Schizophrenia overview
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Transcript Schizophrenia overview
What is Schizophrenia?
Comes from Greek meaning “split” and “mind”
‘split’ refers to loss of touch with reality
not dissociative state
not ‘split personality’
Equally common among men and women but men
have earlier onset
18 to 25 for men
26 to 45 for women
Sample videos
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Symptoms of Schizophrenia
Positive symptoms:
hallucinations
Delusions
Disordered thinking and speech
Heightened or distorted perceptions
Inappropriate affect
Negative symptoms
absence of normal cognition or affect (e.g., flat
affect, poverty of speech, social withdrawal, loss of
motivation)
Psychomotor Symptoms
Awkward movement, grimaces, posturing, gestures
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Examples from “Rose Garden”
Positive symptoms:
Hallucinations
in Yr a voice shrieked out of the deep Pit: Innocent!
Innocent!
after a while the smell of people in the heavy ether-andchloroform stench of the Pit made her think that she
should try to see them.
Delusions – the construction of Yr & Midworld, her Yr name
(Januce), her Yr name for Dr. Fried, others?
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Examples from “Rose Garden”
Disordered thinking/loose associations
Deborah sat down, while the Censor said in Yri: Listen
Bird-one … The tables have no defense against your
clumsiness. ‘Do you know why you are here?’ the doctor
asked. ‘Clumsiness. Clumsiness is first and then we have
a list: lazy, wayward, headstrong, self-centered, fat, ugly,
mean, tactless, and cruel …
Deborah looked at the Nose. “Obstacle,” she said.
Disordered perceptions
Deborah had looked about and found that she could not
see except in outlines, gray against gray, and with no
depth, but flatly, like a picture.
She could only see in gray now, and she could barely
hear. Her sense of touch was also leaving …
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Examples from “Rose Garden”
Psychomotor Symptoms - Catatonic
that day and the next she spent on Yr’s plains, simple long
sweeps of land where the eye was soothed by the depth of
space.
A few days later, Deborah returned to the Midworld looking
down on Earth.
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DSM-IV Criteria
Criteria A – Two or during “significant portion of the
time” during a 1-month period:
Delusions
Hallucinations
Disorganized speech
Disorganized/catatonic behavior
Negative symptoms
B - Social/occupational dysfunction
C - Continuous disturbance for at least 6 months
D - Not Schizoaffective or Mood disorder
E - Not due to substance use/medical condition
F - Can have a co-occuring pervasive developmental
disorder if hallucinations/delusions > 1 month
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Symptoms of Schizophrenia
Delusions of persecution
‘they’re out to get me’
paranoia
Delusions of grandeur
Delusions of being controlled
the CIA is controlling my brain with a radio
signal
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Symptoms of Schizophrenia
Hallucinations
hearing or seeing things that aren’t there
contributes to delusions
command hallucinations: voices giving orders
Disorganized speech
overinclusion - jumping from idea to idea without the
benefit of logical association
paralogic - on the surface, seems logical, but seriously
flawed
e.g., Jesus was a man with a beard, I am a man with a
beard, therefore I am Jesus
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Symptoms of Schizophrenia
Disorganized behavior and affect
behavior is inappropriate for the situation
e.g., wearing sweaters and overcoats on hot days
Affect(emotion) is inappropriately
expressed
flat affect - no emotion at all in face or speech
inappropriate affect - laughing at very serious things,
crying at funny things
catatonic behavior
unresponsiveness to environment, usually marked by
immobility for extended periods
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DSM-IV Criteria
5 subtypes:
Disorganized –confusion, incoherence, and flat or
inappropriate affect
Catatonic –psychomotor disturbance of some sort
Paranoid –an organized system of delusions and
auditory hallucinations
Undifferentiated –symptoms cross subtypes
Residual – symptoms have lessened in strength and
number
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Subtypes of Schizophrenia
Paranoid type
delusions of persecution
believes others are spying and plotting
delusions of grandeur
believes others are jealous, inferior, subservient
Catatonic type - unresponsive to
surroundings, purposeless movement, parrotlike speech
Disorganized type
delusions and hallucinations with little meaning
disorganized speech, behavior, and flat affect
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Other Psychotic Disorders
Schizophreniform Disorder – Criteria A, D, E
from Schizophrenia met
Lasts between 1 and 6 months
Schizoaffective Disorder
Major Depressive, Manic, or Mixed episode at the
same time Criteria A from Schizophrenia met
At least 2 weeks with hallucinations/delusions
without significant mood symptoms
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Other Psychotic Disorders
Delusional Disorder – “Non Bizarre” Delusions
lasting at least 1 month
Erotomanic, Grandiose, Jealous, Persecutory,
Somatic Types
Schizophrenia criteria A never met
Aside from delusions, functioning not impaired
Brief Psychotic Disorder - Lasts between 1
day and 1 month
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Schizophrenia and Genetics
Sz risk increases with genetic similarity
50
Lifetime risk
of developing
schizophrenia
for relatives of
a schizophrenic
40
30
20
10
0
0
General Siblings Children Fraternal Children Identical
population
of two
twin
twin
schizophrenia
victims 14
Cultural Differences in
Schizophrenia
Prevalence of Sz symptoms is similar no
matter what the culture (1-2%)
Less industrialized countries have better
rates of recovery than industrialized
countries
families tend to be more accepting and less critical
of the Sz patients (humanistic)
less use of antipsychotic medications, which may
impair full recovery
think of Sz as transient, rather than chronic and
lasting disorder: see it as a temporary
exaggeration of normal feelings
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