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Schizophrenia 
What Is Schizophrenia? 
Schizophrenia is a mental disorder that generally appears in late adolescence or early adulthood - 
however, it can emerge at any time in life. It is one of many brain diseases that may include 
delusions, loss of personality (flat affect), confusion, agitation, social withdrawal, psychosis, and 
bizarre behavior. 
People with schizophrenia may not make sense when they talk. They may sit for hours without 
moving or talking. Sometimes people with schizophrenia seem perfectly fine until they talk 
about what they are really thinking. 
Families and society are affected by schizophrenia too. Many people with schizophrenia have 
difficulty holding a job or caring for themselves, so they rely on others for help. 
Contrary to public perception, schizophrenia is not split personality or multiple personality. The 
vast majority of people with schizophrenia are not violent and do not pose a danger to others. 
Schizophrenia is not caused by childhood experiences, poor parenting or lack of willpower, nor 
are the symptoms identical for each person. 
The Brain 
Our brain consists of billions of nerve cells. Each nerve cell has branches that give out and 
receive messages from other nerve cells. 
The ending of these nerve cells release neurotransmitters - types of chemicals. These 
neurotransmitters carry messages from the endings of one nerve cell to the nerve cell body of 
another. In the brain of a person who has schizophrenia, this messaging system does not work 
properly. 
Causes 
The cause of schizophrenia is still unclear. Some theories about the cause of this disease include: 
genetics (heredity), biology (the imbalance in the brain’s chemistry); and/or possible viral 
infections and immune disorders 
Below is a list of the factors that are thought to contribute towards the onset of 
schizophrenia: 
Genes 
If there is no history of schizophrenia in family so the chances of developing it are less than 1%. 
However, that risk rises to 10% if one of parents was/is a sufferer from schizophrenia.
A Swedish study found that schizophrenia and bipolar disorder have the same genetic causes. 
Chemical imbalance in the brain 
Experts believe that an imbalance of dopamine, a neurotransmitter, is involved in the onset of 
schizophrenia. They also believe that this imbalance is most likely caused by your genes making 
you susceptible to the illness. Some researchers say other the levels of other neurotransmitters, 
such as serotonin, may also be involved. 
Environment 
Although there is yet no definite proof, many suspect that prenatal or perinatal trauma, and viral 
infections may contribute to the development of the disease. Perinatal means "occurring about 5 
months before and up to one month after birth". 
Stressful experiences often precede the emergence of schizophrenia. Before any acute symptoms 
are apparent, people with schizophrenia habitually become bad-tempered, anxious, and 
unfocussed. This can trigger relationship problems, divorce and unemployment. These factors 
are often blamed for the onset of the disease, when really it was the other way round - the disease 
caused the crisis. Therefore, it is extremely difficult to know whether schizophrenia caused 
certain stresses or occurred as a result of them. 
Some drugs 
Cannabis and LSD are known to cause schizophrenia relapses. According to the State 
Government of Victoria in Australia, for people with a predisposition to a psychotic illness such 
as schizophrenia, usage of cannabis may trigger the first episode in what can be a disabling 
condition that lasts for the rest of their lives. 
The National Library of Medicine says that some prescription drugs, such as steroids and 
stimulants, can cause psychosis. 
Who Is At Risk? 
About 1% of Americans have this illness. 
Schizophrenia affects men and women equally. It occurs at similar rates in all ethnic groups 
around the world. Symptoms such as hallucinations and delusions usually start between ages 16 
and 30. Men tend to experience symptoms a little earlier than women. Most of the time, people 
do not get schizophrenia after age 45. Schizophrenia rarely occurs in children, but awareness of 
childhood-onset schizophrenia is increasing. 
It can be difficult to diagnose schizophrenia in teens. This is because the first signs can include a 
change of friends, a drop in grades, sleep problems, and irritability—behaviors that are common 
among teens. A combination of factors can predict schizophrenia in up to 80% of youth who are
at high risk of developing the illness. These factors include isolating oneself and withdrawing 
from others, an increase in unusual thoughts and suspicions, and a family history of psychosis. In 
young people who develop the disease, this stage of the disorder is called the "prodromal" 
period. 
Signs & Symptoms 
The symptoms of schizophrenia fall into three broad categories: positive symptoms, negative 
symptoms, and cognitive symptoms. 
Positive symptoms 
Positive symptoms are psychotic behaviors not seen in healthy people, people with positive 
symptoms often "lose touch" with reality. These symptoms can come and go. Sometimes they 
are severe and at other times hardly noticeable, depending on whether the individual is receiving 
treatment. They include the following: 
Hallucinations are things a person sees, hears, smells, or feels that no one else can see, hear, 
smell, or feel. "Voices" are the most common type of hallucination in schizophrenia. Many 
people with the disorder hear voices. The voices may talk to the person about his or her behavior, 
order him or her to do things, or warn them of danger. Sometimes the voices talk to each other. 
People with schizophrenia may hear voices for a long time before family and friends notice the 
problem. 
Other types of hallucinations include seeing people or objects that are not there, smelling odors 
that no one else detects, and feeling things like invisible fingers touching their bodies when no 
one is near. 
Delusions are false beliefs that are not part of the person's culture and do not change. The person 
believes delusions even after other people prove that the beliefs are not true or logical. People 
with schizophrenia can have delusions that seem bizarre, such as believing that neighbors can 
control their behavior with magnetic waves. They may also believe that people on television are 
directing special messages to them, or that radio stations are broadcasting their thoughts aloud to 
others. Sometimes they believe they are someone else, such as a famous historical figure. They 
may have paranoid delusions and believe that others are trying to harm them, such as by 
cheating, harassing, poisoning, spying on, or plotting against them or the people they care about. 
These beliefs are called "delusions of persecution." 
Thought disorders are unusual or dysfunctional ways of thinking. One form of thought disorder 
is called "disorganized thinking." This is when a person has trouble organizing his or her 
thoughts or connecting them logically. They may talk in a garbled way that is hard to understand. 
Another form is called "thought blocking." In another explaining it is some kind of moving from 
one topic to another, in a nonsensical fashion. Individuals may make up their own words or 
sounds.
Movement disorders may appear as agitated body movements. A person with a movement 
disorder may repeat certain motions over and over. In the other extreme, a person may become 
catatonic. Catatonia is a state in which a person does not move and does not respond to others. 
Catatonia is rare today, but it was more common when treatment for schizophrenia was not 
available. 
Negative symptoms 
Negative symptoms are associated with disruptions to normal emotions and behaviors. These 
symptoms are harder to recognize as part of the disorder and can be mistaken for depression or 
other conditions. These symptoms include the following: 
 "Flat affect" (a person's face does not move or he or she talks in a dull or monotonous 
voice) 
 Lack of pleasure in everyday life 
 Lack of ability to begin and sustain planned activities 
 Speaking little, even when forced to interact. 
People with negative symptoms need help with everyday tasks. They often neglect basic personal 
hygiene. This may make them seem lazy or unwilling to help themselves, but the problems are 
symptoms caused by the schizophrenia. 
Cognitive symptoms 
Cognitive symptoms are subtle. Like negative symptoms, cognitive symptoms may be difficult to 
recognize as part of the disorder. Often, they are detected only when other tests are performed. 
Cognitive symptoms include the following: 
 Poor "executive functioning" (the ability to understand information and use it to make 
decisions) 
 Trouble focusing or paying attention 
 Problems with "working memory" (the ability to use information immediately after 
learning it). 
Cognitive symptoms often make it hard to lead a normal life and earn a living. They can cause 
great emotional distress. 
Type of Schizophrenia 
 Paranoid schizophrenia -- a person feels extremely suspicious, persecuted, or grandiose, or 
experiences a combination of these emotions. 
 Disorganized schizophrenia -- a person is often incoherent in speech and thought, but may 
not have delusions.
 Catatonic schizophrenia -- a person is withdrawn, mute, negative and often assumes very 
unusual body positions. 
 Residual schizophrenia -- a person is no longer experiencing delusions or hallucinations, 
but has no motivation or interest in life. 
 Schizoaffective disorder--a person has symptoms of both schizophrenia and a major mood 
disorder such as depression. 
Treatments 
Because the causes of schizophrenia are still unknown, treatments focus on eliminating the 
symptoms of the disease. Treatments include antipsychotic medications and various psychosocial 
treatments. 
Antipsychotic medications 
Antipsychotic medications have been available since the mid-1950's. The older types are called 
conventional or "typical" antipsychotics. Some of the more commonly used typical medications 
include: 
 Chlorpromazine (Thorazine) 
 Haloperidol (Haldol) 
 Perphenazine (Etrafon, Trilafon) 
 Fluphenazine (Prolixin). 
In the 1990's, new antipsychotic medications were developed. These new medications are called 
second generation, or "atypical" antipsychotics. 
One of these medications, clozapine (Clozaril) is an effective medication that treats psychotic 
symptoms, hallucinations, and breaks with reality. But clozapine can sometimes cause a serious 
problem called agranulocytosis, which is a loss of the white blood cells that help a person fight 
infection. People who take clozapine must get their white blood cell counts checked every week 
or two. This problem and the cost of blood tests make treatment with clozapine difficult for 
many people. But clozapine is potentially helpful for people who do not respond to other 
antipsychotic medications. 
Other atypical antipsychotics were also developed. None cause agranulocytosis. Examples 
include: 
 Risperidone (Risperdal) 
 Olanzapine (Zyprexa) 
 Quetiapine (Seroquel) 
 Ziprasidone (Geodon) 
 Aripiprazole (Abilify)
 Paliperidone (Invega). 
What are the side effects? 
Some people have side effects when they start taking these medications. Most side effects go 
away after a few days and often can be managed successfully. People who are taking 
antipsychotics should not drive until they adjust to their new medication. Side effects of many 
antipsychotics include: 
 Drowsiness 
 Dizziness when changing positions 
 Blurred vision 
 Rapid heartbeat 
 Sensitivity to the sun 
 Skin rashes 
 Menstrual problems for women. 
Atypical antipsychotic medications can cause major weight gain and changes in a person's 
metabolism. This may increase a person's risk of getting diabetes and high cholesterol. A 
person's weight, glucose levels, and lipid levels should be monitored regularly by a doctor while 
taking an atypical antipsychotic medication. 
Typical antipsychotic medications can cause side effects related to physical movement, such as: 
 Rigidity 
 Persistent muscle spasms 
 Tremors 
 Restlessness. 
Long-term use of typical antipsychotic medications may lead to a condition called tardive 
dyskinesia (TD). TD causes muscle movements a person can't control. The movements 
commonly happen around the mouth. TD can range from mild to severe, and in some people the 
problem cannot be cured. Sometimes people with TD recover partially or fully after they stop 
taking the medication. 
TD happens to fewer people who take the atypical antipsychotics, but some people may still get 
TD. People who think that they might have TD should check with their doctor before stopping 
their medication. 
How are antipsychotics taken and how do people respond to them? 
Antipsychotics are usually in pill or liquid form. Some anti-psychotics are shots that are given 
once or twice a month.
Symptoms of schizophrenia, such as feeling agitated and having hallucinations, usually go away 
within days. Symptoms like delusions usually go away within a few weeks. After about six 
weeks, many people will see a lot of improvement. 
However, people respond in different ways to antipsychotic medications, and no one can tell 
beforehand how a person will respond. Sometimes a person needs to try several medications 
before finding the right one. Doctors and patients can work together to find the best medication 
or medication combination, as well as the right dose. 
Some people may have a relapse-their symptoms come back or get worse. Usually, relapses 
happen when people stop taking their medication, or when they only take it sometimes. Some 
people stop taking the medication because they feel better or they may feel they don't need it 
anymore. But no one should stop taking an antipsychotic medication without talking to his or her 
doctor. When a doctor says it is okay to stop taking a medication, it should be gradually tapered 
off, never stopped suddenly. 
How do antipsychotics interact with other medications? 
Antipsychotics can produce unpleasant or dangerous side effects when taken with certain 
medications. For this reason, all doctors treating a patient need to be aware of all the medications 
that person is taking. Doctors need to know about prescription and over-the-counter medicine, 
vitamins, minerals, and herbal supplements. People also need to discuss any alcohol or other 
drug use with their doctor. 
Psychosocial treatments 
Psychosocial treatments can help people with schizophrenia who are already stabilized on 
antipsychotic medication. Psychosocial treatments help these patients deal with the everyday 
challenges of the illness, such as difficulty with communication, self-care, work, and forming 
and keeping relationships. Learning and using coping mechanisms to address these problems 
allow people with schizophrenia to socialize and attend school and work. 
Patients who receive regular psychosocial treatment also are more likely to keep taking their 
medication, and they are less likely to have relapses or be hospitalized. A therapist can help 
patients better understand and adjust to living with schizophrenia. The therapist can provide 
education about the disorder, common symptoms or problems patients may experience, and the 
importance of staying on medications. 
Too see a short film about schizophrenia: http://www.youtube.com/watch?v=d45BaYYrM2E 
http://www.youtube.com/watch?v=n_Zv59e68mU 
History of Psychiatric: http://www.youtube.com/watch?v=gvdBSSUviys

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Schizophrenia (in short explaination)

  • 1. Schizophrenia What Is Schizophrenia? Schizophrenia is a mental disorder that generally appears in late adolescence or early adulthood - however, it can emerge at any time in life. It is one of many brain diseases that may include delusions, loss of personality (flat affect), confusion, agitation, social withdrawal, psychosis, and bizarre behavior. People with schizophrenia may not make sense when they talk. They may sit for hours without moving or talking. Sometimes people with schizophrenia seem perfectly fine until they talk about what they are really thinking. Families and society are affected by schizophrenia too. Many people with schizophrenia have difficulty holding a job or caring for themselves, so they rely on others for help. Contrary to public perception, schizophrenia is not split personality or multiple personality. The vast majority of people with schizophrenia are not violent and do not pose a danger to others. Schizophrenia is not caused by childhood experiences, poor parenting or lack of willpower, nor are the symptoms identical for each person. The Brain Our brain consists of billions of nerve cells. Each nerve cell has branches that give out and receive messages from other nerve cells. The ending of these nerve cells release neurotransmitters - types of chemicals. These neurotransmitters carry messages from the endings of one nerve cell to the nerve cell body of another. In the brain of a person who has schizophrenia, this messaging system does not work properly. Causes The cause of schizophrenia is still unclear. Some theories about the cause of this disease include: genetics (heredity), biology (the imbalance in the brain’s chemistry); and/or possible viral infections and immune disorders Below is a list of the factors that are thought to contribute towards the onset of schizophrenia: Genes If there is no history of schizophrenia in family so the chances of developing it are less than 1%. However, that risk rises to 10% if one of parents was/is a sufferer from schizophrenia.
  • 2. A Swedish study found that schizophrenia and bipolar disorder have the same genetic causes. Chemical imbalance in the brain Experts believe that an imbalance of dopamine, a neurotransmitter, is involved in the onset of schizophrenia. They also believe that this imbalance is most likely caused by your genes making you susceptible to the illness. Some researchers say other the levels of other neurotransmitters, such as serotonin, may also be involved. Environment Although there is yet no definite proof, many suspect that prenatal or perinatal trauma, and viral infections may contribute to the development of the disease. Perinatal means "occurring about 5 months before and up to one month after birth". Stressful experiences often precede the emergence of schizophrenia. Before any acute symptoms are apparent, people with schizophrenia habitually become bad-tempered, anxious, and unfocussed. This can trigger relationship problems, divorce and unemployment. These factors are often blamed for the onset of the disease, when really it was the other way round - the disease caused the crisis. Therefore, it is extremely difficult to know whether schizophrenia caused certain stresses or occurred as a result of them. Some drugs Cannabis and LSD are known to cause schizophrenia relapses. According to the State Government of Victoria in Australia, for people with a predisposition to a psychotic illness such as schizophrenia, usage of cannabis may trigger the first episode in what can be a disabling condition that lasts for the rest of their lives. The National Library of Medicine says that some prescription drugs, such as steroids and stimulants, can cause psychosis. Who Is At Risk? About 1% of Americans have this illness. Schizophrenia affects men and women equally. It occurs at similar rates in all ethnic groups around the world. Symptoms such as hallucinations and delusions usually start between ages 16 and 30. Men tend to experience symptoms a little earlier than women. Most of the time, people do not get schizophrenia after age 45. Schizophrenia rarely occurs in children, but awareness of childhood-onset schizophrenia is increasing. It can be difficult to diagnose schizophrenia in teens. This is because the first signs can include a change of friends, a drop in grades, sleep problems, and irritability—behaviors that are common among teens. A combination of factors can predict schizophrenia in up to 80% of youth who are
  • 3. at high risk of developing the illness. These factors include isolating oneself and withdrawing from others, an increase in unusual thoughts and suspicions, and a family history of psychosis. In young people who develop the disease, this stage of the disorder is called the "prodromal" period. Signs & Symptoms The symptoms of schizophrenia fall into three broad categories: positive symptoms, negative symptoms, and cognitive symptoms. Positive symptoms Positive symptoms are psychotic behaviors not seen in healthy people, people with positive symptoms often "lose touch" with reality. These symptoms can come and go. Sometimes they are severe and at other times hardly noticeable, depending on whether the individual is receiving treatment. They include the following: Hallucinations are things a person sees, hears, smells, or feels that no one else can see, hear, smell, or feel. "Voices" are the most common type of hallucination in schizophrenia. Many people with the disorder hear voices. The voices may talk to the person about his or her behavior, order him or her to do things, or warn them of danger. Sometimes the voices talk to each other. People with schizophrenia may hear voices for a long time before family and friends notice the problem. Other types of hallucinations include seeing people or objects that are not there, smelling odors that no one else detects, and feeling things like invisible fingers touching their bodies when no one is near. Delusions are false beliefs that are not part of the person's culture and do not change. The person believes delusions even after other people prove that the beliefs are not true or logical. People with schizophrenia can have delusions that seem bizarre, such as believing that neighbors can control their behavior with magnetic waves. They may also believe that people on television are directing special messages to them, or that radio stations are broadcasting their thoughts aloud to others. Sometimes they believe they are someone else, such as a famous historical figure. They may have paranoid delusions and believe that others are trying to harm them, such as by cheating, harassing, poisoning, spying on, or plotting against them or the people they care about. These beliefs are called "delusions of persecution." Thought disorders are unusual or dysfunctional ways of thinking. One form of thought disorder is called "disorganized thinking." This is when a person has trouble organizing his or her thoughts or connecting them logically. They may talk in a garbled way that is hard to understand. Another form is called "thought blocking." In another explaining it is some kind of moving from one topic to another, in a nonsensical fashion. Individuals may make up their own words or sounds.
  • 4. Movement disorders may appear as agitated body movements. A person with a movement disorder may repeat certain motions over and over. In the other extreme, a person may become catatonic. Catatonia is a state in which a person does not move and does not respond to others. Catatonia is rare today, but it was more common when treatment for schizophrenia was not available. Negative symptoms Negative symptoms are associated with disruptions to normal emotions and behaviors. These symptoms are harder to recognize as part of the disorder and can be mistaken for depression or other conditions. These symptoms include the following:  "Flat affect" (a person's face does not move or he or she talks in a dull or monotonous voice)  Lack of pleasure in everyday life  Lack of ability to begin and sustain planned activities  Speaking little, even when forced to interact. People with negative symptoms need help with everyday tasks. They often neglect basic personal hygiene. This may make them seem lazy or unwilling to help themselves, but the problems are symptoms caused by the schizophrenia. Cognitive symptoms Cognitive symptoms are subtle. Like negative symptoms, cognitive symptoms may be difficult to recognize as part of the disorder. Often, they are detected only when other tests are performed. Cognitive symptoms include the following:  Poor "executive functioning" (the ability to understand information and use it to make decisions)  Trouble focusing or paying attention  Problems with "working memory" (the ability to use information immediately after learning it). Cognitive symptoms often make it hard to lead a normal life and earn a living. They can cause great emotional distress. Type of Schizophrenia  Paranoid schizophrenia -- a person feels extremely suspicious, persecuted, or grandiose, or experiences a combination of these emotions.  Disorganized schizophrenia -- a person is often incoherent in speech and thought, but may not have delusions.
  • 5.  Catatonic schizophrenia -- a person is withdrawn, mute, negative and often assumes very unusual body positions.  Residual schizophrenia -- a person is no longer experiencing delusions or hallucinations, but has no motivation or interest in life.  Schizoaffective disorder--a person has symptoms of both schizophrenia and a major mood disorder such as depression. Treatments Because the causes of schizophrenia are still unknown, treatments focus on eliminating the symptoms of the disease. Treatments include antipsychotic medications and various psychosocial treatments. Antipsychotic medications Antipsychotic medications have been available since the mid-1950's. The older types are called conventional or "typical" antipsychotics. Some of the more commonly used typical medications include:  Chlorpromazine (Thorazine)  Haloperidol (Haldol)  Perphenazine (Etrafon, Trilafon)  Fluphenazine (Prolixin). In the 1990's, new antipsychotic medications were developed. These new medications are called second generation, or "atypical" antipsychotics. One of these medications, clozapine (Clozaril) is an effective medication that treats psychotic symptoms, hallucinations, and breaks with reality. But clozapine can sometimes cause a serious problem called agranulocytosis, which is a loss of the white blood cells that help a person fight infection. People who take clozapine must get their white blood cell counts checked every week or two. This problem and the cost of blood tests make treatment with clozapine difficult for many people. But clozapine is potentially helpful for people who do not respond to other antipsychotic medications. Other atypical antipsychotics were also developed. None cause agranulocytosis. Examples include:  Risperidone (Risperdal)  Olanzapine (Zyprexa)  Quetiapine (Seroquel)  Ziprasidone (Geodon)  Aripiprazole (Abilify)
  • 6.  Paliperidone (Invega). What are the side effects? Some people have side effects when they start taking these medications. Most side effects go away after a few days and often can be managed successfully. People who are taking antipsychotics should not drive until they adjust to their new medication. Side effects of many antipsychotics include:  Drowsiness  Dizziness when changing positions  Blurred vision  Rapid heartbeat  Sensitivity to the sun  Skin rashes  Menstrual problems for women. Atypical antipsychotic medications can cause major weight gain and changes in a person's metabolism. This may increase a person's risk of getting diabetes and high cholesterol. A person's weight, glucose levels, and lipid levels should be monitored regularly by a doctor while taking an atypical antipsychotic medication. Typical antipsychotic medications can cause side effects related to physical movement, such as:  Rigidity  Persistent muscle spasms  Tremors  Restlessness. Long-term use of typical antipsychotic medications may lead to a condition called tardive dyskinesia (TD). TD causes muscle movements a person can't control. The movements commonly happen around the mouth. TD can range from mild to severe, and in some people the problem cannot be cured. Sometimes people with TD recover partially or fully after they stop taking the medication. TD happens to fewer people who take the atypical antipsychotics, but some people may still get TD. People who think that they might have TD should check with their doctor before stopping their medication. How are antipsychotics taken and how do people respond to them? Antipsychotics are usually in pill or liquid form. Some anti-psychotics are shots that are given once or twice a month.
  • 7. Symptoms of schizophrenia, such as feeling agitated and having hallucinations, usually go away within days. Symptoms like delusions usually go away within a few weeks. After about six weeks, many people will see a lot of improvement. However, people respond in different ways to antipsychotic medications, and no one can tell beforehand how a person will respond. Sometimes a person needs to try several medications before finding the right one. Doctors and patients can work together to find the best medication or medication combination, as well as the right dose. Some people may have a relapse-their symptoms come back or get worse. Usually, relapses happen when people stop taking their medication, or when they only take it sometimes. Some people stop taking the medication because they feel better or they may feel they don't need it anymore. But no one should stop taking an antipsychotic medication without talking to his or her doctor. When a doctor says it is okay to stop taking a medication, it should be gradually tapered off, never stopped suddenly. How do antipsychotics interact with other medications? Antipsychotics can produce unpleasant or dangerous side effects when taken with certain medications. For this reason, all doctors treating a patient need to be aware of all the medications that person is taking. Doctors need to know about prescription and over-the-counter medicine, vitamins, minerals, and herbal supplements. People also need to discuss any alcohol or other drug use with their doctor. Psychosocial treatments Psychosocial treatments can help people with schizophrenia who are already stabilized on antipsychotic medication. Psychosocial treatments help these patients deal with the everyday challenges of the illness, such as difficulty with communication, self-care, work, and forming and keeping relationships. Learning and using coping mechanisms to address these problems allow people with schizophrenia to socialize and attend school and work. Patients who receive regular psychosocial treatment also are more likely to keep taking their medication, and they are less likely to have relapses or be hospitalized. A therapist can help patients better understand and adjust to living with schizophrenia. The therapist can provide education about the disorder, common symptoms or problems patients may experience, and the importance of staying on medications. Too see a short film about schizophrenia: http://www.youtube.com/watch?v=d45BaYYrM2E http://www.youtube.com/watch?v=n_Zv59e68mU History of Psychiatric: http://www.youtube.com/watch?v=gvdBSSUviys