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Knowing the truth about this condition can help you or someone you know with schizophrenia enjoy

a healthier, happier life.

Why You Should Know the Truth. Schizophrenia is a complex mental illness that interferes with a persons ability to think clearly, manage emotions, make decisions and relate to others. It is also an often misunderstood condition, leading people to stigmatize those who have the illness, and causing people with schizophrenia or their family members to delay or avoid treatment, a mistake that can have tragic repercussions. We still have a lot to learn about schizophrenia, but advances in brain imaging, genetic studies and other research are improving our understanding, says Ken Duckworth, M.D., assistant professor of psychiatry at Harvard University and medical director of the National Alliance on Mental Illness. Perhaps the most important thing to know is that its possible to have schizophrenia and live a productive, happy life. Keep clicking for 14 common myths -- and the truth -- about schizophrenia. Myth #1: People with Schizophrenia Have Split Personalities Truth: Schizophrenia, which translates to split-minded, is a misnomer, as people with the condition dont have split, dual or multiple personalities. A movement to rename the illness has arisen in recent years. In 2002, the Japanese Society of Psychiatry and Neurology adopted the new name integration disorder (togo shitcho sho), which better fits the latest thinking about schizophrenia as a condition that involves cognitive problems and imbalances in interrelated chemicals in the brain, which can affect normal functioning and memory. Just seven months after renaming the condition, Japanese researchers found that the term was being widely used and had increased doctor-patient communication about the condition dramatically. In the United States, experts working on the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) are looking at new ways to classify and describe the condition. Myth #2: People Who Have Schizophrenia Are Always Violent Truth: Most are not. In a Columbia University study of more than 1,400 people with schizophrenia, 81 percent reported no violent behavior in the previous six months. The latest research indicates that its not mental illness itself that raises a persons risk of violence, but rather other problems that often accompany mental illness, such as substance or physical abuse and unemployment. In fact, people with severe mental illness who are not substance abusers and who do not have a history of violence are no more likely to be violent than people in the general population, according to a study of nearly 35,000 adults conducted at the University of North Carolina at Chapel Hill School of Medicine. Living with a supportive family reduces the risk of violence in people with schizophrenia by half. Myth #3: Schizophrenia Is Rare Truth: One in every 100 adults worldwide has been diagnosed with schizophrenia. In the United States, about 2.4 million adults have the condition, which affects men and women equally. Myth #4: If One of Your Parents Had Schizophrenia, You Will Probably Develop It, Too Truth: Not everyone who carries the genes so-far associated with schizophrenia goes on to

develop the disorder. Studies show that in families with schizophrenia, only about 6 percent of relatives have the illness, although many more family members likely carry the genes. If no one in your family has schizophrenia, you have a 1 percent risk of developing it. If a cousin, aunt or uncle has the disorder, your risk rises to 2 percent. If one of your parents has it, your risk is about 10 percent. The greatest genetic risk factor? Having an identical twin with schizophrenia bumps the likelihood that you will develop it up to roughly 50 percent. Although genetics clearly do play a role, so do environmental factors. Myth #5: Bad Parenting Causes Schizophrenia Truth: Back in the 1950s through the 70s, some experts and medical textbooks perpetuated the idea that certain parenting styles -especially being dominant and overprotective but at the same time rejecting -- caused mental illnesses, including schizophrenia. Research has since shown that people with schizophrenia are no more likely to have had this kind of parent than those in the general public. Although the exact cause of schizophrenia is still unknown, it is now believed to be the result of a combination of genetic and environmental factors. These include prenatal exposure to viruses, including rubella and influenza; physical brain trauma or obstetrical complications during pregnancy or birth; social isolation or financial adversity; and head injury during childhood. New studies show that marijuana may also trigger symptoms of schizophrenia in some people. The field is moving toward seeing marijuana as a risk factor for schizophrenia in vulnerable individuals, Duckworth says. This is more true for people in their early to midteens -- the earlier the exposure and the higher the dose, the higher the risk. Myth #6: All People with Schizophrenia See Things That Arent There Truth: Some people with schizophrenia have visual or other types of hallucinations, but many dont. I would estimate that about 20 percent of people with schizophrenia have visual hallucinations, most often seeing faces or figures, says Ralph Hoffman, M.D., professor of psychiatry at Yale School of Medicine. Hearing voices is the most common type of schizophrenic hallucination, affecting roughly 70 percent of people with the disorder. About 5 percent of patients have tactile hallucinations -- particularly thinking someone is touching them -- and even fewer experience odd smells, Dr. Hoffman says. According to the latest guidelines from the American Psychiatric Association, a diagnosis of schizophrenia generally requires two or more of the following symptoms for at least one month: hallucinations, delusions, disorganized speech, abnormal psychomotor behavior (such as not moving for long periods of time) or negative symptoms such as emotional flatness or social isolation. Seeing things and experiencing bizarre smells also increase the possibility that someone has a brain-based problem, such as some forms of epilepsy, rather than schizophrenia, Dr. Duckworth says. Myth #7: Its Easy to Spot People with SchizophreniaTruth: Schizophrenia is a complicated illness and is difficult to diagnose. There is no single test that confirms a diagnosis of the disorder, although certain tests, such as EEGs or MRIs, may help to rule out other conditions that may cause symptoms similar to those of schizophrenia. According to the National Alliance on Mental Illness, doctors need to observe and assess symptoms in someone for at least six months before making a diagnosis. Research shows that the earlier a diagnosis is made and treatment begins, the better people with schizophrenia tend to do. Myth #8: There Are No Good Treatments for Schizophrenia Truth: There is no cure, but there are many good treatments. About half of people with schizophrenia have positive outcomes with appropriate treatment for the condition, according to the National Alliance on Mental Illness. Antipsychotic medications taken orally or by injection can eliminate many symptoms within a few weeks, stabilizing people who can then respond better to other kinds of therapies.

Psychotherapy and cognitive behavior therapy can help people work on their interpersonal relationships, communication skills and symptom management. Rehabilitation programs can teach people to maximize their job skills and manage their money, among other life strategies. Self-help groups and family education can also help someone with schizophrenia function better in the world. Just as symptoms of the disorder vary from person to person, often the best strategy is a combination of therapies tailored to someones individual symptoms and needs. Myth #9: Schizophrenia Is Most Likely to Be Diagnosed in Childhood Truth: Diagnosis in childhood is actually extremely rare. In men, schizophrenia is most likely to be diagnosed in the late teens or early 20s, with the earliest symptoms sometimes showing up in the mid-teens. In women, late 20s and early 30s are the most common ages of diagnosis. People are rarely diagnosed with the condition after age 40. Myth #10: People with Schizophrenia Live As Long As the General Population Truth: People with schizophrenia are more likely to die at younger ages of natural causes, including diabetes, cardiovascular disease, respiratory disease or infections. There are many factors that may contribute to these problems, Dr. Duckworth says. Theres some evidence that people with schizophrenia have about twice the risk of developing diabetes as the general population to begin with. Then, side effects of medications to treat schizophrenia may include weight gain, which can contribute to these cardiovascular problems. People who have schizophrenia are also more likely to smoke cigarettes, and smoking is a well-known cardiovascular risk factor. The best treatments for people with schizophrenia include ongoing communication between a patients psychiatrist and general practitioner to make sure that physical as well as psychological symptoms are being closely monitored. Myth #11: People with Schizophrenia Are Highly Emotional Truth: While some people with schizophrenia are emotionally expressive, others may experience emotional flatness, social isolation, depression or an inability to communicate feelings. In fact, these may be some of their most profound symptoms. Myth #12: Schizophrenia Is One Condition Truth: Scientists are starting to think that schizophrenia may actually be several different conditions. Studies at the University of Pennsylvania have identified different subtypes of schizophrenia based on the areas of the brain affected in people with the condition and the kinds of symptoms they have. One subtype includes people whose primary symptoms involve an inability to organize their thoughts and express ideas in a logical way; these people also have smaller temporal lobes, the part of the brain involved in language and memory. Another subtype comprises people who have problems with the front striatal region, the part of the brain associated with motor function and cognition. A third type is a group that exhibits similar symptoms to the first two groups, but less severe. Neurobiologically, schizophrenia is probably not one illness process, Dr. Duckworth says. Its a complicated illness, and were learning more about it all the time. As our understanding increases, diagnoses may change. Myth #13: People with Schizophrenia Know They Are Sick Truth: About 50 to 80 percent of people who have schizophrenia dont realize that they are sick. This phenomenon is known by the medical term anosognosia, or lack of insight. Its not psychological denial, Dr. Duckworth explains. It seems to be wired into them. Often family members observe symptoms in a loved one and insist they seek help, but the person with schizophrenia is unaware there is a problem.

Myth #14: People with Schizophrenia Cannot Lead Normal LivesTruth: Yes, they can. People learn to live with schizophrenia, Dr. Duckworth says. They learn to ignore their symptoms, which often become less intense as they get older. They find a social role for themselves. This isnt true of everyone, but the idea that schizophrenia is a universally downhill course is not true. Doctors recommend that for the best results, treatment should begin as early as possible once a diagnosis of schizophrenia is made. With the support of family members and other loved ones, therapy and the proper medication, people with schizophrenia can lead normal, productive, happy lives.

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