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Schizophrenia

Schizophrenia. A beautiful mind. 1 st half of movie Interview with John Nash and his family. DSM-IV Criteria for Schizophrenia . Two or more core symptoms (next slide) Significant impairment in work, academic performance, interpersonal relationships, and/or self-care

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Schizophrenia

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  1. Schizophrenia

  2. A beautiful mind • 1st half of movie • Interview with John Nash and his family

  3. DSM-IV Criteria for Schizophrenia • Two or more core symptoms (next slide) • Significant impairment in work, academic performance, interpersonal relationships, and/or self-care • Continuous signs of the disturbance for at least 6 months

  4. Core Symptoms (Positive) • Delusions -- • Persecutory • Delusions of Reference • Grandiose Delusions • Delusions of Thought Insertion • Hallucinations • Disorganized Thought and Speech • Disorganized or Catatonic Behavior

  5. Core symptoms (negative) • 5. Negative Symptoms • Affective Flattening (or Blunted Affect) • Alogia: Severe reduction or complete absence of speech • Avolition: Inability to persist at common, goal-oriented tasks Video clips to demonstrate some of these symptoms

  6. Biological Aspects of Schizophrenia • OVERVIEW • Neuroanatomy -- brain changes / tissue loss • Genetics • Viral theories • Neurotransmitters

  7. Biological Aspects of Schizophrenia • Secret Life of the Brain (episode 3) • Loss of brain tissue (NYTimes video clip)

  8. Biological Aspects of Schizophrenia • Structural Brain Abnormalities (tissue loss – excessive pruning) • Parietal cortex deficits (sensory experience) • Frontal lobe deficits: Reduced volume and neuron density in frontal cortex cause cognitive and emotional deficits (perhaps especially negative symptoms) • Loss of myelin sheath?

  9. Biological Aspects of Schizophrenia, continued • Genetic Theories • Polygenetic influence • May be inheriting a general risk for psychosis • Epigenetics – environment + gene interaction (e.g., Finnish study of children adopted away at birth; Tienari et al., 2004): “Disordered” home environment increases risk

  10. Biological Aspects of Schizophrenia, continued • Birth Complications & Prenatal Viral Exposure • Podcast from “All in the mind” 11/2/07 on viruses and immune system (4’’ – 14.30’’) • Neurotransmitter Theories • Imbalances in levels of or receptors for dopamine cause symptoms; serotonin, GABA, and glutamate may also play roles

  11. Psychosocial Perspectives on Schizophrenia • Social drift • Stress and relapse

  12. Treatments for Schizophrenia • Biological Treatments: Antipsychotic drugs (next slide)

  13. The Treatment of Schizophrenia • Antipsychotics • Most are dopamine receptor antagonists • Older neuroleptics: Haldol & Thorazine • Newer (“atypical”): Clozaril, Seroquel, Risperdal, Zyprexa • Somewhat of Trial and Error approach

  14. Side Effects • Side Effects: Neuroleptics and Atypicals can cause • Sedation, weight gain • “Extrapyramidal” (Parkinsonian) side effects, like tremor, akinesia (e.g., shuffling of feet) • Tardive Dyskinesia (long-term, irreversible -- irregular/involuntary muscle movements) • Anticholinergic (dry mouth/eyes, blurred vision, etc.) • Orthostatic hypotension

  15. Treatments for Schizophrenia • Behavioral, Cognitive, and Social Interventions: Recognition of demoralizing attitudes they may have toward their illness, operant conditioning, modeling, family therapy, token economies, self-help groups, assertive community treatment programs.

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