Home » Mind & Soul » Schizophrenia » What isn't Known About Schizophrenia (Part Two)

What isn't Known About Schizophrenia (Part Two)

© Ian Chovil

There is a lot of other unknowns in schizophrenia. Although schizophrenia strikes men and women equally it usually appears later in women and is less destructive, except for some women in whom schizophrenia is very disabling. Do women fare better because they have acquired more social skills in the time before schizophrenia strikes, or is their chemistry such that schizophrenia is less disabling generally, and why are some women more disabled by schizophrenia than most men?

It is not known how atypical medications work. Some are interacting with seven or eight receptor systems in the brain and it is not known how most of those receptor systems are involved in schizophrenia. Medication advances generally precede an understanding of how they work. Sometimes I think that someone does understand schizophrenia but they work for a pharmaceutical company and that knowledge is a trade secret that will be developed in the next medication. It takes many years to create and test a medication and a lot of money is at stake.

No one has come forward to explain why people respond differently to medication generally. There is agreement that response is best during the first episode, but no understanding why people might respond better to one medication than another, why that might be reversed in the next patient, or why some people only respond to Clozapine.

It is not known why there is so much substance abuse with schizophrenia. With half the people with schizophrenia developing a substance abuse problem in their life time it is a major complicating factor giving rise to the term dual diagnosis. Addiction treatment programs are structured quite differently from schizophrenia treatment programs and merging the two for the dually diagnosed is very rare, despite the need.

The association of violence and schizophrenia is not only unknown but often denied. People with untreated schizophrenia are often violent, although family members are the most common victims. The same woman who physically attacks her mother can be the most least likely to become violent once treated for schizophrenia and on medication. What is happening and whether there should be laws forcing some people to take medication are contentious issues undergoing a lot of public debate at the moment.

It is not known how "toxic" the untreated experience of schizophrenia or how much apparent brain damage is caused by delays in treatment and relapses, although everyone agrees it happens and is an important predictor of outcome. I use the word "apparent" because even though the individual becomes increasingly disabled through delays and relapses, it is not necessarily irreversible.

The copyright of the article What isn't Known About Schizophrenia (Part Two) in Schizophrenia is owned by . Permission to republish What isn't Known About Schizophrenia (Part Two) in print or online must be granted by the author in writing.