Some Statistics and Patterns (prevalence, course, prognosis)

Statistical Prevalence of Schizophrenia

Schizophrenia is not a terribly common disease but it can be a serious and chronic one.
Worldwide about 1 percent of the population is diagnosed with schizophrenia, and approximately
1.2% of Americans (3.2 million) have the disorder. About 1.5 million people will be diagnosed
with schizophrenia this year around the world. In the United States, this means about 100,000
people will be diagnosed, which translates to 7.2 people per 1,000 or about 21,000 people within
a city of 3 million who are likely to be suffering from schizophrenia.

Schizophrenia can affect people throughout the lifespan although new instances of the illness are
most likely to occur in early adulthood. It is relatively rare for children and older adults to
develop schizophrenia, but it does happen. More commonly the incidence (rate of diagnosis) of
new cases of schizophrenia increases in the teen years, reaching a peak of vulnerability between
the ages of 16 and 25 years. Men and women show different patterns of susceptibility for
developing schizophrenic symptoms. Males reach a single peak of vulnerability for developing
schizophrenia between the ages of 18 and 25 years. In contrast, female vulnerability peaks
twice; first between 25 and 30 years, and then again around 40 years of age.

Schizophrenic Symptoms Course

The full onset of schizophrenia is typically preceded by a gradual 'prodromal' (pre-cursor) period
where odd behaviors and experiences, such as anxiety, restlessness and hallucinations begin to
occur, but not yet with their fullest force. There may be a gradual loss of reality. Many
schizophrenic sufferers describe the onset of odd feelings, thoughts and perceptions a few
months before anyone else can see visible evidence of them. It can be quite difficult to recognize
schizophrenia during this early prodromal stage, particularly if it is a new diagnosis and has not
occurred before for a given patient. Though the schizophrenic person may have been hearing
criticizing voices and experiencing delusions for some time, these symptoms may not have been
overwhelming or frightening enough to have caused them to break down and act in a bizarre
manner. Patients experiencing these symptoms for the first time may be able to hide them for a
while, but this becomes more difficult as the psychotic process sets in and their outer actions
begin to reflect their inner perceptual distortions.

Schizophrenia is not generally recognized to be occurring until after truly odd and irrational
behaviors are expressed during what is called a "psychotic break", or "first break". Though the
schizophrenic person's internal experience during psychosis may be terrifying, it is the outward
symptoms characteristic of the psychotic break that are noticed by family members and others:
changes in self-care, sleeping or eating patterns, weakness, lack of energy, headaches, changes
in school or work performance, strange sensations, and confused, strange, or bizarre thinking
that gets expressed as bizarre behavior. Keep in mind, however, that the actual break with
reality may occur prior to the time that people around the psychotic person have noticed that
something is seriously wrong. The schizophrenic symptom-rich period following the psychotic
break is sometimes called the 'active-phase' or, alternatively a period of 'florid' psychosis. The
term florid means "flowering" and the term is a metaphorical usage denoting that the psychosis
is the end result or goal of the schizophrenic illness, just as the bloom is the end result or goal of
a flowering plant.

When schizophrenia does occur, it often becomes a chronic condition that continues throughout
the remainder of life with varying degrees of intensity. The "first break" may be the last break if
the case of schizophrenia is mild and if treatment is administered promptly and continued as
directed by a psychiatrist (a medical doctor specializing in mental health issues). More typically,
however, the first break leads to a pattern of varying periods of relative recovery (which are
termed 'residual' phases) and periods of new active-phase psychosis that continue throughout
the remainder of patients

Prognosis

There is no known cure for Schizophrenia. Fortunately, there are effective treatments that can
reduce symptoms, decrease the likelihood that new episodes of psychosis will occur, shorten the
duration of psychotic episodes, and in general, offer the majority of people suffering from
schizophrenia the possibility of living more productive and satisfying lives. With the proper
medications and supportive counseling, the ability of schizophrenic persons to live and function
relatively well in society is excellent. The outlook for these patients is optimistic.

Ten years after initial diagnosis, approximately fifty percent of people diagnosed with
schizophrenia are either noted to be completely recovered or improved to the point of being able
to function independently. Twenty five percent are improved, but require a strong support
network, and an additional fifteen percent remain unimproved and are typically hospitalized.
Unfortunately, ten percent of the affected population sees no way out of their pain except
through death and ends up committing suicide. Long-term statistics for thirty years after
diagnosis are similar to the ten year mark, except that there are even more people who improve
to become independent. However, there is also an increase in the number of suicides to fifteen
percent. Over time, women appear to have a better chance at sustaining recovery from
symptoms than do men.

It is an unfortunate fact that people with schizophrenia attempt suicide more frequently than do
people in the general population. This may occur for many reasons, including fears and anxieties
associated with psychosis or depression and hopeless feelings that may occur when it is realized
that a serious, chronic and life-changing disease has occurred. It is always difficult to predict
which people are serious suicide risks, and this is the case for the schizophrenic population as
well. While people in the general population talk about suicide from time to time, professional
mental health help should be sought right away for people (schizophrenic or otherwise) who
make a habit of discussing suicide, who express any sort of plan to commit suicide, who stockpile
pills, tools (rope, razors) or weapons for the purpose of suicide or self-harm, or who act out a
suicide or self-harm plan, however half-heartedly. The impulse to suicide is most always a
temporary crisis that can be overcome with time and proper care. Given the right treatment, the
chance for a reasonably balanced life is good.

Recovery

The key to successful recovery is early diagnosis and treatment. In general, the earlier someone
with schizophrenia is diagnosed and stabilized on an appropriate treatment regime, the better
their chance of recovery. In light of this tendency, anyone who suspects that they (or someone
they know) may have signs and symptoms consistent with schizophrenia should consult with a
psychiatrist at their earliest possible convenience.

Multiple factors appear to influence prognosis (disease outcome) in schizophrenia. Family history
of schizophrenia is relevant. If no one in the immediate biological family of first degree relatives
has schizophrenia or a related condition, that is a good sign. Multiple relatives who share
schizophrenia outcomes is a bad sign. Other good signs include good social and professional
adjustment prior to the onset of symptoms, and awareness and insight of symptoms as signs of
a problem (rather than just reaction to symptoms without insight); patients demonstrating both
of these signs may sometimes recover completely. Chances for recovery are improved if the
disease comes on suddenly, as opposed to when it comes on slowly. The older one is at the
onset of schizophrenia, the better. If schizophrenia is treated quickly and consistently (see
above) with good response to treatment, the prognosis is usually very good. A short amount of
time that people suffer with severe symptoms and a lack of symptoms reported during periods
between severe psychotic episodes are also good indicators of recovery potential. A personal
history or family history of mood disorders may help a person to move through a schizophrenic
phase quickly because their primary condition may be some other affliction. Since schizophrenia
is a brain disorder, a good outcome is predicted when the brain has a normal structure and
function as indicated by a brain scan.