Open the Doors Volume 2

8/7/2019 Open the Doors Volume 2

1/52

Introduction

Schizophrenia is a serious mental illness that can devastate the lives of

people who suffer from it and the lives of their families. It usually strikes

adolescents and young adults, disrupting their pursuit of educational and

occupational goals and drastically reducing their quality of life. It occurs

in all countries of the world and is among the ten leading causes of dis-

ability in those 18 to 44 years old (Murray and Lopez 1996).

Schizophrenia is associated with a significant amount of stigma and

discrimination, which further increases the burden on patients and their

families. Individuals with schizophrenia often face social isolation, dis-

crimination in housing, education, and employment opportunities, and

other forms of prejudice. The stigma often also extends to family members

and to those who provide health care services to patients with schizophre-

nia. The treatments patients receive may also increase the stigma associated

with the illness, especially if they produce the debilitating motor side effects

that can result from treatment with certain antipsychotic medications.

Today, there is new hope for those who suffer from schizophrenia. In

recent years, an array of new antipsychotic medications and psychosocialinterventions has been developed that are helping many individuals with

schizophrenia reintegrate into the community, improve their quality of

life, and pursue their life goals. However, the stigma and discrimination

associated with serious mental illness often make it more difficult for

people with schizophrenia to benefit fully from these new treatments and

can thus derail their recovery.

For this reason, the World Psychiatric Association (WPA) has

launched this worldwide programme to reduce the stigma and discrimina-

tion because of schizophrenia. This volume brings together informationabout the diagnosis, epidemiology, and treatment of schizophrenia and

relates it to how stigma develops and how it can best be combated. To

facilitate the use of this information in the development of programmes

designed to combat stigma and discrimination, marginal annotations are

included throughout the volume explaining the particular relevance of the

information for reducing stigma and discrimination.

VOLUME IIInformation about SchizophreniaRelevant to Programme Implementation


2/52

IA. What is Schizophrenia?

One of the best ways to eliminate the stigma and reduce the discrimina

associated with schizophrenia is to clear up common misconceptions

about the illness and replace them with clear accurate information.This section covers the following topics:

Symptoms and diagnosis of schizophrenia

Causes of schizophrenia

Onset, course, and outcome of schizophrenia

Volume II is organized in two parts:

Part I. What Is Schizophrenia (IA) and How Is It Treated (IB)?

This section provides information on the diagnosis, epidemiology, and

treatment of schizophrenia that can be adapted for use in targeted

anti-stigma campaigns.Part II. Decreasing Stigma.This section describes the nature, origins,

and consequences of stigma, prejudice, and discrimination and then

describes the types of initiatives that can be most effective in reducing

stigma and discrimination.Although the material in this section focuses

specifically on schizophrenia, much of the information is also applicable

to the stigma and discrimination associated with other serious mental

illnesses.

[1] Murray CJL, Lopez AD. The Global Burden of Disease. Geneva:World Health Organization;

1996: 270.


3/52


4/52


5/52


6/52


7/52


8/52


9/52


10/52


11/52


12/52


13/52


14/52


15/52


16/52


17/52


18/52


19/52


20/52


21/52


22/52


23/52


24/52


25/52


26/52


27/52


28/52


29/52


30/52


31/52


32/52


33/52


34/52


35/52


36/52


37/52


38/52


39/52


40/52


41/52


42/52


43/52


44/52


45/52


46/52


47/52


48/52

Appendix B

ICD-10 Subtypes of Schizophrenia

Appendix C

Common Standard Antipsychotic Medications


49/52

ICD 10 Subtypes of Schizophrenia

Undifferentiated schizophreniacombines features of two of the follow-

ing types: paranoid, hebephrenic, and catatonic. The persons symptoms

meet the diagnostic criteria for schizophrenia but do not fully conform to

any one of the main subtypes.

Residual schizophreniadescribes a stage in the disorder in which

there has been a clear-cut episode of schizophrenia in the past and promi-

nent negative symptoms are still present. However, the intensity or fre-

quency of other psychotic symptoms, such as delusions, hallucinations, or

catatonic symptoms, is reduced.

Post-schizophrenic depressiondescribes the common situation inwhich a person develops mainly depressive symptoms following an acute

psychotic episode, although negative or positive symptoms may still also

be present.

Common Standard Antipsychotic Medications

Common Standard (Traditional) Antipsychotic Medications*

Benperidol Levomepromazine

Bromperidol Oxypertine

Butaperazine Penfluridol

Chlorpromazine Perazine

Chlorptothixene Periciazine

Clopenthixol Perphenazine

Clotiapine Pimozide

Droperidol Pipamperone

Fluanisone Promazine

Flupentixol Promethazine

Fluphenazine Sulpiride

Fluspiriline Thioridazine

Haloperidol Trifluoperazine

*Product names vary from country to country and more than one product name may be used for

same drug within one country.When participating in this program, it will be helpful to obtain a list

common product names in use in the country where the project is being undertaken.

Appendix DNovel Antipsychotic Drugs That Are Currently Available in Selected Countries

Amisulpiride Risperidone

Clozapine Sertindole

Olanzapine Zotepine

Quetiapine

Four Main Subtypes of Schizophrenia

Subtype Target systems Typical Symptoms Comments

Paranoid Thinking, perception Delusions (mostly of persecution), Commonest type

hallucinations

Hebephreni c ( di so rgan ised ) Emoti ons, vol it ion I nappropria te a ff ec t, s ill iness, f orma l Typi cal ly beg ins in

thought disorder, mental f ragmentation adolescence

Catatonic Volition, motor activity Stupor, agitation, posturing, mannerism, Becoming rare

negativism

Simple Volition, personality Social withdrawal, flat emotions, poverty Insidious onset of

of ideas, decreased drive and motivation behavioural problems


50/52


51/52


52/52

Documents

Open the Doors Volume 2