Mental Health & Public Policy Symposium SCHIZOPHRENIA: A BRAIN DISEASE Alex Kopelowicz, M.D. UCLA School of Medicine San Fernando Mental Health Center

SCHIZOPHRENIAS ARE: A group of biological disorders... That produce handicaps in thinking, learning and social relationships... For which no cure is known... But new treatments promote improved quality of life.

SCHIZOPHRENIAS ARE NOT All psychoses Split personality Contagious Anyone’s fault Hopeless

SYMPTOM CLUSTERS POSITIVE NEGATIVE Hallucinations Few feelings Delusions Loss of motivation IMPAIRMENTS work work relationships relationships self-care self-care COGNITIVE MOOD Memory Depression Problem-solving Hopelessness

SCHIZOPHRENIA ALTERS BRAIN FUNCTIONING

FRONTAL LOBES GOVERN Drive and Ambition Problem solving Cognitive flexibility Capacity to plan Time sequential thinking Social awareness Empathy Mood Insight Impulsivity Judgment Abstraction Working memory

MISSING FRONTAL LOBES

REDUCED FRONTAL LOBE ACTIVITY NormalSchizophrenia

BRAIN FAILS TO ACTIVATE TO DO TASK

TEMPORAL LOBE FUNCTIONS Perception Reality Orientation Memory

REDUCED TEMPORAL LOBE STRUCTURES

BASAL GANGLIA FUNCTIONS Inhibit unwanted sensory input Filter out irrelevant sensory input Regulate arousal Govern concentration

REDUCED BASAL GANGLIA ACTIVITY REDUCED BASAL GANGLIA ACTIVITY

VARIATION IN BASAL GANGLIA ACTIVITY

LIMBIC SYSTEM FUNCTIONS Understanding emotional events Linking current perception to past memories Learning from experience

REDUCED LIMBIC SYSTEM STRUCTURES

TANGLED CELLS IN LIMBIC SYSTEM

GENETIC RISK OF SCHIZOPHRENIA If you have a Your chance of getting Schizophrenic... schizophrenia is... Identical twin46% Both parents48% Sibling or Parent12% Aunt, Nephew, Grandparent 5% First cousin, great aunt 2% No relatives 1%

ANTIPSYCHOTIC MEDICATIONS REDUCE l Hallucinations and delusions l Negative symptoms l Bizarre behavior l Agitation l Hostility and aggression l Disordered thinking

MEDICATION RESTORES BRAIN FUNCTIONING

ANTIPSYCHOTIC MEDICATION ANTIPSYCHOTIC MEDICATION l Reduces relapse rates l Reduces brain dysfunction l Improved medications available l Unique and individual response l First step to recovery

STRATEGY OF TREATMENT l Control symptoms with medication l Form a personal relationship l Teach disease management skills l Teach compensatory techniques l Help maximize unique potential