Schizophrenia

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Schizophrenia
? Characterized by confused disordered
thoughts perceptions ? Most debilitating of
the mental disorders ? Deterioration of adaptive
behavior
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Schizophreniasymptoms

• Bizarre behaviors (catatonia, others)
• Affect (inappropriate, flat)
• Delusions
• Speech (disorganized, incoherent)
• Hallucinations
• Inability to care for self or function
• Negative symptoms

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Positive vs. Negative Sx

• POSITIVE SYMPTOMS
• Presence of something abnormal
• Examples DELUSIONS, HALLUCINATIONS,
  DISORGANIZED SPEECH, ODD BODY MVMTS, CATATONIA
• NEGATIVE SYMPTOMS
• Absence of something normal
• Examples AVOLITION, ALOGIA, ANHEDONIA,
  FLAT AFFECT

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POSITIVE SYMPTOMS

• DELUSIONS
• HALLUCINATIONS
• DISORGANIZED SPEECH
• ODD BODY MOVEMENTS
• CATATONIA

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POSITIVE SYMPTOMS

• DELUSIONS
• False beliefs maintained in the face of contrary
  evidence
• Types Grandeur Identity
• Persecution Reference
• Control
• HALLUCINATIONS
• Sensations in the absence of external stimuli
• Types visual, auditory, tactile, olfactory,
  gustatory

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Of these positive symptoms delusions, in
particular, can be broken down into smaller
subsets Persecutory delusions False beliefs
that ones self or ones loved ones are being
persecuted, watched, or conspired against by
others. Delusions of being controlled Belief
that ones thoughts, feelings, or behaviors are
being imposed or controlled by some external
force Thought broadcasting Belief that ones
thoughts are being broadcast from ones mind for
others to hear Thought insertion Belief that
another person or object is inserting thoughts
into ones head
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Of these positive symptoms delusions, in
particular, can be broken down into smaller
subsets Thought withdrawal Belief that
thoughts are being removed from ones head by
another person or object Delusions of guilt or
sin False belief that one has committed a
terrible act or is responsible for come terrible
event Somatic delusions False belief that ones
appearance or part of ones body is diseased or
altered Grandiose delusions False belief that
one has great power, knowledge, or talent or that
one is a famous and powerful person
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Colleen D. Gjefle
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• NEGATIVE SYMPTOMS
• AVOLITION No Initiative
• ALOGIA Speech is Vacant
• ANHEDONIA No Pleasure
• FLAT AFFECT The Mask
• ASOCIALITY No Social Interest

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SUBTYPES

1. Paranoid
   
2. Disorganized

3. Catatonic 4. Undifferentiated 5. Residual
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Paranoid

• Delusions Hallucinations
• Intact Cognition and Affect
• No Disorganized Speech
• Best Prognosis

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Disorganized

• Disorganized Speech
• Disorganized Behavior
• Flat or Inappropriate Affect
• Delusions Hallucinations Fragmented or
  lacking a theme
• Often Chronic

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Catatonic

• Disorganized Speech
• Disorganized Behavior
• Waxy Flexibility, Rigidity, Odd Mannerisms,
  Mimicry
• Flat or Inappropriate Affect
• Delusions Hallucinations
• Fragmented or lacking a theme
• Often Chronic

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Undifferentiated

• Beginnings of Breakdown
• Major symptoms of Schizophrenia
• Do NOT meet other criteria
• Waste Basket philosophy

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Residual

• Have had one episode
• Now mostly symptom-free
• gtQ Once a schizophrenic always a
  schizophrenic?

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CAUSES
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Causes of Schizophrenia

• Genetic Predisposition
• Twin study evidence
• Neurotransmitters
• Dopamine hypothesis
• Brain Structure Function
• Family Interactions
• Double-bind theory
• Schizophrenogenic mother

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TREATMENT/THERAPIES
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MAPPING THE BRAIN
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Map reveals the 3-dimensional profile of gray
matter loss in the brains of teenagers with
early-onset schizophrenia with a region of
greatest loss in the temporal and frontal brain
regions that control memory, hearing, motor
functions, and attention.
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MORE CHARTS
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• Approximate number of people in the United States
  suffering from
• Schizophrenia Over 2.2 million
• Multiple Sclerosis 400,000
• Insulin-dependent Diabetes 350,000
• Muscular Dystrophy 35,000

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FACTS FIGURES
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After 10 years, of the people diagnosed with
schizophrenia 25 Completely Recover 25
Much Improved, relatively independent 25
Improved, but require extensive support 15
Hospitalized, unimproved 10 Dead (Mostly
Suicide)
After 30 years, of the people diagnosed with
schizophrenia 25 Completely Recover 35
Much Improved, relatively independent 15
Improved, but require extensive support 10
Hospitalized, unimproved 15 Dead (Mostly
Suicide)
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Where are the People with Schizophrenia? Approxim
ately 6 are homeless or live in shelters 6
live in jails or prisons 5-6 live in
Hospitals 10 live in Nursing homes 25
live with a family member 28 are living
independently 20 live in Supervised Housing
(e.g. group homes, etc.) Approximately
200,000 individuals with schizophrenia or
manic-depressive illness are homeless,
constituting 1/3 of the approximately 600,000
homeless population (total homeless population
statistic based on data from Department of Health
and Human Services).
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The 45 percent who acknowledged that they needed
treatment (and thus had awareness of
their illness) but still were not receiving
treatment cited many reasons for this. These
included (respondent could check several
reasons) 32 "wanted to solve problem on own"
27 "thought the problem would get better by
itself" 20 "too expensive" 18 "unsure about
where to go for help" 17 "help probably would
not do any good" 16 "health insurance would not
cover treatment
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DISEASE FY 1999 NIH research expenditures Prevalence Individuals with this disease NIH research dollars per person affected
HIV (including AIDS) 1,792,700,000 800,000 2,240.88
Lung cancer 163,100,000 342,457 476.26
Cervical cancer 75,200,000 231,064 325.45
Multiple sclerosis 96,300,000 350,000 275.14
Breast cancer 474,700,000 2,197,504 216.02
Colorectal cancer 175,900,000 1,041,499 168.89
Parkinsons disease 132,300,000 1,000,000 132.30
Prostate cancer 177,500,000 1,637,208 108.42
Alzheimers disease 406,500,000 4,000,000 101.62
Schizophrenia 196,515,000 2,632,396 74.65
Bipolar disorder 57,805,000 2,227,412 25.95
Depression 199,600,000 10,732,076 18.60
Panic disorder 19,049,000 3,239,872 5.88
Obsessive-Compulsive disorder 12,693,000 4,859,808 2.61