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Schizophrenia

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by

Marta López

on 11 December 2013

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Transcript of Schizophrenia

Symptoms
- COMPLEX
- SERIOUS
- WIDE VARIABILITY
- NO BIOMARKERS
- TREATABLE BUT
CHRONIC DISEASE
TO LEARN MORE...
WHAT HAPPENS INSIDE THE BRAIN?
Mental illness related to:
daily life + genetics
WHY DOES IT HAPPEN?
Simple
Hebephrenic
Paranoid
Catatonic
Types of schizophrenia
How is the diagnosis made?
TRIGINTA
POSITIVE
NEGATIVE
Thought disorders
Delirium
Alterations of
sensory percetion
Hallucinations
Visual
Tactile
Inner speech
Hearing
Affective disorders

Alterations of motor behavor
"Catatonia"
DISORGANITZATION
Language disorders
Drawings by schizophrenic patients are often very important in the interpretation of their thoughts and perceptions.
Nervous
system
Brain
3
HYPOTHESIS
DOPAMIN
SEROTONIN
GLUTAMATE
FROM RESEARCH
Phylogenetic studies

not a Mendelian disease
Monozygotic and dizygotic twins
some monozygotic twins
are not both ill
adoptions
Cases of:
conclusions
- There are many genetic variants that increase the risk of schizophrenia

- Genes are not the only cause for schizofrenia:
THE ENVIRONMENT MATTERS
before
birth
after birth
the disease
arises
STRESS
DRUGS
DURING PREGNANCY
VIRUSES
malnutrition
perinatal
asphyxia
genetics are not the 100% of the causes
one gene is not the 100% of the cause
biological parents affected
son healthy
biological parents not affected
son develops
schizophrenia
genetics are not the 100% of the causes
Neurodevelopmental genes
80%
20%
migrations of cell populations
more risk
Triggering factors
Symptoms
Drugs
Schyzophrenia
How do we know...?
Gens that
affect
disbindina
neuregulina



1 NRG1
other variants
such as....
RET
and
RIT2
COMT,

RGS4,

PPP3CC,

DISC1,

AKT1

....
-genetic
- external risks
Epidemiology
- worldwide prevalence
1%
10% more if you have a close relative
There aren't important differences
but
AGE:

- MEN: 20-28 years old

-WOMEN: 26-32 years
old
Tests to rule out other diseases
DSM (Diagnostic and Statistical Manual of mental disorders)
Diagnostic and Statistical Manual of Mental Diseases IV
Medical treatment
Psychosocial treatment
Treatment
Antipsychotics (typical & atypical)
Adjuvant medications
Side effects
Psychoeducation
Psychotherapy
Environmental management
Psychosocial rehabilitation
"Fostering autonomy"
67% men
87% single
88% schizophrenia


46% legally incapacitated
58% < 400€/month
since 23 years old, until 45
cannabis
BEFORE BIRTH ...

DTNBP1
COMORBIDITY
MORTALITY
10 % of patients suicide
20% less life expectancy
PREVENTION
SCHIZOPHRENIC PARENT
10 % MORE VULNERABILITY
NO STRESS
LSD
SOCIAL IMPACT
STEREOTYPES
THEIR OPINION
"Society and patients have the same problem: they do not know. There are false beliefs that cause prejudices in patients."
"My family thinks I'm a drug addict, but that's not true, I was born this way, with something wrong in my head."
"This diagnostic is like a mark. You can get better, but you'll always be the insane of the neighbourhood..."
"We always get rejected. They make fun of us. On tv, the serial killer is always an schizophrenic..."
"A lot of people think is a willing question. My family thinks I'm ill because I want to, because I'm not strong enough to get over it."
CLÍNICA IMMACULADA,BOGOTÁ. 2007.
Evolution in drawings of Lousi Wain
Evolution in drawings after consuming LSD
even
more risk
27.7%
24.8%
28.7%
13.9%
5%
Homogeneous distribution

- Bernardo, M; Edo, A; Deulofeu, R. Esquizofrenia y disfunción dopaminérgica. Psiquiatría y atención primaria [en línia]. Desembre 2006 [Consulta 1 desembre 2013]. Disponible a:
<http://www.jc-edicionesmedicas.com/ca/system/files/documentos/p4-7_Esquizofrenia.pdf>.

- Grupo de Trabajo de la Guía de Práctica Clínica sobre la Esquizofrenia y el Trastorno Psicótico Incipiente. Fòrum de Salut Mental, coordinación. Guía de Práctica Clínica sobre la Esquizofrenia y el Trastorno Psicótico Incipiente. Herramientas de consulta rápida [Internet]. Madrid: Plan Nacional para el Sistema Nacional de Salud del Ministerio de Sanidad y Consumo. Agència d’Avaluació de Tecnologia i Recerca Mèdiques; maig 2009 [Consulta 18 novembre 2013]. Guía de Práctica Clínica: AATRM Nº 2006/05-2. Disponible a:
<http://www.guiasalud.es/egpc/esquizofrenia/pacientes/01_presentacion.html>

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<https://www.nami.org/Template.cfm?Section=Helpline1&Template=/ContentManagement/ContentDisplay.cfm&ContentID=4633>

-National Library of Medicine U.S. [en línia]. Rockville Pike, Bethesda, MD: David B. Merrill, MD, Assistant Clinical Professor of Psychiatry, Department of Psychiatry, Columbia University Medical Center, New York, NY. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, Bethanne Black, Stephanie Slon, and Nissi Wang, 31 gener 2013 [Consulta 19 novembre 2013].
Disponible a: <http://www.nlm.nih.gov/medlineplus/spanish/ency/article/000928.htm>

- Gutiérrez , M.; Ezcurra, J.; Pichot, P. Esquizofrenia entre la sociogénesis y el condicionamiento biológico (I). 1ª edición 1995. Barcelona: Ediciones en neurociencias. ISBN 84-88648-04.

- Chinchilla Moreno, Alfonso. Las esquizofrenias: sus hechos y valores clínicos y terapéuticos. Barcelona: Elsevier Doyma, 2007. Nuevas generaciones en neurociencias. ISBN 978-84-458-1724-7


- Posininsky, Harald. ¿Qué es la esquizofrenia? Una enfermedad y las posibilidades de su tratamiento. Barcelona: Herder, 1998. Resortes. ISBN 8425020711

- Frith, Christopher D. La esquizofrenia: un enfoque neuropsicológico cognitivo. Barcelona: Ariel, 1995. ISBN 8434408589

- Ariel Graff-Guerrero, Rogelio Apiquian, Ana Fresán, María García-Anaya. PERSPECTIVA NEUROBIOLÓGICA DE LA ESQUIZOFRENIA. Medigraphic, Literaturabiomèdica. - Salud mental Órgano Oficial del Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz [en linia ] Vol. 24, No. 6. Desembre 2001. [29 de desembre 2013] Disponible a:
http://www.medigraphic.com/pdfs/salmen/sam-2001/sam016e.pdf

- Marietan, Hugo. Doxografía sobre la esquizofrénia. Alcmeon. [en línea]. Juliol, 2001. Volum 10, número 1. [20 de noviembre de 2013] Disponible a:
http://www.alcmeon.com.ar/10/37/Marietan.htm

- Biología emocional. Neurociencias. Dopamina y esquizofrenia. [en línia] 14 de desembre, 2011. Teixidó Gómez, Francisco. [21 de noviembre de 2013] Disponible a:
http://biologiaemocional.blogspot.com.es/2011/12/dopamina-y-esquizofrenia.html

- Pontificia Universidad Javeriana. Enfermedades psicológicas. [en línia]. Jairo Alfonso Tovar Franco, Bogotá, 2004.[22 de novembre de 2013] 6. Esquizofrenia y enfermedades depresivas.
http://www.javeriana.edu.co/Facultades/Ciencias/neurobioquimica/libros/neurobioquimica/esquizofrenia.htm

- National Institute of Mental Health. Health and education. [En línia]. NIMH, EEUU. [5 de desembre de 2013] http://www.nimh.nih.gov/health/publications/espanol/esquizofrenia-2011/index.shtml
Bibliography
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