Schizophrenia

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Schizophrenia

• Diagnosis and Treatment

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Brain Differences (Video)
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Clinical Symptoms

• Positive Symptoms
• Hallucinations
• Delusions
• Video
• Loose associations
• Neologisms

• Negative Symptoms
• Flat affect
• Apathy
• Mood changes
• Withdrawal
• Ambivalence/Self Care
• Cognitive impairments
• Video

Disorganized Symptoms
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Diagnosis

• No diagnostic test.
• Clinical interview crucial.
• What are DSM-IV criteria for dx?

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Case Study
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Differential Diagnosis

• Prodromal issues
• Rule out other possibilities
• Mania in active phase?
• Depression with psychotic features?
• Drug induced?
• Extreme OCD?
• PTSD?
• Video Early Warning Signs

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Development of Schizophrenia

• Risk Factors
• Early neurodevelopment
• Onset of illness
• Disrupted brain regions active later
• Hormonal contribution
• Disruption of Neural Circuits
• PFC, Thalamus, Temporal

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Disrupted Neural Circuits

• PFC-Thalamus-Cerebellum
• DLPFC-Medial Temporal

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Outcome

• Symptom reduction varies.
• Social and occupational impairments persist.
• Suicide Rate

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Neurocognitive Deficits Functional Outcome

• Deficits
• Executive Functioning
• Vigilance (reduction in resources)
• Memory (loss of context)
• Social Cognition
• Functional Outcome
• Verbal memory closely related

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Interventions Medication

• Typical antipsychotics
• Haloperidol, Stelazine, Thorazine, Prolixin
• Side Effects akathisia, akinesia, tremor
• Dopamine Sertonin Receptor Antagonists
• Clozapine, Respiridol, Zyprexa, Seroquel, Geodon
• Works on - symptoms
• Serious side effect - agranulocytosis
• Importance of Early Treatment
• Medications and Compliance
• Video The Brain, Schizophrenia Meds

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Typical Neuroleptics
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Atypical Neuroleptics
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Important Interventions for Mental Health
Providers

• Family Education
• Medication Management Support/Groups Safety
  Structure Disease Management
• Cognitive-Behavioral therapy
• Parameters
• Vocational and Self-care skills
• Managing the issues
• Social-skills training
• Developing appropriate boundaries VIDEO Social
  Support
• Cognitive remediation
• Repetitive simple tasks

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Information on Schizophrenia

• Schizophrenia in Children Link
• Paranoid Schizophrenia Link
• Impact on Society Video
• Why the Stigma of Schizophrenia Video
• Cognitive Behavior Therapy Link