Encyclopedia of Health and Medicine

sleep disorders 383
• lack of emotional response or demeanor (flat
affect)
The diagnostic path often includes COMPUTED
TOMOGRAPHY (CT) SCAN or MAGNETIC RESONANCE IMAG-
ING (MRI) of the head to rule out physical causes,
such as BRAIN TUMOR, for symptoms. Diagnosis is
sometimes difficult because symptoms are similar
to those of other psychotic disorders. There are no
conclusive diagnostic procedures, and psychiatrists
sometimes differ in their clinical opinions as to
whether a person has schizophrenia or another
psychotic disorder. However, treatment
approaches are usually the same, at least initially.
Treatment Options and Outlook
Schizophrenia requires treatment with ANTIPSY-
CHOTIC MEDICATIONS to moderate and mitigate
symptoms. Though these medications have significant
side effects, they often restore the ability to
interact in the world. Most people require several
medications to adequately cover all symptoms.
The balance of medication, both DRUG and dosage,
is often a trial-and-error process as each person
responds in a unique way to a particular medication
as well as to combinations of medications.
However, many people who have schizophrenia
are able to work and engage in personal and social
relationships once medications control their symptoms.
People who have schizophrenia are at increased
risk for suicide, a risk that is most significant when
treatment moderates symptoms and the person
begins to reengage with normal life. It is common
for DEPRESSION to emerge at this time. Psychiatrists
often incorporate ANTIDEPRESSANT MEDICATIONS into
the treatment regimen to offset this development.
Schizophrenia is a chronic disorder that
requires lifelong, consistent treatment. Though it
is essential for the person to continue medications
as prescribed, many people fail to do so for various
reasons. Some medications to treat schizophrenia
are expensive, and all have potentially significant
side effects that can make them unpleasant to
take. Inherent in most forms of schizophrenia is
distrust of others, a characteristic particularly
prominent in paranoid schizophrenia. This distrust
may combine with PARANOIA to cause the person to
believe the medications are poisonous and refuse
to take them. Further supporting this distrust is
the sometimes necessary step of involuntary hospitalization
to treat severe symptoms, notably
when the person becomes a threat to self or others.
Inconsistency in complying with medication
regimens results in relapses of symptoms.
Risk Factors and Preventive Measures
The only known risk factor for schizophrenia is
family history, though researchers do not know
the basis of the genetic connections. Most people
who have schizophrenia have no known family
history of the disorder. There are no measures to
prevent schizophrenia.
See also DISSOCIATIVE DISORDER; NEUROSIS; PERSON-
ALITY DISORDER; PSYCHOSIS.
sleep disorders Disturbances of normal sleep
patterns. Though there are dozens of types of
sleep disorders, they fall into three general categories:
insufficient sleep, disrupted sleep, and
excessive or inappropriate sleep.
The body requires adequate sleep to restore cellular
functions throughout the body. The BRAIN is
active on different levels during sleep than when
awake. Dreaming is particularly important for
restful sleep. Though the amount of sleep needed
varies among individuals as well as with age,
everyone needs a consistent amount and quality
of sleep most nights of the week.
Sleep disturbances, and in particular sleep deprivation,
most significantly affect the NERVOUS SYS-
TEM, altering cognitive function and memory as
well as motor function, balance, spatial orientation,
and coordination. Public health experts estimate
that sleep deprivation causes more MOTOR
VEHICLE ACCIDENTS than intoxication and more
work-related injuries than any other single cause.
Sleepy drivers are often unaware of the extent to
which their drowsiness impairs judgment and
reaction time. More than 40 million Americans
have chronic sleep disorders.
Symptoms and Diagnostic Path
The symptoms of inadequate sleep include
• daytime tiredness
• inability to concentrate or remember simple
directions