Schizophrenia is a mental disorder that involves a wide variety of symptoms. Individuals with schizophrenia may hear voices or see people, they may think people are reading their minds, or they may believe people are trying to hurt them. The symptoms are categorized as either positive (an increase/excess of something) or negative (a lack of something).

The positive symptoms are easier to treat and they include:

•  Hallucinations which can be auditory, visual, or tactile (sounds, sights, or feelings)
•  Delusions ( a false belief) they can be delusions of grandeur (think they are the best at everything) or delusions of persecution (think they are being followed or watched)
•  Disorganized thinking

Negative symptoms include:

• Alogia (they do not talk)
•  Anhedonia (nothing makes them happy anymore)
•  Flat affect (no emotion or facial expressions)
• Reduced movements

This disorder usually beings in adolescence to the mid 30’s and can be marked by subtle changes in hygiene, dress, facial expression, mood, and sexual behavior. If the disorder begins in childhood there is typically a delay in language skills and a lack of empathy. Schizophrenia has an unknown etiology but is usually triggered by a stressful event. There is a genetic component, as children with parents who have schizophrenia are 10 times more likely to also develop the disease. About 1% of Americans have this disorder.

There are 5 different types of schizophrenia. They include paranoid, disorganized, catatonic, undifferentiated, and residual.

• Paranoid- this type is characterized by a preoccupation of at least 1 delusion of persecution or grandeur and they have auditory hallucinations. There are very few negative symptoms associated with the paranoid version of schizophrenia. These individuals may be angry, argumentative, and be emotionally distant. They may also have suicidal thoughts and actions but they tend to have normal memory and concentration and can care for their basic everyday needs such as bathing, dressing, and cooking.
•  Disorganized-these individuals have thoughts, speech and behavior that are inappropriate and do not make sense. These individuals may be unable to care for themselves and do simple daily tasks which make disorganized schizophrenia one of the more serious forms. Common symptoms include grimacing, odd postures, making up words, jumping from thought to thought, clumsy and uncoordinated movements, and social isolation.
• Catatonic- characterized by periods of a “coma like state” where they are unable to speak, move or respond in any way or bizarre and hyperactive. These individuals may resist any type of movement or someone trying to move them, they may maintain a rigid posture for a very long period of time, and when they finally do begin to move and respond they will mimic movements and the words of those around them. Even though these individuals may appear to have no emotions of thoughts, they are typically in a state of extreme anxiety.
•  Undifferentiated- The symptoms do not fit into any other of the categories.
• Residual- The individual has at least 2 continued negative symptoms and there is evidence of schizophrenia without a complete diagnosis.

The role of occupational therapy in the treatment of schizophrenia is to help the individual complete everyday tasks and self care. Group therapy is the most effective treatment, but individual therapy is also necessary. Treatment includes structured activities (act as a diversion from symptoms), time management, habit training, expressive activities (a good way of non-verbal communication), functional living skills (helps them learn how to care for themselves, personal hygiene), social skills (verbal and non verbal communication skills), and finally basic safety awareness and safety skills. OT is used to help increase the individual’s independence and help the individual feel personal achievement by doing activities they enjoy which helps with the positive symptoms of schizophrenia. 

People who receive treatment may have a decrease in the many symptoms of schizophrenia, but most people still continue to have symptoms throughout their entire life. 

References:

Mayo Clinic Staff. (2011).Schizophrenia. Retrieved from http://www.mayoclinic.com/health/schizophrenia/DS00196

Logsdon, D. (2009). Persons with serious mental illness.American Occupational Therapy Association, Retrieved from http://www.aota.org/CCL/Mental-Illness-CAT.aspx