3Schizophrenia…symptoms Bizarre behaviors (catatonia, others)Affect (inappropriate, flat)DelusionsSpeech (disorganized, incoherent)HallucinationsInability to care for self or functionNegative symptoms
4Positive vs. Negative Sx POSITIVE SYMPTOMSPresence of something abnormalExamples: DELUSIONS, HALLUCINATIONS, DISORGANIZED SPEECH, ODD BODY MVMTS, CATATONIANEGATIVE SYMPTOMSAbsence of something normalExamples: AVOLITION, ALOGIA, ANHEDONIA, FLAT AFFECT
5POSITIVE SYMPTOMS DELUSIONS HALLUCINATIONS DISORGANIZED SPEECH ODD BODY MOVEMENTSCATATONIA
6Types Grandeur Identity POSITIVE SYMPTOMSDELUSIONSFalse beliefs maintained in the face of contrary evidenceTypes Grandeur IdentityPersecution ReferenceControlHALLUCINATIONSSensations in the absence of external stimuliTypes: visual, auditory, tactile, olfactory, gustatory
7Of these positive symptoms delusions, in particular, can be broken down into smaller subsets: Persecutory delusions – False beliefs that one’s self or one’s loved ones are being persecuted, watched, or conspired against by others.Delusions of being controlled – Belief that one’s thoughts, feelings, or behaviors are being imposed or controlled by some external forceThought broadcasting – Belief that one’s thoughts are being broadcast from one’s mind for others to hearThought insertion – Belief that another person or object is inserting thoughts into one’s head
8Of these positive symptoms delusions, in particular, can be broken down into smaller subsets: Thought withdrawal – Belief that thoughts are being removed from one’s head by another person or objectDelusions of guilt or sin – False belief that one has committed a terrible act or is responsible for come terrible eventSomatic delusions – False belief that one’s appearance or part of one’s body is diseased or alteredGrandiose delusions – False belief that one has great power, knowledge, or talent or that one is a famous and powerful person
33Map reveals the 3-dimensional profile of gray matter loss in the brains of teenagers with early-onset schizophrenia~with a region of greatest loss in the temporal and frontal brain regions that control memory, hearing, motor functions, and attention.
40After 10 years, of the people diagnosed with schizophrenia: 25% Completely Recover % Much Improved, relatively independent 25% Improved, but require extensive support 15% Hospitalized, unimproved 10% Dead (Mostly Suicide)After 30 years, of the people diagnosed with schizophrenia:25% Completely Recover % Much Improved, relatively independent 15% Improved, but require extensive support 10% Hospitalized, unimproved % Dead (Mostly Suicide)
41Where are the People with Schizophrenia? …Approximately:6% are homeless or live in shelters 6% live in jails or prisons % live in Hospitals % live in Nursing homes % live with a family member % are living independently % live in Supervised Housing (e.g. group homes, etc.)Approximately 200,000 individuals with schizophrenia or manic-depressive illness are homeless, constituting 1/3 of the approximately 600,000 homeless population(total homeless population statistic based on data from Department of Health and Human Services).
42The 45 percent who acknowledged that they needed treatment The 45 percent who acknowledged that they needed treatment ~(and thus had awareness of their illness) ~but still were not receiving treatment cited many reasons for this.These included (respondent could check several reasons):32% "wanted to solve problem on own" 27% "thought the problem would get better by itself" 20% "too expensive" 18% "unsure about where to go for help" 17% "help probably would not do any good" 16% "health insurance would not cover treatment
43FY 1999 NIH research expenditures DISEASEFY 1999 NIH research expendituresPrevalence: Individuals with this diseaseNIH research dollars per person affectedHIV (including AIDS)$1,792,700,000800,000$2,240.88Lung cancer$163,100,000342,457$476.26Cervical cancer$75,200,000231,064$325.45Multiple sclerosis$96,300,000350,000$275.14Breast cancer$474,700,0002,197,504$216.02Colorectal cancer$175,900,0001,041,499$168.89Parkinson’s disease$132,300,0001,000,000$132.30Prostate cancer$177,500,0001,637,208$108.42Alzheimer’s disease$406,500,0004,000,000$101.62Schizophrenia$196,515,0002,632,396$74.65Bipolar disorder$57,805,0002,227,412$25.95Depression$199,600,00010,732,076$18.60Panic disorder$19,049,0003,239,872$5.88Obsessive-Compulsive disorder$12,693,0004,859,808$2.61