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Schizophrenia and its Portrayal in a Beautiful Mind

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Colleen Bursley

on 19 February 2015

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Transcript of Schizophrenia and its Portrayal in a Beautiful Mind

Based on the true story of John Forbes Nash Jr
Mathematical genius with Schizophrenia
Symptoms first became apparent while attending Princeton University
Had hallucinations, became delusional
Symptoms escalated
Believed he was a government code breaker
Given psychological help
Learned how to control symptoms
Became a professor & earned his pens ceremony
Awarded the Nobel Prize in economics
The Movie vs. Real World
Summary
Other Therapies
Electroconvulsive
Therapy
Sometimes used for:
delusions
hallucinations
disorganized thinking
Antipsychotics
Suppresses delusions/hallucinations
A Beautiful Mind VS. The Real World
Possible Treatments
Schizophrenia
Individual psychotherapy
Cognitive remediation
Self-help groups
Extremely useful for catatonia

The movie was an accurate portrayal of the disorder of schizophrenia itself, but not an accurate portrayal of the life of John Nash.
The movie correctly portrayed the onset of schizophrenia, the symptoms of paranoid schizophrenia, treatments that were used, and the effect of the disorder on a person's life.
A mental illness that disrupts how a person thinks, speaks, feels, functions socially, and perceives reality through disturbances such as:

Delusions
Confused thinking
Hallucinations
Definition:
Causes:
The etiology is unknown, however...

Biological view has most research
Genetic factors: people may have biological predisposition to schizophrenia and may trigger it when facing extreme stress
Neurons fire dopamine too often and transmit too many messages
Research has found that those with negative symptoms have abnormal brain structure- reduced gray matter affecting the brain's neurotransmitter systems
Virus entering fetus's brain before birth may also be a cause
What is Schizophrenia?
Symptoms are divided into three categories:

Positive Negative Cognitive
Affects:
thinking, feeling, movement, behavior
Delusions Hallucinations Feelings Movements Behavior
Lack of important activities:
Low energy
Less facial movement
Low motivation
Less physical movement
Inability to make and keep friends
Disorganized thinking
Slow/Confused thinking
Difficulty understanding
Poor concentration
Poor memory
Difficulty expressing
Statistics

About 1% of Americans, or about
2.2 million people have this illness.
Symptoms appear earlier in males than in females, however this disease
is race and gender neutral
If you have a parent or sibling with
Schizophrenia, you have a 1/10 chance of developing it as well.
50/50 chance of developing Schizophrenia
if that sibling is an identical twin.
In the United States alone 100,000 people are diagnosed yearly.
References
Halter, M. (2014). Foundations of psychiatric mental health nursing (7th Ed.). St Louis, MO: Saunders.
http://www.neomed.edu/academics/bestcenter/helpendstigma/myths-and-facts-about-schizophrenia
http://psychcentral.com/blog/archives/2010/01/18/13-myths-of-schizophrenia/
http://www.webmd.com/schizophrenia/guide/schizophrenia-medications
http://www.webmd.com/schizophrenia/guide/schizophrenia-therapy
http://www.webmd.com/schizophrenia/guide/electroconvulsive-therapy
Can control symptoms
Minimizes side effects if taken over time
http://www.nimh.nih.gov/health/topics/schizophrenia/index.shtml
http://www.mentalhelp.net/poc/view_doc.php?type=doc&id=8805
John Nash started having symptoms in his early 20s in college and was diagnosed at age 30
He experienced persecutory and grandiose delusions, along with visual hallucinations
Subcategories of delusions: persecutory, referential, grandiose, erotomaniac, nihilistic, and somatic

Subcategories of hallucinations: auditory and visual
Paradnoid Schizophrenia

Treatment Modalities utilized in the movie
Wide range of side effects including acute dystonia, akathisia, metabolic syndrome, agranulocytosis, tardive dyskinesia, and even fatal cardiac dysrhythmias
Antidepressants to treat depression common in schizophrenics, benzodiazepines to reduce anxiety
In the movie, John Nash took unnamed medications to treat his positive symptoms

Thorazine was used to sedate him

At the psychiatric hospital, John Nash received Insulin Shock Therapy

Insulin Shock Therapy was used for those with schizophrenia who could withstand the treatment. Insulin doses were given gradually each day until the patient would experience seizures and even coma.
DSM- V Diagnosis
Diagnostic Criteria

The individual must exhibit at least two of the specified symptoms most of the time for a one month period, with some level of disturbance being present for at least six months
1. Delusions
2. Hallucinations
3. Disorganized Speech
4. Grossly disorganized or catatonic behavior
5. Negative symptoms (diminished emotional expression or avolition)
Family Therapy
American Psychiaric Publishing. (n.d.). Schizophrenia. Retrieved from http://www.dsm5.org/Documents/Schizophrenia%20Fact%20Sheet.pdf
Examples of Therapeutic and Non-theraputic communication
Therapeutic
Non-Therapeutic
"Who are you talking to John?
There is no one there." ~Dr Rosen
"You want to know what is real? This, this is real" ~Alicia
Students at Princeton mocking his gait upon his return to the university
John's collegues allow him to continue doing non-sensical work without questioning it
Dr. Rosen: "You can't reason your way out of this"
Nash: "Why not? Why can't I?"
Dr. Rosen: "Because your mind is where the problem is to begin with!"
Nash: "And then, on the way home, Charles was there again. Sometimes I miss talking to him. Maybe Rosen is right. Maybe I have to think about going back to the hospital."
Alicia: "Maybe try again tomorrow"
and its portrayal in "A Beautiful Mind"
http://www.nimh.nih.gov/health/publications/schizophrenia/index.shtml
http://www.mayoclinic.org/diseases-conditions/schizophrenia/basics/tests-diagnosis/CON-20021077
http://www.dsm5.org/Documents/Schizophrenia%20Fact%20Sheet.pdf
Full transcript