Schizophrenia

For a lay person:

Schizophrenia is a serious, long-term mental health condition that affects how a person thinks, feels and perceives the world. People may hear voices, hold unusual beliefs, have muddled thinking, or lose motivation and withdraw from others. It often begins in late adolescence or early adulthood, and with treatment and support many people manage their symptoms and live meaningful lives.

For a trained medical person:

A psychotic disorder of neurodevelopmental origin with genetic and environmental contributions (including cannabis use and obstetric complications), associated with dopaminergic and glutamatergic dysregulation and characterised by positive, negative and cognitive symptoms. Diagnosis is clinical against DSM-5 or ICD-11 criteria after excluding substance-induced, mood and organic causes. Management is antipsychotic medication (clozapine for treatment-resistant illness), psychological interventions such as CBT for psychosis and family therapy, early intervention services, and physical-health monitoring.

In Chinese medicine:

Liu and Tseng's textbook differentiates this condition into these patterns: Liver Stagnation and Excess Fire; Blood Deficiency and Phlegm-Fire; Yang Ming Excess Heat; Qi Stagnation and Blood Stasis; Knotted Phlegm and Qi Stagnation; Dian Syndrome (Psychosis); Kuang Syndrome (Mania). Treatment follows the pattern a patient presents with, not the Western diagnosis alone.

When to get help: Get urgent help from a doctor, crisis team or emergency department for thoughts of suicide or harming others, or a sudden worsening of symptoms. Schizophrenia needs medical treatment and Chinese medicine is adjunctive at most; do not stop prescribed antipsychotics without medical advice, and check before using herbs, which can interact with antipsychotics such as clozapine.