1. Watch the clip You tube You tube Gerald – schizophrenia Gerald – schizophrenia Heather – schizophrenia Heather – schizophrenia Real life case studies…. Real life case studies….

2. Schizophrenia What is it and what are the symptoms……

3. The 1500’s Disturbances mainly in thoughts Disturbances mainly in thoughts In the 15 th & 16 th Centuries Europe – women with Sz were thought to be possessed by the devil and tortured and burned to the stake to exorcise the devil In the 15 th & 16 th Centuries Europe – women with Sz were thought to be possessed by the devil and tortured and burned to the stake to exorcise the devil

4. The 1800’s Inmates were chained to the floor, and treated quite unkindly. "In the 18th century people used to go there to see the lunatics. For a penny one could peer into their cells, view the freaks and laugh at their antics, generally of a sexual nature or violent fights. Entry was free on the first Tuesday of the month. Visitors were permitted to bring long sticks with which to poke and enrage the inmates Inmates were chained to the floor, and treated quite unkindly. "In the 18th century people used to go there to see the lunatics. For a penny one could peer into their cells, view the freaks and laugh at their antics, generally of a sexual nature or violent fights. Entry was free on the first Tuesday of the month. Visitors were permitted to bring long sticks with which to poke and enrage the inmates

5. Today Although in the 50’s and 60’s most people diagnosed spent their lives in a psychiatric ward – today patients can live independently at home – usually under some supervision also undertaking a combination of drug therapies and psychotherapy Although in the 50’s and 60’s most people diagnosed spent their lives in a psychiatric ward – today patients can live independently at home – usually under some supervision also undertaking a combination of drug therapies and psychotherapy

6. Schizophrenia John Nash thought foreign governments were communicating with him. He had to live with the delusions that never left him – and shows how you can to a certain degree live with the condition John Nash thought foreign governments were communicating with him. He had to live with the delusions that never left him – and shows how you can to a certain degree live with the condition

7. Schizophrenia The Greek meaning for sz means ‘split mind’. The Greek meaning for sz means ‘split mind’. It implies the person is split between reality and delusions. It implies the person is split between reality and delusions. It is a psychotic disorder – lose touch with the world It is a psychotic disorder – lose touch with the world The onset is more early in men than women (20’s – 30’s) The onset is more early in men than women (20’s – 30’s) Sz patients suffer the greatest stigma – seen as ‘mad’ Sz patients suffer the greatest stigma – seen as ‘mad’

8. Classification of SZ To accurately diagnose (classify sz) the DSMIV has distinguished between 5 main categories of sz so that is does not get mixed up with other psychotic disorders To accurately diagnose (classify sz) the DSMIV has distinguished between 5 main categories of sz so that is does not get mixed up with other psychotic disorders Some categories require that symptoms be present for a month and some 6 months before diagnosis can be accurately made. Some categories require that symptoms be present for a month and some 6 months before diagnosis can be accurately made. There are 5 major categories for the classification of sz… There are 5 major categories for the classification of sz… (use the handout to make a table as below: DisorganisedCatatonic Unintelligible speech Absence of emotion Loss of interest

9. Classifications of psychotic disorders PSYCHOTIC DISORDER MAIN SYMPTOMS DURATION Schizophrenia Delusions, hall, flat effect, disorganised speech, catatonic behaviour 6 months + Schizoaffective disorder As above plus mood disorder 6 months + Delusional disorder Delusions not associated with sz, usually of grandeur, jealousy or persecution 1 month +

10. Evaluations The catatonic type is relatively rare and may be due to certain types of drugs used to treat the disorder (McGlashan and Fenton, 1991). Some argue it is not a true category of sz and so should be dropped as a classification The catatonic type is relatively rare and may be due to certain types of drugs used to treat the disorder (McGlashan and Fenton, 1991). Some argue it is not a true category of sz and so should be dropped as a classification The undifferentiated classification is also controversial because it is said to be too vague and ill defined. Many clinicians believe it to be over used and sometimes confused with other psychotic disorders. The undifferentiated classification is also controversial because it is said to be too vague and ill defined. Many clinicians believe it to be over used and sometimes confused with other psychotic disorders. Another example of confusion is where psychiatrists may wrongly diagnose an individual with sz instead of schizoaffective disorder (which is sz with depression). Another example of confusion is where psychiatrists may wrongly diagnose an individual with sz instead of schizoaffective disorder (which is sz with depression).

11. Exam questions (a) Identify one sub-type of schizophrenia and give two symptoms typically associated with that sub-type. (3 marks) (b) Explain one consequence of being diagnosed with schizophrenia. (4 marks)

12. Symptom similarities Mis-diagnosis treatment Active/residual phase support onset depressionSub-categories

13. Independent Cost effective Discharge Drugs/therapy Less chance of relapse Remission No cure but reduces the symptoms Treatment