Chapter XII: Schizophrenia

Schizophrenia

• Psychosis

• Prevalence: 1% of population

• symptoms: 6+ mo & deterioration in work, social relationships, & self-care

• Downward drift

• Onset men: 23 onset: 28, equal in men & women

Symptoms of Schizo

• Positive

  • pathological excesses

• delusions'

  • persecution

  • reference

  • grandeur

  • control

• disorganized thinking & speech

  • loose association, neologisms, perseveration, & clang/rhyme

• hallucinations

• inappropriate affect

Negative symptoms:

• alogia/poverty of speech

• restricted affect

• loss of volition

• social withdrawl

• pyschomotor symptoms; catatonic;

  • stupor

  • rigidity

  • posturing

  • excitement

Course of Schizophrenia

• prodromal phase

• active phase

• residual phase

  • ¼ recover

• type i

• type ii

Biological Causes

• genetic factors

  • identical twins: 48% frateral: 17%

  • two schizo parents

  • polygenic disorder

• biochem abnormalities

  • dopamine hypothesis

  • antipsychotic drugs

    • phenothiazines & D2 receptors

    • atypical antipsychotic drugs -serotonin

• abnormal brain structure

  • enlarged ventricles

• viral problems

Psychological Causes

• Cognitive

  • misinterpretation of sensory problems

• sociocultural views

  • multicultural factors

    • higher rates in african americans

    • course & outcome vary by country

  • social labeling

  • family dysfunction

    • expressed emotion

Treatment

• Institutional treatment

  • milieu therapy - maxwell jones

• token economy

• antipsychotic drugs

  • phentothiazines

  • conventional antipsychotic drugs

  • atypical antipsychotic drugs

• unwanted effects

  • parkinsons symptoms

  • taradive dyskinesia

• cognitive-behvaioral therapy

• family therapy

• social therapy

• community approach

  • community mental health act

  • effective community care

  • problems with community treatment