UTHealth Harris County Psychiatric Center
Schizophrenia
精神分裂症的类型•Causes•Signs and Symptoms•神话•Treatments•Living with Schizophrenia•How Family and Friends Can Help
精神分裂症是最令人衰弱和令人困惑的精神疾病之一，它定义了一组疾病，这些疾病会导致思想和感知扭曲。思想可以被扰乱或从主题跳到主题。感知可能会扭曲现实，从而导致人们看到或听到不存在的事物。
People with schizophrenia go through periods of getting better and worse --- remission and relapse. They can go for long periods of time without any symptoms, but because schizophrenia is often a chronic illness, it requires ongoing medical attention, like hypertension or diabetes.
精神分裂症是一种既非“分裂”的个性也不multiple personality disorder, a different and extremely rare problem. Though often stigmatized for the behaviors caused by the illness, people with schizophrenia did not bring the illness upon themselves by becoming involved with the "wrong" crowd or interests. And, contrary to the beliefs that are reinforced by movies, television and books, people with the disorder are more likely to withdraw into isolation or become victims of crime than they are to hurt anyone else.
Much less common than other chronic diseases, schizophrenia occurs in around 150 of every 100,000 people, or about one to one and a half percent of the population, and usually appears during adolescence or young adulthood. However, it can be one of the most catastrophic illnesses because it can cause devastating impairments, emotional and financial loss and the need for long-term, intensive medical and supportive care.
精神分裂症可以以多种形式之一出现。例如，据说一个不断受到监视，遵循或迫害的人患有偏执的精神分裂症。一个不连贯但没有妄想的人据说精神分裂症混乱。缺乏主动性，动力，社会兴趣，享受和情感反应能力的人没有差异化精神分裂症。精神分裂症的强度，严重程度和频率在人之间的强度，严重程度和频率都不同。因此，科学家使用“精神分裂症”一词指的是从轻度到重度的一系列疾病。
Research has not yet identified the cause of schizophrenia. However, most experts agree that a serious of factors combine with a genetic risk to contribute to the start of the disorder.
Just as the risks for diabetes and heart disease are thought to run in families, the risk to develop schizophrenia is often thought to have a genetic link. For example, if one identical twin develops schizophrenia, the other twin has a 50 to 60 percent chance of developing the illness as well.
Exactly what triggers the illness in those with a family risk for schizophrenia is not yet known. Some theories suggest that because schizophrenia most often first occurs during the hormonal changes of puberty, these changes in biochemistry set off the illness in those who are at risk. In addition, viral infection, severe stress such as poverty or violence, and other similar external factors are all viewed as possible causes of the disorder.
家人和朋友可能不会注意到精神分裂症的早期迹象。患有精神分裂症的人有时会在疾病的早期阶段表现出以下症状或多种症状：
- prolonged feelings of tension
- sleeplessness
- 浓度不佳
- 社交退出
- personality change
As the disorder progresses, the symptoms become more intense and bizarre. The person develops peculiar behavior, begins talking nonsense and has unusual perceptions. These more severe symptoms are usually the reason for seeking treatment.
Delusions are unusual beliefs that are not based in reality. For example, people suffering from schizophrenia might believe that someone can hear their thoughts or control their feelings, actions or impulses.
幻觉是感官的扭曲。听觉幻觉会导致人们听到不存在的声音。视觉幻觉使人们看到不存在的事物。触觉幻觉是没有原因的感觉，例如燃烧或瘙痒。还可能发生嗅觉幻觉，闻起来不存在气味。
Preoccupations are thoughts that take on more importance in the sufferer’s mind than they normally would. The same though returns often and can become unrealistic. This may include a preoccupation with health, or “doing the right thing”.
Disordered thinking interferes with planning, motivation and communication. For example, a person may use words that make no sense, or jump from one thought to another unrelated thought.
社交戒断使精神分裂者寻求孤立。这可能包括不容忍人群，小型聚会甚至是另一个人。
Lack of motivation and emotion as well as apathy are symptoms, which are troubling for family members to see in their loved ones. Few people experience all these symptoms at once. Some may occur during the remission phase and may worsen in the most active phase of the disorder.
"Any person with schizophrenia is incapable of making life decisions and requires the help of a legal guardian.”
The diagnosis of schizophrenia does not mean that the person will always be dependent upon others to make decisions and care for them. In fact, most people with this illness handle their own affairs successfully. However, just as people with other medical conditions may have symptoms that cause periods when their ability to make decisions is impaired, people with schizophrenia may require the appointment of someone to handle their affairs for a specified length of time.
"Smoking ‘pot’ can help sometimes more than regular medicine.”
This is a myth. The use of any illicit drug is dangerous and illegal, no matter who uses them. For people with schizophrenia, such use can impair judgment, worsen symptoms and cause interactions with medications. People with schizophrenia often have difficulty with healthy social interaction. Being with people who use or sell drugs can place an already vulnerable person in a potentially dangerous position.
由于这些原因，重要的是要告知治疗精神科医生任何滥用药物或使用。他或她将建议采取步骤避免非法吸毒，并处理该药物似乎不提供帮助的原因。
"People with schizophrenia are violent.”
暴力不是精神分裂症的症状，在这种疾病患者中并不常见。实际上，精神分裂症患者更有可能成为暴力的受害者。但是，如果发生暴力或侵略性，通常会当一个人感到拐弯或误解对方的意图时会这样做。通常，幻觉，妄想，关注或混乱的想法引起了导致暴力的恐惧和误解。
像许多其他精神疾病一样，精神分裂症通常通过疗法的组合进行治疗，这些疗法是根据个人的症状和需求量身定制的。
在精神科医生的监督下，抗精神病药是精神分裂症的选择治疗，因为该疾病与生化失衡有关。这些药物可以减少幻觉，妄想和混乱的思维，但很少有人能够充分地治疗精神分裂症中发生的社交戒断和冷漠。
As with all medications, antipsychotic medications have side effects. Some, such as dry mouth, dizziness, drowsiness and constipation, go away with time. Other side effects include restlessness, tremor and muscle spasms, cramping or stiffness. An irreversible side effect is tardive dyskinesia, which causes abnormal movements in the mouth, face and later in the arms and legs.
Many of these side effects can be helped or avoided when reported to the psychiatrist. It is important not to abruptly stop taking the medications, increase the medications or take additional medications without consulting a doctor. Such changes can cause relapse or other serious problems.
Medication is usually prescribed through the remission phase of the illness to prevent relapse. Though relapse may occur even when medication is taken as prescribed, taking the medication provides the best protection from future relapse.
Psychotherapy and other supportive therapies address the emotional and practical responses to these illnesses and are typically recommended in addition to medication.
The hallucinations, delusions and isolation caused by schizophrenia can impair a person’s relationships with other people, daily living, spiritual growth and job skills. Individual psychotherapy helps patients to understand their emotions and deal with life’s problems in a more confident, healthy way. Group psychotherapy allows patients to learn social skills and gain emotional support for the difficult times as well as offer support to others.
职业疗法可以帮助患者恢复日常生活技能和常规，这可能会受到精神疾病的损害。活动疗法通过娱乐和小组活动的重点关注问题。
在过去的二十年中，精神分裂症患者的前景有所改善。尽管尚未确定绝对的治疗，但现代疗法使许多精神分裂症患者能够独立，实现生活。但是，重要的是，可能会迅速诊断出这种疾病的人可以尽快开始治疗。
How Family and Friends Can Help
家人和朋友可以帮助的第一种方法是在让患者寻求治疗方面发挥积极作用。精神分裂者通常认为妄想和幻觉是真实的，不需要精神病治疗。
当治疗开始时，认识到许多抗精神病药可能会导致患者需要比平时更多的睡眠。另外，理解并准备识别可能的药物副作用以及需要与医生联系的症状。
Speak clearly and simply. Because the illness can cause problems with thinking, it is helpful to limit conversation to the most simple statements and questions. Recognize delusions and hallucinations as symptoms. The perceptions are real to the patient; do not argue that the delusion is true or false. Pointing out that he or she does not have to listen to the voice or wait for the voice to speak again can be helpful.
找到一种同情的方法。例如，邻居在夜间演奏的大声音乐可能会被解释为一种控制患者思想的策略。与其坚持这是不真实的，不如承认试图睡觉时的响亮音乐会多么令人沮丧。
Provide structure. Help the person recovering from the illness to plan the days to include plenty of sleep, healthy food, fresh air, time for exercise, cleanliness and social interaction.
Family and friends should plan ahead and be prepared for possible crises. Medications, phone numbers and other important information and materials should be kept readily available.
Dealing with a relative or friend with schizophrenia can be tremendously stressful. Family and friends can find emotional support, understanding and hope from outreach, education and advocacy groups. Whether you are the victim, a family member or friend, everyone who is affected by this mental illness should seek help.
