Schizophrenia True or False?  Schizophrenia exists in the same form in every culture that has been studied.  Visual hallucinations (“seeing things”) are the most common type of hallucinations in people with schizophrenia.  It is normal for people to hallucinate nightly.  If you have two parents with schizophrenia, it’s nearly certain that you will develop schizophrenia yourself.  Although schizophrenia is widely believed to be a brain disease, evidence of abnormalities in the brains of schizophrenic patients remains lacking.  We now have drugs that not only treat schizophrenia but can also cure it in many cases.  Some people have delusions that they are loved by a famous person.

Schizophrenia- what it isn’t  It is NOT dissociative identity disorder.  People afflicted with schizophrenia or any of the psychotic disorders to not have several people or personalities in one body.

So, what is it?  A cognitive disorder (as opposed to the emotional disorders we have studied so far). It involves motor function, perception, and some emotion, but it is primarily a cognitive issue.  The term ‘schizophrenia’ actually refers to a group of disorders characterized by confused and disconnected thoughts, emotions, and perceptions.

Major Features of Schizophrenia Two or more of the following must be present for a significant portion of time over the course of one month:  Delusions: false beliefs maintained in the face of contrary evidence  Hallucinations: perceptions in the absence of corresponding sensation; “hearing voices,” “seeing things”  Incoherence: marked decline in thought processes; indicated by use of a “word salad” in which the speaker gradually speeds up his or her speech to the point where it all becomes a jumble of words seemingly thrown together  Disturbances of affect: emotions that are inappropriate for the circumstances  Deteriorations in normal movement: slowed movement, catatonic behavior, or highly agitated behavior  Decline in previous levels of functioning  Diverted attention: possibly brought on by cognitive flooding

Causes of Schizophrenia  Biochemical Factors: excessive levels of dopamine have been linked to schizophrenia.  Viral Infections: theory, those exposed to influenza during the 1 st trimester of their prenatal development have seven times the chance of developing schizophrenia.  Brain Abnormalities: Many (though notable not all) schizophrenic patients have up to 5% more brain tissue loss than those without schizophrenia.

Treating Schizophrenia  Anti-psychotics: drug therapy is often used to help patient cope with having schizophrenia and to lessen symptoms or episodes  Personal Therapy: working one on one with a psychoanalyst to help patients cope with stress and build social skills (helps reduce relapse rates and improve social functioning)

 Disorganized Schizophrenia: characterized by  disorganized behavior: including incoherent speech, silly irrelevant laughter, and inappropriate affect  bizarre delusions often involving sexual or religious themes  vivid hallucinations A 40-year old man who looks more like 30 is brought to the hospital by his mother, who reports that she is afraid of him. It is his twelfth hospitalization. He is dressed in a tattered overcoat, baseball cap, and bedroom slippers, and sports several medals around his neck. His affect ranges from anger (hurling obscenities at his mother) to giggling. He speaks with a childlike quality and walks with exaggerated hip movements and seems to measure each step carefully. Since stopping his medication about a month ago, his mother reports, he had been hearing voices and looking and acting more bizarrely. He tells the interviewer he has been “eating wires” and lighting fires. His speech is generally incoherent and frequently falls into rhyme and clanging associations. His history reveals a series of hospitalizations since the age of 16. Between hospitalizations, he lives with his mother, who is now elderly, and often disappears for months at a time, but is eventually picked up by police for wandering the streets. Sub-types of Schizophrenia

 Catatonic Schizophrenia: characterized by gross disturbances in motor activity, such as catatonic stupor.  Patient may, however, still be aware of what is happening around them, despite being unable to respond  Movements typically slow down until they reach a stupor, but may abruptly switch into an agitated phase.  May maintain unusual or apparently strenuous positions for hours, despite limbs becoming stiff or swollen.  Waxy flexibility may also be a feature. *Note: catanonia is not unique to schizophrenia. It is more typically found in those with mood disorders Sub-types of Schizophrenia

 Paranoid Schizophrenia: characterized by hallucinations and systematized delusions, commonly involving themes of persecution.  Hallucination of grandeur: “I am the savior of my people”  Delusion of persecution: “Someone is always watching me!”  Film clip: A Beautiful Mind