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Schizophrenia

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Laurie Ganey

on 6 May 2013

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Transcript of Schizophrenia

Schizophrenia Laurie Ganey &
Andrea Fronsman Symptoms Types Diagnosis Treatment History Causes Prognosis Kraepelin first isolated schizophrenia from other forms of psychosis in 1887, but this is not to say that schizophrenia—or ‘dementia praecox’, as he called it—had not existed long before Kraepelin’s day.
The oldest available description of an illness closely resembling schizophrenia can be found in the Ebers papyrus, which dates back to the Egypt of 1550 BC.
Archaeological discoveries of Stone Age skulls with burr holes drilled into them (presumably to release ‘evil spirits’) have led to speculation that schizophrenia is as old as mankind itself. Sources Paranoid Schizophrenia These persons are very suspicious of others and often have grand schemes of persecution at the root of their behavior. Hallucinations, and more frequently delusions, are a prominent and common part of the illness.
people with this subtype may be more functional in their ability to work and engage in relationships than people with other subtypes of schizophrenia Disorganized Schizophrenia (Hebephrenic Schizophrenia) In this case the person is verbally incoherent and may have moods and emotions that are not appropriate to the situation.
Hallucinations are not usually present.
They may fail to show ordinary emotional responses in situations that evoke such responses in healthy people. Mental health professionals refer to this particular symptom as blunted or flat affect.
They may have significant impairment in their ability to communicate effectively. At times, their speech can become virtually incomprehensible, due to disorganized thinking. In this case, the person is extremely withdrawn, negative and isolated, and has marked psychomotor disturbances.
The predominant clinical features seen in the catatonic subtype involve disturbances in movement. Affected people may exhibit a dramatic reduction in activity, to the point that voluntary movement stops, as in catatonic stupor. Alternatively, activity can dramatically increase, a state known as catatonic excitement. Catatonic Schizophrenia Residual Schizophrenia This subtype is diagnosed when the patient no longer displays prominent symptoms. In such cases, the schizophrenic symptoms generally have lessened in severity.
Hallucinations, delusions or idiosyncratic behaviors may still be present, but their manifestations are significantly diminished in comparison to the acute phase of the illness. Schizoaffective Disorder? These people have symptoms of schizophrenia as well as mood disorder such as major depression, bipolar mania, or mixed mania.
Misdiagnosis is common! Undifferentiated Schizophrenia The symptoms of any one person can fluctuate at different points in time, resulting in uncertainty as to the correct subtype classification.
Other people will exhibit symptoms that are remarkably stable over time but still may not fit one of the typical subtype pictures. Genetic Factors Environmental Factors Brain Structure first-degree relatives have a risk that is 10X greater than general population
risk increases with degree of genetic relatedness to schizophrenic person
Most first-degree relatives (e.g. siblings, dizygotic (DZ) twins) share about 50% of their genes and show a risk of about 9%. Monozygotic (MZ) twins share 100% of their genes, and show risks near 50%.
for fraternal (DZ) twins, the concordance rate is about 6%
Genes that have been studied include the neuregulin-1 gene, the OLIG2 gene, and the COMT gene.
Heredity does not explain all cases of the disease. About 60% of people with schizophrenia have no close relatives with the illness. Positive Symptoms Negative Symptoms Delusions
Hallucinations
Disorganized Behavior
Disorganized Speech
Disturbed Movement Alogia (Lack of/Poorness of speech)
Affective Flattening (Lack of Emotions/Expression)
Avolition (Lack of motivation) Medication Typical antipsychotics (Thorazine, Haldol, Mellaril)
First discovered mid- 1950's (Thorazine)
Effective in treating positive symptoms
Side effects
drowsiness, involuntary muscle tremors, constipation, sexual dysfunction, weight gain
Tardive Dyskinesia
Atypical antipsychotics (Clozaril, Risperdal, Zyprexa)
Developed late- 1980's (Clozaril)
Similar effectiveness to typical antipsychotics
Side effects
Created in hopes of avoiding Tardive Dyskinesia
Clozaril and Agranulocytosis A. Characteristic Symptoms
B. Social/Occupational Dysfunction
C. Duration
D. Schizoaffective and Mood Disorder
exclusion
E. Substance/ general medical condition
exclusion
F. Relationship to a Pervasive Developmental
Disorder Therapy Through clinical interview, self-report on the part of the patient. Cognitive Behavioral Therapy
For Positive Symptoms:
Normalizing Psychotic Symptoms
Peripheral Questioning
Inference Chaining
For Negative Symptoms:
Activity Scheduling
Social Skills Training
Behavioral Self-Monitoring Dopamine Antagonists-- Block dopamine receptors Mortality
On average, die 15 years younger than
general population
Suicide
Suicide rate 13x that of general population
Quality of Life
Occupational difficulties
Poverty
Imprisonment
Homelessness Schizophrenia is associated with an unusual imbalance of neurotransmitters (chemical messengers between nerve cells) and other brain chemicals, such as dopamine overactivity, glutamate, reelin, and others.
Abnormalities in brain structure are also reflected in the disrupted connections between nerve cells that are observed in schizophrenia. Such miswiring could impair information processing and coordination of mental functions.
Strong evidence suggests that schizophrenia involves decreased communication between the left and right sides of the brain.
Enlarged brain ventricles
There is also evidence of abnormally low activity in the frontal lobe Although parental influence is no longer believed to play a major role in the development of schizophrenia, it would be irresponsible to ignore outside pressures and influences that may exacerbate or trigger symptoms.
Research points to several stress-inducing environmental factors that may be involved in schizophrenia, including:
Prenatal exposure to a viral infection
Low oxygen levels during birth (from prolonged labor or premature birth)
Exposure to a virus during infancy
Early parental loss or separation
Physical or sexual abuse in childhood "A Brilliant Madness: John Nash." Top Documentary Films RSS. N.p., n.d. Web. 03 May 2013
Bengston, M. (2006). Types of Schizophrenia. Psych Central. Retrieved on May 3, 2013, from
http://psychcentral.com/lib/2006/types-of-schizophrenia/
Cognitive Factors in Schizophrenia: Causes, Impact, and Treatment. Meltzer, Herbert Y.
CNS Spectrums, Vol 9(10,Suppl11), Oct 2004, 15-24.
Gillig, Paulette M., and Ann K. Morrison. "Cognitive Behavior Therapy for People with
Schizophrenia." Psychiatry (Edgemont) 6.12 (2009): 32-39. Print.
"John F. Nash Jr." The Concise Encyclopedia of Economics. 2008. Library of Economics and Liberty.
Retrieved May 3, 2013 from the World Wide Web:http://www.econlib.org/library/Enc/bios/Nash.html
Lyons, Charles, and Barclay Martin. Abnormal Psychology: Clinical and Scientific
Perspectives. Redding, CA: BVT, 2011. Print.
The natural history of schizophrenia in the long term .Ciompi, Luc. The British Journal of Psychiatry,
Vol 136, May 1980, 413-420. doi: 10.1192/bjp.136.5.413
Van Os, Jim, and Kapur, Shitij. "Schizophrenia." Lancet 374.9690 (2009): 635-645.
Psychology and Behavioral Sciences Collection. Web. 3 May 2013. WHO WAS JOHN NASH?
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