1. SCHIZOPHRENIA Julian Prosser, Katana Tripi, Trevor Balnaves, Rachel Crowe, & Taylor Eberhart

2. DSM V Diagnosis  It is characterized by the following:  Delusions  Hallucinations  Disorganized Speech & Behavior  Other symptoms that cause social or occupational dysfunction  For a diagnosis symptoms must be:  Present for six months  Active for at least one month

3. DSM V Changes in Diagnosis  Increased symptom threshold that an individual exhibit at least two of the specified symptoms, which previously it only required one symptom.  The diagnostic criteria no longer identify subtypes.  Symptoms frequently changed from one subtype to another and caused overlap  It caused unclear distinctions of the five subtypes which decreased their validity  Subtypes can now help specify the diagnosis to provide more detail

4. Epidemiology  Etiology – excess of dopamine (neurotransmitter)  Those that are diagnosed can be separated into three broad groups:  Those treated successfully with a full recovery  Those in partial recovery leading a reasonably normal life  Those with little or no recovery having repeated hospitalizations

5. Epidemiology Cont’d  The median incidence rate was 15.2/100,000 (1.5%)  Higher incidence among the lower class 3:1  The overall heritability estimate for the liability to schizophrenia is 60% to 70%. The risk for schizophrenia in close relatives of schizophrenics is 5 to 15 times greater than in the general population  Two Hypothesis: 1. These individuals fail to achieve their potential and suffer a decline in occupational performance relative to expectation 2. One of the cardinal features of schizophrenia—the failure ever to achieve one’s potential or, once diagnosed, to return to one’s best previous level of functioning.

6. Epidemiology Cont’d  In the Suffolk County Mental Health Study: 65.2% (148/227) of people with a research diagnosis of DSM-IV schizophrenia or schizoaffective disorder were male. This generically speaking is a male to female rate ratio of 1.4:1  There is wide variation in incidence rates of schizophrenia across populations, regions, and groups and that this variation cannot be accounted for on a methodological basis only.  Countries characterized by a large rich–poor gap may be at increased risk of schizophrenia. It is suggested that income inequality impacts negatively on social cohesion, eroding social capital, and that chronic stress associated with living in highly disparate societies places individuals at risk of schizophrenia.  Heredity is a large factor: 45% chance for identical twins or offspring of two persons with disorder; 15% for fraternal twin or offspring of one person with disorder; 10% for a sibling; 4% for nephew or niece

7. Risk Factors  Family History  Pregnancy  Risks during gestation:  Mothers use of medication  Physical trauma during pregnancy  Inflammatory disease/infection  Prenatal poor nutrition  Increased immunoglobulin GEM

8. Risk Factors Cont’d  Risks at Birth  Being male (2x as likely)  Prolonged delivery  Born in the Spring/Winter  High fever (febrile seizure) during infancy  Raised in an urban setting

9. Risk Factors Cont’d  Risks in Adulthood  Being migrant  Being divorced or never married  Unemployment  Low social class

10. Protective Factors  Living in areas of high ethnic density  Early cognitive training  Residing in rural communities  Increase in Vitamin D  Healthy, low-stress family environment

11. Interventions - Micro  Family  Family education is about providing support, education, and resources to the family members of someone with schizophrenia. Family interventions are strength based which include psycho-education, behavior problem solving, family support, and crisis management.

12. Interventions - Micro  Psychotherapy  Focuses on the client with schizophrenia in individual and group settings. Psychotherapies are used to help a client define reality. Therapist and groups can be used to reassure, give advice, and organize environment for the client.

13. Interventions - Micro  Medication  Using medication in schizophrenia can not be used to cure it, however it can help to minimize some of the symptoms that come with schizophrenia.

14. Interventions - Macro  Grand Challenges in Global Mental Health (GCGMH)  They provide a framework for schizophrenia research worldwide. The reason for GCGMH is to develop a multinational perspective on the policies that govern human research in mental health specifically schizophrenia.

15. Community Resources 1410 S. Telegraph Rd. Bloomfield Hills, MI 48302 (248) 456-8150 or contact the crisis center at (800) 231-1127 Provides free, safe 24 hour shelter for mental health individuals, as well as 3-week residential counseling to runaways and youth ages 10-17 15920 W. Twelve Mile Southfield, MI 48076 (810) 557-6777 Schizophrenics Anonymous is a self-help group for persons who have schizophrenia. Common Ground Schizophrenics Anonymous

16. Community Resources Cont’d 12800 E. Warren Ave. Detroit, MI 48215 (313) 824-8000 Provides mental health services for children, families, and adults and also work towards community support. 1700 Waterman St. Detroit, MI 48209 (313) 841-8900 Offers mental health treatment, case management, assessments, therapy including group individual and family, as well as mentoring, employment, and youth assistance programs Northeast Guidance Center Southwest Counseling and Development Services

17. Community Resources Cont’d 1525 University Dr. Auburn Hills, MI 48326 (248) 373-9200 Havenwyck provides psychiatric treatment to children, adolescents, and adults. Havenwyck Hospital