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What is schizophrenia?
Schizophrenia is a serious mental health condition that affects how a person thinks, feels, and behaves. People with schizophrenia aren’t usually violent.
Many believe that people with schizophrenia tend to be violent and aggressive. Even the media reports more cases of schizophrenia violence than of violence associated with other mental illnesses. However, people with schizophrenia aren’t usually violent.
Schizophrenia is a complex mental illness. The violence and aggression displayed by people with schizophrenia may be related to other risk factors. It’s important to understand the condition and why a patient might act aggressively.
Schizophrenia is a serious mental health condition that affects how a person thinks, feels, and behaves. People with schizophrenia may have psychosis, which means that they lose touch with reality — they can confuse what’s real and what they've imagined. This can cause problems for the individual as well as their family and friends.
Schizophrenia can last for a long time if left untreated. With continuous treatment, people with schizophrenia can live independent lives.
What causes schizophrenia?
The causes of schizophrenia are unclear. But several factors can increase your chances of getting schizophrenia.
Schizophrenia risk factors include:
- Genetics. Schizophrenia can be genetic. If someone in your family has schizophrenia, you may be at risk.
- Environmental factors. Environmental triggers such as living conditions, stressful environments, emotional trauma, exposure to viruses, or nutritional problems before birth may increase the risk of schizophrenia.
- Brain structure and function. Changes in brain structure, function, and chemistry can increase the risk of schizophrenia. People with schizophrenia may have different brain circuits and levels of certain brain chemicals called neurotransmitters.
- Drug use. Drugs don’t usually cause schizophrenia. But drug abuse may increase your risk of getting it. Cannabis, cocaine, LSD, and methamphetamines may trigger psychosis in people who are already at a high risk of developing schizophrenia.
What are schizophrenia symptoms?
Schizophrenia symptoms can be divided into three categories:
Psychotic symptoms
These include:
- Hallucinations, or seeing or hearing things that aren’t actually there
- Delusions, or firm beliefs that are not supported by facts
- Paranoia, or irrational fear
- Abnormal, confused, or unusual thinking
- Disorganized and unclear speech
- Odd behavior
- Inability to tell the difference between reality and imagination
Negative symptoms
These include:
- Loss of motivation
- Disinterest or lack of pleasure in daily life
- Social withdrawal
- Lack of feelings and difficulty showing emotions
- Difficulty functioning
- Decreased communication
Cognitive symptoms
These include:
- Attention, concentration, and memory problems
- Difficulty processing information
- Difficulty making decisions
- Learning problems
When is schizophrenia diagnosed?
Schizophrenia is typically noticed in someone's late teen years, or in their early 20s to early 30s. It's usually diagnosed earlier for men than for women. It's rarely seen in children.
Schizophrenia is often diagnosed after a person's first episode of psychosis. Doctors will check for changes in mood, thinking, and social behavior to help them make a decision.
Do people with schizophrenia tend to be violent?
Schizophrenia is often associated with violence. Some studies even say that patients with schizophrenia are 4 to 7 times more likely to be aggressive. However, most people with schizophrenia don’t get violent. Research shows that the risk of violence in people with schizophrenia is associated with these underlying factors:
Alcohol and drug abuse
People with schizophrenia are prone to substance abuse. If they misuse alcohol or drugs, they have a 15 times greater risk of engaging in violent behavior.
Genetics
Certain genes that regulate brain chemicals may be responsible for violence and aggressive behavior in people with schizophrenia. If a person with schizophrenia has a genetic tendency for substance abuse and violent behavior, they may be at an even higher risk of aggression. More studies are needed to confirm the role of genes in schizophrenia-related violence.
History and behavior
A person with schizophrenia may become violent if they had a history of violent behavior before their schizophrenia diagnosis. Other aspects of a person's personality that may play a role in violence include:
- Paranoid beliefs
- Impulsivity
- Suicidal tendencies
- Agitation
- Excitement
- Unusual social behavior
How to manage violence in people with schizophrenia
People with schizophrenia rarely resort to violence with strangers. Their behavior mainly affects their family and friends. If your loved one with schizophrenia starts to show signs of becoming violent, seek help from a medical professional immediately.
Psychiatrists use risk assessment tools to determine a patient’s tendency toward violence. They account for factors like substance abuse, a history of violence, general behavior, and the patient’s understanding of their condition.
If a patient does get violent, doctors typically use schizophrenia treatment strategies to manage symptoms and their behavior. Schizophrenia treatment includes:
Antipsychotic medications
Antipsychotic medications can help manage psychotic symptoms. Doctors can prescribe these as either daily pills or monthly injections. Patients who tend to get violent are usually treated with the antipsychotic medicine clozapine. It effectively reduces aggression and violent behavior.
Psychosocial treatments
For people with schizophrenia, cognitive behavioral therapy helps address negative symptoms. Cognitive remediation therapy can help manage cognitive symptoms. Skills training and supported employment may also help people with schizophrenia stick to a daily routine. If a person is violent and has a substance abuse problem, they’ll be rehabilitated to treat these underlying concerns.
Family therapy and support
Family members and friends of people with schizophrenia should be educated about the condition, including its symptoms and treatments. There are several programs and support groups to help you learn how to assist your loved one with schizophrenia.
Coordinated specialty care
Coordinated specialty care involves treatment programs to help people in the early stages of schizophrenia work toward recovery. It can include:
- Psychotherapy
- Medication management
- Help with employment and education
- Family support
Assertive community treatment
Assertive community treatment is a program for people with schizophrenia who are at risk of repeated hospitalization or homelessness. The programs typically provide coordinated care from — and frequent contact with — a team of medical professionals.
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How to help someone with schizophrenia
Although it can be challenging, here's how you can care for and support your loved one with schizophrenia:
- Make sure they get the treatment they need.
- Encourage them to continue treatment.
- Remember that what they see, hear, and believe is real to them.
- Be respectful, supportive, and kind.
- Don’t tolerate violent or aggressive behavior.
- Seek help from healthcare professionals.
- Look for support groups in your area.
If things get out of hand, contact a doctor immediately. Some symptoms require emergency care. And if a loved one with schizophrenia considers or engages in violence, seek help from qualified professionals immediately.