A Powerpoint Presentation SCHIZOPHRENIA A Powerpoint Presentation by: Kathryn Kicklighter

SCHIZOPHRENIA It is the most prevalent of chronic psychotic disorders. It affects 1-2% of the population It can be severely debilitating Those affected have an abnormal interpretation of reality. Its distinguishing characteristics include a combination of positive and negative symptoms the most prevalent being: Hallucinations Lack of socialization Delusions Disordered Thinking and Behavior

ONSET Average onset in the mid to late 20‘s Males present earlier than females Incidence of childhood onset is growing-- especially when one or both of a child’s parents are diagnosed

SUBTYPES The most common subtypes are: Even though there are several subtypes of schizophrenia, the clinical presentation is wide enough that not everyone can easily fit into a specific category. The most common subtypes are: Paranoid. Characterized by delusions and hallucinations, this type generally involves less functional impairment and offers the best hope for improvement. Catatonic. People with this subtype don't interact with others, get into bizarre positions, or engage in meaningless gestures or activities. Disorganized. Characterized by disorganized thoughts and inappropriate expressions of emotion, this type generally involves the most functional impairment and offers the least hope for improvement. Undifferentiated. This is the largest group of people with schizophrenia, whose dominant symptoms come from more than one subtype. Residual. This type is characterized by extended periods without prominent positive symptoms, but other symptoms continue.

POPULATION Substance abuse is the most frequent co-occurring disorder with Schizophrenics Because schizophrenics isolate themselves from others and they exhibit odd and often extreme behaviors, they are typically unable to keep a job and, thus, make up a large percentage of the homeless population

PATHOPHYSIOLOGY There is not a clearly discovered cause of schizophrenia. Most experts believe there to be many pathophysiologic factors involved in its development. One of the most clear discoveries, is that there is a discrepancy between the amount of dopamine in a healthy brain than a schizophrenic brain. Some scientists believe some symptoms of schizophrenia can be attributed to an overactive dopamine system. To further support the evidence of the dopamine theory, included in the most affective drugs available for schizophrenia are those that block dopamine receptors. Despite the stacking evidence, this overactivity of dopamine is not an official cause of schizophrenia. What is known is that the pathophysiology is very complex. No one answer seems to fit exactly. Researchers are continually striving to learn more about schizophrenia's pathophysiology

RISK FACTORS Genetics and environment are the only known risk factors of schizophrenia. Both are necessary for schizophrenia to develop. GENETICS: Heredity is a major contributor to the development of schizophrenia.Those with schizophrenic family members are at a higher risk for developing it themselves. Several specific genes have been associated with susceptibility for development of the disease; but, not a single variation has been found as a cause. ENVIRONMENT: Many environmental factors may be put a person at risk for schizophrenia. These include: Exposure to viruses or malnutrition before birth Problems during birth, Other not yet known psychosocial factors

CLINICAL MANIFESTATIONS Symptoms of schizophrenia can be placed into two broad categories: These manifestations are wide and evolve over time. Positive symptoms Ambivalence Associative looseness Delusions Echopraxia Flight of Ideas Hallucinations Ideas of Reference Perseveration Negative symptoms Alogia Anhedonia Apathy Blunted affect Catatonia Flat Affect Lack of Volition

DIAGNOSTIC TESTS Most frequent, Schizophrenia is diagnosed by psychological or psychiatric evaluation. A diagnosis of schizophrenia requires a person to meet the criteria in the American Psychiatric Association’s Diagnostic and Statistical Manual of Medical Disorders (DSM) When the psychological or psychiatric evaluation is performed, the doctor evaluates the patient’s mental status through observing appearance, demeanor and questioning. Typical questions asked by a Psychologist or Psychiatrist include those related to: Thought Process and Content Daily Moods Suicidal and Homicidal Ideations Hallucinations Delusions Substance Abuse etc.

OTHER TESTS SPECT scans may be used to detect small changes in the brains of people with schizophrenia. These visible changes include: Ventricles are larger in some people with schizophrenia Schizophrenics tend to have less gray matter Some areas of the brain may have less or more activity.

PHARMACOTHERAPY Pharmacologic therapy for schizophrenics is targeted to eliminate the disease symptoms. Antipsychotics are the drugs of choice for schizophrenia.These include but are not limited to the following: Although these medications help to relieve the symptoms associated with schizophrenia, most patients with this disorder will learn to cope with the symptoms throughout their lives. Risperidone (Risperdal) Olanzapine (Zyprexa) Quetiapine (Seroquel) Ziprasidone (Geodon) Aripiprazole (Abilify) Paliperidone (Invega)

EVIDENCE-BASED TREATMENT MODALITIES In addition to treatments of antipsychotic medications, various psychosocial treatments have also been proven affective with schizophrenics. Psychosocial treatments Psychosocial treatments can assist schizophrenias who are stabilized on medication. Psychosocial treatments help these stabilized patients deal with daily challenges of their disorder. These include: A therapist might help patients more whole understand and adapt to living with their disorder. Using learned coping strategies to face these issues allow schizophrenics to socialize and attend school and work. Patients who receive regular psychosocial treatment also shown to be more likely to continue their medication, and are subsequently less likely to have relapses leading to a need for hospitalization. Difficulty with communication Self-care Work Forming and keeping relationships Etc

YouTube VIDEO https://www.youtube.com/watch?v=B9v4FsKXmj8 This video is about the growing diagnosis of Childhood Schizophrenia. As you see the videos of this young schizophrenic as an infant, the role genetics play in this disorder is undeniable. Although uncommon in the past, childhood schizophrenia is presenting more frequently and the awareness videos like this bring is invaluable.

REFERENCES YouTube.com googleimages.com Adams, M. P., & Holland, L. N. (2014). Pharmacology for nurses: A pathophysiologic approach (4th ed.). Pearson. ISBN-13: 978-0-13-508981-1. http://www.nimh.nih.gov/health/topics/schizophrenia/index.shtml http://www.schizophrenia.com http://www.mayoclinic.com/health/schizophrenia/DS00196/TAB=indepth