WASHINGTON, DC—While the nation’s attention is heavily focused on the treatment of war-related mental health issues, military providers are also busy caring for those psychiatric conditions that may not be war related.

Schizophrenia affects about 1.1% of the population. The devastating disease is one that not only civilian providers see patients with, but one which military providers also treat.

While it is not possible to join the military with schizophrenia, symptoms can develop after an individual has joined the military, preventing a servicemember from continued service. “Schizophrenia is a severe mental illness in which individuals have difficulty differentiating what is real and what is not,” said Air Force Maj Kaustubh G Joshi, associate psychiatry residency training director and senior forensic psychiatrist for the 59th Mental Health Squadron at Lackland Air Force Base.

Schizophrenia diagnosis is made by interviewing the patient and gathering information from their commanders and family members. There are five major clusters of symptoms for the condition: disorganized thinking, disorganized behavior, delusions, hallucinations, and negative symptoms. Negative symptoms are symptoms associated with disruptions to normal emotions and behaviors.

At Wilford Hall Medical Center at Lackland Air Force Base, Joshi said that there is an inpatient psychiatric ward where patients with schizophrenia and other disorders can be treated. “We hospitalize active duty members who have developed psychotic symptoms and who may develop schizophrenia. If they come to our base and they are having these symptoms and need hospitalization, we can treat them in our inpatient unit.”

In addition, there is an outpatient mental health clinic where mental health professionals use a multidisciplinary approach to help active duty servicemembers with mental illnesses.

Schizophrenia Symptoms

While mental health is receiving more attention in the military, schizophrenia differs greatly from PTSD and other types of war-related mental health conditions, Joshi explained. Schizophrenia is an illness in which individuals cannot distinguish what is real or not. “That is different than PTSD or depression in which those individuals have retained the ability to differentiate what is real from what is not.”

The prognosis for schizophrenia when compared to PTSD or depression is also poorer because it is a chronic mental illness. With schizophrenia, patients may have difficulty taking care of themselves, as well as maintaining any sort of stable interpersonal relationships or gainful employment since they have difficulty in differentiating what is real and what is not real.

A schizophrenia diagnosis can be devastating for the patient’s family. Joshi said that getting family members involved by educating them about the signs and symptoms of the disease and the patient’s treatments is helpful.

The cause of schizophrenia is still unknown. According to NIMH, scientists think interactions between genes and the environment are necessary for schizophrenia to develop. A number of environmental factors may be involved, such as malnutrition prior to birth, exposure to viruses, problems during birth, and other not yet known psychosocial factors.

Although there is no cure for the disease, treatments to help control the symptoms include antipsychotic medications and various psychosocial treatments.

Finding a cure for the disease has been a challenge since the cause is still not known, Joshi said. “We know what the symptoms are, we know when we see certain sets of symptoms and a deterioration in functioning that we can likely identify schizophrenia, but what is really causing it is still unknown.”

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