- [Instructor] Schizophrenia
is a disorder of the brain. What it is absolutely not, it has nothing to do with
multiple personalities. When we think about the brain, we think about things that can cause schizophrenia and there are likely to
be many different causes, but we know that it's
likely to be a combination of genetics and environmental
causes that will be at play, and when I say environmental,
that may include things like the experience in the womb and also growing up,
childhood experiences, so it's really a combination
of these two big factors that leads to abnormalities in the brain, and these abnormalities
in the brain can actually be picked up by some of the
tests that we have today. Some of our brain imaging
tests can show some abnormal changes in some
individuals with schizophrenia. We know that some of
the neurotransmitters, the brain chemicals, are also
abnormal in schizophrenia. In particular, there is a
neurotransmitter called dopamine that is often thought to
be too high or elevated in certain parts of the
brain in schizophrenia, and quite a number of the medicines I use to treat schizophrenia, the
anti-psychotic medicines, aim to work against dopamine. Unfortunately, brain scans,
measuring neurotransmitters, none of these tests ever
diagnose schizophrenia. Schizophrenia is actually diagnosed based on a clinical interview, and that means taking a history, hearing from the patient or their family exactly what's been happening over time, and also observing the patient. Well, why would we observe the patient? Because we know that these
brain changes may actually cause changes in how a patient behaves. Their behavior may be altered, and we can further break this down into changes in the way they think and changes in the way they
act, and we think about ways that people with schizophrenia
may think differently. We start to think about
having abnormal beliefs, something that we actually call delusions, and they may also happen
to see and hear things that aren't there, something that
we refer to as hallucinations. Now, people can have
delusions and hallucinations in other conditions, but these are some of the symptoms of schizophrenia. Also, the way that they
act may be different. They may isolate themselves socially. They may be somewhat disorganized or somewhat confused in their actions, especially to people looking
at them from a distance. They may have something
that we call a flat affect, and that basically means they
lack emotions on their face. This is by no means an exhaustive list, but we can start to see
that the way that they think and the way that people
with schizophrenia act, there's a lot of changes
here that people would start to feel maybe abnormal or different. Now, let's think a little more
widely about schizophrenia. How common is this condition? Well, we know that
approximately one percent of people have schizophrenia. The exact number is actually
a little bit less than that in the US; it's actually 0.7%, and we know that males
are typically affected as much as females, and we know that this is a condition
that affects people between the age of 16 and 30. Although it can happen in childhood and in older individuals, this
is the most common age group, with males being affected at
a younger age than females. When we think about schizophrenia, we should also think about the fact that there is something
called the prodrome and the prodrome
represents a period of time before schizophrenia, the
symptoms are fully present, but it's actually a kind of deterioration in a person's behavior and functioning. Things are starting to go downhill and in the prodrome,
typically what may happen is that people will start to demonstrate some of the signs of schizophrenia, but what you will notice is
their academic or schoolwork may suffer, and I say schoolwork
because if you think about between 16 and 30, and if
the prodrome precedes that, you're talking about individuals that are often still in
the educational system, but if they're working,
the work can suffer. Also, their relationships may suffer. They may exhibit some paranoia or suspiciousness towards other people. Some of their thoughts may be that people are working against them, so they may develop some
of these delusional ideas and they may start to act differently. The prodrome then often
leads to schizophrenia and we know that if
somebody has schizophrenia, they are at risk of having
lots of different consequences. For example, they're at
a higher risk of suicide, a higher risk of being homeless, and a higher risk of being
in prison or in jail. So these are some basics to think about when we start to hear
the word schizophrenia. Schizophrenia is a brain disorder
that's neurodevelopmental, a combination of genetics and environment, and we can notice that there's differences in brain scans and neurotransmitters, but it's really diagnosed
on clinical interview and it affects how people think and act. It's preceded by this prodrome period where we notice a decrease in functioning and schizophrenia has
a lot of repercussions. It stops people engaging in
society, results in higher rates of suicide, homelessness
and incarceration.