Schizophrenia

Schizophrenia is a disease of the brain that usually occurs in the late teenage years or early adulthood, but has been known to occur in children as well. It is a chronic disease in which symptoms worsen or improve at times. With appropriate treatment, most symptoms can be controlled. Schizophrenia affects about one in 100 people in the course of their lifetime.

The cause of schizophrenia is complex. There is probably more than one cause, just as there is more than one way to treat the disease. There is evidence that genetics play a role in schizophrenia. People with a family history of schizophrenia are more susceptible to developing the disease than the general population.

Studies of brain chemistry show that there is a chemical imbalance in the brains of people with schizophrenia. It is this imbalance that is thought to cause psychotic symptoms such as hearing voices or experiencing thought disturbances.

Schizophrenia involves a breakdown in the experience of reality, thinking and emotions. A person with schizophrenia often hears voices, experiences delusions and hallucinations and may believe their thoughts, feelings and actions are controlled or shared by someone else. Other symptoms include emotional flatness, lack of facial expression, inability to start or finish activities, speech that is brief and without content, a lack of pleasure or interest in life and other symptoms in common with depression and other mood disorders. A person with schizophrenia may be unaware or unable to understand that they have the condition.

The Royal, in cooperation with its research program at the University of Ottawa Institute of Mental Health Research, treats schizophrenia in people 16 years and older through its specialized Schizophrenia Program. Due to its complexity, schizophrenia is treated from a variety of perspectives. The Schizophrenia Program utilizes a team approach. The team may include psychiatrists, psychologists, nurses, occupational therapists, social workers, orderlies, recreation therapists, clinical dietitians, addictions counselors, a Chaplain, and a pharmacist. Each member has a wide range of experience dealing specifically with schizophrenia and related disorders.

The program’s philosophy is to regard each treatment as a respectful partnership between the patient and staff with the goal of providing psychiatric rehabilitation. The goal is to assure that an individual with a mental illness has the physical, emotional and intellectual skills needed to live, learn, and work in his or her own particular environment.

The Schizophrenia Program provides education not only to the individual but also to their family and community support network. The program provides assessments of accommodation, financial, vocational, leisure and nutritional needs and offers a wide range of group sessions to meet each patient’s social, emotional, recreational and occupational needs.

Young Adult Services
The Young Adult Service provides comprehensive care to individuals (and their families) that are in the first five years of a psychotic illness.  The Young Adult Team provides assessment, individual and group treatment, family counseling and family support groups in the hospital, in the community and — as required — in your home. Education and support is extended to your social, school and work network.  The team also provides important links to other community resources.

Inpatient Service
A person may be admitted to one of The Royal’s inpatients units designated for care of people with schizophrenia (40 beds in total), for one of the following reasons:

  • symptoms of the person’s illness have increased;
  • the person’s medication needs adjustment;
  • the person is experiencing a crisis; or
  • the person needs monitoring for a new treatment program or research project.

The person will meet individually with members of their treatment team.  The person will also have the opportunity to participate in individual and group activities, some of which may be in the community.  For questions about the Inpatient Service, please contact the Schizophrenia Program Director of Patient Care Services at 613.722.6521, ext. 6141.

Outpatient Services
The Royal’s Schizophrenia Clinic offers individualized treatment according to each person’s needs.  The care includes treatment, support, education, regular evaluation of the person’s progress and referrals to community services.  Staff will also assist the person and their family in dealing with crisis situations.

Transitional Day Hospital Service
The Transitional Day Hospital Service is available on weekdays for patients who want to improve their quality of life and enhance their recovery process.  The Service is open to patients from the inpatient unit who require more intensive support on discharge; and outpatients who need added support/structure to prevent hospitalization.

On referral, an outpatient nurse will meet with the patient to set up a schedule of group activities and individual support to meet their goals. For questions about this service, please contact the Day Hospital Nurse at 613.722.6521, ext. 7019.

Referral and Admission Criteria
A physician referral is needed for acceptance into The Royal’s Schizophrenia Program. To be admitted into the Schizophrenia Program, a person must:

  • Be 16 years of age or older;
  • Meet the DSM IV criteria for schizophrenia or schizophrenia disorder; and
  • Have clinical needs that cannot be adequately addressed in the community or the general psychiatry setting.

Clinical needs are defined as:

  • Unstable symptoms or failure to respond well to medication.
  • Psychosocial needs in at least three of the following five areas:
    • Basic tasks of independent living
    • Housing
    • Finances
    • Educational or occupational functioning
    • Ability to establish or maintain social support system

The person must have at least one of the clinical needs listed above, and/or the person would benefit from clinical research activity in the Schizophrenia Program.  Another requirement is that the referring community physician is willing to participate in shared care of the person being admitted to The Royal’s Schizophrenia Program.

For more information about the Schizophrenia Program or to make a referral, please call 613.722.6521 ext 6211.

Follow-Up Treatment
The length of stay in the inpatient Schizophrenia Program is determined by each patient’s individual progress and their need for specialized services. As their illness stabilizes, the patient, together with the team, may feel that the patient’s needs would be better served outside the Royal Ottawa Mental Health Centre (for example, by a family doctor or in a community health centre). A patient may also be followed for a time through the Schizophrenia Program Outpatient services.

Consultation Services
Consultation is available to persons with schizophrenia or suspected schizophrenia or a related disorder with a referral from a physician.  The main purposes of consultation are:

  • to assist in establishing a diagnosis;
  • to determine if the person would benefit from admission to the Schizophrenia Program;
  • to provide an opinion regarding treatment and management (change of medication or participation in a drug study); and
  • to obtain information about accessing community-based resources (housing, financial assistance, etc.).

Family Information and Support
Family information and support is important. Family information sessions about major mental illnesses are offered regularly during evening hours and are open to the public.  The Royal’s Centre’s Patient and Family Resource Centre contains books, brochures and other sources of information that provide a better understanding of mental illnesses and how to manage them.

Research
Research activities increase our understanding of the nature of schizophrenia and lead to better help for patients.  Research is conducted through the Institute of Mental Health Research (IMHR), affiliated with the Royal Ottawa Mental Health Centre and the University of Ottawa.

Current and past research areas include focus on:

  • determining the effectiveness of different treatments
  • development of new medications
  • effect of stress on the illness of schizophrenia
  • genetics of schizophrenia
  • first episode and early phase schizophrenia
  • factors contributing to ‘comorbidity’ of schizophrenia, such as substance abuse and addictions.

For opportunities to participate in research activities, please contact the Schizophrenia Research Unit of the IMHR at 613.722.6521, ext. 6844 or check out the Research section of this website.

For more information about schizophrenia, contact: