Schizophrenia

Definition: Schizophrenia was formerly known as dementia praecox. The term "dementia praecox" is derived from Latin, meaning "out of one's mind before one's time."
The renaming was done by Swiss psychiatrist Eugene Bleuler, to better describe the disease, particularly the mental divisions within thoughts, feelings, and behavior, which he termed "schizophrenia" (literally meaning "split mind").
Distinction: Schizophrenia is often confused with dissociative identity disorder, also formerly known as split personality disorder, but they are distinct disorders.

Nature: Schizophrenia is a long-lasting psychotic disorder characterized by a severe break from reality, leading to an inability to distinguish what is real from fantasy.
Affects: The disorder impacts thinking, emotions, behavior, and perception.
Onset: Typically arises in late teens or early twenties; affects both males and females and is consistent across cultures.

Definition of Positive Symptoms: Refers to excess or addition to normal behavior, not positive in a good connotation.
Delusions:
- Definition: An unshakeable false belief held despite evidence to the contrary. Not all individuals with schizophrenia have prominent delusions.
- Common types include:
  - Delusions of Persecution: Belief that others are trying to harm them.
  - Delusions of Reference: Belief that other people, TV characters, or even books are specifically addressing them.
  - Delusions of Influence: Belief that they are being controlled by external forces (e.g., the devil, aliens).
  - Grandiose Delusions: Belief that they have extraordinary powers or a special mission.
Speech Disturbances: Includes making up words, repeating phrases, stringing words based on sounds (called clanging), and sudden interruptions in speech or thought.
Hallucinations: The most common form is auditory hallucinations (hearing voices). Visual and other sensory hallucinations (taste, touch, smell) are less prevalent.
Emotional Disturbances: Characterized by flat affect (little to no emotional expression), or inappropriate emotional responses (e.g., laughing when sadness is more appropriate).
Disorganized Behavior: Behaviors may be odd and disjointed, including not responding to the environment at all (catatonia) or exhibiting erratic movements.

Definition of Negative Symptoms: Refers to a reduction or absence of normal behavior.
Common issues include attention deficits and poor focus due to an inability to screen out superfluous information, also leading to disorganized thoughts.
Example of discourse: "word salad" - a mixture of meaningless or jumbled words and phrases.

The speaker states that they have rarely diagnosed someone with schizophrenia but recounts two cases observed during their teaching tenure.
These cases illustrate how trauma may act as a trigger for those with genetic vulnerabilities.

Biological Models: Indicate that both genetic and environmental factors contribute to the onset of schizophrenia.
- Neurodevelopmental Hypothesis: Suggests that genetic predispositions combined with environmental influences can lead to the disorder.
- Factors include:
- Genetics: Family twin and adoption studies support genetic contributions, with rates of 7-8 individuals out of 1000 developing schizophrenia across various cultures.
- Prenatal Influences: Viral infections experienced by the mother during pregnancy may contribute.
- Neurotransmitter Imbalances: Involvement of dopamine, GABA, and glutamate.
- Structural Brain Defects: Issues with the frontal lobe and reduced white matter integrity.
Dopamine Hypothesis:
- Initially proposed from observing psychotic symptoms in amphetamine users, as amphetamines increase dopamine levels. Treatments for schizophrenia often focus on diminishing dopamine activity in areas associated with positive symptoms.
- The prefrontal cortex, responsible for planning and organization, may produce lower dopamine levels, correlating with negative symptoms and attention deficits.

Twin Studies: Identical twins have a 50% risk factor for developing schizophrenia if one twin is affected, yet this highlights the influence of environmental factors.
Adoption Studies: Show that adoptees with schizophrenia had biological relatives also diagnosed, but only among biological connections, indicating genetic factors play a significant role.
The Stress Vulnerability Model proposes that genetic predispositions must be triggered by environmental stressors during critical developmental periods (e.g., puberty).
Observations suggest that the brain's immune system heightened during stress may contribute to new-onset schizophrenia.

The complexity of schizophrenia is acknowledged, as it is influenced by a combination of various factors, including genetic, prenatal, and postnatal influences.
The speaker ties in personal experiences of cases to illustrate theoretical points discussed.

The speaker indicates that a discussion on addictive disorders will follow, but emphasizes that this content will not be included in the upcoming test, but aims to enhance understanding of behavioral issues related to schizophrenia.