1. Schizophrenia

2. Intro Two greek words A split between mind and reality Schizo: split
Phrenia: mind
A split between mind and reality

3. Intro Category: Psychotic Disorders
Definition: characterized by disorganized and delusional thinking, disturbed perceptions, and inappropriate emotions and actions

4. History
Kraepelin: labeled similar symptoms as dementia praecox in the late 19th century
Schneider: First rank symptoms
Crow: Type I and Type 2

5. Etiology
evidence shows that genetic & environmental factors can act in combination to result in schizophrenia
Genetic factors exist
Social factors
Social disadvantage; child abuse
Neurotransmitters
Dopamine-hypothesis
Brain Structure

6. Prevalence of Schizophrenia
General population 0.85
With one parent schizophrenic 13.90
With 2 parents schizophrenic 46.30
With mz twin schizophrenic 47.40
With dz twin schizophrenic 15.00
With sibling schizophrenic 10.20
Parents of schizophrenic children 4.40
With Uncles, Aunts schizophrenic 3.60
With nephews, nieces schizophrenic 2.80
Grandchildren of schizophrenics 3.50
1st cousins of schizophrenics 3.50

8. Stats
Schizophrenia ranks among the top 10 causes of disability in developed countries worldwide
One way to express the prevalence of schizophrenia at any give time is the number of individuals affected per 1,000 total population. In the United States that figure is 7.2 per 1,000. This means that a city of 3 million people will have over 21,000 individuals suffering from schizophrenia.

9. Stats Where are the People with Schizophrenia? Approximately:
6% are homeless or live in shelters
6% live in jails or prisons
5% to 6% live in Hospitals
10% live in Nursing homes
25% live with a family member
28% are living independently
20% live in Supervised Housing (group homes, etc.)

10. Symptoms Positive: additions to normal behavior Negative Psychomotor
Delusions, disorganized thinking & speech, hallucinations, inappropriate emotions
Negative
Poverty of speech, flat affect (less emotion), drained of energy and interest
Psychomotor
Loss of movement; catatonic

11. Types of Schizophrenia
Paranoid: delusions & hallucinations; themes of persecution
Disorganized: disorganized speech or behavior; inappropriate emotion
Catatonic: Immobility, parrotlike repeating of another’s speech/movement
Undifferentiated: Many & varied symptoms
Residual: Withdrawal, after hallucinations and delusions have disappeared

12. Culture
International Pilot Study of Schizophrenia sponsored by WHO (1973, 1979, 1981)
Evidence of a universal set of symptoms
Some important cross-cultural differences exist
Differences in symptom expression
U.S. less likely to demonstrate auditory hallucinations
Recovery happens faster in developing countries as opposed to industrialized countries
Cultures differ in tolerance of symptoms
Nigerian culture is more accepting of presence of voices

13. Age
3/4 of persons with schizophrenia develop the disease between 16 and 25 years of age
Onset is uncommon after age 30, and rare after age 40

14. Gender
In the year old age group, schizophrenia affects more men than women
In the year old group, the incidence is higher in women than in men

15. The Perspectives Biological Some evidence of a genetic component
Gottesman and Shields (twin studies)
40 to 65 percent chance of developing the disorder
Dopamine hypothesis (Iverson & Iverson)
Excess dopamine is a cause of schizophrenia
Enlarged ventricles

17. The Perspectives Sociocultural Social disadvantage
The Social Defeat Hypothesis
Environment affects dopamine

18. The Perspectives Cognitive
Some biological abnormality leads to strange sensory experiences
Schizophrenic attempts to understand and explain them (the mental processes)
Family & Friends will deny existence of such things
Schizophrenic believes the truth is being hidden from him/her

19. Diathesis-stress model
a genetic vulnerability or predisposition (diathesis) interacts with the environment and life events (stressors)

20. Treatments Antipsychotic drugs Behavior Therapy Most commonly used
Decrease dopamine levels
Chlorpromazine (Thorazine)
More recently, Clozapine is being used
Blocks action of serotonin & norepinephrine
Behavior Therapy
Token economy concept has worked to improve interpersonal behavior

21. Cognitive-Behavior Therapy
CBT helps patients with symptoms that do not go away even when they take medication
The therapist teaches people with schizophrenia how to test the reality of their thoughts and perceptions, how to "not listen" to their voices, and how to manage their symptoms overall
CBT can help reduce the severity of symptoms and reduce the risk of relapse.
(From the National Institute of Mental Health)

22. Case Study http://www.mhhe.com/socscience/psychology/faces/#