Schizophrenia is a brain disease and a kind of serious mental disorder. About 1% of the population has this illness. Patients usually have symptoms for the first time when they are young but the illness can occur in any age and affects men and women at similar rates. Many people have the misconception that schizophrenia patient has multiple personality or split personality, but actually the illness mainly affects our emotion, perception and thinking, causing abnormal behavior while the patient has only one personality.

Schizophrenia can be treated but it has high relapse rate. The earlier it is discovered and treated, the better the prognosis for recovery.

(Special thanks to Dr S F HUNG, Hospital Chief Executive, Kwai Chung Hospital for reviewing the information of this page.)


Schizophrenia is a serious mental illness. It is caused by the disturbances of concentration of brain neurotransmitters, changes of  receptors of the  brain cells and structural brain abnormalities rather than pure psychological reasons. Patient will have abnormal thinking, feeling, emotion, speech and behavior which affect daily life, work, social activities and the ability of taking care of oneself. Some patients are prone to attempt or commit suicide.

People can have schizophrenia in any age, but symptoms usually emerge in the age range of 20 to 30. The relapse rate is very high if there is no appropriate maintenance treatment.


The following people have higher chance of the illness: 

  • Those who have family history of schizophrenia
  • Those who are exposed to viruses while in the womb
  • Drug abusers

Although there are no preventive measures with 100% certainty, avoiding drug abuse can lower the chances of morbidity and relapse. Take appropriate methods to relieve stress, keep oneself positive and have enough rest can help maintain mental health.


The causes are still uncertain. It is generally considered to be related to brain lesions and genetics and psychological reasons. Some studies found that the brain structure and central nervous system of schizophrenia patient as shown in scanned images are different from those of normal people. In addition, the secretion of dopamine, a neurotransmitter in the brain, of schizophrenia patient is higher than normal people.

相片 Patient usually has one or both types of the following symptoms:

(1) Positive symptoms
“Positive symptoms” are also called “acute symptoms” which are unusual, surreal thoughts and senses leading to unusual behaviors of patient. These symptoms may recur, including:

  • Delusion:firmly held belief that is  without ground, persists despite evidence of contrary and cannot be corrected by logic and common sense, e.g. thinking he/she is persecuted, someone is controlling his/her thoughts and behaviors or thinking that other people are talking about him/her.
  • Hallucinations:patient perceives something very vivid that does not exist in reality, e.g. seeing some images that other people cannot see, hearing some voices that do not exist or feeling of being touched.
  • Thought disorder:unclear thought, lack of continuity and logic, resulting in disorganized speech, talking to him/herself or stop talking suddenly.
  • Bizarre behaviors:talking to him/herself, unpredictable crying or laughing or even dressing in a bizarre way.

(2) Negative symptoms
“Negative symptoms” or “chronic symptoms” are more difficult to recognize than “positive symptoms” and usually become obvious after the decline in positive symptoms. If the conditions deteriorate, the patient’s work and self-care ability will be affected. These symptoms include:

  • Social withdrawal:become closed, cool, self-centered, alienated from others, etc.
  • Lack of motivation:loss of interest to the surrounding things and even personal hygiene and self-care.
  • Blunted thinking and movement.
  • Flat of facial expression

If you think your friends or families have the above symptoms, you should encourage them to see family doctor who will refer to psychiatrists if necessary. Apart from normal body check, doctor may undergo the following tests depending on patient’s condition in diagnosing schizophrenia:

  1. Psychological evaluation:through conversation, questionnaires, etc., doctor can understand and analyses the patient’s symptoms, for diagnosing whether it is schizophrenia or other mental illness. Schizophrenia can be further divided into Paranoid, Catatonic, Disorganized and Residual types. Doctor will also ask about whether the patient consumes alcohol or abuses drugs to have better understanding of the condition.
  2. Blood sample analysis, computerized tomography scan or MRI (magnetic resonance imaging) can help rule out other underlying physical disorders that can cause symptoms mimicking schizophrenia

Doctor may suggest the following treatments to patient:

(1) Medications
Medications can reduce or eliminate the positive symptoms of patient effectively, e.g. delusion, hallucinations and disordered thoughts. Medications can also control anxiety and help the patient to get back to real life. But there are also side effects, e.g. stiffness of muscles, slow movement, shaky hands, dry mouth, constipation, fatigue, fast heartbeat and gaining weight.

Doctor usually prescribes two kinds of antipsychotics (drugs for mental illnesses), which are typical antipsychotics (e.g. Haloperidol, Thioridazine and Fluphenazine) and atypical antipsychotics (e.g. Clozapine, Risperidone and Olanzapine). Doctor will prescribe different kinds of medications depending on the patient’s condition, status of medication and the patient’s reaction to drugs. Both kinds of medications may have different side effects.

(2) Adjuvant treatment
Rehabilitation can help and train patient to face and manage daily life. Depending on individual condition, medical professionals will set out appropriate treatment programme for patient, e.g. self-care training (including personal hygiene, cooking, household safety, adaptation to community and use of money), work ability training, stress management and interpersonal skills with family members.

Family support is particularly important for patient. If the patient’s family faces schizophrenia in a right attitude, supports the patient with care to follow the treatment programme and keeps watch of the changes of condition and symptoms, patient will be better rehabbed. However, family members shall also pay attention to their own physical and mental health, learn how to relax and seek help if needed when taking care of the patient. Family members should avoid expressing critical comments, adopting hostile attitude and harboring emotional over-involvement towards the patient. These undesirable attitudes (high expressed emotions) have been shown by research to increase relapse rate of schizophrenic illness.

The environment will affect treatment. Usually places where patient feel most comfortable will be chosen, e.g. home treatment. If there is special need, patient may need to be hospitalized.

If there is no appropriate treatment, the emotion, behavior as well as daily life of patient may be seriously affected. Patient may become depressed, self-destructive or even commit suicide.

As schizophrenia has a very high relapse rate, patient should have follow-up consultation regularly and take medicines with dosage and time interval as instructed by doctor. For most patients, long-term medication can significantly reduce the chance of relapse and keep oneself in rehabilitation state. In addition, patient should undergo rehabilitation training, return to the society gradually for sooner recovery.

Family members should encourage and help patient to follow the treatment programme and join social activities to have more social life. Moreover, family members should express themselves and communicate with patient in a positive and direct manner, pay attention to the improvement and virtue of patient, and giving praise and encouragement to boost the patient’s confidence.

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