Helping A Suicidal Friend Or Relative
If you see any of these warning signs:
- get professional help for the person, such as from a crisis resolution team or the duty psychiatrist at your local A& E department
- let them know they’re not alone and you care about them
- offer your support in finding other solutions to their problems
If you feel there’s an immediate danger of the person attempting to end their life , stay with them or have someone else stay with them. Remove all available means of suicide, such as sharp objects and medication.
Schizophrenia Patients Risk Of Death From Heart Disease Respiratory Diseases Is Higher
Patients with schizophrenia have a higher risk of heart disease and respiratory disease, according to the latest findings. Schizophrenia is a mental disorder characterized by the hearing of voices that do not exist, believing someone else is controlling their mind, and being in a state of distress, which can lead to social withdrawal.
Individuals with schizophrenia may seem perfectly normal until they reveal their paranoid thoughts or hallucinations. It can be very stressful to care for a loved one with schizophrenia patients often cannot hold a job or care for themselves.
What Are The Symptoms Of Schizophrenia
Schizophrenia usually happens in stages, with different symptoms and behaviors depending on the stage.
- Onset . This is an early phase that happens before a person develops more severe symptoms. It can include social withdrawal, anxiety, lack of motivation and neglect of personal hygiene.
- Active. This is when psychotic symptoms take full effect. Another term for this is psychotic break, where a person shows a disconnection from reality. That includes showing at least two of the five main symptoms listed immediately below.
- Residual. People in this stage still have some schizophrenia signs and symptoms, but theyre not as severe. Odd beliefs, lack of motivation, decreased feelings of enjoyment or pleasure, limited speaking and reduced emotional expression tend to be the most noticeable effects. Many people often improve to the point where they seem mostly or fully recovered. However, this is usually temporary, and symptoms of schizophrenia will return as a person goes back into the active stage of the condition.
What are the early signs of schizophrenia?
The early symptoms of schizophrenia, which happen in the onset stage, usually arent severe enough for a schizophrenia diagnosis but are still a cause for concern. This stage sometimes happens quickly, only taking weeks before moving to the next stage.
The most common symptoms or changes in this stage include:
What are the active stage symptoms?
Are there other possible symptoms?
Lack of insight
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How Is It Diagnosed
Your healthcare provider can diagnose schizophrenia or its related disorders based on a combination of questions they ask, the symptoms you describe or by observing your actions. Theyll also ask questions to rule out causes other than schizophrenia. They then compare what they find to the criteria required for a schizophrenia diagnosis.
According to the DSM-5, a schizophrenia diagnosis requires the following:
- At least two of five main symptoms. Those symptoms, explained above, are delusions, hallucinations, disorganized or incoherent speaking, disorganized or unusual movements and negative symptoms.
- Duration of symptoms and effects. The key symptoms you have must last for at least one month. The conditions effects must also last for at least six months.
- Social or occupational dysfunction. This means the condition disrupts either your ability to work or your relationships .
Who Does It Affect
Schizophrenia typically starts at different ages, depending on sex. It usually starts between ages 15 and 25 for men and between 25 and 35 for women. It also tends to affect men and women in equal numbers.
Schizophrenia in children, especially before age 18, is possible but rare. However, these cases are usually very severe. Earlier onset tends to lead to a more severe, harder-to-treat condition.
About 20% of new schizophrenia cases occur in people over age 45. These cases tend to happen more in women. Delusion symptoms are stronger in these cases, with less-severe negative symptoms and effects on the ability to think and focus.
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What Can I Do If A Loved One Shows Signs Of Schizophrenia Or A Similar Condition
Because people with schizophrenia often cant recognize their symptoms or condition, they often dont believe they need medical care or treatment. That can be frustrating or frightening for both the person with the symptoms and those who care about them.
If you notice a loved one showing signs of schizophrenia or a related condition, you can try helping them by doing the following:
A note from Cleveland Clinic
Schizophrenia can be a frightening condition for the people who have it and their loved ones. Despite stereotypes, this isnt a condition where any thought of recovery or living a happy, fulfilling life is impossible. If you think you have symptoms of schizophrenia, its important to talk to a healthcare provider as soon as you can. Their job is to help you, and healthcare providers especially those who specialize in mental health conditions like schizophrenia have the training to help you not feel judged, ashamed or embarrassed. If you notice a loved one struggling with symptoms of psychosis or schizophrenia, encourage them gently and supportively to get care. Early diagnosis and treatment can make a big difference in helping people recover and manage this condition.
What Are The Types Of Schizophrenia
There are different types of schizophrenia. The International Classification of Diseases manual describes them as below.
Paranoid schizophrenia
- Pranks, giggling and health complaints.
- Usually diagnosed in adolescents or young adults.
Catatonic schizophrenia
- Unusual movements, often switching between being very active and very still.
- You may not talk at all.
Simple schizophrenia
- Negative symptoms are prominent early and get worse quickly.
- Positive symptoms are rare.
Undifferentiated schizophrenia
Your diagnosis may have some signs of paranoid, hebephrenic or catatonic schizophrenia, but doesnt obviously fit into one of these types alone.
Residual schizophrenia
This type of schizophrenia is diagnosed in the later stages of schizophrenia. You may be diagnosed with this if you have a history of schizophrenia but only continue to experience negative symptoms.
Other schizophrenia
There are other types of schizophrenia according to the ICD-10, such as.
- Cenesthopathic schizophrenia. This is where people experience unusual bodily sensations.
- Schizophreniform. Schizophreniform disorder is a type of psychotic illness with symptoms similar to those of schizophrenia. But symptoms last for a short period.
Unspecified schizophrenia
Symptoms meet the general conditions for a diagnosis, but do not fit in to any of the above categories.
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Schizophrenia Linked To Early Death
Suicide, Cancer, Heart Disease Leading Causes of Death in Schizophrenics
June 22, 2009 — The mortality rate among schizophrenics is four times higher than in the general population, with suicide being the No. 1 cause of death, followed by cancer, according to a new study.
Deaths from cancer among women with schizophrenia were twice that of the general population, based on standardized mortality data. Deaths from breast cancer were almost three times higher than expected. The study appears in the Aug. 1 issue of Cancer.
Lung cancer death rates among male schizophrenics were about twice that of men in the general population, but the overall risk of dying from cancer was not significantly different between the two groups.
It has long been recognized that schizophrenia is associated with a higher risk for suicide and death from heart disease, but the investigation is one of the largest and longest follow-up studies to explore cancer deaths in schizophrenic patients.
Schizophrenics are more likely to smoke than the general population, and are less likely to have comprehensive medical care.
They may also be more likely to have a delayed cancer diagnosis, have poorer access to treatment, or be noncompliant with treatment, lead investigator Frederic Limosin, MD, PhD, of France’s University of Reims tells WebMD.
What Have We Learnt Since 2005
This systematic review has replicated some of the key findings found in Hawton et al. , including identifying a strong association with later suicide in schizophrenia and earlier depression, history of suicide attempts, and drug misuse. Depression is one of the major risk factors for suicide among individuals with schizophrenia. A randomized controlled trial investigated suicidal thoughts and plans, depressive symptoms and drug misuse in predicting suicidal attempts at 1- and 2-year follow-up. This trial has shown that suicidal thoughts and plans, previous suicide attempts and depressive symptoms are among the strongest predictors of suicidality in patients presenting with first-episode psychosis. One of our top-scoring articles used the Beck Depression Inventory as a measure of the severity of depression and its association with the risk of committing suicide. This study has shown that the likelihood of patients with scores equal or greater than 2 on Suicide Item committing suicide increases by seven-fold.
A history of prior suicide attempts elevates risk of completed suicide threefold according to both Reutfors et al. and Sinclair et al. , who found that individuals who were admitted for an attempted suicide had the highest risk of committing suicide =8.10).
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Search Strategy And Study Eligibility
This systematic review included literature published between June 2004 and January 2010. An electronic search on the following databases were carried out EMBASE, PsychINFO and OVID Medline . The subject headings used included:
The results of the search were screened for suitability independently by both investigators. These studies were further screened for eligibility based on the inclusion criteria:
When Should I See My Healthcare Provider
You should see your healthcare provider as recommended. You should also see them if you notice a change in your symptoms, such as symptoms getting worse even if youre taking your medication. You can also see them if side effects of your medication are causing disruptions in your life. Your healthcare provider can sometimes recommend alternative medications or treatments that might better treat your condition without causing those same effects.
When should I go to ER?
You should go to the ER or call 911 if you have thoughts about harming yourself, including thoughts of suicide, or about harming others. If you have thoughts like this, you can call any of the following:
- National Suicide Prevention Lifeline . To call this line, dial 1.800.273.TALK .
- Local crisis lines. Mental health organizations and centers in your area may offer resources and help through crisis lines.
- 911 : You should call 911 if you feel like youre in immediate danger of harming yourself. Operators and dispatchers for 911 lines can often help people in immediate danger because of a severe mental crisis and send first responders to assist.
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What Risks And Complications Can Schizophrenia Cause
Physical health
Research suggests that people with serious mental illness , such as schizophrenia, have a shorter life expectancy. People with mental illness may die 15 to 20 years earlier than the general population. This may because people who live with SMI are at higher risk of having a range of health issues. Such as being overweight, having heart disease, smoking and diabetes.
Because of these issues, NICE recommends that when you start taking antipsychotic medication, your doctor should do a full range of physical health checks. This should include weight, blood pressure and other blood tests. These checks should be repeated regularly.
Mental health professionals are responsible for doing these checks for the first year of treatment. Responsibility may then pass to your GP. Your doctor or mental health team should offer you a programme which combines healthy eating and physical health checks. You should be supported by a healthcare professional to help stop smoking.
Suicide
The risk of suicide is increased for people with schizophrenia. Research indicates that around 513% of people who live with with schizophrenia die by suicide.
Research has found that the increased risk is not usually because of positive symptoms. The risk of suicide is associated more to affective symptoms, such as low mood.
Key risk factors for suicide include:
- previous suicide attempts,
Why The Risk Of Death Is Higher
Schizophrenia itself isnât life-threatening. But people who have it are more likely to have other health conditions that raise their chances of death. The 2015 study found that heart disease was the top cause of death in people with schizophrenia, accounting for about a quarter of all cases. Conditions like chronic obstructive pulmonary disease , type 2 diabetes, and lung cancer were also common causes of death.
âAdults with schizophrenia are about 10 times more likely to die of COPD and 7 times more likely to die of diabetes,â says a co-author of the study, Mark Olfson, MD, a psychiatrist at Columbia University Irving Medical Center in New York City.
Cigarette use is one reason why someone with schizophrenia may be more at risk of heart or lung disease. âMost people with schizophrenia smoke, and those who smoke tend to do so more heavily than people in the general population,â Olfson explains.
Antipsychotic medications that treat schizophrenia can also cause weight gain, as well as raising blood glucose, cholesterol, and blood pressure levels.
Up to 85% of people with schizophrenia also have some kind of cognitive impairment, which can make it harder for them to make basic healthy lifestyle choices such as avoiding junk food and getting regular exercise, says Tiffany Herlands, PhD, an assistant professor of medical psychology in the Department of Psychiatry at Columbia University Irving Medical Center.
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How Do I Take Care Of Myself
People with schizophrenia should do the following to help care for themselves and manage their condition:
- Take medications as prescribed. One of the most critical things a person with schizophrenia can do to help themselves is to take their medications. If you have schizophrenia, you should not stop your medication without talking to your healthcare provider. Sudden stopping of medication often speeds up the return of psychosis symptoms. Side effects are common with antipsychotics. However, there are many antipsychotic medications, so its often possible to work with your healthcare provider to find one that both works well for you and has minimal or no side effects.
- See your healthcare provider as recommended. Your healthcare provider will set up a schedule for you to see them. These visits are especially important to help with managing your condition.
- Dont ignore or avoid symptoms. Schizophrenia is more likely to respond and have a good outcome with early diagnosis and treatment.
- Avoid alcohol and recreational drug use. Alcohol and drug use can make schizophrenia symptoms worse and can lead to other issues. This includes using prescription medications in a way other than prescribed.
- Consider seeking support. Organizations such as the National Alliance on Mental Illness can offer resources and information that can help.
Spotting The Signs Of An Acute Schizophrenic Episode
Learning to recognise the signs that you’re becoming unwell can help you manage your illness. Signs can include losing your appetite, feeling anxious or stressed, or having disturbed sleep.
You may also notice some milder symptoms developing, such as:
- feeling suspicious or fearful
- hearing quiet voices now and again
- finding it difficult to concentrate
You may also want to ask someone you trust to tell you if they notice your behaviour changing.
Recognising the initial signs of an acute schizophrenic episode can be useful, as it may be prevented through the use of antipsychotic medicines and extra support.
If you have another acute episode of schizophrenia, your written care plan should be followed, particularly any advance statement or crisis plan.
Your care plan will include the likely signs of a developing relapse and the steps to take, including emergency contact numbers.
Read about treating schizophrenia for information about advance statements.
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The Importance Of Early Psychosis Treatment
Studies have shown that the earlier treatment is initiated for psychosis, the better the long-term outcomes for the patient. The duration of untreated psychosis, or DUP, is measured as the time from the beginning of psychotic symptoms to the time a person starts treatment for those symptoms or a diagnosed condition.
There is strong evidence that treatment for psychosis is more effective the shorter the DUP is. Patients treated sooner see better improvement in symptoms, have a better quality of life after treatment, and have improved functioning, as compared to those who have long DUPs. In the U.S., the average DUP is longer than what is considered to be acceptable by international standards.
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Schizophrenia Treatment And Breast Cancer
Although the excess in breast cancer deaths could be explained by delayed diagnosis and poorer access to or compliance with treatment, schizophrenia expert Donald C. Goff, MD, says there may be more going on.
Goff cites a 2002 study, which suggested a link between the use of dopamine-blocking drugs, including the antipsychotics used to treat schizophrenia, and an increased risk for breast cancer.
“This study raised questions about whether antipsychotics cause breast cancer,” Goff tells WebMD. “The conclusion at the time was that there wasn’t much evidence to support this.”
Goff, who directs the schizophrenia program at Massachusetts General Hospital, says it has long been recognized that patients with schizophrenia are at risk for early death, but efforts to address this have generally targeted suicide prevention, smoking cessation, and heart disease.
Gregory Dalack, MD, tells WebMD that the psychiatric community is increasingly recognizing the need to integrate primary care interventions into psychiatric practice.
Dalack is interim chair of the department of psychiatry at the University of Michigan Health System.
“These patients are vulnerable,” he says. “They are high risk, and yet we are not doing the basic things for them that we do for other high-risk populations.”
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