Care for Schizophrenia

Schizophrenia is a complex psychiatric disorder that our team of nurse practitioners and psychiatrists diagnose and treat. It’s characterized by disruptions in thinking, perception, and behavior, including hallucinations, delusions, disorganized thoughts, and unusual behaviors.

** Of note, not all providers, or locations, are able to treat patients with Schizophrenia and/or other Psychotic Disorders. If patients have new onset illness, recently required hospitalization, or are assessed as high risk, we may refer to providers or hospital systems outside of our practice that have additional emergency resources, inpatient admitting privileges, and/or 24-7 practice coverage.

Positive Symptoms of Schizophrenia

Positive symptoms are linked to overactive dopamine activity in the brain’s mesolimbic pathway. They represent added experiences not typical in everyday mental functioning, such as:

• Hallucinations: Perceiving things that aren’t real, like hearing voices, seeing images, or experiencing unusual smells or sensations (that aren’t actually present). For instance, someone hearing an auditory hallucination, may turn to see where the voice is coming from, or respond, thinking that someone was engaging them in conversation.
• Delusions: Strongly held, false beliefs that may explain perceived threats or hallucinations. Examples include thought broadcasting (the idea that one’s thoughts are being broadcast to others, over radio waves or other modalities), thought insertion (the idea that others can insert thoughts into one’s mind), thought withdrawal (the idea that others can take thoughts out of one’s mind), somatic passivity (believing one’s actions can be controlled by external factors) and others.
• Disorganized thoughts or behaviors: Difficulty organizing speech or actions, resulting in jumbled conversation, incoherent speech, or unexpected behaviors, such as repetitive movements or standing still for extended periods.

Negative Symptoms of Schizophrenia

Negative symptoms, are often associated with reduced dopamine in the mesocortical pathway of the brain, involve loss of typical abilities and behaviors.
These include:

• Affect flattening: Limited emotional expression
• Alogia: Reduced speech
• Avolition: Decreased motivation for purposeful activity
• Anhedonia: Lowered ability to experience pleasure
• Cognitive deficits: Challenges with memory, attention, or decision-making

Negative symptoms can affect social interactions, work, school performance, and independence. Certain medications that treat positive symptoms may worsen negative symptoms, highlighting the need for treatment from an experienced psychiatrist for schizophrenia. I.E. overly medication psychosis, can result in worse academic, social and occupational function, but under treatment can result in severe psychiatric symptoms.

Schizoaffective Disorder

Schizoaffective disorder combines schizophrenia symptoms with mood disorders—such as bipolar disorder or major depression. Psychotic symptoms must occur independently of mood episodes. Our psychiatrists and psychiatric nurse practitioners who treat schizophrenia can distinguish between schizoaffective disorder and other conditions to create personalized treatment plans.

Prevalence of Schizophrenia

Schizophrenia affects about 1% of the U.S. population, impacting men and women equally. Symptoms typically appear between ages 15–25 for men and 25–35 for women, though onset can occur later or, rarely, in children.

Importance of Early Intervention

Early treatment improves outcomes by reducing the number and severity of psychotic episodes. Many mental health professionals believe that psychotic episodes (and their severity), actually worsen the patient’s prognosis.

Therefore, maintaining a treatment regimen that limits the number and severity of episodes, may improve a patient’s long-term function. An expert clinician can recognize prodrome symptoms, and consider early treatment.

The term prodrome refers to a phase of subtle early symptoms like social withdrawal, reduced motivation, and minor perceptual changes—before someone’s first full psychotic episode. Recognizing these signs allows for timely intervention and a better prognosis.

Risk Factors

Factors that may increase schizophrenia risk include:

• Family history of schizophrenia or other psychotic disorders
• Adolescent heavy (daily, or regular) marijuana use
• Birth complications or prenatal exposure to seasonal illnesses
• Urban living or socioeconomic stress
• Traumatic brain injury and other environmental or genetic factors

When to Seek Help

If you notice symptoms of schizophrenia, schizoaffective disorder, or psychosis, prompt evaluation is crucial. Early diagnosis and treatment helps reduce relapses, improve functioning, and support long-term stability.

For new-onset psychosis or recent hospitalization, specialized programs with 24/7 coverage are recommended. Our psychiatrists and psychiatric nurse practitioners who treat schizophrenia provide ongoing outpatient care, once patients are stabilized, and collaborate with larger health systems when needed.

Treatment Options

Effective schizophrenia care is individualized and may include:

• Psychiatric evaluation: Typically early in one’s illness, to assess for prodrome symptoms or early symptoms of psychosis.
• Medication management: First- and second-generation antipsychotics, including long-acting injectables
• Psychotherapy and behavioral support: Enhance daily functioning, social skills, and treatment adherence
• Ongoing monitoring: Regular follow-up with a psychiatrist or psychiatric nurse practitioner for schizophrenia treatment and medication adjustments

At Fine Tune Psychiatry, our clinicians combine academic expertise with compassionate care. Many have taught at institutions such as Johns Hopkins and the University of Pennsylvania. Our team includes board-certified psychiatrists, psychiatric nurse practitioners, and licensed therapists skilled in managing schizophrenia and co-occurring conditions.

*A Note on Long Acting Injectable Medications

Nicole Leighton, CRNP is an experienced mental health provider, who serves as Clinical Adjunct Faculty at Thomas Jefferson University in Philadelphia. She is able to personally provide long acting injectable medications to patients with schizophrenia (other psychosis and bipolar disorder), out of our Philadelphia, PA office. Additionally, several providers within our practice can utilize pharmacies throughout Pennsylvania that will administer long-acting injectable medications to patients (with their prescriptions).

Long-acting medications are helpful for patient that would prefer not to take a pill everyday or have difficulty following their regimen. With a long-acting injectable medication patients come to the office every 2-4 weeks instead of taking a pill daily. This can lead to more consistent treatment for patients, lead to fewer psychotic or manic episodes, and potentially improve a patient’s outcomes (particularly if a patient has a history of becoming ill, after missing only a few doses of oral medication).

We believe that these medications may be underutilized, as many physicians, nurse practitioners and other providers simply have not been educated in their use, or do not know about their availability. We are proud to provide this option to patients at Fine Tune Psychiatry.

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Why Choose Fine Tune Psychiatry?

• Specialized, compassionate care for schizophrenia and other psychiatric disorders
• Board-certified psychiatrists and psychiatric nurse practitioners
• Collaboration between our providers and a patient’s therapist, psychologist and other providers
• Academic expertise, with many providers having served as instructors at academic institutions
• Timely access with appointments typically available within two weeks
• Flexible scheduling: in-office and secure virtual visits
• Integrated care for co-occurring conditions
• Inclusive, welcoming environment
• Compassionate, non-judgemental, trauma-informed care