Table of Contents
Introduction xiii
Chapter 1 Schizophrenia Basics 1
A Brief Overview of Schizophrenia 1
Features of the Disease 3
Schizophrenia's Effect on Relationships 5
A Brief History of Schizophrenia 7
Early Treatments and Explanations 10
What Schizophrenia Is Not 13
Chapter 2 What Causes Schizophrenia? 16
The Role of Genetics 16
A Look at the Brain 19
Altered Brain Structure in Schizophrenia 22
Normal Chemical Signals 26
Altered Brain Chemistry in Schizophrenia 27
The Role of Environment 28
What Might Cause Schizophrenia? 30
Chapter 3 What Type of Schizophrenia Are You Dealing With? 32
Diagnosing Schizophrenia 32
Paranoid Schizophrenia 33
Disorganized Schizophrenia 34
Catatonic Schizophrenia 35
Undifferentiated and Residual Schizophrenia 37
Type I and Type II 38
Chapter 4 Related Psychotic Disorders 41
Brief Psychotic Disorder 41
Shared Psychotic Disorder 42
Schizophreniform Disorder 43
Schizoaffective Disorder 44
Delusional Disorder 46
Psychotic Disorder Due to a General Medical Condition 49
Other Mental Disorders with Similarities to Schizophrenia 50
Chapter 5 Symptoms of Schizophrenia 53
Positive Symptoms 53
Negative Symptoms 57
Cognitive Problems 60
Variability of Symptoms 63
Gender Differences 64
The Threat of Suicide 65
Chapter 6 Warning Signs of Schizophrenia 67
Onset: The Early Warning Signs 67
Some Indicators in Early Childhood Behavior 71
Developing Schizophrenia Before and After Adolescence 73
Can Schizophrenia Be Prevented? 76
Psychotic Symptoms Are an Emergency 78
Early Warning Clinics 80
Chapter 7 Schizophrenia-like Symptoms in Other Medical Conditions 82
Bipolar Disease 82
Drug-InducedPsychosis 84
Alzheimer's Disease and Other Dementias 86
Psychosis Resulting from Other Medical Conditions 87
Other Psychotic Disorders 88
Chapter 8 Impressions of Schizophrenia 90
Hallucinations 90
Delusions 91
Loss of Control 93
Sense of Self and Emotions 95
Chapter 9 Treating Schizophrenia with Drugs 98
Finding the Right Medication 98
How Do Antipsychotic Medications Work? 100
Two Main Types of Antipsychotic Drugs 102
Features of Some Popular Antipsychotic Medications 108
Is There a "Right" Medicine for Everyone? 110
Realizing the Benefits 113
Side Effects of First-Generation versus Second-Generation Drugs 116
Recognizing the Side Effects 118
Effects of Conventional Antipsychotic Drugs on the Extrapyramidal System 120
Side Effects of Atypical Antipsychotic Drugs 122
Precautions 123
Combination Treatments 125
Chapter 10 Therapy for Schizophrenia 127
Why Therapy? 127
Modern Therapies versus Older Therapies 129
Supportive or Rehabilitative Therapies 131
Family Therapy and Rehabilitation 133
Cognitive Therapy 134
Finding Good Therapists 134
Chapter 11 What if Nothing Works? 137
Are Alternative Therapies Right for You? 137
Lack of Compliance or Failure of Medical Care 138
Assisted Treatment 140
What Is a Clinical Trial? 146
Finding Clinical Trials 150
Applying to Take Part in a Clinical Trial 151
Chapter 12 Other Views of Schizophrenia and Current Treatments 153
Public Perception of Schizophrenia 153
Anti-Psychiatry 156
Does Mental Illness Really Exist? 157
Do Drugs Do More Harm than Good? 158
Do Pharmaceutical Companies Control Modern Psychiatry? 159
Are Nontraditional Treatments Effective? 161
Chapter 13 Ensuring Good Psychiatric Care 165
Diagnosing a Mental Illness 165
Locating Good Care Near You 167
Researching a Doctor's Background 168
Professional Physician Background Checks 172
Working with Your Doctor 173
Encouraging Treatment in Reluctant Individuals 175
Confidentiality 177
Affordability of Mental Health Care 178
Chapter 14 Should a Person with Schizophrenia Live at Home? 180
When Living at Home Is a Good Idea! 180
When Living at Home Is Not a Good Idea 183
Full-and Part-Time Hospitalization 184
Hospitalizing Children 188
Legal Rights and Hospitalization 189
Outpatient Care 191
Chapter 15 What You Can Do to Aid Recovery 193
Attitude: Accept the Pain and Take Charge of Your Situation 193
Setting Realistic Goals of Recovery 195
Encouraging Someone to Seek Medical Treatment 197
Communication 198
Sticking to a Helpful Course of Treatment 200
Mastering the Health Care System 202
Chapter 16 Success Stories and Case Histories 206
The Difficulty of Predicting the Future 206
What Does Successful Schizophrenia Treatment Mean? 208
"Mary" 210
"John" 213
Lori Schiller 214
Ken Steele 218
Chapter 17 How to Handle a Schizophrenia Emergency 220
Preparing for an Emergency 220
Who to Call for Help 221
Dealing with Aggressive Behavior 222
What You Should Do 225
What to Avoid 226
Learning from the Experience 229
Chapter 18 Support for the Caregiver 231
Problems of the Caregiver 231
Coping with Daily Stresses 234
Coping with the Stigma of Mental Illness 237
Dealing with Prejudice and Ignorance 238
Paying for Mental Health Care 240
Chapter 19 Advocating for Better Understanding and Treatment 244
Established Advocacy Groups 244
Local Support Groups 245
Educating Your Neighbors 246
Services that Need Improvement 248
Organizing 250
Politicking 252
Chapter 20 The Promise of Future Research 255
Schizophrenia Research 255
The Need for More Basic Research 256
Need for Better Medications 258
Developing New Medications 259
The Drug Pipeline 260
Appendix A Glossary 263
Appendix B Resources 271
Appendix C Early Treatment Clinics in the United States and Canada 276
Appendix D Top Psychiatric Hospitals in the United States 281
Index 284
