Schizophrenia is a serious mental illness that changes how a person thinks, feels and behaves. It also changes how they perceive the world, themselves and other people. About 1% of the population of most countries has schizophrenia although symptoms may differ from culture to culture. Symptoms vary widely between people who have schizophrenia. They may be mild or severe. Some people experience one episode of the illness and having received treatment do not relapse. Others have more frequent episodes but remain well for a lot of the time. Still others remain unwell and require a high level of ongoing support and treatment. Medication is usually a central part of the treatment. This can be very effective although side effects can be problematic. Counselling, social support, assistance with employment, accommodation, finances and education are also important in assisting the person and their family to cope with the illness. Symptoms of Schizophrenia
Delusions
These are false personal beliefs that are not subject to reason or contradictory
evidence and are not explained by a person’s usual cultural concepts (US
Hallucinations
These refer to a person’s perception of something that does not really exist in
their environment. The most common form of hallucination is auditory, e.g. when
Disordered thinking
A person may think very quickly or in bizarre or confused ways, making it difficult
for others to follow their train of thought.
Flat or inappropriate affect
‘Affect’ means feelings or emotions, so a person is often unresponsive or finds it
difficult to feel appropriate emotions at an appropriate time.
Cognitive impairment
A person has difficulty with mental processes like memory or concentration.
Withdrawal
A person does not want to interact with others and spends a lot of time alone.
Loss of motivation
A person loses their ‘drive’ to do things, including basic self-care.
A fact sheet produced by the Mental Health Information Service What causes schizophrenia? The causes of schizophrenia are not yet clearly understood although a combination of factors is seen as the most likely. These include:
• genetics • a biochemical imbalance in the brain • environmental stressors • drug use.
Treatment of Schizophrenia
Medication
Antipsychotic medication is usually prescribed for those with schizophrenia. This
medication can help to control the symptoms, particularly the delusions or
hallucinations that a person may experience. There are two main kinds of
medication that are commonly prescribed. They are known as the ‘typicals’ and
the ‘atypicals.’ The ‘typicals’ refer to the medications that have been widely used
over many years, while the ‘atypicals’ refer to the newer drugs. Although the
newer drugs often produce fewer side effects some people respond better to the
‘Atypical’ antipsychotic ‘Typical’ antipsychotic medications medications Clozapine (Clozaril, Clopine)
Each person is different and medication options need to be explored with a
Rehabilitation services can assist the person to find and maintain
accommodation, education, social skills, contacts and employment.
Cognitive Behavioural Therapy (CBT) can be useful in helping the person
learn ways of managing their schizophrenia. Supportive or insight-oriented
Hospitalisation may be necessary at times if the person becomes unwell or their
medication needs to be changed or stabilised.
Support groups offer people with schizophrenia and their families the
opportunity to meet people in a similar situation, share experiences, and find
Psycho-education is useful in helping to understand the illness and reduce A fact sheet produced by the Mental Health Information Service How Relatives and Friends Can Help
• learn more about the illness by joining an organisation like the Schizophrenia
• share your experiences of caring with the professionals treating your relative • encourage your relative to comply with medication • have important phone numbers ready in case you need them, e.g. the crisis team
• draw up an ‘action plan’ with your relative when they are well. Discuss the
person’s early warning signs and decide what to do if the person seems to be deteriorating
• be realistic about what your relative may be able to achieve and praise small
• take time off from your caring role when you can.
Where to get help
• Call the Mental Health Information Service on 1300 794 991 for information about
• Contact your local Community Mental Health Centre (look under ‘Community’ in
• Make sure you have regular contact with a local doctor (GP). Even if you are
seeing a psychiatrist your GP will play an important role in monitoring your general health.
• Ask your GP for a referral to a psychiatrist. • Schizophrenia Fellowship of NSW (02) 9879 2600 www.sfnsw.org.au • Association of Relatives and Friends of the Mentally Ill (ARAFMI)
(02) 9332 0700 or 1800 655 198 (rural NSW) www.arafmi.org
• Richmond Fellowship (02) 9701 3600, www.rfnsw.org.au • Aftercare, (02) 9810 7100, www.aftercare.com.au
Further Reading The following booklets are available for purchase from the Mental Health Association: SANE Guide to Schizophrenia and other Psychotic Illness About Schizophrenia (ARAFMI) Living Well with Schizophrenia (Mental Illness Fellowship of SA) Useful websites
• The Schizophrenia Fellowship of NSW www.sfnsw.org.au • US National Institute for Mental Health
http://www.nimh.nih.gov/publicat/schizoph.cfm
• SANE www.sane.org/ • Royal College of Psychiatrists www.rcpsych.ac.uk • Mental Health Care, Institute of Psychiatry, London
A fact sheet produced by the Mental Health Information Service Medicare rebates and accessing private practitioners What is the difference between psychiatrists and psychologists? Psychiatrists are medically trained doctors who specialise in the treatment of mental illness. Like GPs they can prescribe, administer and monitor medication. Psychiatrists do not advertise so it is up to your GP to refer you to someone appropriate. Psychologists are trained in human behaviour and use a range of therapies to treat patients. They provide services including assessment, psychological testing, and various types of psychotherapy and counselling. Medicare rebate for psychologists A Medicare rebate is now available for up to 12 sessions per calendar year with a registered psychologist* with a Medicare Provider Number. To obtain the rebate you must be referred by an appropriate medical practitioner, i.e. a GP, psychiatrist or paediatrician. The practitioner will ensure that you meet the eligibility requirements and develop a management plan for your condition. The cost and rebate from Medicare can vary depending on the consultation length and fee charged. If the psychologist bulk bills there will be no extra cost. For further information about the rebate or to locate a psychologist in your area contact the Australian Psychological Society on 1800 333 497 www.psychology.org.au. * Similar Medicare rebates also exist for mental health accredited social workers and occupational therapists. Resource Centre The Mental Health Resource Centre contains material that promotes a better understanding of mental health issues. New books and DVDs are purchased on a regular basis and visitors are welcome to come in and browse. Much of the material can be borrowed and books can be mailed to those who are unable to come in. You can find the Resource Centre Booklist at our website: www.mentalhealth.asn.au For further information contact 1300 794 991.
Disclaimer This information is for educational purposes. As neither brochures nor websites can diagnose people it is always important to obtain professional advice and/or help when needed. The listed websites provide additional information, but should not be taken as an endorsement or recommendation. This information may be reproduced with an acknowledgement to the Mental Health Association NSW. This and other fact sheets are available for download from www.mentalhealth.asn.au. The Association encourages feedback and welcomes comments about the information provided. This Fact Sheet was last updated in January 2008.
Phone: 1300 794 991 Fax: (02) 9339 6066 Email: info@mentalhealth.asn.au Web: www.mentalhealth.asn.au A fact sheet produced by the Mental Health Information Service
Pain Relief Connection Issue #4 April 15, 2007 In this issue: Clinical Focus: Ten Guidelines for Assessing and Treating Pain This is the 4th in a series on the principles and guidelines for pain management. 5. Anticipate and treat side effects of analgesics • Opioid receptors in the GI tract are the cause of the most common side effects of opioids: constipation. Every patient w
Schizophrenia 
Medicare rebates and accessing private practitioners