Q: My relative, a married woman of about 28 yrs, PG in Science, married one and half years ago has the following problems: She suffered from deep depression during the final PG exam 3 years ago and could not appear for some papers. A psychiatrist treated her and after a year she reappeared and passed. She got married after 8 months. A year ago she suffered from a viral fever for about a week and was treated with antibiotics. About 40 days after the viral fever the following symptoms ocurred: Loss of speach, hesitation; head oscillations; low BP (90/60 mm); confusion & delusions; loss of appetite; headache; negativity; suicidal behaviour; staring eyes; insomnia; imagining widowhood and loss of sense. She was given saline and the BP was brought to normal. A psychiatrist treated her for about 40 days with the following medicines - Tab Loripam 1mg, Tab Limbitrol (chlordiazepoxide), Sertrax 50 (Sertraline tabs) 50 mg. Her mental condition did not improve and she was admitted to a mental hospital for 15 days. Then she was treated for about three and half months during which period she became abnormally fat. The doctor was changed and the following medicines were given - Tab. DON 2mg, Tab Pacitane 2mg, Tab Citepam 20mg, Cap Amantrel 100mg, Tab Zorax SR 5mg, Tab Oleanz 2.5mg for about 10 days. As there was no improvement, another opinion was sought and Oleanz 5mg and Platin 10mg were given for 1 week and at half dose for 3 weeks. The obesity reduced and there was some improvement in the mental condition. The psychiatrist advised the treatment for another 6 months. He said the disease is Psychosis-Scizophrenia and that it is incurable. He also said that she should not have children as they would be prone to inherit the disease. The disease being of a recurring nature, marital life will be strained and advised separation. I wish to know following: i) Your opinion on the diagnosis of the disease based on the medicines given. ii) Is separation from the husband advisable due to the disease; if so for how long (for the last 8 months she is staying separately and is not with her husband). iii) Is this disease curable?

A:I. A diagnosis of schizophrenia is considered when a person experiences at least two of the following symptoms for at least one month (or less if the person has been treated before): · Delusions (false beliefs) · Hallucinations (perceiving the presence of something not really there) · Disorganized speech · Irrational or catatonic behavior, such as stupor, rigidity, or floppiness of limbs. · Negative symptoms, such as inaction, silence, or loss of will Your relative seems to exhibit a few of these symptoms and the diagnosis seems to be accurate. I would also like to inform you that genetics does seem to play a role, as schizophrenia runs in families, but there is no single schizophrenia gene. It appears that multiple genes are involved in creating a predisposition to the disease. Therefore it is advisable to put off pregnancy. II. It would be her doctors decision as far as living with her husband is concerned. Although family support is the key to preventing relapse she may not be prepared to cope with family life at the moment and may require constant monitoring. III. Some people experience only a single episode and remain symptom-free afterward. More commonly, however, the course of illness fluctuates over several decades, with each recurrence leading to increasing impairment. Some people have very few attacks in a lifetime; others have more and some may lead relatively normal lives between episodes. Others find that they are very listless, depressed and unable to function well. I would suggest that your relative should not change doctors often and should regularly consult her psychiatrist.