Schizophrenia is a severe mental disorder that affects a person's ability to think clearly, distinguish reality from fantasy, and interact socially. It is a long-term illness that requires extensive treatment and rehabilitation. The document discusses what schizophrenia is, how widespread it is, its symptoms, why rehabilitation is needed, and treatment aspects like biological, psychological and social support. It notes schizophrenia cannot be cured but can be managed through proper long-term treatment involving medicines, therapy and social support. Non-compliance with treatment is a major challenge and can lead to worsening of symptoms.

2. Outline
 What is schizophrenia?
 How widespread is this?
 Symptoms of schizophrenia
 Why does schizophrenia need rehabilitation?
 Treatment for schizophrenia
 Some facts related schizophrenia: statistics

3. Schizophrenia
Schizophrenia is a long standing mental illness. It has
longer convalescence period therefore requires
extensive care.
Because of this illness a person’s ability to
differentiate between reality and his/her
imagination diminishes. If not treated in time, it’s
severity increases manifold and can lead to
imbalance in thought, emotion and behaviour.

4. What is Schizophrenia?
Thinking (विचार)
Behavior (िर्तन)Feeling (िाटर्े)
Impact of Schizophrenia:
 Affects thinking, feeling and behaviour
 Unable to differentiate between reality
and imaginary
 Positive and Negative Symptoms
 Affects important areas of life –
interpersonal relations, social life and
work place
Schizophrenia is a mental disorder causing abnormal social behaviour and failure to
understand reality.
Schizophrenia is not split personality or multiple personality disorder.

5. Schizophrenia – A Low-Down
Incidence and Epidemiology
 Any gender – Male as well as Female
 Age Group – Male 15 – 30 years; Female 25 – 30 years
 Incidence Rate – 1:100
Pathology
 Imbalance of neuro-chemicals/transmitters
 Dopamine and Glutamate
 Other causative factors
 Hereditary (Genetics)
 Brain injury while birth
 Infection during pregnancy
 Precipitating factors
 Stress
Cure for schizophrenia is not discovered. However, with proper treatment, many
people with this illness can lead productive and fulfilling lives.

6. How widespread is this illness?
 Globally, more than 21 billion people are suffering
from schizophrenia
 Types of Schizophrenia:
 Paranoid Schizophrenia
 Catatonic Schizophrenia
 Disorganized Schizophrenia or hebraphrenic
schizophrenia
 Simple Schizophrenia
 Mostly occurrence of Schizophrenia is observed to be
around adolescence.
 Onset in males is observed to be in age 15-20, whereas
females experience late onset

7. Symptoms of Schizophrenia
Positive symptoms: these symptoms are called as +ve
symptoms as they add disruption person’s ability to
perceive reality, understand intentions of others,
behaviour to a great extent.
 Hallucinations : seeing and feeling things that are not
there (may happen to all five sensory organs)
 Delusions: fixed false irrational beliefs that believe the
unreal (e.g. someone is plotting against me, my
thoughts are being controlled etc.
 Inability to manage own behaviour, emotions,
thoughts, especially aggressive ones.
 State of confusion and perplexity.

8. Symptoms of Schizophrenia
Negative symptoms: these symptoms take away
integration, functionality and liveliness from a person’s life.
 Lack of energy and enthusiasm
 Inability to express emotions verbally or through facial
expressions
 Confusion of thoughts or loss of logical thinking
 Inability to maintain hygiene and personal care
 Decline in ability to function like earlier, quality and drive
wise
 Unwillingness to mingle with people, diminishing social
skills

9. Why does Schizophrenia need
Rehabilitation?
Not taking
treatment for long
time/ quitting
medicines often
Very severe illness
Illness relapses and
becomes difficult to treat
and requires even longer
intense treatment.
If treatment is not taken
properly, the symptoms
increase and functionality
reduces
Family finds it difficult to
manage patient with
increase in severity
Chances of recovery start
diminishing
Rehabilitation

10. 3 Aspects of Treatment
Bio
PsychoSocial

11. Biological
Medicine
management
Social
Care after parents
Money & Finance
Handling
Employment & Work
Social skills
Psychological
Reduced functionality
Slowed cognitions
Hampered interpersonal
skills
Hampered family
relationship
Conti.....

12. Team required
Patient
Doctor
Counsellor/
Psychologist
Social
Worker
Vocational
Trainer
Family
Members

13. Treatment related facts
 Schizophrenia as an illness is not curable but is
definitely is manageable with right kind of treatment
and care.
 Early detection and timely intervention for adequate
time can help manage Schizophrenia.
 Schizophrenia patients tend to quit medicines often
due to which the symptoms tend to worsen.
 If a mental illness relapses many times, it makes
treatment increasingly difficult and may not attain
desired recovery.
 Irreversible brain damage occurs if not treated in the
first 5 years.

14. Conti…
 5-20% relapse every year
• 20 to 30% patients have an inadequate response to
treatment.
 Compliance remains a major issue
 Some patients relapse even when on medicines
 The bulk of functional deterioration tends to occur in
the first 5 years of the onset and the illness becomes
stable.
 As the time passes positive symptoms settle down and
negative symptoms become more prominent

15. Non compliance in schizophrenia
Some statistics

16. Lower level of adherence reported by Indian Psychiatrists with 1 in 4 suspecting
their patients are non-adherent compared to Rest of APAC & EMEA
Q: Of the patients with schizophrenia you saw in the past month, what percentage
do you suspect may have been non-adherent, partially adherent or fully adherent?
Levels of adherence in patients seen in the past
month
Based on:
No Answer: 18% 5%
1616
Psychiatrists
3045
Psychiatrists
4722
Psychiatrists
21%
Adherent
Partially Adherent
Non-Adherent
India
%
Rest
of
APAC
%
EMEA
%

17. Psychiatrists in India estimate around 1 in 4 patients to have stopped medication
altogether without consulting them, compared to 1 in 5 in Rest of APAC and EMEA
Q: What percentage of your patients with schizophrenia you estimate may have stopped
medication altogether (>5 consecutive days), in the past month, without consulting you?
Mean number of
patients stopped
medication
altogether
Stopped medication altogether in the past month
Based on:
No Answer:
1616
Psychiatrists
3045
Psychiatrists
4722
Psychiatrists
2%6% 1%
India
%
Rest of
APAC
%
EMEA
%

18. As seen in EMEA and across APAC, Indian psychiatrists report a third of
their patients to attribute their deterioration to non-adherence
Mean % of patients with
deterioration attributable
to non-adherence
Effect of non/partial adherence on the patient
Based on:
No Answer:
1616
Psychiatrists
3045
Psychiatrists
4722
Psychiatrists
9% 2% 5%
Q. What percentage of your patients with schizophrenia, in the past month, who deteriorated
after stopping medication were able to attribute this to medication non-adherence?
India
%
Rest of
APAC
%
EMEA
%

19. Lack of insight is cited as the main reason for discontinuation of medication by Indian
psychiatrists. Cognitive impairment is seen to be more of a concern in India
Q: What is, in your experience, the most important reason for your patients
to discontinue medication?
Lack of insight
Undesirable side effects
Insufficient efficacy
Cognitive impairment
Drug/alcohol abuse
Base:
Patients feel better and think its not
necessary to take medication
Feel embarrassed/upset about taking
medication
Main reason for patient non/partial adherence based on clinical experience
No Answer:
(1616)
6%
(3045)
1%
(4722)
2%
India
%
Rest of APAC % EMEA
%