Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved. Schizophrenia

Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 11 A beautiful mind 1 st half of movie Interview with John Nash and his family

Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 11 DSM-IV Criteria for Schizophrenia A. Two or more core symptoms (next slide) B. Significant impairment in work, academic performance, interpersonal relationships, and/or self-care C. Continuous signs of the disturbance for at least 6 months

Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 11 Core Symptoms (Positive) 1. Delusions Persecutory 2. Delusions of Reference 3. Grandiose Delusions 4. Delusions of Thought Insertion 2. Hallucinations 3. Disorganized Thought and Speech 4. Disorganized or Catatonic Behavior

Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 11 Core symptoms (negative) 5. Negative Symptoms – Affective Flattening (or Blunted Affect) –Alogia: Severe reduction or complete absence of speech –Avolition: Inability to persist at common, goal- oriented tasks Video clips to demonstrate some of these symptoms

Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 11 Biological Aspects of Schizophrenia OVERVIEW Neuroanatomy -- brain changes / tissue loss Genetics Viral theories Neurotransmitters

Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 11 Biological Aspects of Schizophrenia Secret Life of the Brain (episode 3) Loss of brain tissue (NYTimes video clip)

Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 11 Biological Aspects of Schizophrenia Structural Brain Abnormalities (tissue loss – excessive pruning) – Parietal cortex deficits (sensory experience) – Frontal lobe deficits: Reduced volume and neuron density in frontal cortex cause cognitive and emotional deficits (perhaps especially negative symptoms) – Loss of myelin sheath?

Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 11 Biological Aspects of Schizophrenia, continued Genetic Theories – Polygenetic influence – May be inheriting a general risk for psychosis – Epigenetics – environment + gene interaction (e.g., Finnish study of children adopted away at birth; Tienari et al., 2004): “Disordered” home environment increases risk

Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 11 Biological Aspects of Schizophrenia, continued Birth Complications & Prenatal Viral Exposure – Podcast from “All in the mind” 11/2/07 on viruses and immune system (4’’ – 14.30’’) Neurotransmitter Theories – Imbalances in levels of or receptors for dopamine cause symptoms; serotonin, GABA, and glutamate may also play roles

Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 11 Psychosocial Perspectives on Schizophrenia Social drift Stress and relapse

Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 11 Treatments for Schizophrenia Biological Treatments: Antipsychotic drugs (next slide)

Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 11  Most are dopamine receptor antagonists  Older neuroleptics: Haldol & Thorazine  Newer (“atypical”): Clozaril, Seroquel, Risperdal, Zyprexa  Somewhat of Trial and Error approach  Most are dopamine receptor antagonists  Older neuroleptics: Haldol & Thorazine  Newer (“atypical”): Clozaril, Seroquel, Risperdal, Zyprexa  Somewhat of Trial and Error approach  Antipsychotics

Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 11  Side Effects: Neuroleptics and Atypicals can cause  Sedation, weight gain  “Extrapyramidal” (Parkinsonian) side effects, like tremor, akinesia (e.g., shuffling of feet)  Tardive Dyskinesia (long-term, irreversible -- irregular/involuntary muscle movements)  Anticholinergic (dry mouth/eyes, blurred vision, etc.)  Orthostatic hypotension  Side Effects: Neuroleptics and Atypicals can cause  Sedation, weight gain  “Extrapyramidal” (Parkinsonian) side effects, like tremor, akinesia (e.g., shuffling of feet)  Tardive Dyskinesia (long-term, irreversible -- irregular/involuntary muscle movements)  Anticholinergic (dry mouth/eyes, blurred vision, etc.)  Orthostatic hypotension Side Effects

Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 11 Treatments for Schizophrenia Behavioral, Cognitive, and Social Interventions: Recognition of demoralizing attitudes they may have toward their illness, operant conditioning, modeling, family therapy, token economies, self-help groups, assertive community treatment programs.