SchizophreniaSchizophreniaTrue or False?True or False?

Schizophrenia exists in the same form in every culture that has Schizophrenia exists in the same form in every culture that has been studied.been studied.

Visual hallucinations (“seeing things”) are the most common type of Visual hallucinations (“seeing things”) are the most common type of hallucinations in people with schizophrenia.hallucinations in people with schizophrenia.

It is normal for people to hallucinate nightly.It is normal for people to hallucinate nightly. If you have two parents with schizophrenia, it’s nearly certain that If you have two parents with schizophrenia, it’s nearly certain that

you will develop schizophrenia yourself.you will develop schizophrenia yourself. Although schizophrenia is widely believed to be a brain disease, Although schizophrenia is widely believed to be a brain disease,

evidence of abnormalities in the brains of schizophrenic patients evidence of abnormalities in the brains of schizophrenic patients remains lacking.remains lacking.

We now have drugs that not only treat schizophrenia but can also We now have drugs that not only treat schizophrenia but can also cure it in many cases.cure it in many cases.

Some people have delusions that they are loved by a famous Some people have delusions that they are loved by a famous person.person.

Schizophrenia- what it Schizophrenia- what it isn’tisn’t

It is NOT dissociative identity disorder.It is NOT dissociative identity disorder. People afflicted with schizophrenia or any People afflicted with schizophrenia or any

of the psychotic disorders to not have of the psychotic disorders to not have several people or personalities in one several people or personalities in one body. body.

So, what is it?So, what is it?

A cognitive disorder (as opposed to the A cognitive disorder (as opposed to the emotional disorders we have studied so emotional disorders we have studied so far). It involves motor function, far). It involves motor function, perception, and some emotion, but it is perception, and some emotion, but it is primarily a cognitive issue.primarily a cognitive issue.

The term ‘schizophrenia’ actually refers The term ‘schizophrenia’ actually refers to a group of disorders characterized by to a group of disorders characterized by confused and disconnected thoughts, confused and disconnected thoughts, emotions, and perceptions.emotions, and perceptions.

Major Features of Major Features of SchizophreniaSchizophreniaTwo or more of the following must be present for a significant portion of Two or more of the following must be present for a significant portion of

time over the course of one month:time over the course of one month:

Delusions: false beliefs maintained in the face of contrary evidenceDelusions: false beliefs maintained in the face of contrary evidence Hallucinations: perceptions in the absence of corresponding Hallucinations: perceptions in the absence of corresponding

sensation; “hearing voices,” “seeing things”sensation; “hearing voices,” “seeing things” Incoherence: marked decline in thought processes; indicated by use Incoherence: marked decline in thought processes; indicated by use

of a “word salad” in which the speaker gradually speeds up his or of a “word salad” in which the speaker gradually speeds up his or her speech to the point where it all becomes a jumble of words her speech to the point where it all becomes a jumble of words seemingly thrown togetherseemingly thrown together

Disturbances of affect: emotions that are inappropriate for the Disturbances of affect: emotions that are inappropriate for the circumstancescircumstances

Deteriorations in normal movement: slowed movement, catatonic Deteriorations in normal movement: slowed movement, catatonic behavior, or highly agitated behaviorbehavior, or highly agitated behavior

Decline in previous levels of functioningDecline in previous levels of functioning Diverted attention: possibly brought on by cognitive floodingDiverted attention: possibly brought on by cognitive flooding

Causes of SchizophreniaCauses of Schizophrenia Biochemical FactorsBiochemical Factors: :

excessive levels of dopamine excessive levels of dopamine have been linked to have been linked to schizophrenia. schizophrenia.

Viral InfectionsViral Infections: theory, those : theory, those exposed to influenza during exposed to influenza during the 1the 1stst trimester of their trimester of their prenatal development have prenatal development have seven times the chance of seven times the chance of developing schizophrenia.developing schizophrenia.

Brain AbnormalitiesBrain Abnormalities: Many : Many (though notable not all) (though notable not all) schizophrenic patients have up schizophrenic patients have up to 5% more brain tissue loss to 5% more brain tissue loss than those without than those without schizophrenia.schizophrenia.

Treating SchizophreniaTreating Schizophrenia

Anti-psychoticsAnti-psychotics: : drug therapy is often drug therapy is often used to help patient used to help patient cope with having cope with having schizophrenia and to schizophrenia and to lessen symptoms or lessen symptoms or episodesepisodes

Personal TherapyPersonal Therapy: : working one on one working one on one with a psychoanalyst with a psychoanalyst to help patients cope to help patients cope with stress and build with stress and build social skills (helps social skills (helps reduce relapse rates reduce relapse rates and improve social and improve social functioning)functioning)

Disorganized SchizophreniaDisorganized Schizophrenia: characterized by : characterized by disorganized behavior: including incoherent speech, silly irrelevant disorganized behavior: including incoherent speech, silly irrelevant

laughter, and inappropriate affectlaughter, and inappropriate affect bizarre delusions often involving sexual or religious themesbizarre delusions often involving sexual or religious themes vivid hallucinationsvivid hallucinations

A 40-year old man who looks more like 30 is brought to the hospital by his A 40-year old man who looks more like 30 is brought to the hospital by his mother, who reports that she is afraid of him. It is his twelfth mother, who reports that she is afraid of him. It is his twelfth hospitalization. He is dressed in a tattered overcoat, baseball cap, and hospitalization. He is dressed in a tattered overcoat, baseball cap, and bedroom slippers, and sports several medals around his neck. His affect bedroom slippers, and sports several medals around his neck. His affect ranges from anger (hurling obscenities at his mother) to giggling. He ranges from anger (hurling obscenities at his mother) to giggling. He speaks with a childlike quality and walks with exaggerated hip movements speaks with a childlike quality and walks with exaggerated hip movements and seems to measure each step carefully. Since stopping his medication and seems to measure each step carefully. Since stopping his medication about a month ago, his mother reports, he had been hearing voices and about a month ago, his mother reports, he had been hearing voices and looking and acting more bizarrely. He tells the interviewer he has been looking and acting more bizarrely. He tells the interviewer he has been “eating wires” and lighting fires. His speech is generally incoherent and “eating wires” and lighting fires. His speech is generally incoherent and frequently falls into rhyme and clanging associations. His history reveals a frequently falls into rhyme and clanging associations. His history reveals a series of hospitalizations since the age of 16. Between hospitalizations, he series of hospitalizations since the age of 16. Between hospitalizations, he lives with his mother, who is now elderly, and often disappears for months lives with his mother, who is now elderly, and often disappears for months at a time, but is eventually picked up by police for wandering the streets.at a time, but is eventually picked up by police for wandering the streets.

Sub-types of Sub-types of SchizophreniaSchizophrenia

Catatonic SchizophreniaCatatonic Schizophrenia: : characterized by gross characterized by gross disturbances in motor activity, disturbances in motor activity, such as catatonic stupor. such as catatonic stupor. Patient may, however, still be Patient may, however, still be

aware of what is happening aware of what is happening around them, despite being around them, despite being unable to respond unable to respond

Movements typically slow down Movements typically slow down until they reach a stupor, but may until they reach a stupor, but may abruptly switch into an agitated abruptly switch into an agitated phase.phase.

May maintain unusual or May maintain unusual or apparently strenuous positions for apparently strenuous positions for hours, despite limbs becoming stiff hours, despite limbs becoming stiff or swollen.or swollen. Waxy flexibility may also be a Waxy flexibility may also be a

feature.feature.

*Note: catanonia is not unique to *Note: catanonia is not unique to schizophrenia. It is more schizophrenia. It is more typically found in those with typically found in those with mood disordersmood disorders

Sub-types of Sub-types of SchizophreniaSchizophrenia

Sub-types of Sub-types of SchizophreniaSchizophrenia

Paranoid SchizophreniaParanoid Schizophrenia: characterized by hallucinations : characterized by hallucinations and systematized delusions, commonly involving themes of and systematized delusions, commonly involving themes of persecution.persecution. Hallucination of grandeur: “I am the savior of my people”Hallucination of grandeur: “I am the savior of my people” Delusion of persecution: “Someone is always watching me!”Delusion of persecution: “Someone is always watching me!”

Film clip: Film clip: A Beautiful MindA Beautiful Mind