What is Schizophrenia

1
What is Schizophrenia?

• A chronic, severe, and disabling mental disorder
  that is marked by at least a single episode of
  psychotic () symptoms lasting at least 2 weeks
  and other (-) symptoms lasting at least 6 months
  (criteria, p. 312)

2
Not a single illness but a group of Disorders (p.
298)

• Schizophrenia
• Schizophreniform (shorter duration of symptomatic
  presentation)
• Schizoaffective (mood episode w/active symptoms)
• Delusional (1 mo. Nonbizarre delusions w/o active
  phase symptoms

3
Positive Symptoms

• Delusions (bizarre personal beliefs not based in
  reality)
• -not subject to reason or
• contradictory evidence
• -not explained by usual
• cultural concepts
• -Different themes
• -paranoia/conspiracy
• -grandeur

4
symptoms (cont.)

• Hallucinations
• -perceptions that occur w/o
• connection to an appropriate
• source
• -auditory (most common)
• -visual
• -tactile (touch)
• -gustatory (taste)
• -olfactory (smell)

5
(cont.)

• Disorganized Thinking
• -Tangential
• -circumstantial speech
• -Loose Association
• -lack of continuity of
• thought

6
Negative Symptoms

• Social withdrawal/isolation
• Extreme apathy
• Diminished motivation
• Blunted emotional expression

7
Subtypes

• Paranoid Typepreoccupation with one or more
  delusions or frequent auditory hallucinations
• Disorganized TypeProminent disorganized speech,
  behavior, flat or inappropriate affect (not
  catatonic)
• Catatonic Type (p. 316)
• Undifferentiated (p. 316)
• Residual Type (p. 316-317)

8
Exclusions

• Rule out Mood Disorders/Schizoaffective
• Rule out Due to Substance Abuse
• Rule out Due to Medical Condition

9
Common Misconceptions

• Split/multiple personality (Dr. Jekyll/Mr. Hyde)
• Always abnormal
• -can appear completely
• normal and perfectly
• reasonable
• -with proper Tx more than 50
• percent can function in society
• Likelihood of violence
• Intelligence Impairment

10
Origins

• Inherited
• Brain Biochemical Abnormalities
• Environmental Influences

11
Prevalence

• General Populationapprox. 1
• 10 Chance if one parent has schizophrenia
• 40-50 chance of monozygotic (identical) twin if
  one has schizophrenia

12
Course

• Onset for men is usually earlier than women,
  occurring in late adolescence thru early
  adulthood
• Onset for women is usually in late 20s to early
  30s.
• Though rare, earlier onset can occur.

13
Other Complications

• Substance abuse is common
• -Etoh
• -Nicotine most common (25-
• 30 gen. Population, 3x as
• high w/schizophrenia)
• Stimulants can cause major problems
• Interference w/anti-psychotic meds.

14
Treatment

• Anti-psychotics
• -1st introduced in 1950s
• Neuroleptics
• (Haldol, Thorazine)
• -More recently Zyprexa,
• Seroquel, and Risperdal
• -some cases may require the
• addition of an anti-depressant for
• severe negative symptoms

15
Tx (cont.)

• Psychosocial Tx
• -the anti-psychotics relieve
• positive symptoms but
• therapy, psychoeducational,
• socialization, and vocational
• adjunct therapy is needed as
• well for negative symptoms