mental health & public policy symposium schizophrenia: a brain disease alex kopelowicz, m.d....
TRANSCRIPT
Mental Health & Public Policy Mental Health & Public Policy SymposiumSymposium
SCHIZOPHRENIA:
A BRAIN DISEASE
Alex Kopelowicz, M.D.
UCLA School of Medicine
San Fernando Mental Health Center
SCHIZOPHRENIAS ARE:SCHIZOPHRENIAS ARE:
• A group of biological disorders . . .
• That produce handicaps in thinking, learning and social relationships ...
• For which no cure is known . . .
• But new treatments promote improved quality of life.
SCHIZOPHRENIAS ARE NOTSCHIZOPHRENIAS ARE NOT
• All psychoses
• Split personality
• Contagious
• Anyone’s fault
• Hopeless
SYMPTOM CLUSTERSSYMPTOM CLUSTERSPOSITIVEPOSITIVE NEGATIVENEGATIVEHallucinationsHallucinations Few feelingsFew feelings
DelusionsDelusions Loss of motivationLoss of motivation
IMPAIRMENTSIMPAIRMENTS workwork relationshipsrelationships self-careself-care
COGNITIVECOGNITIVE MOODMOODMemoryMemory Depression DepressionProblem-solvingProblem-solving Hopelessness Hopelessness
SCHIZOPHRENIA ALTERSSCHIZOPHRENIA ALTERSBRAIN FUNCTIONINGBRAIN FUNCTIONING
FRONTAL LOBES GOVERNFRONTAL LOBES GOVERN
• Drive and Ambition
• Problem solving
• Cognitive flexibility
• Capacity to plan
• Time sequential thinking
• Social awareness
• Empathy
• Mood
• Insight
• Impulsivity
• Judgment
• Abstraction
• Working memory
MISSING FRONTAL LOBESMISSING FRONTAL LOBES
REDUCED FRONTALREDUCED FRONTALLOBE ACTIVITYLOBE ACTIVITY
Normal Schizophrenia
BRAIN FAILS TO ACTIVATEBRAIN FAILS TO ACTIVATETO DO TASKTO DO TASK
TEMPORAL LOBE FUNCTIONSTEMPORAL LOBE FUNCTIONS
PerceptionPerception
Reality OrientationReality Orientation
MemoryMemory
REDUCED TEMPORALREDUCED TEMPORALLOBE STRUCTURESLOBE STRUCTURES
BASAL GANGLIA FUNCTIONSBASAL GANGLIA FUNCTIONS
• Inhibit unwanted sensory input
• Filter out irrelevant sensory input
• Regulate arousal
• Govern concentration
REDUCED BASAL REDUCED BASAL GANGLIA ACTIVITYGANGLIA ACTIVITY
VARIATION IN BASAL VARIATION IN BASAL GANGLIA ACTIVITYGANGLIA ACTIVITY
LIMBIC SYSTEM FUNCTIONSLIMBIC SYSTEM FUNCTIONS
• Understanding emotional events
• Linking current perception to
past memories
• Learning from experience
REDUCED LIMBICREDUCED LIMBICSYSTEM STRUCTURESSYSTEM STRUCTURES
TANGLED CELLS INTANGLED CELLS INLIMBIC SYSTEMLIMBIC SYSTEM
GENETIC RISK OF GENETIC RISK OF SCHIZOPHRENIASCHIZOPHRENIA
If you have aIf you have a Your chance of gettingYour chance of getting
Schizophrenic. . .Schizophrenic. . . schizophrenia is ... schizophrenia is ...
Identical twinIdentical twin 46% 46%
Both parentsBoth parents 48%48%
Sibling or ParentSibling or Parent 12%12%
Aunt, Nephew, GrandparentAunt, Nephew, Grandparent 5% 5%
First cousin, great auntFirst cousin, great aunt 2% 2%
No relativesNo relatives 1% 1%
ANTIPSYCHOTIC ANTIPSYCHOTIC MEDICATIONS REDUCEMEDICATIONS REDUCE
Hallucinations and delusionsHallucinations and delusions Negative symptomsNegative symptoms Bizarre behaviorBizarre behavior AgitationAgitation Hostility and aggressionHostility and aggression Disordered thinkingDisordered thinking
MEDICATION RESTORES MEDICATION RESTORES BRAIN FUNCTIONINGBRAIN FUNCTIONING
ANTIPSYCHOTIC ANTIPSYCHOTIC MEDICATIONMEDICATION
Reduces relapse ratesReduces relapse rates
Reduces brain dysfunctionReduces brain dysfunction
Improved medications availableImproved medications available
Unique and individual responseUnique and individual response
First step to recoveryFirst step to recovery
STRATEGY OF TREATMENTSTRATEGY OF TREATMENT
Control symptoms with medicationControl symptoms with medication
Form a personal relationship Form a personal relationship
Teach disease management skillsTeach disease management skills
Teach compensatory techniquesTeach compensatory techniques
Help maximize unique potentialHelp maximize unique potential