1. SCHIZOPHRENIA

2. WHAT IS SCHIZOPHRENIA?  One of the most heavily researched disorders  Literally means “split mind”  A split from reality (not multiple personalities)  Series of disorders characterized by disorganized thinking, disturbed perceptions, and inappropriate emotions and actions  Has both positive and negative symptoms  Positive: presence of…  Negative: absence of…  It is a psychotic disorder: out of touch with reality

3. DISORGANIZED THINKING  “This morning I was at Hillside [hospital], I was making a movie. I was surrounded by movie stars…I’m Mary Poppins. Is this room painted blue to get me upset? My grandmother died four weeks after my eighteenth birthday.”  Thinking is bizarre, fragmented, and often distorted by delusions  Delusions: false beliefs, often of persecution or grandeur, that may accompany many psychotic disorders  Those with paranoid tendencies are prone to delusions of persecution  May result from a breakdown in selective attention  Can’t filter out the other things!

4. DISTURBED PERCEPTIONS  May have hallucinations (sensory experiences without sensory stimulation)  Seeing, hearing, feeling, tasting, smelling  Most are auditory – hearing voices making insulting remarks or giving orders

5. INAPPROPRIATE EMOTIONS AND ACTIONS  Laughing when hearing of death  Crying when others laugh  Some have “flat affect” – emotionless state  Motor behaviors may be inappropriate  Senseless, compulsive acts (rocking, rubbing an arm)  Catatonia: may remain motionless for hours and then become agitated

6. TYPES OF SCHIZOPHRENIA  Paranoid  Disorganized  Catatonic  Undifferentiated  Share some common features  Also have some distinguishing symptoms (see textbook)

7. EFFECTS OF SCHIZOPHRENIA  Disrupt social relationships  Makes it difficult to hold a job  Often live in a private inner world  With support, some may recover to enjoy a normal life or only experience bouts of schizophrenia intermittently

8. ONSET AND DEVELOPMENT OF DISORDER  Strikes those who are developing into adulthood  Afflicts 1 in 100 people (.5-1%)  Knows no national boundaries  Affects both males and females  Men are often struck earlier, more severely, and slightly more often  Does it develop quickly or slowly?  Both  For some, appears suddenly, as a reaction to stress  For others, develops gradually

9. SLOW OR RAPID DEVELOPMENT  When it is slow-developing(chronic or process schizophrenia), recovery is doubtful  Often have negative symptoms  Those who develop rapidly (acute or reactive schizophrenia), often following life stresses, recovery is much more likely  Often have positive symptoms  Respond better to drug therapy

10. WHAT CAUSES SCHIZOPHRENIA?

11. CAUSES: BRAIN ABNORMALITY  Excess of receptors for dopamine  May intensify brain signals, which would create the positive symptoms of hallucinations and paranoia  Drugs that block dopamine receptors often lessen positive symptoms  Drugs that increase dopamine activity (amphetamines and cocaine) can intensify them  But dopamine is also linked to Parkinson’s disease, so patients who take drugs to block dopamine develop Parkinson’s like symptoms  Dopamine blocking drugs have little effect on negative symptoms  Investigating the role of glutamate (excitatory neurotransmitter)  Drugs that interfere with glutamate receptors can produce schizophrenia-like negative symptoms

12. CAUSE: BRAIN CONT.  People with schizophrenia have abnormal brain activity in several areas  NOT one isolated area  Low brain activity in frontal lobes  PET scans during hallucinations showed activity in the thalamus  Temporal lobe is activated during auditory hallucinations  People with paranoia showed increased activity in the amygdala  Brain size  Enlarged, fluid-filled areas in brains of patients  Smaller cerebral cortex  Smaller thalamus  Can show these BEFORE onset!  What causes these abnormalities?  Mishap during prenatal development or delivery  Famine during pregnancy

14. MATERNAL VIRUS DURING PREGNANCY

15. GENETIC FACTORS  If your parent or siblings have schizophrenia, your odds of developing it are 1 in 10  If your identical twin has it, your odds are 1 in 2 (even when reared apart)  Those who share a placenta have an increased risk  Children adopted by someone who develops schizophrenia, seldom “catch” the disorder  Genes could affect dopamine levels or production of myelin  Identifying specific genes is difficult  Other factors (viruses, oxygen deprivation at birth, etc) may “turn off” or “turn on” the genes that predispose people to the disease

16. GENAIN QUADRUPLETS  All have schizophrenia  Two of the sisters have more severe forms  Environmental factors!

17. PSYCHOLOGICAL FACTORS  “No environmental causes have been discovered that will invariably, or even with moderate probability, produce schizophrenia in persons who are not related to a person with schizophrenia”  Susan Nicol and Irving Gottesman in 1983

18. EARLY WARNING SIGNS  Study of “at risk” children/young adults who had relatives with schizophrenia  A mother whose schizophrenia was severe and long lasting  Birth complications, often involving oxygen deprivation and low birth weight  Separation from parents  Short attention span and poor muscle coordination  Disruptive or withdrawn behavior  Emotional unpredictability  Poor peer relations and solo play