Is it really you, schizophrenia?

Today I’d like to bring attention to something we have all heard about, but do we really know what it is? Schizophrenia. What immediately comes into your mind? Double personalities? Craziness? Something incurable? About 1 in 100 will develop schizophrenia. 

Schizophrenia is a mental health condition causing a range of psychological symptoms. These can include hallucinations: hearing or seeing things that do not exist (commonly hearing a voice saying derogatory things), and delusions: beliefs not supported by reality and the facts (i.e. I was the King of England, and then a rebellion took away my crown). People are unable to challenge these beliefs and experiences. They do honestly feel that they were once part of the royal family and to them it is as true as the sky’s blue to you and I.

Going back to the question I asked before, do you think sufferers will be immediately obvious to you out in the streets? No, not necessarily. Many people continue living normal lives and can be treated with a combination of antipsychotic medication and cognitive behavioral therapy. Mental health teams can also offer help on a day-to-day basis. Most importantly, you can recover from schizophrenia. There may be relapse periods but those again can be treated like before. Although the exact cause of schizophrenia is still unknown, it will usually be diagnosed equally in men and in women in the ages of 15 to 35.

Keeping that in mind, a Finnish study focused on the mortality rate of those whose schizophrenia started after the age of 60, way out of the normal 15-35 range. They gathered 918 of these very late onset sufferers and 6142 similar-aged people with schizophrenia diagnosed before 60. They looked at whether there was any difference in mortality betweem the groups.

The mortality rate for the late starters was 5.02, five times higher than in the Finnish population. For patients with earlier onset schizophrenia it was only three times higher. This affected more men than women. Men with late onset had 8 times the normal mortality but women only had 4 times the normal mortality. This difference between men and women for the early onset group.

The increase in mortality in the late onset group seemed to be linked to more cases if dementia and a higher rate of cancer. They also appeared to be more prone to fatal accidents.

Why all this difference? The study was measuring a group all around the same age and all supposedly with schizophrenia, the only difference being when it was diagnosed. Perhaps, very-late-onset schizophrenia-like psychosis is not schizophrenia at all. The brain areas affected may be the same, therefore causing similar symptoms, but the causes behind are probably very different. What we call schizophrenia is a collection of symptoms. It is similar to what would happen if we called every illness that presented with coughing, sore throat, temperature, headache and muscle pain 'the sniffles' instead of differenciating between whooping cough, a common cold and the flu. What DSM V calls schizophrenia today is probably a collection of different illnesses as varied as those that all present with coughing. We have a long way to go but this study and others that are looking at different presentations of the schizophrenia syndrome will eventually help us get to the bottom of this complex problem.