Schizophrenia is a family of related disorders that are associated with changes in the brain's processing of reality, thoughts, and feelings. Each person experiences it in their own way. Two people with the same diagnosis can look completely different.
Symptoms of schizophrenia spectrum disorders are divided into three groups:
1) Positive symptoms (not good, but something added above the norm): hallucinations, delusions, disorganized thinking. Something that should not be there normally, but is.
2) Negative symptoms (not bad, something taken away): lack of emotions, motivation, speech, pleasure. Something that should normally be there, but has decreased or disappeared.
3) Cognitive symptoms: difficulties with memory, attention, and planning. They are the ones that most affect the ability to learn, work, and live independently.
The schizophrenia spectrum includes both short-term and long-term disorders with or without acute psychotic states. In remission or with moderate disorders, a person’s behavior may not differ from the conventional healthy norm until, for example, you get to the topic of their delusions. Some people may simply seem eccentric, but do not need to consult a psychiatrist without the encouragement of their loved ones.
According to various estimates, up to 1% of the world’s population lives with schizophrenia spectrum disorders. In Ukraine, this is hundreds of thousands of people. Exact figures are difficult to specify due to insufficient diagnosis and stigma.
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Unfortunately, the diagnosis of schizophrenia is still strongly associated with aggression and a threat to society. In fact, the conclusions of scientific studies from different countries indicate that this connection is greatly exaggerated and does not take into account important nuances. The main risk factor is considered to be the abuse of psychoactive substances. Without comorbid addiction, the risk of violent behavior is not significantly different from that of the general population. [2,3,4] Moreover, a person with schizophrenia is 14 times more likely to become a victim of violence than to commit a crime. [5]
Currently, no test or brain scan can definitively diagnose schizophrenia. Such tests show certain patterns and are studied by scientists. But in clinical practice, they are not a diagnostic tool. For example, MRI results of diagnosed patients often do not show specific changes. Diagnosis is based on a comprehensive assessment of the condition, observation of symptoms, and their duration.
The causes of schizophrenia are also not limited to one thing. It is a combination of biological factors, genetic vulnerability, and environmental influences — including stress, traumatic events, or social conditions. Risk factors also include brain injuries, substance abuse, and complications of pregnancy or childbirth.
Early intervention is paid special attention in modern practice. The sooner a person receives support after the first symptoms, the better the prognosis usually is. In some people, before the first psychotic episode, a period of gradual changes appears, which in research is called prodromal. At this time, the condition may change imperceptibly and not look unambiguous, however the person already feels that it is becoming more difficult to think, interact with others, and cope with the mundane rhythm.
Possible early symptoms of schizophrenia include:
- difficulties with concentration and thinking;
- a feeling that reality has become less understandable or changed;
- increased suspicion, distrust of people;
- unusual ideas or strange interpretations of events;
- increased sensitivity to sounds, light, and meanings;
- anxiety without an obvious cause;
- emotional detachment from others or from oneself;
- loss of interest in usual activities;
- decreased energy and motivation;
- sleep disturbances;
- gradual avoidance of social contacts;
- difficulties in studying or working.
It is important that these symptoms are not specific only to schizophrenia and can occur in other conditions. What matters is their combination, increase, duration, and effect on daily life. That is why being attentive to such changes and early access to support can significantly affect the further course of the disease.
The most effective treatment for schizophrenia is a comprehensive approach that combines medication with psychosocial support. This may include psychotherapy, assistance in restoring daily skills, assisted living and employment, and participation in peer groups. Such formats help not only to stabilize the condition but also to regain a sense of control over one’s own life.
The work of the NGO Psihability is based exactly on this approach. We are developing a self-help group and working on the implementation of case management, a support format that allows a person to receive help that meets their real needs and life situation.
Today, there is increasing evidence that there is no single path to schizophrenia. Some people's symptoms improve over time, while others need long-term support, but in both cases, a life filled with meaning, relationships, and personal goals is possible.
And perhaps most importantly, behind every diagnosis is a person with a story, experience, and right to a dignified life. Support, care, and acceptance are often just as important as any treatment.
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[1] Share of the population with schizophrenia, IHME, 2023
