Schizophrenia

1
Schizophrenia

• Definition
• Psychotic disorder
• Split from reality
• NOT split or multiple personality

2
Symptoms of Schizophrenia

• Positive Symptoms
• Loose associations
• Word salad
• Delusions
• Hallucinations
• Negative Symptoms
• Poverty of speech content
• Flat or blunted affect
• Avolition or apathy
• Anhedonia

3
Subtypes of Schizophrenia

• Paranoid
• Disorganized
• Catatonic
• Undifferentiated
• Residual

4
Age of Onset
5
Biological Aspects

• Runs in Families
• Increased Risk Based on Genetic Relatedness

6
Genetics and Schizophrenia
7
Biological Aspects

• Search for Marker Genes
• Still inconclusive
• Likely involves multiple genes
• Smooth Pursuit Eye Tracking
• Tracking deficit in persons with schizophrenia,
  including their relatives
• Brain Structure and Functioning
• Enlarged ventricles and reduced tissue volume
• Hypofrontality

8
Biological Aspects

• Dopamine Hypothesis
• Drugs that increase dopamine (agonists), result
  in schizophrenic-like behavior (e.g.,
  amphetamines)
• Drugs that decrease dopamine (antagonists),
  reduce schizophrenic-like behavior
• Excess Dopamine and D2 Receptors
• Considered too simplistic (multiple NTs involved)

9
Psychosocial Influences

• The Role of Stress
• Diathesis-Stress Model
• Family Interactions
• Communication patterns
• High expressed emotion associated with relapse
• Psychological factors seem relatively small

10
Socioeconomic Status and Schizophrenia
11
Treatment of Schizophrenia

• Seldom Results in Complete Recovery
• Early Methods
• Insulin Coma Therapy
• Psychosurgery
• ECT
• Biological Treatments (Current)
• Neuroleptics (Major Tranquilizers)
• Haldol, Thorozine, others
• Clozaril, Risperdal, Zyprexa, others

12
Treatment of Schizophrenia

• Biological Treatment Issues
• Major (Social) Reform in Treatment
• Revolving Door Process
• Trial and Error
• Extrapyramidal Side Effects
• Tardive Dyskinesia
• Address Positive Symptoms Only
• Medication Compliance Problems

13
Antipsychotic Drugs and Inpatient Treatment
14
Psychosocial Treatment

• Psychosocial Approaches
• Behavioral (i.e., token economies) on inpatient
  units
• Community care programs
• Social and living skills training
• Behavioral family therapy
• Vocational rehabilitation
• Facilitate Medication Compliance

15
Psychosocial Treatment
16
Myths About Schizophrenia

• People with schizophrenia have split
  personalities.
• People with schizophrenia are intellectually
  disabled
• People with schizophrenia are dangerous
• People with schizophrenia are addicted to their
  drugs