Paranoid Schizophrenia The Schizies: Becky Guiler, Misty Mahan, Renee Pittman, and Keima Thomas

DSM-IV-TR Diagnostic Criteria: Schizophrenia Characteristic symptoms: Two (or more) of the following, each present for a significant portion of time during a 1-month period (or less if successfully treated):  (1) delusions – false beliefs that usually involve a misinterpretation of perceptions or experiences (2) hallucinations (3) disorganized speech (e.g., frequent derailment or incoherence)  ** “Derailment is disordered thought in which the idea changes spontaneously to another idea that is unrelated or only distantly related” (BehaveNet.com, 2008)

DSM-IV-TR Diagnostic Criteria: Schizophrenia (4) grossly disorganized or catatonic behavior (5) negative symptoms, i.e., affective flattening, alogia, or avolition **Affective flattening is “complete or nearly complete absence of affective expression” (BehaveNet.com, 2008). **Affect is “outward behaviors, including but not limited to facial expression and vocal modulation, which express emotions” (BehaveNet.com, 2008). **Alogia is lacking or limited thinking as evidence by empty or limited speech (BehaveNet.com,2008). **Avolition is “absence of initiative or motivation to begin and maintain behavior in pursuit of a goal” (BehaveNet.com, 2008).

DSM-IV-TR Diagnostic Criteria: Schizophrenia Note: Only one Criterion A symptom is required if delusions are bizarre or hallucinations consist of a voice keeping up a running commentary on the person's behavior or thoughts, or two or more voices conversing with each other.  B. Social/occupational dysfunction: There is a decrease in levels of major areas of functioning such as work, interpersonal relations, or self-care for a significant portion of time since onset C. Duration: Continuous signs of the disturbance persist for at least 6 months. D. – F. The disorder is not better characterized or due to Schizoaffective Disorder and Mood Disorder With Psychotic Features, use of a substance or general medical condition, or a developmental disorder (See DSM-IV-TR for criteria needed for making a dual diagnosis.)

Characteristics of Schizophrenia Prevalence: In the range of .5% - 1.5% of the population and occurs equally among men and women. Onset for men is typically between ages 18 – 25. Onset for women is typically between ages 25 – mid 30’s. “A majority of individuals with Schizophrenia have poor insight regarding the fact that they have a psychotic illness” (DSM-IV-TR, 2000).

DSM-IV-TR Diagnostic Criteria: Paranoid Schizophrenia (295.30) A type of Schizophrenia in which the following criteria are met:  A. Preoccupation with one or more delusions or frequent auditory hallucinations. B. None of the following is prominent: disorganized speech, disorganized or catatonic behavior, or flat or inappropriate affect. Delusions are typically persecutory or grandiose, or both, but delusions with other themes may also occur (e.g. jealousy) and are usually organized around a coherent theme. Hallucinations are typically related to the delusional theme. With persecutory delusions the person believes he or she is being tormented, followed, tricked, spied on, or ridiculed. These delusions could predispose the individual to suicidal behavior.

DSM-IV-TR Diagnostic Criteria: Paranoid Schizophrenia (295.30) Associated features include anxiety, anger, aloofness, and argumentativeness. The individual may have a superior and patronizing manner or extreme intensity in interpersonal interactions. Combinations of delusions with anger may predispose the individual to violence. Onset tends to be later in life than the other types of schizophrenia. Show little or no impairment on neuropsychological or other cognitive testing. Some evidence suggests that individuals with paranoid schizophrenia may have better chance of functioning at work and living on their own than the other types of schizophrenia.

Examples of Paranoid Schizophrenia Barbara Tetty Dee Dee ( Be prepared it’s kind of gross). Being a Schizophrenic

There are many different medications to treat Paranoid Schizophrenia

Treatments for Paranoid Schizophrenia Like many other mental illnesses, schizophrenia is usually treated with a combination of therapies, tailored to the individual’s symptoms and needs. Antipsychotic medications under the supervision of a psychiatrist is the treatment of choice for schizophrenia, because the illness is related to biochemical imbalances. These medications can reduce hallucinations, delusions and disordered thinking, but few of them adequately treat the social withdrawal and apathy that occurs in schizophrenia.

Types of Drugs In the last decade new "atypical" antipsychotics have been introduced. Compared to the older "conventional" antipsychotics these medications appear to be equally effective for helping reduce the positive symptoms like hallucinations and delusions - but may be better than the older medications at relieving the negative symptoms of the illness, such as withdrawal, thinking problems, and lack of energy. The atypical antipsychotics include aripiprazole (Abilify), risperidone (Risperdal), clozapine (Clozaril), olanzapine (Zyprexa), quetiapine (Seroquel) thiothixene (Navane).

Drugs Navane Pronounced: NA-vain Generic name: Thiothixene Navane is used in the treatment of schizophrenia (a disruption of thought and the understanding of reality). Researchers theorize that antipsychotic medications such as Navane work by lowering levels of dopamine, a neurotransmitter (or chemical messenger) in the brain. Excessive levels of dopamine are believed to be related to psychotic behavior.

Drugs Clozaril Pronounced: KLOH-zah-ril Generic name: Clozapine Clozaril is given to help people with severe schizophrenia who have failed to respond to standard treatments. It is also used to help reduce the risk of suicidal behavior in people with schizophrenia. Clozaril is not a cure, but it can help some people return to more normal lives.

Drugs Abilify Pronounced: a-BILL-i-fie Generic name: Aripiprazole Abilify is used in the treatment of schizophrenia, the psychological disorder that causes its victims to lose touch with reality, often triggering hallucinations, delusions (false beliefs), and disorganized thinking. The drug is thought to work by modifying sensitivity to two of the brain's chief chemical messengers, serotonin and dopamine.

Drugs Risperdal Pronounced: RIS-per-dal Generic name: Risperidone Other brand name: Risperdal M-Tab Risperdal is prescribed for the treatment of schizophrenia, a severe mental disorder that can cause delusions (false beliefs) and hallucinations.

Drugs Seroquel Pronounced: SER-oh-kwell Generic name: Quetiapine fumarate Seroquel is prescribed for the treatment of schizophrenia, a mental disorder marked by delusions (false beliefs), hallucinations, disrupted thinking, and loss of contact with reality.

Drugs Side Effects As with all medications, antipsychotic medications have side effects. Some, such as dry mouth, dizziness, drowsiness and constipation, go away with time. Other side effects include restlessness, tremor and muscle spasms, cramping or stiffness. An irreversible side effect is tardive dyskinesia, which causes abnormal movements in the mouth, face and later in the arms and legs.

Drugs Side Effects The two classes of antipsychotics are generally thought equally effective for the treatment of the positive symptoms. Some researchers have suggested that the atypicals offer additional benefit for the negative symptoms and cognitive deficits associated with schizophrenia, although the clinical significance of these effects has yet to be established. Recent reviews have refuted the claim that atypical antipsychotics have fewer extrapyramidal side effects than typical antipsychotics, especially when the latter are used in low doses or when low potency antipsychotics are chosen.

Drugs Side Effects Many of these side effects can be helped or avoided when reported to the psychiatrist. It is important not to abruptly stop taking the medications, increase the medications or take additional medications without consulting a doctor. Such changes can cause relapse or other serious problems. Medication is usually prescribed through the remission phase of the illness to prevent relapse. Though relapse may occur even when medication is taken as prescribed, taking the medication provides the best protection from future relapse.

References American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text revision). Washington, DC: American Psychiatric Association. Dr. Davis (lecture) BehaveNet.com. (2008) Retrieved March 12, 2008 from http://www.behavenet.com/ HealthSquare.com Wikipedia.com Utube.com PANSS Training DVD, Volume I: Harvey, Barbara, and Dennis 2004 by The PANSS Institute LLC & Philip R. Muskin,MD Schizophrenia.com. (2007) Retrieved March 13, 2008 from http://www.spizophrenia.com/