Schizophrenia: symptoms, causes, and treatments of a disorder still surrounded by myths

Schizophrenia is a severe mental disorder that disrupts how a person perceives the world, leading to experiences like delusions and hallucinations, alongside persistent changes in cognition, emotions, and social functioning. Contrary to common misconceptions, it is not a "double personality" disorder but a complex brain condition.

Symptoms are typically grouped into three areas. Positive symptoms include additions like delusions and hallucinations, particularly auditory ones, as well as disorganized thinking and behavior. Negative symptoms involve a lack of normal functions, such as apathy, social withdrawal, emotional blunting, and difficulty initiating activities.

Cognitive symptoms significantly affect attention, working memory, and planning, which are crucial for daily tasks like studying or working. The causes of schizophrenia are multifactorial, involving a combination of genetic predispositions, brain development issues, and environmental factors. These environmental influences can include perinatal complications, early life stress, trauma, and the use of high-potency cannabis in susceptible individuals.

Schizophrenia usually emerges in late adolescence or early adulthood, typically between ages 15 and 30, with men often showing earlier onset. Subtle signs may appear before the first psychotic episode, such as a decline in academic performance, social withdrawal, insomnia, unusual suspicions, or a loss of interest. These early signs warrant clinical evaluation, especially if they progress.

It is important to distinguish schizophrenia from psychosis, which is a broader syndrome of losing touch with reality that can stem from various conditions, including severe depression, bipolar disorder, substance use, or medical illnesses. Schizophrenia is a diagnosis made when psychotic symptoms are persistent and accompanied by functional decline and other characteristic alterations. The confusion between schizophrenia and dissociative identity disorder (formerly "multiple personality disorder") fuels myths and can delay access to crucial help.