 Characterized by: confused & disordered thoughts & perceptions  Most debilitating of the mental dis

1. Schizophrenia  Characterized by: confused & disordered thoughts & perceptions  Most debilitating of the mental disorders  Deterioration of adaptive behavior

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

4. Positive vs. Negative Sx POSITIVESYMPTOMS • Presence of something abnormal • Examples: DELUSIONS, HALLUCINATIONS, DISORGANIZED SPEECH, ODD BODY MVMTS, CATATONIA NEGATIVESYMPTOMS • Absence of something normal • Examples: AVOLITION, ALOGIA, ANHEDONIA, FLAT AFFECT

5. POSITIVE SYMPTOMS • DELUSIONS • HALLUCINATIONS • DISORGANIZED SPEECH • ODD BODY MOVEMENTS • CATATONIA

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

7. Of these positive symptoms delusions, in particular, can be broken down into smaller subsets: Persecutory delusions – False beliefs that one’s self or one’s loved ones are being persecuted, watched, or conspired against by others. Delusions of being controlled – Belief that one’s thoughts, feelings, or behaviors are being imposed or controlled by some external force Thought broadcasting – Belief that one’s thoughts are being broadcast from one’s mind for others to hear Thought insertion – Belief that another person or object is inserting thoughts into one’s head

8. Of these positive symptoms delusions, in particular, can be broken down into smaller subsets: Thought withdrawal – Belief that thoughts are being removed from one’s 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 one’s appearance or part of one’s 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

9. Colleen D. Gjefle

10. NEGATIVESYMPTOMS • AVOLITION: “No Initiative” • ALOGIA: “Speech is Vacant” • ANHEDONIA: “No Pleasure” • FLAT AFFECT: “The Mask” • ASOCIALITY: “No Social Interest”

11. SUBTYPES • Paranoid • Disorganized 3. Catatonic 4. Undifferentiated 5. Residual

12. Paranoid • Delusions & Hallucinations • Intact Cognition and Affect • No Disorganized Speech • Best Prognosis

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

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

15. Undifferentiated • Beginnings of Breakdown • Major symptoms of Schizophrenia • Do NOT meet other criteria • “Waste Basket” philosophy

16. Residual • Have had one episode • Now mostly symptom-free • >Q: Once a schizophrenic always a schizophrenic?

17. CAUSES

18. Causes of Schizophrenia • Genetic Predisposition • Twin study evidence • Neurotransmitters • Dopamine hypothesis • Brain Structure & Function • Family & Interactions • Double-bind theory • Schizophrenogenic mother

26. TREATMENT/THERAPIES

30. MAPPING THE BRAIN

33. 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.

36. MORE CHARTS

38. 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

39. FACTS & FIGURES

40. 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)

41. Where are the People with Schizophrenia? …Approximately: 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).

42. 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