It is important to diagnose and treat schizophrenia as early as possible to help people avoid or reduce frequent relapses and re-hospitalizations. Most people who stop taking their medications after an acute episode will have a relapse within one year. A patient should talk with his doctor about any side effects before discontinuing treatment, as options may be available to reduce or eliminate negative effects.
Studies indicate that except for those persons with a record of criminal violence before becoming ill, and those with substance abuse or alcohol problems, people with schizophrenia are not especially prone to violence. Most individuals with schizophrenia are not violent; more typically, they are withdrawn and prefer to be left alone.
Medication appears to improve the long-term prognosis for many people with schizophrenia. Studies show that after ten years of treatment, one-fourth of those with schizophrenia have recovered completely, one-fourth have improved considerably, and one-fourth have improved modestly. Fifteen percent have not improved, and ten percent have passed away.
Positive, or psychotic symptoms include delusions, hallucinations and disorganized thinking. These symptoms occur because the patient has lost touch with reality in certain important ways. Disorganized thinking, speech and behavior affect most people with this illness. Negative symptoms include lack of expression or emotional flatness, an inability to start and follow through with activities and a lack of pleasure or interest in life.
Psychosocial treatments may be useful for patients with less severe symptoms or for patients whose psychotic symptoms are under control. Most focus on improving the patient's social functioning, whether in the hospital or community, at home or on the job. Patients often become ill during the critical career-forming years of life (ages 18-35), and thus are less likely to complete the training required for skilled work.
According to the National Advisory Mental Health Council, the treatment success rate for schizophrenia is comparable to the treatment success rate for heart disease.
Individuals with schizophrenia die at a younger age than healthy people. Males have a 5.1 greater than expected early mortality rate than the general population, and females have a 5.6 greater risk of early death. Suicide is the single largest contributor to the excess mortality rate. The suicide rate is 10 to 13 percent higher among the schizophrenia community than among the general population
Anosognosia, the impaired awareness of illness, is a major problem because it is the single largest reason individuals with schizophrenia fail to take their medications. It affects at least 50 percent of individuals with schizophrenia, and is caused by damage to specific parts of the brain, especially the right hemisphere. As a result, patients do not realize they are sick.
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