Paranoid Schizophrenia

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Paranoid Schizophrenia

• The Schizies
• Becky Guiler, Misty Mahan,
• Renee Pittman, and Keima Thomas

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DSM-IV-TR Diagnostic CriteriaSchizophrenia

• 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)

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DSM-IV-TR Diagnostic CriteriaSchizophrenia

• (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).

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DSM-IV-TR Diagnostic CriteriaSchizophrenia

• 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.)

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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 30s.
• A majority of individuals with Schizophrenia
  have poor insight regarding the fact that they
  have a psychotic illness (DSM-IV-TR, 2000).

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DSM-IV-TR Diagnostic CriteriaParanoid
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.
• 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.

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DSM-IV-TR Diagnostic CriteriaParanoid
Schizophrenia (295.30)

• 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.

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Examples of Paranoid Schizophrenia

• Barbara
• Tetty Dee Dee ( Be prepared its kind of gross).
• Being a Schizophrenic

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There are many different medications to treat
Paranoid Schizophrenia
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Treatments for Paranoid Schizophrenia

• Like many other mental illnesses, schizophrenia
  is usually treated with a combination of
  therapies, tailored to the individuals 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.

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Types of Drugs

• 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).

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Drugs

• Navane
• 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.

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Drugs

• Clozaril
• 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.

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Drugs

• Abilify
• 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.

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Drugs

• Risperdal
• 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.

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Drugs

• Seroquel
• 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.

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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.

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Drugs Side Effects

• 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.

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Drugs Side Effects

• 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.

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References

• American Psychiatric Association. (2000).
  Diagnostic and statistical manual of mental
  disorders (4th 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/