By Andrea Hargraves 
the schizophrenia It is the most common disease in CAPS (psychosocial care centers) for adults in the city of São Paulo. 73,506 patients were treated in 34 units in the capital from January 2022 to July 2024.
There is no waiting line for service. The patient can go to one of these centers and visit him on the same day or be transferred from another health unit, such as: UBS (Basic Health Unit) Or a UPA (Emergency Care Unit)For example.
In addition to schizophrenia, in the period from January 2022 to July this year, the most frequent conditions are bipolar affective disorder, with 27,378 patients treated during this period, and depressive episodes, with 22,038 patients.
Senior professor of the PBPC (Brazilian Association of Clinical Psychoanalysis), psychoanalyst Artur Costa says that one of the main symptoms of schizophrenia is the distortion of reality through hallucinations. The patient can hear sounds, see objects, feel touches, smells, and even taste.
“Delusions, called paranoia, are also a symptom of the disease. The person believes that he or she is being persecuted, for example,” he says.
Since there is no cure, symptoms are controlled with antipsychotic medications and other forms of treatment, such as psychotherapy, psychosocial rehabilitation (reintegration into society) and occupational therapy.
The earlier treatment begins, the better the patient's quality of life, as he will be able to carry out his daily activities normally, such as work and study.
Translator João Rosa de Castro, 51, was diagnosed with schizophrenia at the age of 24. He was treated in Cap des Berdez, between 1997 and 2019, and at the Itaim Paulista Center, from 2019 to today, and is currently able to control the symptoms of the disease and live more peacefully.
Castro has written 46 books and published 22. But writing is just a hobby, like the guitar. Despite his retirement, translation is still his day job and the source of income for the household. In addition, he also develops works of poetry and prose.
The patient says about the diagnosis: “I suffer from schizoaffective disorder consisting of schizophrenia and depression.” “I used to have a lot of delirium and hallucinations, but I don't feel that way anymore. I haven't had a crisis in more than four years.”
What took the translator to the doctor for the first time was a crisis, in 1996. He remembers that time being in a loop for two months, without control of his mind and body.
“It all started from feeling lonely, because I lived with my sister and I went on vacation to Pernambuco. It was the first time I was alone, as a homeowner, and it sparked a crisis, but before that I never felt anything.”
When he arrived at CAPS, prejudice made the translator find it difficult to accept treatment. “I saw people with different disorders and I thought: 'I'm not crazy', because I had an active life, I was an English teacher and was very respected by people. But today I understand the importance of hats,” he says.
In Itaim Paulista, Castro is in the process of being discharged from the hospital thanks to advances in treatment. Now, he goes there once or twice a month for psychological counseling and other activities carried out there, such as support groups.
Diagnosis of schizophrenia
To diagnose schizophrenia in CAPS, the patient undergoes an initial reception, where he is listened to by a health professional, such as a nurse, psychiatrist, social worker or psychiatrist.
According to psychiatrist Claudia Longhi, director of the mental health department at the municipal health department, a care plan is then drawn up that includes medical monitoring, counselling, support groups and other activities.
It is possible to stay at Caps from Monday to Friday (from morning to evening), or go once a week for a specific activity (such as support groups), or, if the medical team deems it necessary, to stay at the 24-hour reception. Including finals week.
The diagnosis of schizophrenia, which includes a variety of symptoms, requires multidisciplinary team work, with the main evaluation by a psychiatrist.
According to psychoanalyst Artur Costa, one of the characteristics noted in the diagnosis is the patient's inability to show joy, sadness, or any other type of emotion.
Other symptoms that help in the diagnosis include difficulty maintaining a line of thought, inability to feel pleasure in any activity, negligence in assuming responsibilities, and lack of concentration.
Schizophrenia is usually diagnosed in late adolescence and early adulthood, from age 20 onward. “When we talk about childhood and youth, we are talking about childhood psychosis, which we still do not call schizophrenia,” says Claudia Longhi.
In Brazil, it is estimated that about 1.6 million people have schizophrenia, which represents 1 in 100 people. However, patients still face biases associated with the disease, such as the misconception that they are violent or dangerous.
“For people in general, what is always different is the person who is causing the discomfort. But we work a lot with populations in the sense that in addition to the illness, there is someone suffering from an illness,” he says. Longhi.
Which project It is partnered with Umane, an association that supports public health initiatives