Schizophrenia - Fact Sheet
A person with a dual diagnosis of Acquired Brain
Injury and schizophrenia requires a high level of understanding and
specialised support. With the right support schizophrenia is highly
a treatable illness.
What is schizophrenia?
Schizophrenia is a potentially severe mental illness that can
make it difficult to know what is real and what is not.
Schizophrenia impacts on the functioning of the brain, resulting in
changes in behaviours, feelings and thinking .
During an acute episode, a person often experiences 'Psychosis'.
"Psychosis" means a loss of contact with reality. During psychosis
a person may have difficulty thinking and experience hallucinations
or delusions during which the individual's perception of reality,
or belief about reality, is impaired. For example, a person may
hear voices and smell or taste things that other's do not, the
person may have experience unusual beliefs. Other symptoms include
disorganized speech and behaviour, apathy, difficulty organising
tasks, and paranoia.
The illness occurs in cycles, with periods of no symptoms to
relapse into an acute episode of psychosis. Symptoms may develop
gradually over months or develop rapidly leading to an acute
episode . With appropriate treatment and support, a person
living with a diagnosis of schizophrenia can lead a productive and
fulfilling life. It is treatable.
Some misconceptions exist in the community about
General misconceptions of schizophrenia include:
- It is the same as a split, multiple or dual personality. This
is untrue and myth created by films.
- People with schizophrenia are violent and aggressive. The
majority of people living with schizophrenia are not violent.
- Schizophrenia is the result of a character weakness.
Schizophrenia is a medical condition that requires treatment by
- How is Traumatic Brain Injury (TBI) related to
- Research that has been conducted to date has indicated some
relationship between traumatic brain injury and the development of
schizophrenia for those with a genetic predisposition and for those
exposed to traumatic events and stressors [3, 4, 5].
- More generally, research indicates that traumatic brain injury
increases the risk of developing a mental illness, including
Depressive disorders, Anxiety Disorders, and Post-Traumatic Stress
Schizophrenia has a wide range of symptoms, which are often broken
down into categories; positive symptoms and negative symptoms.
This refers to a reduction in normal behaviours rather than a
change or increase in behaviours. Some examples include:
- Limited or reduced emotional responses or apathy
- Difficulty expressing thoughts
- Reduced speech
- Social withdrawal
Refers to a distortion or exaggeration of normal functions, it
is some thing added to a persons usual behaviour, speech or
- Delusions - False or inaccurate beliefs that appear very real;
such as thinking US intelligence is spying on you. These believes
are often fixed during an acute episode and logical argument cannot
convince the person.
- Hallucinations - Auditory or visual, which means hearing or
seeing things that do not exist. Hallucinations may also come in
the form of taste or smell.
- Disorganised speech - a person may make up words or speak in a
- Disorganised thinking - Every day thoughts and ideas may be
disorganized, preventing a person from functioning normally and
having clear speech. Engaging in conversation may be very difficult
as a result.
No single symptom is enough for a diagnosis of schizophrenia. A
diagnosis must include a pattern of signs and symptoms, in
conjunction with impaired occupational or social functioning. If
schizophrenia is suspected it is important to see your GP for an
initial consultation and referral to an appropriate mental health
Causes of schizophrenia
It is largely unknown what causes schizophrenia. Schizophrenia
is a complex a disorder, for which it is difficult to link to any
one cause. However, there is evidence for a number of risk or
contributing factors, including:
- Genetics: First-degree relatives of someone with schizophrenia
are ten times more likely to develop the disorder than someone
without a relative with schizophrenia.
- Neurobiological: There is a connection between schizophrenia
and structural differences in the brain for example, enlarged
ventricles have been found in sufferers of schizophrenia.
- Neurochemical: There is a connection between schizophrenia and
chemical imbalance of certain brain neurotransmitters e.g.
- Drug-related: Although this topic is still controversial, the
consumption of legal and illegal drugs is linked with a greater
risk of developing schizophrenia. Drug's that have been associated
include Marijuana and alcohol abuse.
- Environmental: High levels of stress or stressful events may
trigger the onset of schizophrenia in individuals with a genetic
- Warning signs of coming episode
- Often an acute episode is preceded by a prodromal (warning)
phase, with a variety of behaviour changes that may include:
- Decline in performance at work or school
- Withdrawal from social activities
- Loss of attention to personal hygiene and grooming,
- Loss of interest in things they usually enjoy
- Unusual behaviours
- Odd statements
- Increased anxiety
The prodromal or warning phase can stretch on for two years until
psychotic symptoms appear . The psychotic or acute episode
itself is typically characterised by delusions and hallucinations,
which can affect any of the senses although auditory hallucinations
("hearing voices") are most common. These symptoms are often
characterised as been frightening for the person experiencing them.
These symptoms often impact on a person's ability to concentrate on
studies, work and conversations.
Treatments for schizophrenia
Antipsychotic medications are the standard treatment for
schizophrenia, due to the biological basis of the illness. For
advice on medications for schizophrenia a psychiatrist needs to be
consulted. The symptoms and issues associated with schizophrenia
can not be treated by medication alone.
Medication is most effective in conjunction with additional
supports such as:
- Case management to assist with locating services and support a
person is entitled to.
- Psychosocial rehabilitation programs to assist with development
of social and living skills, which may have been reduced due to
mental illness. Things such as social skills training, assistance
with domestic tasks and finances.
- Psychological therapies, which can be helpful following
stabilisation of symptoms through medication. Psychological therapy
may assist a person to develop helpful coping strategies and to
improve levels of confidence and feelings toward yourself and the
illness. Cognitive Behavioural Therapy has supporting evidence for
its effectiveness in reducing symptoms of schizophrenia and
reducing stress levels.
- Support Groups - face to face or online.
- Education about schizophrenia; having a clear understanding of
the illness can help those impacted have a greater sense of control
over the illness and enhance coping. It is particularly important
to educate yourself on the early warning signs of an upcoming
episode to get adequate assistance.
- Maintain a regular routine and set of activities e.g. hobbies
and enjoyable social outings
- Attend programs, read books or talk to a professional about
relaxation strategies such as breathing exercises to minimise and
cope with stress.
STEPS to Getting Treatment
The earlier schizophrenia is diagnosed and treated, the better the
outcome. Some steps for getting an assessment and support:
- Initial Assessment - you may like to consult your GP for an
initial assessment of symptoms of schizophrenia, this will also
assist in ruling out other medical conditions. Following an
assessment a referral can be made to a mental health professional
or service .
- You may be referred to a psychiatrist or professional within
the public mental health system .
- Having ongoing case management is important. Case managers put
together the treatment plan and provide information and resources
on supports in the community .
How Family and Friends can
A person with schizophrenia requires high levels of support and
understanding from their family, friends and wider network. The
symptoms of schizophrenia can be frightening and have a large
impact on those skills needed to maintain employment, social
networks and maintaining a house hold.
Family and friends must avoid judgment, such as making comments
the person is weak or by downplaying the person's symptoms. Family
should avoid arguing or trying to convince the person that any
hallucinations or delusion the person may be having are not real or
stupid. The symptoms often appear very real and frightening at the
time, providing empathy and support to the person during that
period is very important. Schizophrenia is a medical condition and
the problems associated with schizophrenia are very real.
Families should seek to educate themselves as much as possible
on schizophrenia. This can assist family members in understanding
the illness and ways to best help their loved one. It can also
assist in detecting those signs that a loved one's health is
declining, so treatment can be put in place early. Resources may be
obtained from the internet, attending support groups, conferences
and from organisation in the community such as the Mental Illness
Fellowship, GROW and ARAFMI
References and further information
 The Mental Illness Fellowship of Australia has a wealth of
information people with a mental illness, their family and friends.
The Royal Australian and New Zealand College of psychiatrists
(2005). Schizophrenia: Australian Treatment Guide for Consumers and
Carers. Retrieved on 25 August 2009,from,
 Malaspina, D., Goetz, R.R., Friedman, J. H., Kaufmann, C.
A., Faraone, S. V., Tsuang, M., Cloninger, R., Nurnberger, J. I.,
& M. C Blehar. (2001). Traumatic Brain Injury and Schizophrenia
in Members of Schizophrenia and Bipolar Disorder Pedigrees. The
American Journal of Psychiatry, 158, 440-446. http://ajp.psychiatryonline.org/cgi/content/full/158/3/440
 Arehart-Treichel, J. (2001). Head Injury May Tip
Schizophrenia Scales. Psychiatric News http://pn.psychiatryonline.org/cgi/content/full/36/7/37
 Shoumitro, D., Lyons, I., Koutzoukis, C., Ali, I., &
McCarthy, G. (1999). Rate of Psychiatric Illness 1 Year After
Traumatic Brain Injury. Am J Psychiatry, 156, 374-378.
 Rao, V & Lyketsos, C. (2000). Neuropsychiatric Sequelae
of Traumatic Brain Injury. Psychosomatics, 41, 95-103.
 Koponen, S, Taiminen, T., Portin, R., Himanen, L., Isoniemi,
H., Heinonen, H., Hinkka, S., & Tenovuo, O. (2002). Axis I and
II Psychiatric Disorders After Traumatic Brain Injury: A 30-Year
Follow-Up Study. Am J Psychiatry, 159, 1315-1321