Lecture Outline

1
Lecture Outline

• Symptoms of Schizophrenia
• Subtypes of Schizophrenia (4)
• Course, Prevalence
• Causes
• Genetic, Nongenetic, Social/Cultural
• Treatment
• Deinstitutionalization
• Medication, Psychological

2
Symptoms of Schizophrenia

• Delusions
• - unsubstantiated ideas and opinions contrary to
  a persons background and not held by members of
  the persons cultural or ethnic group
• - false beliefs, crazy ideas
• - Includes paranoid, persecution, grandiose,
  thought withdrawal or insertion, and mind reading
• Hallucinations
• - perceptions that are not based in reality
• - may be auditory, visual, olfactory,
  tactile, or
• gustatory
• - Auditory hallucinations most common
  (hearing voices conversing or commenting
  on behavior)

3
Symptoms of Schizophrenia

• Disorganized speech (Formal Thought Disorder)
• - Derailments
• - Neologisms
• - Tangential response
• - Word salad (incoherence)
• Grossly disorganized or catatonic behavior
• Negative symptoms (absence of normal )
• -Flat affect
• - Limited speech
• - Lethargy

4
DSM-IV Diagnostic Criteria for Schizophrenia

• - 2 of the previous symptoms
• - Social/occupational dysfunction
• - Presence of disturbed behavior for at least 6
  months, including at least 1 month of active
  symptoms
• - Exclusion of other conditions
• schizoaffective and mood disorder
• substance abuse or medical condition
• pervasive developmental disorder

5
Subtypes of Schizophrenia

• Paranoid
• Catatonic
• Disorganized
• Undifferentiated
• Residual

6
The Course of Schizophrenia

• Prodomal phase
• symptoms have not yet appeared but personality
  changes are often noticed by others
• marked by deterioration from higher level of
  functioning
• Active phase
• symptoms such as hallucinations and delusions
  present
• Residual phase
• symptoms may be episodic or continuous

7
How Common Is Schizophrenia?

• The prevalence of schizophrenia is about 1
• Occurs equally commonly in males and females
• Typical age of onset is
• 1425 years for men
• 2435 years for women
• Men spend more time hospitalized than women

8
Causes of Schizophrenia Genetic Factors

• Family studies -probability of developing
  schizophrenia
• Twin/adoption studies - distinguish between
  genetic and environmental factors
• Attentional dysfunction and eye-tracking
  abnormalities - two potential markers for
  schizophrenia
• Schizophrenia the result of several interacting
  genes, not a single gene

9
Etiology of Schizophrenia Nongenetic Risk Factors

• Viral infection
• Life-stress
• Demographic and socioeconomic status
• Communication and expressed emotion
• Brain structure and function
• Brain chemistry

10
Cultural and Social Factors in Schizophrenia

• Schizophrenia is more common among
• people raised in large cities
• new immigrants
• divorced and single people
• those with lower socioeconomic status
• social drift theory
• social stress theory
• differences in access to medical care

11
Past Approaches to Treatment

• Hospitals - house patients and provide milieu
  treatment
• Deinstitutionalization
• failed to provide community-based treatment
• many patients have become homeless and untreated

12
Current Treatments

• Medication treatments
• neuroleptic drugs
• Psychological treatment
• reduction of expressed emotion
• token economies
• social skills and cognitive training