Schizophrenia

Intro Two greek words A split between mind and reality Schizo: split Phrenia: mind A split between mind and reality

Intro Category: Psychotic Disorders Definition: characterized by disorganized and delusional thinking, disturbed perceptions, and inappropriate emotions and actions

History Kraepelin: labeled similar symptoms as dementia praecox in the late 19th century Schneider: First rank symptoms Crow: Type I and Type 2

Etiology evidence shows that genetic & environmental factors can act in combination to result in schizophrenia Genetic factors exist Social factors Social disadvantage; child abuse Neurotransmitters Dopamine-hypothesis Brain Structure

Prevalence of Schizophrenia General population 0.85 With one parent schizophrenic 13.90 With 2 parents schizophrenic 46.30 With mz twin schizophrenic 47.40 With dz twin schizophrenic 15.00 With sibling schizophrenic 10.20 Parents of schizophrenic children 4.40 With Uncles, Aunts schizophrenic 3.60 With nephews, nieces schizophrenic 2.80 Grandchildren of schizophrenics 3.50 1st cousins of schizophrenics 3.50

Stats Schizophrenia ranks among the top 10 causes of disability in developed countries worldwide One way to express the prevalence of schizophrenia at any give time is the number of individuals affected per 1,000 total population. In the United States that figure is 7.2 per 1,000. This means that a city of 3 million people will have over 21,000 individuals suffering from schizophrenia.

Stats Where are the People with Schizophrenia? Approximately: 6% are homeless or live in shelters 6% live in jails or prisons 5% to 6% live in Hospitals 10% live in Nursing homes 25% live with a family member 28% are living independently 20% live in Supervised Housing (group homes, etc.)

Symptoms Positive: additions to normal behavior Negative Psychomotor Delusions, disorganized thinking & speech, hallucinations, inappropriate emotions Negative Poverty of speech, flat affect (less emotion), drained of energy and interest Psychomotor Loss of movement; catatonic

Types of Schizophrenia Paranoid: delusions & hallucinations; themes of persecution Disorganized: disorganized speech or behavior; inappropriate emotion Catatonic: Immobility, parrotlike repeating of another’s speech/movement Undifferentiated: Many & varied symptoms Residual: Withdrawal, after hallucinations and delusions have disappeared

Culture International Pilot Study of Schizophrenia sponsored by WHO (1973, 1979, 1981) Evidence of a universal set of symptoms Some important cross-cultural differences exist Differences in symptom expression U.S. less likely to demonstrate auditory hallucinations Recovery happens faster in developing countries as opposed to industrialized countries Cultures differ in tolerance of symptoms Nigerian culture is more accepting of presence of voices

Age 3/4 of persons with schizophrenia develop the disease between 16 and 25 years of age Onset is uncommon after age 30, and rare after age 40

Gender In the 16-25 year old age group, schizophrenia affects more men than women In the 25-30 year old group, the incidence is higher in women than in men

The Perspectives Biological Some evidence of a genetic component Gottesman and Shields (twin studies) 40 to 65 percent chance of developing the disorder Dopamine hypothesis (Iverson & Iverson) Excess dopamine is a cause of schizophrenia Enlarged ventricles

The Perspectives Sociocultural Social disadvantage The Social Defeat Hypothesis Environment affects dopamine

The Perspectives Cognitive Some biological abnormality leads to strange sensory experiences Schizophrenic attempts to understand and explain them (the mental processes) Family & Friends will deny existence of such things Schizophrenic believes the truth is being hidden from him/her

Diathesis-stress model a genetic vulnerability or predisposition (diathesis) interacts with the environment and life events (stressors)

Treatments Antipsychotic drugs Behavior Therapy Most commonly used Decrease dopamine levels Chlorpromazine (Thorazine) More recently, Clozapine is being used Blocks action of serotonin & norepinephrine Behavior Therapy Token economy concept has worked to improve interpersonal behavior

Cognitive-Behavior Therapy CBT helps patients with symptoms that do not go away even when they take medication The therapist teaches people with schizophrenia how to test the reality of their thoughts and perceptions, how to "not listen" to their voices, and how to manage their symptoms overall CBT can help reduce the severity of symptoms and reduce the risk of relapse. (From the National Institute of Mental Health)

Case Study http://www.mhhe.com/socscience/psychology/faces/# http://www.cerebromente.org.br/gallery/gall_leonardo/fig1-a.htm