Transcript Paranoid Schizophrenia

Paranoid Schizophrenia
The Schizies:
Becky Guiler, Misty Mahan,
Renee Pittman, and Keima Thomas
DSM-IV-TR Diagnostic Criteria:
Schizophrenia
A.
Characteristic symptoms: Two (or more) of the
following, each present for a significant portion of time
during a 1-month period (or less if successfully
treated):
(1) delusions – false beliefs that usually involve a
misinterpretation of perceptions or experiences
(2) hallucinations
(3) disorganized speech (e.g., frequent derailment or
incoherence)
** “Derailment is disordered thought in which the idea
changes spontaneously to another idea that is
unrelated or only distantly related” (BehaveNet.com,
2008)
DSM-IV-TR Diagnostic Criteria:
Schizophrenia
(4) grossly disorganized or catatonic behavior
(5) negative symptoms, i.e., affective flattening, alogia, or
avolition
**Affective flattening is “complete or nearly complete
absence of affective expression” (BehaveNet.com,
2008).
**Affect is “outward behaviors, including but not limited to
facial expression and vocal modulation, which express
emotions” (BehaveNet.com, 2008).
**Alogia is lacking or limited thinking as evidence by
empty or limited speech (BehaveNet.com,2008).
**Avolition is “absence of initiative or motivation to begin
and maintain behavior in pursuit of a goal”
(BehaveNet.com, 2008).
DSM-IV-TR Diagnostic Criteria:
Schizophrenia
Note: Only one Criterion A symptom is required if delusions are bizarre
or hallucinations consist of a voice keeping up a running
commentary on the person's behavior or thoughts, or two or more
voices conversing with each other.
B. Social/occupational dysfunction: There is a decrease in levels of
major areas of functioning such as work, interpersonal relations, or
self-care for a significant portion of time since onset
C. Duration: Continuous signs of the disturbance persist for at least 6
months.
D. – F. The disorder is not better characterized or due to
Schizoaffective Disorder and Mood Disorder With Psychotic
Features, use of a substance or general medical condition, or a
developmental disorder (See DSM-IV-TR for criteria needed for
making a dual diagnosis.)
Characteristics of Schizophrenia

Prevalence: In the range of .5% - 1.5% of the
population and occurs equally among men and
women.
 Onset for men is typically between ages 18 – 25.
 Onset for women is typically between ages 25 –
mid 30’s.
 “A majority of individuals with Schizophrenia
have poor insight regarding the fact that they
have a psychotic illness” (DSM-IV-TR, 2000).
DSM-IV-TR Diagnostic Criteria:
Paranoid Schizophrenia (295.30)
A type of Schizophrenia in which the following criteria are met:
A. Preoccupation with one or more delusions or frequent auditory
hallucinations.
B. None of the following is prominent: disorganized speech,
disorganized or catatonic behavior, or flat or inappropriate affect.
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Delusions are typically persecutory or grandiose, or both, but
delusions with other themes may also occur (e.g. jealousy) and are
usually organized around a coherent theme. Hallucinations are
typically related to the delusional theme.
•
With persecutory delusions the person believes he or she is being
tormented, followed, tricked, spied on, or ridiculed. These delusions
could predispose the individual to suicidal behavior.
DSM-IV-TR Diagnostic Criteria:
Paranoid Schizophrenia (295.30)
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Associated features include anxiety, anger, aloofness, and
argumentativeness.
The individual may have a superior and patronizing manner or
extreme intensity in interpersonal interactions.
Combinations of delusions with anger may predispose the
individual to violence.
Onset tends to be later in life than the other types of
schizophrenia.
Show little or no impairment on neuropsychological or other
cognitive testing.
Some evidence suggests that individuals with paranoid
schizophrenia may have better chance of functioning at work
and living on their own than the other types of schizophrenia.
Examples of Paranoid
Schizophrenia
 Barbara
Dee Dee ( Be prepared it’s kind of
gross).
 Tetty
 Being
a Schizophrenic
There are many different medications to
treat Paranoid Schizophrenia
Treatments for Paranoid
Schizophrenia

Like many other mental illnesses, schizophrenia
is usually treated with a combination of
therapies, tailored to the individual’s symptoms
and needs.
 Antipsychotic medications under the supervision
of a psychiatrist is the treatment of choice for
schizophrenia, because the illness is related to
biochemical imbalances. These medications can
reduce hallucinations, delusions and disordered
thinking, but few of them adequately treat the
social withdrawal and apathy that occurs in
schizophrenia.
Types of Drugs
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In the last decade new "atypical" antipsychotics have
been introduced. Compared to the older "conventional"
antipsychotics these medications appear to be equally
effective for helping reduce the positive symptoms like
hallucinations and delusions - but may be better than the
older medications at relieving the negative symptoms of
the illness, such as withdrawal, thinking problems, and
lack of energy. The atypical antipsychotics include
aripiprazole (Abilify), risperidone (Risperdal), clozapine
(Clozaril), olanzapine (Zyprexa), quetiapine (Seroquel)
thiothixene (Navane).
Drugs
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Navane
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Pronounced: NA-vain
Generic name: Thiothixene Navane is used in the
treatment of schizophrenia (a disruption of thought and
the understanding of reality). Researchers theorize that
antipsychotic medications such as Navane work by
lowering levels of dopamine, a neurotransmitter (or
chemical messenger) in the brain. Excessive levels of
dopamine are believed to be related to psychotic
behavior.
Drugs
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Clozaril
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Pronounced: KLOH-zah-ril
Generic name: Clozapine Clozaril is given to
help people with severe schizophrenia who have
failed to respond to standard treatments. It is
also used to help reduce the risk of suicidal
behavior in people with schizophrenia. Clozaril is
not a cure, but it can help some people return to
more normal lives.
Drugs
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Abilify
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Pronounced: a-BILL-i-fie
Generic name: Aripiprazole Abilify is used in the
treatment of schizophrenia, the psychological
disorder that causes its victims to lose touch with
reality, often triggering hallucinations, delusions
(false beliefs), and disorganized thinking. The
drug is thought to work by modifying sensitivity
to two of the brain's chief chemical messengers,
serotonin and dopamine.
Drugs
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Risperdal
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Pronounced: RIS-per-dal
Generic name: Risperidone
Other brand name: Risperdal M-Tab Risperdal is
prescribed for the treatment of schizophrenia, a
severe mental disorder that can cause delusions
(false beliefs) and hallucinations.
Drugs
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Seroquel
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Pronounced: SER-oh-kwell
Generic name: Quetiapine fumarate Seroquel is
prescribed for the treatment of schizophrenia, a
mental disorder marked by delusions (false
beliefs), hallucinations, disrupted thinking, and
loss of contact with reality.
Drugs Side Effects
 As
with all medications, antipsychotic
medications have side effects. Some, such
as dry mouth, dizziness, drowsiness and
constipation, go away with time. Other
side effects include restlessness, tremor
and muscle spasms, cramping or stiffness.
An irreversible side effect is tardive
dyskinesia, which causes abnormal
movements in the mouth, face and later in
the arms and legs.
Drugs Side Effects
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The two classes of antipsychotics are generally thought
equally effective for the treatment of the positive
symptoms. Some researchers have suggested that the
atypicals offer additional benefit for the negative
symptoms and cognitive deficits associated with
schizophrenia, although the clinical significance of these
effects has yet to be established. Recent reviews have
refuted the claim that atypical antipsychotics have fewer
extrapyramidal side effects than typical antipsychotics,
especially when the latter are used in low doses or when
low potency antipsychotics are chosen.
Drugs Side Effects
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Many of these side effects can be helped or avoided
when reported to the psychiatrist. It is important not to
abruptly stop taking the medications, increase the
medications or take additional medications without
consulting a doctor. Such changes can cause relapse or
other serious problems.
Medication is usually prescribed through the remission
phase of the illness to prevent relapse. Though relapse
may occur even when medication is taken as prescribed,
taking the medication provides the best protection from
future relapse.
References
American Psychiatric Association. (2000). Diagnostic
and
th
statistical manual of mental disorders (4 ed.,
text revision).
Washington, DC: American Psychiatric Association.
 Dr. Davis (lecture)
 BehaveNet.com. (2008) Retrieved March 12, 2008 from
http://www.behavenet.com/
 HealthSquare.com
 Wikipedia.com
 Utube.com
 PANSS Training DVD, Volume I:
Harvey, Barbara, and Dennis
2004 by The PANSS Institute LLC & Philip R. Muskin,MD
Schizophrenia.com. (2007) Retrieved March 13, 2008 from
http://www.spizophrenia.com/
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