introduction. a biological disorder of the brain which causes disturbances in thinking speech,...

SchizophreniaIntroduction

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

Schizophrenia – What is it?

• 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• These symptoms leave them fearful and withdrawn.

Schizophrenia – What is it?

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.

Schizophrenia – What is it?

1. Paranoid Schizophrenia

2. Disorganized Schizophrenia

3. Catatonic Schizophrenia

4. Undifferentiated Schizophrenia

5. Residual Schizophrenia

Types of Schizophrenia

• Delusions of being prosecuted by

others

• Delusions of grandeur where they are

enormously important

• Suspicious, anxiety and anger

• Hallucinations may also be present

Paranoid Schizophrenia

• Confusion and Incoherence

• Severe deterioration of adaptive behavior

– Lack of social skills

– Poor personal hygiene & self care

• Behavior appears silly and/or child-like

• Highly in appropriate emotional responses

Disorganized Schizophrenia

• 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

Catatonic Schizophrenia

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.

Undifferentiated Schizophrenia

Less common subtype Characterized by extended periods without

prominent positive symptoms, but other symptoms continue

Residual Schizophrenia

SchizophreniaSymptoms

1. Positive

2. Negative

3. Cognitive

4. Affective

Main Classes of Symptoms

Positive “Psychotic” Symptoms

Characterized by the presence of odd or unusual feelings, thoughts, and behaviors

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

Positive and Negative

Cognitive Pertain to thinking

processes MATRICS

◦Measurement And Treatment Research to Improve Cognition in Schizophrenia

Affective Influenced by and

resulting from emotion

Cognitive and Affective Symptoms

SchizophreniaRisk Factors

• 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)

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.

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.

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 low- income 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.

SchizophreniaDiagnosing

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

Diagnosing schizophrenia

Delusions

Paranoid delusions

Delusions of reference

Somatic delusions

Delusions of Grandeur

Diagnostic criteria

Hallucinations◦ Auditory◦ Gustatory◦ Olfactory◦ Somatic/Tactile◦ Visual◦ Mood Congruent◦ Mood Incongruent

Diagnostic Criteria (continued)

Lab tests◦ blood count◦ blood tests◦ screening for alcohol & drugs

Imaging studies◦ Magnetic Resonance Imaging (MRIs)◦ CT Scan◦ PET scan

MRI

PET Scan

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

Schizophrenia Treatment

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.

Treating Schizophrenia

Conventional Antipsychotics Atypical Antipsychotics

Introduced in the 1950’s

Help relieve Positive Symptoms

Introduced in the 1990’s

Equally effective in relieving positive symptoms.

Better at relieving negative symptoms

Conventional Antipsychotics ◦ Chlorpromazine◦ Fluphenazine◦ Haloperidol◦ Thiothixene◦ Trifluperazine◦ Perphenazine◦ Thioridazine

Atypical Antipsychotics◦ Risperidone◦ Clozapine◦ Olanzapine◦ Quetiapine◦ Ziprasidone

Types of medication

Recovery Support and Relapse Prevention Family to Family education programs Vocational rehabilitation and supported

employment Individual therapy Hospitalization

Other types of Treatments