Who is most likely to improve? Researchers have linked a number of factors to better outcomes in patients. These include functioning successfully in their lives before the disease emerged; experiencing severe symptoms suddenly, all at once, rather than little by little; being older when the disease appeared; being female; having a higher IQ; and lacking a family history of the disorder. All these traits and features, however, allow at best modest forecasts of schizophrenia’s prognosis.
Clearly, we have made considerable progress in our understanding of schizophrenia’s course and are more optimistic than we have ever been about the future of those afflicted. Nevertheless, we need even more effective remedies if our aim is to bring patients back to the productive, happy lives they enjoyed before their illness struck—and shattered their sense of self.
Although most people have heard of schizophrenia, many misunderstand the disorder. Here we dispel three widespread misconceptions about this troubling mental illness.
Myth #1: People with schizophrenia have multiple personalities.
Fact: This belief reflects a confusion between schizophrenia and dissociative identity disorder—once called multiple-personality disorder—a controversial diagnosis that is supposedly marked by the coexistence of multiple personalities or personality states within individuals. People with schizophrenia possess only one personality, but that personality has beenshattered, with severe impairments in thinking, emotion and motivation.
Myth #2: All people with schizophrenia are essentially alike.
Fact: People with schizophrenia experience a bewildering variety of symptoms. Some suffer primarily from “positive” symptoms, such as delusions, which are fixed false beliefs—the idea, say, that government agents are following them—and hallucinations, such as hearing voices. In contrast, others mainly have “negative” symptoms, such as social withdrawal and diminished emotional and verbal expression. Still another set of patients experiences cognitive deficits—problems with paying attention, remembering and planning. Many patients’ deficits span all three categories.
Myth #3: Schizophrenia is caused by family attitudes and behaviors.
Fact: In 1948 German psychoanalyst Frieda Fromm-Reichmann introduced the notion of the schizophrenia-inducing mother—one who was hostile and hypercritical—an idea that persisted for decades. Yet research has consistently failed to directly link parenting to the onset of schizophrenia, although numerous investigations suggest that intense familial criticism may hasten its relapse.
This article was originally published with the title Living with Schizophrenia.