The Physhology of Schizophrenia

7/28/2019 The Physhology of Schizophrenia

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The Psychology of

SchizophreniaDR Paula jean manners

Highly Specialist clinical psychologist and lecturer


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By end of this lecture

You should

Know something about cause, symptoms andtreatment of schizophrenia

Know something about the experience of

psychosis

Know something about the controversies and

future of treatment


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Controversies and

misconceptions

A mentally ill serial killer who murdered four

people during a drug-fuelled rampage was

failed by the NHS, according to an independent

report.

Paranoid schizophrenic Daniel Gonzalez

received inadequate treatment from doctorsand carers before arming himself with a variety

of knives and launching a Freddy Krueger-

inspired killing spree.

Read more: http://www.dailymail.co.uk/news/article-1158908/Schizophrenic-serial-killer-murdered-people-attack-

inspired-horror-film-failed-NHS.html#ixzz1j3g6AA7g
http://www.dailymail.co.uk/news/article-1158908/Schizophrenic-serial-killer-murdered-people-attack-inspired-horror-film-failed-NHS.html%252523ixzz1j3g6AA7ghttp://www.dailymail.co.uk/news/article-1158908/Schizophrenic-serial-killer-murdered-people-attack-inspired-horror-film-failed-NHS.html%252523ixzz1j3g6AA7ghttp://www.dailymail.co.uk/news/article-1158908/Schizophrenic-serial-killer-murdered-people-attack-inspired-horror-film-failed-NHS.html%252523ixzz1j3g6AA7ghttp://www.dailymail.co.uk/news/article-1158908/Schizophrenic-serial-killer-murdered-people-attack-inspired-horror-film-failed-NHS.html%252523ixzz1j3g6AA7ghttp://www.dailymail.co.uk/news/article-1158908/Schizophrenic-serial-killer-murdered-people-attack-inspired-horror-film-failed-NHS.html%252523ixzz1j3g6AA7ghttp://www.dailymail.co.uk/news/article-1158908/Schizophrenic-serial-killer-murdered-people-attack-inspired-horror-film-failed-NHS.html%252523ixzz1j3g6AA7ghttp://www.dailymail.co.uk/news/article-1158908/Schizophrenic-serial-killer-murdered-people-attack-inspired-horror-film-failed-NHS.html%252523ixzz1j3g6AA7ghttp://www.dailymail.co.uk/news/article-1158908/Schizophrenic-serial-killer-murdered-people-attack-inspired-horror-film-failed-NHS.html%252523ixzz1j3g6AA7ghttp://www.dailymail.co.uk/news/article-1158908/Schizophrenic-serial-killer-murdered-people-attack-inspired-horror-film-failed-NHS.html%252523ixzz1j3g6AA7ghttp://www.dailymail.co.uk/news/article-1158908/Schizophrenic-serial-killer-murdered-people-attack-inspired-horror-film-failed-NHS.html%252523ixzz1j3g6AA7ghttp://www.dailymail.co.uk/news/article-1158908/Schizophrenic-serial-killer-murdered-people-attack-inspired-horror-film-failed-NHS.html%252523ixzz1j3g6AA7ghttp://www.dailymail.co.uk/news/article-1158908/Schizophrenic-serial-killer-murdered-people-attack-inspired-horror-film-failed-NHS.html%252523ixzz1j3g6AA7ghttp://www.dailymail.co.uk/news/article-1158908/Schizophrenic-serial-killer-murdered-people-attack-inspired-horror-film-failed-NHS.html%252523ixzz1j3g6AA7ghttp://www.dailymail.co.uk/news/article-1158908/Schizophrenic-serial-killer-murdered-people-attack-inspired-horror-film-failed-NHS.html%252523ixzz1j3g6AA7ghttp://www.dailymail.co.uk/news/article-1158908/Schizophrenic-serial-killer-murdered-people-attack-inspired-horror-film-failed-NHS.html%252523ixzz1j3g6AA7ghttp://www.dailymail.co.uk/news/article-1158908/Schizophrenic-serial-killer-murdered-people-attack-inspired-horror-film-failed-NHS.html%252523ixzz1j3g6AA7ghttp://www.dailymail.co.uk/news/article-1158908/Schizophrenic-serial-killer-murdered-people-attack-inspired-horror-film-failed-NHS.html%252523ixzz1j3g6AA7ghttp://www.dailymail.co.uk/news/article-1158908/Schizophrenic-serial-killer-murdered-people-attack-inspired-horror-film-failed-NHS.html%252523ixzz1j3g6AA7ghttp://www.dailymail.co.uk/news/article-1158908/Schizophrenic-serial-killer-murdered-people-attack-inspired-horror-film-failed-NHS.html%252523ixzz1j3g6AA7ghttp://www.dailymail.co.uk/news/article-1158908/Schizophrenic-serial-killer-murdered-people-attack-inspired-horror-film-failed-NHS.html%252523ixzz1j3g6AA7ghttp://www.dailymail.co.uk/news/article-1158908/Schizophrenic-serial-killer-murdered-people-attack-inspired-horror-film-failed-NHS.html%252523ixzz1j3g6AA7ghttp://www.dailymail.co.uk/news/article-1158908/Schizophrenic-serial-killer-murdered-people-attack-inspired-horror-film-failed-NHS.html%252523ixzz1j3g6AA7ghttp://www.dailymail.co.uk/news/article-1158908/Schizophrenic-serial-killer-murdered-people-attack-inspired-horror-film-failed-NHS.html%252523ixzz1j3g6AA7ghttp://www.dailymail.co.uk/news/article-1158908/Schizophrenic-serial-killer-murdered-people-attack-inspired-horror-film-failed-NHS.html%252523ixzz1j3g6AA7ghttp://www.dailymail.co.uk/news/article-1158908/Schizophrenic-serial-killer-murdered-people-attack-inspired-horror-film-failed-NHS.html%252523ixzz1j3g6AA7g


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Schizophrenia

in the news

Paranoid schizophrenic released into community to murder

Paranoid schizophrenic Tennyson Obih who was sectioned twicebefore being released into care in the community went "off the radar"of the health services and murdered a policeman in broad daylight.

'Community care' schizophrenics have killed 60


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DSM and ICD 10

Two or more (in last month)

Delusions

Hallucinations

Disorganised speech

Disorganised behaviour

Negative symptoms (flat affect, socialwithdrawal)


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Features

Perception (hallucinations

Thought (delusions)

Emotion (anxiety and depression)

Behaviour (sleep disturbed, impulsive, OCD,mutism)

Interpersonal adjustment(withdrawal/deterioration in relationships)


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Schizophrenia, paranoid type is characterized bypersecutory (feeling victimized or spied on) orgrandiose delusions, hallucinations, and occasionally,excessively religiosity (delusional focus) or hostile andaggressive behavior.

Schizophrenia, disorganized type is characterized bygrossly inappropriate or flat affect, incoherence, looseassociations, and extremely disorganized behavior.

Schizophrenia, catatonic type is characterized bymarked psychomotor disturbance, either motionless orexcessive motor activity. Motor immobility may bemanifested by catalepsy (waxy flexibility) or stupor.

Schizophrenia, undifferentiated type is characterizedby mixed schizophrenic symptoms (of other types)along with disturbances of thought, affect, andbehavior.

Schizophrenia, residual type is characterized by atleast one previous, though not a current, episode,social withdrawal, flat affect and looseness ofassociations.


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Is it common?

Prevalence is 1 percent (more male than

female)

Many (25%) have a single episode with a good

outcome

Many (25%) have multiple relapses but

function well in between

50% seem to struggle throughout their lives


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Annoying Concepts of

Schizophrenia


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Delusions


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Some Delusions are good

for our confidence


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Joan of Arc

God spoke to her She led France to victory

She has been canonised

Today she would be sectioned


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E i


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Experiences are very

strange


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Distortion in perception


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A t f th lf b


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A part of the self becomes

personified


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Th E i f


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The Experience of

psychosis in Film


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I See Dead people


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Causes

Genetic predisposition

Dopamine dysfunction hypothesisNeurodevelopmental hypothesis (growing

evidence for this from brain imaging)

Psychological (brain overloaded and the mindfractures/splits)


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Importance of Environment


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Treatments

Medication

CBT


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CBT

Thoughts

Behaviour


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Psychological treatment

Reducing sensory input

Teaching distraction techniques and ways tocope with the voices

Increasing physical activity

Modulating social interactionsLearning stress management


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Medications

Side effects of typical antipsychotics can include:

- Stiffness and shakiness this can often be reduced by lowering the dose. However, if a high dose isnecessary, the shakiness can be treated with the same kind of medication that is used for Parkinsons

disease.

- Uncomfortable restlessness (akathisia)

- Persistent abnormal movement, usually of jaw, lips and tongue (tardive dyskinesia)

- Sexual problems due to hormonal changes

Side effects of atypical antipsychotics can include:

- Sleepiness and slowness (sedation)

- Severe weight gain (obesity)

- Diabetes

- Stiffness and shakiness which can be treated with anti-parkinsonian medications

- Sexual problems due to hormonal changes


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Rufus May and the Doctor who

heard voices


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A Radical Approach


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Conclusion

Psychosis is a symptom of lots of different mental illnesses

Schizophrenia is one of these and there are several types of

schizophrenia

From a psychological perspective its more helpful to think aboutpsychosis as a symptom to be understood and managed

Psychotic experiences include delusions and hallucinations

One in a hundred people will be diagnosed with schizophrenia.

Psychotic experiences are even more common.

There are many interacting causes of psychosis

There are many ways of treating and helping people manage their

symptoms

The biggest barriers to recovery include stigma

Documents

The Physhology of Schizophrenia