Schizophrenia

Schizophrenia's causes remain largely unknown, though scientists suggest it's caused by multiple factors. Its symptoms include disruption of thought processes rather than the exhibiting of multiple personalities. This brief video provides an overview of the condition.

Contrary to the name, patients do not have multiple personalities. Rather, the split mind refers to the sufferers' inability to distinguish reality from hallucinations when they are aware and awake. Cognitive difficulties, including challenges focusing and communicating are also common among those with schizophrenia, as well as auditory and visual hallucinations.

The syndrome, which affects roughly 1 in 233 adults, is often associated with other serious health issues, including cardiovascular, metabolic, and infectious diseases, which may contribute to early deaths. The side effects of long-term antipsychotic medications also may influence the mortality timing—weight gain, for example, is a common side effect of the drugs and can contribute to cardiovascular issues.

It remains contentious if something inherent about the disease or antipsychotics' side effects (weight gain) are mostly to blame. Some newly diagnosed schizophrenia patients already have insulin resistance, raising questions about if patients' brains are getting enough energy from glucose, and if dietary changes—like a high-fat, low-carbohydrate, moderate-protein diet—may help alleviate symptoms.

Up to 80% of schizophrenia patients may have auditory hallucinations. Recent research concluded that this symptom may be from misfired motor signals that feed into each other, essentially failing to suppress certain sensory neural activities and that resulting overexcitment fuels hallucinations. The finding suggests that, one day, magnetic pulses might be used to stimulate specific nerves to better regulate the errant signals and reduce or stop hallucinations. (Some users may encounter a paywall.)

Though other antipsychotics block dopamine receptors, a new drug, Cobenfy, influences dopamine levels via a different pathway—it stimulates a pair of specialized receptors in the brain that control the release of a substance called acetylcholine. This alternative approach may help patients avoid serious side effects like weight gain. (Some users may experience a paywall.)

Evidence shows that people with schizophrenia have an inherently harder time regulating internal body temperatures. People with schizophrenia may also struggle to find safe shelter during extreme heat, and their prescribed antipsychotic medications often have dehydrating effects, collectively elevating the risk of heat-related illness and death, as illustrated by this article that focuses on the final days of Stephan Goodwin's life in 2022. (Some users may encounter a paywall.)

Schizophrenia used to be considered a progressive disease that was beyond a patient's ability to manage. This article gives an in-depth look at OnTrackNY, a New York-based program that empowers patients to define the goals of their own treatment for psychotic disorders. At the time of this 2022 article, it consisted of 25 affiliate clinics and hospitals in 14 New York counties, with another seven sites then slated to begin offering services in 2023.

Michael Laudor attended Yale, succumbed to schizophrenia, and killed his pregnant fiancée. The podcast, which includes a long but moving interview with Laudor's friend Jonathan Rosen, uses the tragedy to frame how America's approach to severe mental illness has fallen short.

Yet both associations are not yet considered firm enough to definitively be causative. Schizophrenia is a multi-causal syndrome and a mixture of factors, including genetics, are widely believed to be behind its development.