Introduction to Schizophrenia Flashcards
3 Major Componets
- The psychological science of schizophrenia
- Neuroscience of schizophrenia
- Evidence-Based treatments for Schizophrenia
The psychological science of schizophrenia
Disrupts in attention
Memory
Planning
Emotional and Social processing
Neuroscience of schizophrenia
Functional and Structural brain imaging studies
Evidence-Based Treatments for Schizophrenia
Medication and Psychosocial Interventions
Epidemiology of Schizophrenia
- About 1% prevalence in population
- Occurs in all cultures, socioeconomic groups
- Peak onset in men, 15-25
- Peak onset in woman, 25-35
- prevalence higher in men than women
- 50% attempt suicide, 10 % succeed
- Most expensive of al mental disorders
Gender Differences Woman
Women are more likely:
>to have a relative with the disorder
>to experience more positive symptoms
> to have a better treatment response
Gender Differences Men
negative symptoms
> earlier onset
> worse long-term outcomes
Etiology of Schizophrenia
(What causes it??)
Biological Condition
Genetic studies using twins, family and adoption techniques reveal that a predisposition for schizophrenia is transmitted genetically
The neural diathesis–stress model of schizophrenia
In a nutshell:
The neural diathesis–stress model of schizophrenia proposes that stress, through its effects on cortisol production, acts upon a pre-existing vulnerability to trigger and/or worsen the symptoms of schizophrenia.
Symptoms of Schizophrenia
Positive,
Negative
Disorganized
Positive (involves excesses or distortions)
Hallucinations
Delusions
Hallucinations
Hallucinations are sensory experiences that occur in the absence of environmental stimulation
(Hear or see things that don’t exist)
Hallucinations are commonly auditory
Delusions
beliefs that are contrary to reality
(believe things that aren’t real)
Persecutory delusions are common (feel that people are out to get them)
Types of Delusions
Grandiose Delusions
Paranoid Delusions
Delusions of Reference
Somatic Delusions
Delusions of Being Controlled
Grandiose Delusions
Thinking you have special powers
Thinking you are someone powerful or famous
Thinking you can control others just by thinking
Exampe: A patient believes they are Jesus
Paranoid Delusions
Thinking people plan to hurt or cheat you
Thinking people are against you
Thinking people are sick or dying
Thinking catastrophes will happen
Example: The devil made my boss fire me
Delusions of Reference
Thinking others are talking about you
Example: Believing you have received special messages from the TV or radio
Somatic Delusions
A false belief about your body
Example: Thinking your heart had stopped working
Delusions of Being Controlled
Thinking others or an externa force controls your feelings, thoughts, actions or behaviours
Example: Believing the FBI is controlling your behaviour by radio waves
Negative (are characterized by behavioural deficits)
Avolition
Alogia
Anhedonia
Asociality
Avolition
Refers to a lack of energy and an inability to persist in routine activities
Alogia
Refers to the reduction in the amount or content of speech
Anhedonia
An inability to experience pleasure
Asociality
(the most debilitating effect of this disorder)
Refers to severe impairment in social relationships including:
social isolation
poor hygiene or grooming
poor motivation
- Blunted affect
> no facial or emotional expression on their face or through their bodies
Disorganization
Thought disorder which in extreme cases can lead to “word salad” and is often accompanied by: behavioural disorganization clang association (words that rhyme to communicate)
Inappropriate affect
Diagnosed with 2 different systems
ICD-10
DSM - V
(Both are overlapping)
ICD -10 Diagnoses Criteria
A. Thought echo thought insertion or withdrawal, and thought broadcasting;
B. Delusions of control, influence, or passivity, clearly referred to body or limb movements or specific
thoughts, actions, or sensations; delusional perception
C. Hallucinatory voices giving a running commentary on the patient’s behaviour
D. Persistent delusions of other kinds that are culturally inappropriate and completely impossible, such as religious or political identity, or superhuman powers and abilities (e.g. being able to control the weather, or being in communication with aliens from another world)
E. Persistent hallucinations in any modality.
F. Breaks in the train of thought, resulting in incoherence or irrelevant speech or neologisms;
G. Catatonic behaviour such as excitement, posturing, or waxy flexibility, negativism, mutism, and stupor;
H. “Negative” symptoms such as marked apathy, paucity of speech, and blunting or incongruity of emotional responses, usually resulting in social withdrawal and lowering of social performance.
I. A significant and consistent change in the overall aspects of personal behaviour, manifest as loss of interest, aimlessness, idleness, a self-absorbed attitude, and social withdrawal.
A diagnosis of Schizophrenia is made when
very clear major symptoms are present for at least one month if untreated: if symptoms are not clear cut, two or more symptoms might be needed
no other medical condition which might cause the symptoms
Schizophrenia Categories
Disorganized Type
Catatonic Type
Paranoid Type
Simple Type
Disorganized Type
Disorganized speech and flat affect
A general disruption of behaviour
Catatonic Type
Prolonged motor immobility states that alternate with periods of excitability
Paranoid Type
involves the presence of prominent delusions including persecution and grandiosity
Simple Type
The characteristic “negative” features of residual schizophrenia develop without being preceded by any overt psychotic symptoms
ICD -10 Diagnoses Criteria - A
Thought echo thought insertion or withdrawal, and thought broadcasting;
ICD -10 Diagnoses Criteria - B
Delusions of control, influence, or passivity, clearly referred to body or limb movements or specific
thoughts, actions, or sensations; delusional perception
ICD -10 Diagnoses Criteria - C
Hallucinatory voices giving a running commentary on the patient’s behaviour
ICD -10 Diagnoses Criteria - D
Persistent delusions of other kinds that are culturally inappropriate and completely impossible, such as religious or political identity, or superhuman powers and abilities (e.g. being able to control the weather, or being in communication with aliens from another world)
ICD -10 Diagnoses Criteria - E
Persistent hallucinations in any modality.
ICD -10 Diagnoses Criteria - F
Breaks in the train of thought, resulting in incoherence or irrelevant speech or neologisms;
ICD -10 Diagnoses Criteria - G
Catatonic behaviour such as excitement, posturing, or waxy flexibility, negativism, mutism, and stupor
ICD -10 Diagnoses Criteria - H
“Negative” symptoms such as marked apathy, paucity of speech, and blunting or incongruity of emotional responses, usually resulting in social withdrawal and lowering of social performance.
ICD -10 Diagnoses Criteria - I
A significant and consistent change in the overall aspects of personal behaviour, manifest as loss of interest, aimlessness, idleness, a self-absorbed attitude, and social withdrawal.
