Schizophrenia is a chronic mental illness that is characterized mainly by distortion from reality. It affects how someone thinks, behaves and feels. Schizophrenia is a global burden, as many people have stigma towards schizophrenic patients even though the disease is not contagious.

I got inspired to write this article while doing my clinical rotation for medical school in a psychiatry department. I have seen the stigma given to schizophrenic patients, and I want to raise more awareness of this disease as someone can prevent further complications by knowing the first positive symptoms of the disease and seek for medical help hence living a normal life.

Schizophrenia is a disease like other Non-communicable disease, the real cause of this disease is unknown, but the genetic and environmental factors can act together to bring the disease. Although there is no definitive proof, many suspect traumas before birth (birth asphyxia) and viral infections to contribute to the development of the disease ( Stressful experiences may also precede the emergence of schizophrenia. The chemical imbalance of neurotransmitters in the brain, especially dopamine and serotonin, also plays a major role in the occurrence schizophrenia. Some substance uses like marijuana and cannabis can also affect the relapse of the disease. So everyone should be concerned about schizophrenia, as we can all get it.

The onset of schizophrenia is insidious, but there are some common warning signs (subjective to individuals) like social withdrawal, deterioration of personal hygiene, depression, unable to concentrate, oversleeping or insomnia, extreme reaction to criticism, etc.

Schizophrenia starts by the positive symptoms, in this case the word “positive” does not mean good, rather it refers to the exaggerated forms of thinking or behaviors that becomes irrational.  

These positive symptoms according to DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) criteria of schizophrenia include, hallucinations, delusions, disorganized behaviors and thought disorder. Hallucinations constitute sensory perception of something that does not exist, and they can be associated with all five senses, (visual, auditory, olfactory, tactile and gustatory Researchers have found that hearing non-existent voices is more common than seeing non-existent visions. When it comes to delusions, these are the false believes that someone with schizophrenia has, they include delusions of grandiosity (belief of being famous or an important figure),  erotomanic delusions, where the libido of someone increases considerably, leading to exaggerated sexual urges, delusions of persecution involves bizarre ideas and plots , mystic delusions which is the belief of  having the capacity to read and heal human hearts, here the person starts to preach the gospel everywhere (which is different from how she/he used to be). Some people may also present delusions of jealousy, etc.  Thought disorder is when a person jumps from one subject to another without a logical flow.

When someone presents these positives symptoms, the society most of the time don’t think that they are sick. People in the community starts to diagnose schizophrenia and even consult the hospital when the patient has negative symptoms, which means loss of normal function and diminished capacity to experience pleasure, decrease social affiliation, lack of motivation to do something, diminished or increased speech, inability to carry a conversation and spending most of the day alone.

The first onset of schizophrenia can be unpleasant, and may take a long time to recover, so It is important that a person living with schizophrenia receives full support from family, friends and community services.

As am concluding, I call upon everyone to help me prevent the stigma towards these patients, because the experience of stigma towards these people is common, and may be internalized to patients leading to “self-stigma”. This self-stigma can be damaging and lead to poor response to vocational rehabilitation and treatment adherence. So, everyone who sees the above mentioned symptoms, on him/herself or on someone around should seek for the medical help as soon as possible, because in many cases, someone with schizophrenia can live a relatively normal life if the disease is caught early enough and proper treatment is administered. And please remember, people with schizophrenia need everyone’s help, so we shouldn’t stigmatize them.

Written by Victoire MUKAMITARI, a medical student at University of Rwanda Year5




06 January 2019 21:46
Keep it up Doctor Vicky!

Pauline UWERA

Pauline UWERA

24 February 2019 20:38
Woow! It's a really good piece! Congratulations!



22 May 2019 08:57
Courage my young Doctor! The sky is no longer the limit!

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