What are Schizophrenia Spectrum disorders?

As a BetterHelp affiliate, we may receive compensation from BetterHelp if you purchase products or services through the links provided.

In this blog we will discuss what Schizophrenia Spectrum Disorder is. 

We will also briefly discuss what Schizophrenia is, what causes it, and what are the possible treatments available for Schizophrenia Spectrum Disorders.

What are Schizophrenia Spectrum disorders?

Schizophrenia spectrum and other psychotic disorders is the category of mental disorders that has been categorised in the Diagnostic and Statistical Manual for mental disorders, fifth edition, in which psychosis is a primary symptom. 

Psychosis includes symptoms such as hallucinations (sensory experiences that are not real) and/or delusions (persistent false beliefs that are not based in reality).

In the current edition (DSM-5), the different types of schizophrenia were removed and replaced with a broader definition of schizophrenia  and placed on a spectrum. 

Individuals with schizophrenia spectrum and other psychotic disorders often experience a loss of contact with reality and tend to experience psychosis related symptoms such as:

  • Hallucinations: Seeing, hearing, smelling, tasting, or feeling (through touch) things that are not there
  • Delusions: False beliefs that don’t change even when the person is presented with evidence that they are false- which lead to paranoia or irrational fears.
  • Unusual thinking or disorganised speech

Psychotic disorders on the schizophrenia spectrum include schizophrenia, schizoaffective disorder, schizophreniform disorder, brief psychotic disorder, delusional disorder, shared psychotic disorder, substance-induced psychotic disorder, and paraphrenia. 

These disorders share similarities in symptoms however they are classified differently based on certain factors, such as:

  • Duration of psychotic symptoms 
  • The presence of mood disorder characteristics.

The schizophrenia spectrum disorders include:

Schizophreniform disorder

In this disorder, the person exhibits the same symptoms as schizophrenia however unlike schizophrenia, this diagnosis is given to people whose condition lasts less than six months. 

People with thai disorder are further diagnosed with schizophrenia if the symptoms reach the six-month mark even after treatments and interventions.

Schizoaffective disorder

People who are diagnosed with schizoaffective disorder exhibit symptoms of schizophrenia along with symptoms of a mood disorder. 

This means that a person will experience symptoms such as hallucinations, delusions., along with other schizophrenia related symptoms but also exhibit symptoms related to either major depressive disorder or bipolar disorder. 

For a person to be diagnosed with this disorder, the person must experience psychosis for at least two weeks when they are not having a depressive or manic episode. \

Delusional disorder

People who are diagnosed with delusional disorder has experienced at least one delusion for at least one month but have never met the criteria for schizophrenia. 

Another criteria that they must meet is functional impairment is due to the delusion only and not experienced outside of it- meaning that they can function well in areas not related to the delusion.

Brief psychotic disorder

A person is diagnosed with Brief psychotic disorder when they experience an episode of psychotic behaviour with a sudden onset- meaning that it is not gradual- and the episode  lasts less than a month and is followed by complete remission. 

What Is Schizophrenia? 

Schizophrenia is the name given to a complex and often long term/lifelong mental disorder that can impact the ability of a person to think clearly, be in touch or be connected to reality, manage their emotions and their relationship with people, as well as functioning well in society as a contributing member to the economy.

Schizophrenia is just one of several conditions that fall under the spectrum of psychotic disorders and share similar symptoms  with other psychotic disorders. 

The symptoms of schizophrenia fall into three main categories.

Positive Symptoms 

Positive Symptoms which involves things that are present which should not be. These includes

  • Hallucinations: Seeing, hearing, smelling, tasting, or feeling (through touch) things that are not there
  • Delusions: False beliefs that don’t change even when the person is presented with evidence that they are false- which lead to paranoia or irrational fears.
  • Unusual thinking or disorganised speech

Negative Symptoms

Negative symptoms refer to behaviours, thoughts, and feelings that should be present but are not. These might include:

  • Loss of motivation
  • Disinterest or lack of enjoyment in daily life
  • Social withdrawal and reduced speaking
  • Difficulty showing emotions
  • Difficulty planning, beginning, and sustaining activities
  • Difficulty expressing emotions using facial expression or voice tone

Cognitive Symptoms

These symptoms include problems and deficits in processing information to make decisions, using information immediately after learning it, problems focusing or paying attention

The Diagnosis of schizophrenia spectrum disorders is based on the outlining criteria that must be met for a diagnosis of a specific condition as prescribed by the DSM 5.

The criteria as per the Diagnostic and Statistical manual of mental disorder  include.

A diagnosis of schizophrenia is typically made after the first episode of psychosis with symptoms that have been persistent. At least two or more of the following should be present:

  • Delusions
  • Hallucinations
  • Disorganised speech
  • Disorganised or catatonic behaviour
  • Negative symptoms
  • Decreased level of functioning or dysfunction in the areas of work, interpersonal relationships, or self-care must also be present (American Psychological Association)

What causes schizophrenia?

Some of the suspected causes of schizophrenia and schizophrenia spectrum disorders include:

Neurobiology

Although its specific cause is unknown, schizophrenia has a neurobiological basis.

  • Alterations or abnormality in brain structure caused by head trauma or innately born defects. 
  • Changes in neurochemistry related to dopamine and glutamate transmission
  • Neurodevelopmental vulnerabilities caused by genetic disposition and the disorder developing as a result of interactions between these enduring vulnerabilities and environmental stressors such as Intrauterine, birth, or postnatal complications, viral central nervous system infections.

Genetics

Genetic factors related to the development of schizophrenia are strongly implicated. People who have an immediate relative with schizophrenia such as parents and siblings have about a 10-12% risk of developing the disorder, compared with a 1% risk among people who do not have such family history. 

Environmental stressors

Environmental stressors can trigger the emergence or recurrence of psychotic symptoms in vulnerable people.

Stressors can include  substance use, especially marijuana or social stressors such as becoming unemployed or impoverished, leaving home for college, breaking off a romantic relationship, conflict related trauma, childhood trauma and abuse. 

Protective factors such as positive psychosocial support, developed coping skills may mitigate the effect of stress on symptom formation or exacerbation.

What are the treatments available for Schizophrenia spectrum disorders?

Some of the treatments available for schizophrenia spectrum disorders include:

Antipsychotic drugs

Antipsychotic drugs for the treatment of schizophrenia are divided into conventional antipsychotics and 2nd-generation antipsychotics (SGAs).

SGAs may offer some advantages as they have been clinically observed to have greater efficacy and reduced likelihood of an involuntary movement disorder and related adverse effects. 

However, this class of drugs have some risks in terms of developing metabolic syndrome causing excess abdominal fat, insulin resistance, dyslipidemia, and hypertension as compared to conventional antipsychotics. 

Rehabilitation Services

Interventions that include training and programs aimed to help individuals rehabilitate include skill training and vocational programs to help many patients work and care for themselves.

This training is to help them be able to manage a household; socialise, work with mental health care practitioners, as well as ease their way into the work through supported employment. 

In terms of supported employment, they usually work with job coaches where they are mostly engaged in on-site adaptation and skill training to help them in porblemsolving as well as communicate with their employers.

Community support services

Support services include supervision for patients with schizophrenia that can help them to reside in the community. 

Most people with schizophrenia in treatment can live independently however some might require supervision to ensure safety and adherence to treatment. 

These support services promote patient autonomy while providing sufficient care to minimise the likelihood of relapse and need for inpatient hospitalisation.

In some cases, hospitalisation may be required during severe relapses, and involuntary hospitalisation may be necessary if patients pose a danger to themselves or others.

Psychotherapy

Treatment for schizophrenia along with pharmacological treatment also includes psychotherapy where the goal of psychotherapy in schizophrenia is to develop strategies to help patients manage their symptoms to form routines of care including reducing stress and taking their drugs efficiently and on time. 

These strategies are usually created through a collaborative relationship between the patients, family members, and physician/therapist.

Treatment includes addressing the needs of the patient, providing education and support for the family of the patient, promoting adaptiveness and management skills of their condition. 

This approach involves empathy and understanding of the condition- for both family and patient along with support to adapt to what is often a lifelong illness which is substantially limiting.

Conclusion

In this blog we will discuss what Schizophrenia Spectrum Disorder is. 

We will also briefly discuss what Schizophrenia is, what causes it, and what are the possible treatments available for Schizophrenia Spectrum Disorders.

FAQ related to Schizophrenia Spectrum Disorders

Is schizophrenia considered a spectrum disorder?

Yes. Schizophrenia, as of 2013 in the Diagnositic and Statistical Manula of mental disorders published by the Amercial Psychplgocial Association, is considered to be part of a spectrum of disorders called the Scipzophrenial Spectrum disorders. 

What are the 4 main types of schizophrenia?

The main types of schizophrenia include paranoid schizophrenia, catatonic schizophrenia, disorganised or hebephrenic schizophrenia, residual schizophrenia, and undifferentiated schizophrenia.

What are positive signs of schizophrenia?

Positive Symptoms which involve things that are present which should not be. These includes

  • Hallucinations: Seeing, hearing, smelling, tasting, or feeling (through touch) things that are not there
  • Delusions: False beliefs that don’t change even when the person is presented with evidence that they are false- which lead to paranoia or irrational fears.
  • Unusual thinking or disorganised speech

What is residual schizophrenia?

Residual schizophrenia is a subtype of schizophrenia in which the individual has suffered an episode of schizophrenia but there are no longer any delusions, hallucinations, disorganised speech or behaviour.

Can a person with schizophrenia act normal?

With the right treatment that involves persistent and early intervention- pharmacological, psychotherapy, and social rehabilitation interventions-many people with schizophrenia are able to regain normal functioning and even become symptom-free.

References

Schizophrenia Working Group of the Psychiatric Genomics Consortium: Biological insights from 108 schizophrenia-associated genetic loci. Nature 511(7510):421-427, 2014. doi: 10.1038/nature13595.

Correll CU, Rubio JM, Inczedy-Farkas G, et al: Efficacy of 42 pharmacologic cotreatment strategies added to antipsychotic monotherapy in schizophrenia. JAMA Psychiatry 74 (7):675-684, 2017. doi: 10.1001/jamapsychiatry.2017.0624.

Wang SM, Han C, Lee SJ: Investigational dopamine antagonists for the treatment of schizophrenia. Expert Opin Investig Drugs 26(6):687-698, 2017. doi: 10.1080/13543784.2017.1323870.

Jones.H. What Is the Schizophrenia Spectrum? Verywellmind. Retrieved on 18th March 2022.https://www.verywellhealth.com/schizophrenia-spectrum-and-types-5193053#toc-what-is-schizophrenia

Carol Tamminga. Schizophrenia. MSD Manual. Retrieved on 18th March 2022. https://www.msdmanuals.com/professional/psychiatric-disorders/schizophrenia-and-related-disorders/schizophrenia#v1029197

What was missing from this post which could have made it better?

Leave a Reply

Your email address will not be published.