1 / 25

Schizophrenia

Schizophrenia. Nature of Schizophrenia and Psychosis : overview. Schizophrenia vs. Psychosis: Psychosis is a broad term (e.g. hallucination, delusions) Schizophrenia is a type of psychosis Psychosis and schizophrenia are heterogeneous Disturbed thoughts, emotions, behavior.

faris
Download Presentation

Schizophrenia

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Schizophrenia

  2. Nature of Schizophrenia and Psychosis : overview Schizophrenia vs. Psychosis: • Psychosis is a broad term (e.g. hallucination, delusions) • Schizophrenia is a type of psychosis • Psychosis and schizophrenia are heterogeneous • Disturbed thoughts, emotions, behavior

  3. Early Figures in The History of Schizophrenia John Haslam (1764 – 1844) • Superintendent of a British hospital • In “observation on madness and melancholy” He outlined a description of the symptoms.

  4. Psychosis • Involves a “loss of touch” with reality. • Unable to determine what is real and what is not. • Perceptions fail to “map on” to reality. • Schizophrenia is a psychotic illness. • One can be said to be suffering from psychosis, and this could mean that they have schizophrenia.

  5. General Diagnostic Considerations • At least one month of acute symptoms of: • Delusions • Hallucinations • Disorganized thought and speech • Disorganized behavior • Negative symptoms • Some symptoms must be present for at least 6 months.

  6. Prevalence • Worldwide (lifetime) : 0.2% to 1.5% • The disorder will affect about 1% of the general population in some time.

  7. Group 1: one episode only – no impairment, 22% . • Group 2: several episodes with minimal or no impairment, 35%. • Group 3: impairment after the first episode with subsequent exacerbation an no return to normality, 8%. • Group 4: impairment increasing with each of several episodes and no return to normal, 35%.

  8. Symptoms • Positive/type 1: exaggerations of normal phenomenon • Hallucinations (auditory/ visual) • Delusions • Disorganized thoughts and speech • Disorganized / Catatonic behavior

  9. Delusions Ideas that are believed to be true. • Persecutory • “I am being followed by MOI” • Delusion of reference • “secret messages about me are broadcaster On TV” • Delusions of being controlled • Thought broadcasting “my thoughts are being played on the radio” • Thought insertion “my father is transmitting terrible thoughts into my brain.”

  10. Delusions • Thought withdrawal • “when I study, my thoughts are being stolen by people around me” • Delusion of guilt or sin • “I am a murderer” • Somatic delusions • “I have a demon growing inside of my stomach”

  11. Hallucinations • Unreal sensory/ perceptual experiences • Verbal/ visual • Not just a psychotic experience • Delusion of auditory hallucinations : • Hearing voices, music, etc…. • Most common type • Voices maybe accusatory • May ask to harm selves or others • People with schizophrenia may talk back to the voices • Auditory hallucinations are experiences by 60% of people with schizophrenia

  12. Hallucinations • Visual hallucinations : • Seeing a friend’s face “melting away” • Tactile hallucination • “bugs are crawling on my body” • Somatic hallucinations • “bugs are crawling under my skin”

  13. Disorganized Thought and Speech • Sometimes called formal thought disorder • Tendency to move from one topic to another • Loosing of association • The person may see connections, but they are not apparent to observers • Tendency to answer questions with unrelated information • Incoherent speech: “word salad”

  14. Disorganized / Catatonic Behavior • Behavior can be unpredictable • Agitated • Shouting, swearing, etc…. • Self care is often compromised. • Catatonia: an extreme lack of responsiveness to the outside world. • Excessive behavior • Lack of behavior

  15. Negative/ Type II Symptoms • Involves losses or deficts in certain domains • Not as note worthy as positive symptoms • When people think about schizophrenia, negative symptoms are often not considered • However negative symptoms are very common in schizophrenia

  16. Affective flattening: a severe reduction emotional responses to the environment. • Facial features remain unchanged • Reactions seem very understated • Alogia: poverty of speech; reduction in speaking • Very brief, empty replies • Avolition: an inability to persist at common goal directed activities.

  17. Other symptoms: • Inappropriate affect • Anhedonia: a pervasive loss of interest in all activities in life • Impaired social skills

  18. Biological Theories • Genetics • Family, twin, adoption studies suggest a genetic component. • Probably a cluster of genes • Structural brain abnormalities • Enlarged ventricles • Fluid-filled spaces in the brain • Ventricle enlargement could be related to the deterioration of other brain areas • Prefrontal cortex seems to be smaller and shows less activity • Smaller prefrontal cortex found in people at risk for schizophrenia

  19. Biological Theories • Birth complications • Prenatal and birth complications more common in people with schizophrenia. • 30% of people with schizophrenia have a history of hypoxia • Prospective studies indicates that the risk of schizophrenia increase with degree of hypoxia • Majority do not develop schizophrenia • Genetic predisposition might be required

  20. Biological Theories • Prenatal viral exposure • High rates of schizophrenia among persons who’s mothers were exposed to influenza virus while pregnant • Especially during second trimester

  21. Biological Theories • Dopamine hypothesis of schizophrenia • Substance that decrease DA levels, also decreases symptoms of schizophrenia • Reserpine affects vesicles- reduces schizophrenia • Substances that block access to DA receptors effective in schizophrenia • High correlation between blocking and effective treatment • Compounds that increase DA formation (L-Dopa) worsen. • This, amphetamine and cocaine can lead to psychotic behaviors.

  22. Biological Theories • Neurotransmitters • Thought that too much dopamine leads to schizophrenia • Later dopamine theories • Increases DA activity in mesolimbic pathway account for positive symptoms • Decreased DA activity in prefrontal cortex account for negative symptoms

  23. Psychosocial Perspectives • Social drift/ urban birth • Schizophrenia makes it more difficult to obtain an education/ good job (people drift downward in social status) • People with schizophrenia more likely to be born in large urban/ metropolitan area • Possibly related to stress • Overcrowding, exposure to toxins

  24. Psychosocial Perspectives Stress and relapse Expressed emotion • Not very good evidence that EE causes schizophrenia but • It does seem to lead to more frequent relapse • Very difficult to ascertain “what is causing what?”

  25.  Good Luck To You All 

More Related