how people think and act.
It's preceded by this prodrome period
where we notice a decrease in functioning
and schizophrenia has a lot of repercussions.
It stops people engaging in society, results in higher rates
of suicide, homelessness and incarceration.