Transcript Schizophrenia

Introduction
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A biological disorder of the brain which causes
disturbances in thinking speech, perception of
reality, emotion (mood), and behavior.
Approximately 1% of the population develops
schizophrenia during their lifetime.
Although schizophrenia affects men and
women with equal frequency, the disorder
often appears early in men (usually late teens),
than women (generally late twenties/early
thirties).
Rarely is schizophrenia diagnosed in early
childhood development
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World Health Organization has identified
schizophrenia as one of the ten most
debilitating diseases affecting human beings.
People with schizophrenia often suffer from
terrifying symptoms such as hearing voices,
believing that people can read their minds,
controlling their thoughts and are plotting
against them
These symptoms leave them fearful and
withdrawn.
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Introduced in 1911 by Psychiatrist Eugene
Bleuer
Dr. Bleuer suggested that psychological
functions that are normally integrated with
one another(such as thoughts, emotions and
language) are somehow split apart from or
are disconnected in people with
schizophrenia.
The term schizophrenia literally means “split
mind”
◦ People often mistake “split mind” with split
personality.
1.
Paranoid Schizophrenia
2.
Disorganized Schizophrenia
3.
Catatonic Schizophrenia
4.
Undifferentiated Schizophrenia
5.
Residual Schizophrenia
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Delusions of being prosecuted by
others
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Delusions of grandeur where they are
enormously important
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Suspicious, anxiety and anger
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Hallucinations may also be present
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Confusion and Incoherence
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Severe deterioration of adaptive behavior
– Lack of social skills
– Poor personal hygiene & self care
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Behavior appears silly and/or child-like
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Highly in appropriate emotional responses
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Striking motor disturbances ranging from
muscular rigidity to random or repetitive
movements
Alternate between stuperous states and
agitated excitement
– During stuperous states, people with catatonic
schizophrenia may exhibit catatonic rigidity
which is a phenomenon where they maintain an
unusual position for up to several hours. This
phenomenon is known as waxy flexibility
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People who exhibit some of the symptoms
and thought disorders of the other subtypes
but do not have enough of the specific
criteria to be diagnosed within another
category.
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Less common subtype
Characterized by extended periods without
prominent positive symptoms, but other
symptoms continue
Symptoms
1.
Positive
2.
Negative
3.
Cognitive
4.
Affective
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Positive “Psychotic”
Symptoms
Characterized by
the presence of odd
or unusual feelings,
thoughts, and
behaviors
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Negative, an
absence of normal
reactions
“Negative” does not
refer to the persons
attitude, but rather
the lack of certain
characteristics that
should be there
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Cognitive
Pertain to thinking
processes
MATRICS
◦ Measurement And
Treatment Research
to Improve Cognition
in Schizophrenia
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Affective
Influenced by and
resulting from
emotion
Risk Factors
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Three Types of Biological Factors
– Genetic Predisposition: If your related to someone diagnosed
with schizophrenia the more likely you could develop the
disorder.
– Brain Abnormalities: Brain scans of schizophrenic patients have
shown a number of brain abnormalities.
• MRI’s Show mild to moderate brain atrophy
• It is more likely to see these structural differences in patients
who have negative symptom patterns.
– Biochemical Factors: People who are diagnosed with
schizophrenia have more dopamine receptors on neuron
membranes then people who don’t have it.
• Dopamine Hypothesis- the symptoms of schizophrenia,
particularly positive symptoms, are produced by over activity
of the dopamine system in areas of the brain that regulate
emotional expressions, motivated behavior, and cognitive
functioning (Heinrichs, 2001)
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Psychological Factors
◦ Regression is when a person retreats to an earlier and more
secure state of psychosocial development in the face of
overwhelming anxiety.
◦ It is believed by some cognitive theorists that it is a defect in
the attentional mechanism that filters out irrelevant stimuli, so
they become overwhelmed by internal and external stimuli.
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Environmental Factors
◦ Stressful life events can play an important role in showing the
signs of schizophrenia .
◦ Expressed emotion involves high levels of criticism, hostility
and over involvement.
◦ Schizophrenics who are returning home from the hospital are
more likely to relapse if their environment is an expressed
emotion.
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Sociocultural Factors
◦ Lower socioeconomic populations have a higher prevalence of
schizophrenia.
◦ Social Causation hypothesis: attributes the higher prevalence
of schizophrenia to the higher levels of stress that lowincome people experience.
◦ Social drift Hypothesis: Proposes that as people develop
schizophrenia, their personal and occupational functioning
deteriorates, so that they drift down the social ladder.
Diagnosing
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Currently no physical or lab test absolutely
diagnose schizophrenia.
Primary method for diagnosing Schizophrenia
are psychological evaluations
Rule out other disorders
Some lab test help confirm Schizophrenia
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Delusions
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Paranoid delusions
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Delusions of reference
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Somatic delusions
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Delusions of Grandeur
 Hallucinations
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Auditory
Gustatory
Olfactory
Somatic/Tactile
Visual
Mood Congruent
Mood Incongruent
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Lab tests
◦ blood count
◦ blood tests
◦ screening for alcohol & drugs
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Imaging studies
◦ Magnetic Resonance Imaging (MRIs)
◦ CT Scan
◦ PET scan
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Misdiagnoses is common
Prominent symptoms are shared with other
disorders
According to one study there’s an average
delay of 10 years from the first onset of
symptoms
Treatment
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Currently there is no cure
Antipsychotics are the primary medications
prescribed to treat schizophrenia.
May need to try several different antipsychotics
before finding the right one or combination.
medication changes should be closely monitored
by a doctor.
People with schizophrenia who stop taking
medicine are at risk of relapsing into an acute
psychotic episode.
Conventional Antipsychotics Atypical Antipsychotics
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Introduced in the
1950’s
Help relieve Positive
Symptoms
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Introduced in the
1990’s
Equally effective in
relieving positive
symptoms.
Better at relieving
negative symptoms
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Conventional
Antipsychotics
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Chlorpromazine
Fluphenazine
Haloperidol
Thiothixene
Trifluperazine
Perphenazine
Thioridazine
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Atypical Antipsychotics
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Risperidone
Clozapine
Olanzapine
Quetiapine
Ziprasidone
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Recovery Support and Relapse Prevention
Family to Family education programs
Vocational rehabilitation and supported
employment
Individual therapy
Hospitalization