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Chapters

0:00 Introduction
1:14 causes of Schizophrenia
1:40 infections
2:02 Environment
2:21 substance abuse
2:34 Brain chemistry
2:46 Symptoms of Schizophrenia
3:36 Diagnosis
4:25 Treatment f Schizophrenia




Schizophrenia is a mental disorder[13] characterized by continuous or relapsing episodes of psychosis.[5] Major symptoms include hallucinations (typically hearing voices), delusions, paranoia, and disorganized thinking.[7] Other symptoms include social withdrawal, decreased emotional expression, and apathy.[5] Symptoms typically come on gradually, begin in young adulthood, and in many cases never resolve.[3][7] There is no objective diagnostic test; the diagnosis is used to describe observed behavior that may stem from numerous different causes. Besides observed behavior, doctors will also take a history that includes the person's reported experiences, and reports of others familiar with the person, when making a diagnosis.[7] To diagnose someone with schizophrenia, doctors are supposed to confirm that symptoms and functional impairment are present for six months (DSM-5) or one month (ICD-11).[7][11] Many people with schizophrenia have other mental disorders, especially substance use disorders, depressive disorders, anxiety disorders, and obsessive–compulsive disorder.[7]

About 0.3% to 0.7% of people are diagnosed with schizophrenia during their lifetime.[14] In 2017, there were an estimated 1.1 million new cases and in 2019 a total of 20 million cases globally.[2][15] Males are more often affected and on average have an earlier onset,[2] although some large reviews have not found gender differences in the prevalence of the disorder.[needs update][16][17] The likely causes of schizophrenia include genetic and environmental factors.[5] Genetic factors include a variety of common and rare genetic variants.[18] Possible environmental factors include being raised in a city, cannabis use during adolescence, infections, the ages of a person's mother or father, and poor nutrition during pregnancy.[5][19]

About half of those diagnosed with schizophrenia will have a significant improvement over the long term with no further relapses, and a small proportion of these will recover completely.[7][20] The other half will have a lifelong impairment.[21] In some cases people may be repeatedly admitted to hospitals.[20] Social problems such as long-term unemployment, poverty, homelessness, exploitation, and victimization are commonly correlated with schizophrenia.[22][23] Compared to the general population, people with schizophrenia have a higher suicide rate (about 5% overall) and more physical health problems,[24][25] leading to an average decrease in life expectancy by 20 years.[10] In 2015, an estimated 17,000 deaths were linked to schizophrenia.[12]

The mainstay of treatment is antipsychotic medication, along with counseling, job training, and social rehabilitation.[5] Up to a third of people do not respond to initial antipsychotics, in which case the atypical antipsychotic clozapine may be used.[26] In a network comparative meta-analysis of 15 antipsychotic drugs, clozapine was significantly more effective than all other drugs, although clozapine's heavily multimodal action may cause more side effects.[27] In situations where doctors judge that there is a risk of harm to self or others, they may impose short involuntary hospitalization.[28] Long-term hospitalization is used on a small number of people with severe schizophrenia.[29] In some countries where supportive services are limited or unavailable, long-term hospital stays are more common.[30]