Psychosis & Schizophrenia - Assessment
About 1% of Australians have this illness. Schizophrenia affects men and women equally. It occurs at similar rates in all ethnic groups around the world. Symptoms such as hallucinations and delusions usually start between ages 16 and 30. Men tend to experience symptoms a little earlier than women.
Most of the time, people do not get schizophrenia after age 45.3 Schizophrenia rarely occurs in children, but awareness of childhood-onset schizophrenia is increasing.4,5
If you are experiencing psychotic symptoms or know someone who is, try to seek help as soon as possible. Tell someone you trust such as a parent, teacher or friend if you are having some strange experiences you cannot explain and ask for an assessment by your Family Physician or a behavioral health practitioner. Treatment for psychosis is available and the earlier you seek help by getting assessed and formally diagnosed then the better the outcome and the quicker the recovery.
Early multi-disorder assessment is particularly important for teens. This is because schizophrenia can be difficult to diagnose in teens since the first signs can include a change of friends, a drop in grades, sleep problems, and irritability—behaviors that are common among teens. A combination of factors can predict schizophrenia in up to 80 percent of youth who are at high risk of developing the illness. These factors include isolating oneself and withdrawing from others, an increase in unusual thoughts and suspicions, and a family history of psychosis.6 In young people who develop the disease, this stage of the disorder is called the "prodromal" period.
Young people experiencing psychosis are not always able to understand or willing to explain what is happening to them. Most fear they will be labeled as ‘mad’. Many do not seek help on their own. It is therefore important that workers working with young people who identify psychotic symptoms assist the young person to get the help they need. If you are working with a young person who you think may be experiencing psychosis and you are not sure what to do, it is always best to contact someone with experience in this field and diskuss the situation with them.
When requesting a behavioral health assessment from your Family Physician or behavioral health practitioner, ask for a multi-disorder assessment that enables the practitioner to get a differential diagnosis, meaning they will be able to assess for depression, bipolar, drug use and other possible co-existing behavioral health conditions at the same time.
This is important because people with psychosis or Schizophrenia may also develop psychotic symptoms when in high or low mood phases. For example, people who are depressed may hear voices telling them they should commit suicide. Someone who is unusually excited or happy may believe they are special and can perform amazing feats like jumping from heights.
Schizophrenia and drug use
Drug use and psychosis often go hand in hand. Some people who abuse drugs show symptoms similar to those of schizophrenia. Therefore, people with schizophrenia may be mistaken for people who are affected by drugs. Some researchers believe that substance abuse can cause schizophrenia. However, people who have schizophrenia are much more likely to have a substance or alcohol abuse problem than the general population.11
Substance abuse can make treatment for schizophrenia less effective. Some drugs, like marijuana and stimulants such as amphetamines or cocaine, may make symptoms worse. In fact, research has found increasing evidence of a link between marijuana and schizophrenia symptoms.12,13 In addition, people who abuse drugs are less likely to follow their treatment plan.
Schizophrenia and smoking
Addiction to nicotine is the most common form of substance abuse in people with schizophrenia. They are addicted to nicotine at three times the rate of the general population (75 to 90 percent vs. 25 to 30 percent).14
The relationship between smoking and schizophrenia is complex. People with schizophrenia seem to be driven to smoke, and researchers are exploring whether there is a biological basis for this need. In addition to its known health hazards, several studies have found that smoking may make antipsychotic drugs less effective.
Quitting smoking may be very difficult for people with schizophrenia because nicotine withdrawal may cause their psychotic symptoms to get worse for a while. Quitting strategies that include nicotine replacement methods may be easier for patients to handle. Doctors who treat people with schizophrenia should watch their patients' response to antipsychotic medication carefully if the patient decides to start or stop smoking.
The outlook for people with schizophrenia continues to improve. Although there is no cure, treatments that work well are available. Many people with schizophrenia improve enough to lead independent, satisfying lives.
