100 Questions and Answers about Schizophrenia: Painful Minds

Table of Contents

Foreword xi

Introduction xxiii

Part 1 The Illness and Its Characteristics 1

Questions 1-21 introduce the signs and symptoms of schizophrenia:

1 What is schizophrenia?

2 Is schizophrenia a split personality?

3 What are the first signs of this illness? How do I know whether I (or my relative) have schizophrenia?

4 Is being "schizophreniform" the same as having schizophrenia?

5 What does it mean to have a "schizoptypal personality"?

6 What is schizoaffective disorder?

7 How is schizophrenia different from bipolar disease (or manic depression)?

8 Is it possible to hear voices that are not there and not be ill?

9 What is catatonia?

10 What is the course of the illness over time?

11 What exactly is considered a delusion?

12 What is meant by "positive" and "negative" symptoms?

13 Do people with schizophrenia have language problems?

14 Do people with schizophrenia get depression?

15 Are memory problems symptoms of schizophrenia?

16 Do people with schizophrenia have a low IQ?

17 Are muscular problems associated with schizophrenia?

18 Do people with schizophrenia have a reduced life span or die from their illness?

19 Are there medical conditions that look like schizophrenia?

20 Do people with schizophrenia have fewer offspring?

21 Are there some societies in which no individuals develop schizophrenia?

Part2 Treatment: When, Where, by Whom, and with What? 31

Questions 22-41 review different options available to treat schizophrenia:

22 What type of professional can treat the first symptoms of schizophrenia?

23 Does a psychiatrist always need to be seen and how frequently?

24 Why do some psychiatrists not treat people withschizophrenia?

25 What if I do not have insurance or if my policy does not cover psychiatric care?

26 Do I have to be treated in a hospital if I have schizophrenia, and, if so, for how long?

27 What treatments were used before pharmaceutical companies introduced neuroleptic medication?

28 What are the current choices for medication?

29 Are combinations of different medications more effective than one alone?

30 What are the medication side effects?

31 What are the treatments for side effects?

32 How long does medication have to be taken?

33 Are there alternative treatments to medication?

34 What is cognitive behavioral therapy?

35 What can TMS do?

36 Can a specific diet help?

37 What about vitamins and fish oil?

38 Can psychotherapy help?

39 Can family therapy help?

40 Is electroconvulsive therapy used for schizophrenia?

41 What are the pros and cons of participating in research studies?

Part3 The Consideration of Nongenetic Risk Factors 61

Questions 42-48 discuss nongenetic-based risk factors that can contribute to schizophrenia:

42 Do birth complications cause schizophrenia?

43 Is schizophrenia more common in some cultural or racial groups than others?

44 Can bad family relationships cause schizophrenia?

45 Can immigration from another country increase risk for schizophrenia?

46 Is it better to live in a rural area?

47 Is schizophrenia infectious?

48 Do viruses cause schizophrenia?

Part 4 The Genetic Risk 69

Questions 49-64 discuss the genetic risks associated with schizophrenia:

49 What are the lessons from history?

50 Is schizophrenia inherited, and if so, how?

51 If my aunt, uncle, or cousin has schizophrenia, what are the chances of my children getting it?

52 If I have a brother with schizophrenia and my partner does too, what are the chances of our children getting schizophrenia?

53 If I have an identical twin with schizophrenia, but I am well, what are my children's chances of having schizophrenia?

54 How has biologic genetic research on schizophrenia been conducted in the past?

55 What does linkage to a chromosome mean?

56 What are the methods developed to find gene functional and structural differences?

57 What are the current candidate genes for schizophrenia?

58 What do DNA Copy Number Variations (CNVs) have to do with schizophrenia?

59 How is it assumed that genes cause schizophrenia?

60 What is an intermediate phenotype (sometimes called endophenotype) for schizophrenia?

61 Will there be future DNA testing for schizophrenia?

62 Will DNA testing be useful to determine which medication to administer?

63 Can genetic research provide new treatments?

64 In this new genome age, what are ethical concerns for the future?

Part 5 The Biology Underlying Schizophrenia: Current Research Findings 93

Questions 65-72 provide information about the biologic findings on schizophrenia and the testing being done to determine the disease's effects on the body:

65 Are there any tests that can be taken from blood, urine, or spinal fluid?

66 Are there any differences in the brains of people who have schizophrenia?

67 Should an MRI scan be performed?

68 Are functional MRI scans useful?

69 Should an EEG be done on patients with schizophrenia?

70 Is schizophrenia a "chemical imbalance"?

71 When do the brain changes occur, and is schizophrenia considered a progressive brain disorder?

72 What is the neurodevelopmental hypothesis about schizophrenia?

Part 6 Substance Abuse and Schizophrenia 105

Questions 73-77 review the effects of substance abuse in schizophrenia:

73 Can drug use in adolescence cause schizophrenia?

74 Can someone who has schizophrenia smoke marijuana?

75 Are there any specific drugs that more frequently cause schizophrenia-like symptoms?

76 Is it okay to drink alcohol if you have schizophrenia?

77 Why do people with schizophrenia smoke cigarettes excessively?

Part 7 Violence and Aggression in Schizophrenia 111

Questions 78-80 examine the connection between violent behavior and this mental illness:

78 Do people with schizophrenia frequently commit violent acts and crimes?

79 What should I do if my relative or friend is behaving violently?

80 How can violent behavior be predicted?

Part 8 Suicidal Behavior and Schizophrenia 117

Questions 81-82 discuss how to best recognize someone at high risk for suicidal behaviors and prevent this tragic outcome:

81 What are the signs of suicidal thoughts in schizophrenia?

82 What can be done to prevent suicide attempts?

Part 9 Issues for Women 123

Questions 83-87 review specific issues unique to female patients with schizophrenia:

83 Is schizophrenia different in women?

84 Should patients who are pregnant take medication for schizophrenia?

85 What is the risk of a postpartum relapse?

86 What about breast-feeding?

87 Can estrogen for birth control help suppress symptoms?

Part 10 The Homeless and Schizophrenia 131

Questions 88-90 discuss the connections between homelessness and mental illness:

88 How prevalent is schizophrenia among the homeless?

89 What causes homelessness?

90 Can homeless people be forced into shelters and hospitals?

Part 11 Living with Schizophrenia 139

Questions 91-94 provide information on the quality of daily life of someone with schizophrenia:

91 What are the origins of the stigma attached to having schizophrenia?

92 Can a person with schizophrenia be professionally creative?

93 Should I adopt a baby whose birth parent had schizophrenia?

94 Should a person with schizophrenia drive a car?

Part 12 Ethical Issues 145

Questions 95-100 examine ethical issues relevant to someone who has schizophrenia:

95 What does "involuntary" hospital commitment involve?

96 What is the legal insanity defense?

97 Have there been abuses of the insanity defense?

98 Do patients with schizophrenia have the capacity to give informed consent for research and other procedures?

99 Can genetic information be abused?

100 What support groups, books, and Web sites can I go to for help?

Resources 157

Bibliography 159

Glossary 163

Index 173