Need Help - Tough Decision about Schizophrenia

I don't know any other way to put it. We adopted an 11 yr old boy (now 13yrs old). In 2.5 yrs he: poisoned us, his grandparents, his sisters, the dogs, the neighbors dogs, with his own heart medicine, the grandfather's heart/kidney/dialysis/diabetes medicine, clorox, 409, etc in the koolaid, oatmeal, etc. He raped my daughters (keep in mind we know all of this because he confessed freely to DCS and his therapists because he was proud of himself and his obedience to the "voices"), and me, attempted to stab and smother us, attacked us various times and raped our dogs. He stole from us, ran away and left our house open, tried to trade his youngest sister to another boy for drugs (the boy wanted to rape her) and made up incredibly fantastic lies of abuse and neglect against his birth mom, us, the lady at Walmart, etc. He was also hooked on inhalants. Why? The doctors say "inherited early onset schizophrenia". Children of known schizo's or bipolars (his mom was one, his birth dad the other) who experience abuse/neglect/disruption of the home are very likely to have this diagnosis. Our lives have been a nightmare for 2 years. he's been in inpatient care for 6 mos (you can read my posts prior to november and you'll see the nightmares we went through), and life is wonderful! Our girls are now happy, well adjusted, honest, friendly and eager to live life. Their only request? Please never ever ever again adopt another boy. They'll take 50 sisters, or a biological brother, but not another adopted boy. According to the dr, boys are most likely to have these problems and have the lowest success rate of rehabilitation. I'm sorry to be so negative, but don't take the risk. We almost died, and had no idea. The day we admitted him to the hospital, it was because he told us the voices wanted him to hurt himself. When we got there, he laughed and said the truth was, he had tried to kill us the night before but couldn't keep the dogs from barking. I don't have time or space to go into the details of how this all happened, unless requested. Just know that I hate it, wish I could change it, feel sorry for him and all others like him, but pray that no one else makes the same mistake. We are currently putting him into state care as unruly, in hopes he'll get better care. We know we can't bring him home, that's for sure. Good luck to you. I know each situation is different, but be careful.

You might consider consulting with a geneticist to review the specifics of your child's background. Generally, the risk goes up from 2-5% to maybe 8 to 10% when both parents have schizophrenia.

Dr. Art, does this mean that there are tests that can be done to show a child's genetic risk of mental illness? (severity, etc) If so, is there funding available or is this a "if you want it bad enough, you'll find a way" type thing. What exactly would a geneticist be able to determine? Sorry to sound like 20 questions, but I've never heard of this option. Thanks in advance...

Don't worry too much. Having schizophrenia doesn't mean that your child is going to do bad things. I have a friend who inherited it and although he doesn't take medicine and is mild, he still does fine. Invest some money aside for a counselor or make it your priority to make counselling fees part of your monthly bills. If he does, talk about it as much you can with him. I'm sure everything will be alright. -Diana

Schizophrenia Facts and Statistics Schizophrenia is a serious disorder of the mind and brain but it is also highly treatable. Although there is no cure (as of 2007) for schizophrenia, the treatment success rate with antipsychotic medications and psycho-social therapies can be high. If the appropriate level of investment is made in research, it has been estimated that a cure for schizophrenia could be found within 10 years (by the year 2013). Traditionally, however, schizophrenia has only received a small fraction of the amount of medical research dollars that go into other serious diseases and disorders (see below - Schizophrenia Research - for more information). New Treatments: There are over 15 new medications for the treatment of schizophrenia currently in development by different biotech and pharmaceuticals companies (source: Special report on New Schizophrenia Medications). Additionally, there are many new and improving psycho-social treatments and cognitive therapies for schizophrenia that are being rolled out with significant success. Together these new treatments hold significant promise of a better life in the future for people who have schizophrenia. Check here for the latest news coverage of these new therapies. Schizophrenia is a devastating disorder for most people who are afflicted, and very costly for families and society. The overall U.S. 2002 cost of schizophrenia was estimated to be $62.7 billion, with $22.7 billion excess direct health care cost ($7.0 billion outpatient, $5.0 billion drugs, $2.8 billion inpatient, $8.0 billion long-term care). (source: Analysis Group, Inc.) Today the leading theory of why people get schizophrenia is that it is a result of a genetic predisposition combined with an environmental exposures and / or stresses during pregnancy or childhood that contribute to, or trigger, the disorder. Already researchers have identified several of the key genes - that when damaged - seem to create a predisposition, or increased risk, for schizophrenia. The genes, in combination with suspected environmental factors - are believed to be the factors that result in schizophrenia. These genes that seem to cause increased risk of schizophrenia include the DISC1, Dysbindin, Neuregulin and G72 genes, but it has been estimated that up a dozen or more genes could be involved in schizophrenia risk. See our Schizophrenia Genetics news for the latest information in this fast-moving area. One of the most positive areas of schizophrenia research today is in the area of identification of early risk factors for development of schizophrenia, and prevention of schizophrenia in those people who are predisposed to the disease. (source: Neuropsychiatry Review ). For more information see Schizophrenia Causes and Prevention. One of the most easily avoided factors linked to development of schizophrenia are brain-altering street drugs like marijuana and cannabis. Schizophrenia is a disease that typically begins in early adulthood; between the ages of 15 and 25. Men tend to get develop schizophrenia slightly earlier than women; whereas most males become ill between 16 and 25 years old, most females develop symptoms several years later, and the incidence in women is noticably higher in women after age 30. The average age of onset is 18 in men and 25 in women. Schizophrenia onset is quite rare for people under 10 years of age, or over 40 years of age. The diagram below demonstrates the general "age of onset" trends for schizophrenia in men and women, from a representative study on the topic. Source: A typological model of schizophrenia based on age at onset, sex an familial morbidity. Acta Psych8atr. Scand. 89, 135-141 (1994). The diagram below represents the differences in needs for hospitalizations, at different ages, for men and women who have schizophrenia. As shown in the diagram, schizophrenia tends to hit younger males hardest, with a much higher rate of hospitalization required between the ages of 15 and 40. (source: Hospital data from Canada). The earlier that schizophrenia is diagnosed and treated, the better the outcome of the person and the better the recovery. (Source: Yale University Medical School) Schizophrenia occurs in all societies regardless of class, colour, religion, culture - however there are some variations in terms of incidence and outcomes for different groups of people. (Source: Dr. Robin Murray ) Schizophrenia Ranks among the top 10 causes of disability in developed countries worldwide (source: The global burden of disease: a comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020. Cambridge, MA: Published by the Harvard School of Public Health on behalf of the World Health Organization and the World Bank, Harvard University Press, 1996. [url]http://www.who.int/msa/mnh/ems/dalys/intro.htm[/url] ) For additional information See the World Health Organization's mental health publications. The Prevalance Rate for schizophrenia is approximately 1.1% of the population over the age of 18 (source: NIMH ) or, in other words, at any one time as many as 51 million people worldwide suffer from schizophrenia, including; 6 to 12 million people in China (a rough estimate based on the population) 4.3 to 8.7 million people in India (a rough estimate based on the population) 2.2 million people in USA 285,000 people in Australia Over 280,000 people in Canada Over 250,000 diagnosed cases in Britain Rates of schizophrenia are generally similar from country to countryabout .5% to 1 percent of the population (there are variations - but the variance is difficult to track due to differing measuring standards in many countries, etc.). Source: Dr. Robin Murray. Another way to express the prevalence of schizophrenia at any give time is the number of individuals affected per 1,000 total population. In the United States that figure is 7.2 per 1,000. This means that a city of 3 million people will have over 21,000 individuals suffering from schizophrenia. Incidence: The number of people who will be diagnosed as having schizophrenia in a year is about one in 4,000. So about 1.5 million people will be diagnosed with schizophrenia this year, worldwide. About 100,000 people in the United States will be diagnosed with schizophrenia this year. [Note: The term 'prevalence' of Schizophrenia usually refers to the estimated population of people who are living with Schizophrenia at any given time. The term 'incidence' of Schizophrenia refers to the annual diagnosis rate, or the number of new cases of Schizophrenia diagnosed each year. ] Prevalence of schizophrenia compared to other well-known diseases Source: BCSS Therefore, the approximate number of people in the United States suffering from: Schizophrenia: Over 2.2 million people Multiple Sclerosis: 400,000 people Insulin-dependent Diabetes: 350,000 people Muscular Dystrophy: 35,000 people The Course of Schizophrenia Early intervention and early use of new medications lead to better medical outcomes for the individual The earlier someone with schizophrenia is diagnosed and stabilized on treatment, the better the long-term prognosis for their illness Teen suicide is a growing problem -- and teens with schizophrenia have approximately a 50% risk of attempted suicide In rare instances, children as young as five can develop schizophrenia. Anti-psychotic medications are the generally recommended treatment for schizophrenia. If medication for schizophrenia is discontinued, the relapse rate is about 80 percent within 2 years. With continued drug treatment, only about 40 percent of recovered patients will suffer relapses.( Source: NIMH ) Wide variation occurs in the course of schizophrenia. Some people have psychotic episodes of illness lasting weeks or months with full remission of their symptoms between each episode; others have a fluctuating course in which symptoms are continuous but rise and fall in intensity; others have relatively little variation in the symptoms of their illness over time. At one end of the spectrum, the person has a single psychotic episode of schizophrenia followed by complete recovery; at the other end of the spectrum is a course in which the illness never abates and debilitating effects increase. (source: Openthedoors ). Recent research increasingly shows that the disease process of schizophrenia gradually and significantly damages the brain of the person, and that earlier treatments (medications and other therapies) seem to result in less damage over time (source: UCLA NeuroImaging Lab , Other info - see "Early Treatment" section of this page). After 10 years, of the people diagnosed with schizophrenia: 25% Completely Recover 25% Much Improved, relatively independent 25% Improved, but require extensive support network 15% Hospitalized, unimproved 10% Dead (Mostly Suicide) After 30 years, of the people diagnosed with schizophrenia: 25% Completely Recover 35% Much Improved, relatively independent 15% Improved, but require extensive support network 10% Hospitalized, unimproved 15% Dead (Mostly Suicide) (Source: Surviving Schizophrenia) Where are the People with Schizophrenia? Approximately: 6% are homeless or live in shelters 6% live in jails or prisons 5% to 6% live in Hospitals 10% live in Nursing homes 25% live with a family member 28% are living independently 20% live in Supervised Housing (group homes, etc.) (Source: Surviving Schizophrenia) Homelessness and Schizophrenia Approximately 200,000 individuals with schizophrenia or manic-depressive illness are homeless, constituting one-third of the approximately 600,000 homeless population (total homeless population statistic based on data from Department of Health and Human Services). These 200,000 individuals comprise more than the entire population of many U.S. cities, such as Hartford, Connecticut; Charleston, South Carolina; Reno, Nevada; Boise, Idaho; Scottsdale, Arizona; Orlando, Florida; Winston Salem, North Carolina; Ann Arbor, Michigan; Abilene, Texas or Topeka, Kansas. At any given time, there are more people with untreated severe psychiatric illnesses living on Americaגs streets than are receiving care in hospitals. Approximately 90,000 individuals with schizophrenia or manic-depressive illness are in hospitals receiving treatment for their disease. Source: Treatment Advocacy Center The Cost of Schizophrenia to Society: Schizophrenia, long considered the most chronic, debilitating and costly mental illness, now consumes a total of about $63 billion a year for direct treatment, societal and family costs. Richard Wyatt, M.D., chief of neuropsychiatry, National Institutes of Mental Health , has said that nearly 30 percent ($19 billion) of schizophrenia's cost involves direct treatment and the rest is absorbed by other factors -- lost timefrom work for patients and care givers, social services and criminal justice resources. Wyatt said schizophrenia affects one percent of the population, accounts for a fourth of all mental health costs and takes up one in three psychiatric hospital beds. Since most schizophrenia patients are never able to work, they must be supported for life by Medicaid and other forms of public assistance. Source: NIMH A more recent estimate of the cost of schizophrenia and other serious mental illnesses (biplar disorder, serious depression, etc) from Dr, E. Fuller Torrey in Q1, 2004 was that federal costs for the care of seriously mentally ill individuals now total $41 billion yearly and are rocketing upward at a rate of $2.6 billion a year. More hospital beds in Canada (8%) are occupied by people with schizophrenia than by sufferers of any other medical condition (Source: BCSS ) In the UK, in economic terms: some 80 million working days are lost each year at a cost of 3.7 billion; the NHS spends around ã1 billion on treatment and personal social services another 400 million. The greatest cost of schizophrenia , however, is the non-economic costs to those who have it and their families. Schizophrenia Ranks among the top 10 causes of disability in developed countries worldwide (source: The global burden of disease: a comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020. Cambridge, MA: Published by the Harvard School of Public Health on behalf of the World Health Organization and the World Bank, Harvard University Press, 1996. [url]http://www.who.int/msa/mnh/ems/dalys/intro.htm[/url] ) For additional information See the World Health Organization's mental health publications. Schizophrenia Research Expenditures: Research expenditures on schizophrenia still lag far behind those on other serious illnesses. US Government spending on research per person - Comparison (For More information: A Federal Failure in Psychiatric Research , November, 2003) NIH Research Expenditure by Disease, 1999 Disease FY 1999 NIH research expenditures Prevalence: Individuals with this disease NIH research dollars per person affected HIV (including AIDS) $1,792,700,000 800,000 $2,240.88 lung cancer $163,100,000 342,457 $476.26 cervical cancer $75,200,000 231,064 $325.45 multiple sclerosis $96,300,000 350,000 $275.14 breast cancer $474,700,000 2,197,504 $216.02 colorectal cancer $175,900,000 1,041,499 $168.89 ParkinsonÒs disease $132,300,000 1,000,000 $132.30 prostate cancer $177,500,000 1,637,208 $108.42 Alzheimers disease $406,500,000 4,000,000 $101.62 schizophrenia $196,515,000 2,632,396 $74.65 bipolar disorder $57,805,000 2,227,412 $25.95 depression $199,600,000 10,732,076 $18.60 panic disorder $19,049,000 3,239,872 $5.88 obsessive-compulsive disorder $12,693,000 4,859,808 $2.61 Sources of data: The 1999 NIMH expenditures by disease were provided by the NIMH budget office, July 24, 2000. There are suggestions that some of these expenditures are inflated. The $196.5 million estimate for schizophrenia research in 1999, for example, is more than 50 percent higher than the $124.3 million estimate for 2002, recently made public by NIMH. The number of persons affected with serious mental illness was derived by using the ғbest estimate one-year prevalence figures from the 1999 Report of the Surgeon General (op. cit., p. 47) and multiplying by the 1999 U.S. population figures for all individuals 18 and over (202,492,000). The figure for schizophrenia and bipolar disorder is consistent with other prevalence figures for these disorders. However, the figures for depression (unipolar major depression), panic disorder, and obsessive-compulsive disorder clearly include individuals with non-severe forms of these disorders. The authors are not aware of reliable prevalence data that include only severe forms of these disorders. The 1999 NIH expenditures for other diseases were obtained from NIHԒs annual report Research Initiatives/Programs of Interest Ӕ for 1999, [url]http://www4.od.nih.gov/ofm/diseases/index.stm[/url] . The number of individuals with various cancers was obtained from the National Cancer Institute, [url]http://seer.cancer.gov/faststats/html/pre_all.html[/url] (click on PrevalenceӔ on the left, under Available StatisticsӔ) and represents complete prevalence, i.e., anyone who has ever had that cancer who is still alive. The number of individuals with other diseases was taken from the websites of the various advocacy organizations Suicide Risk People with the condition have a 50 times higher risk of attempting suicide than the general population; the risk of suicide is very serious in people with schizophrenia. Suicide is the number one cause of premature death among people with schizophrenia, with an estimated 10 percent to 13 percent killing themselves and approximately 40% attempting suicide at least once (and as much as 60% of males attempting suicide). The extreme depression and psychoses that can result due to lack of treatment are the usual causes. These suicides rates can be compared to the general population, which is somewhere around 0.01%. (source: Treatment Advocacy Center and other sources) Schizophrenia and Violence People with schizophrenia are far more likely to harm themselves than be violent toward the public. Violence is not a symptom of schizophrenia. News and entertainment media tend to link mental illnesses including schizophrenia to criminal violence. Most people with schizophrenia, however, are not violent toward others but are withdrawn and prefer to be left alone. Drug or alcohol abuse raises the risk of violence in people with schizophrenia, particularly if the illness is untreated, but also in people who have no mental illness. Schizophrenia and Jail The vast majority of people with schizophrenia who are in jail have been charged with misdemeanors such as trespassing. As many as one in five (20%) of the 2.1 million Americans in jail and prison are seriously mentally ill, far outnumbering the number of mentally ill who are in mental hospitals, according to a comprehensive study. Source: Human Rights Watch The American Psychiatric Association estimated in 2000 that one in five prisoners were seriously mentally ill, with up to 5 percent actively psychotic at any given moment. In 1999, the statistical arm of the Justice Department estimated that 16 percent of state and federal prisoners and inmates in jails were suffering from mental illness. These illnesses included schizophrenia, manic depression (or bipolar disorder) and major depression. The figures are higher for female inmates, the report says. The Justice Department study found that 29 percent of white female inmates, 22 percent of Hispanic female inmates and 20 percent of black female inmates were identified as mentally ill. Many individuals with schizophrenia revolve between hospitals, jails and shelters. In Illinois 30% of patiants discharged from state psychiatric hospitals are rehospitalized within 30 days. In New York 60% of discharged patients are rehospitalized within a year. Source: Surviving Schizophrenia What Percentage of Individuals with sever mental illnesses are untreated, and why? Recent American studies report that approximately half of all individuals with severe mental illnesses have received no treatment for their illnesses in the previous 12 months. These findings are consistent with other studies of medication compliance for individuals with schizophrenia and manic-depressive illness (bipolar disorder). The majority (55 percent) of those not receiving treatment have no awareness of their illness (anosognosia) and thus do not seek treatment. Stigma and dissatisfaction with services are relatively unimportant reasons why individuals with severe mental illnesses do not seek treatment. The 45 percent who acknowledged that they needed treatment (and thus had awareness of their illness) but still were not receiving treatment cited many reasons for this. These included (respondent could check several reasons): 32% "wanted to solve problem on own" 27% "thought the problem would get better by itself" 20% "too expensive" 18% "unsure about where to go for help" 17% "help probably would not do any good" 16% "health insurance would not cover treatment" Source: Treatment Advocacy Center The Risks of Getting Schizophrenia