1. Schizophrenia Module 39 A talk by a schizophrenic…a bit dry…
Online link:
A talk by a schizophrenic…a bit dry…
4 in 10 Schizophrenic patients attempt suicide.
From Quirk
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2. See my other products at my store on Teachers Pay Teachers
My online activities for Abnormal Psychology
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3. Psychological Disorders
Schizophrenia overview
Symptoms of Schizophrenia
Onset and Development of Schizophrenia
Understanding Schizophrenia
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4. Schizophrenia
The literal translation is “split mind” which refers to a split from reality. A group of severe disorders characterized by the following:
Mnemonic for types of schizophrenia
Dr. Cup treats schizophrenia
Disorganized
Residual
Catatonic
undifferentiated
Paranoid
Sequential thinking is impaired
Which of the following is most characteristic of individuals with chronic schizophrenia? (AP94)
(A) Extreme mood swings
(B) Disordered thinking
(C) Profound sadness
(D) Unaccountable loss of body function
(E) Loss of memory
16. Delusional thinking is central to which of the following? (AP13)
(A) Fugue states
(B) Panic attacks
(C) Schizophrenic disorders
(D) Dissociative disorders
(E) Affective disorders
37 6. Distrust of others is symptomatic of (AP94)
(A) Mania
(B) Dementia
(C) Catatonia
(D) Paranoia
(E) hebephrenia
Disorganized and delusional thinking.
Disturbed perceptions.
Inappropriate emotions and actions.
Link 58:42
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5. AM World of Abnormal Psychology
9. The Schizophrenias In emotionally moving interviews, this program visits people who suffer from the hallucinations, paranoia, and psychological disarray of these disabling illnesses. In addition to examining symptoms and treatments, the program helps debunk some of the myths associated with the disorder and shows its human side and the strength of those who fight to overcome it.
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6. The proverb test
Proverbs like "birds of a feather flock together" or "a rolling stone gathers no moss" will be explained in a literal fashion by a schizophrenic
i.e. a stone that is rolling can't get moss on it because it's moving.
The next trouble is with abstraction - is this literal? A parable? A rumor? Schizophrenics are terrible at this; they tend to take things more concretely than they should. For example, if you ask for commonality among an apple, a watermelon and a banana, a schizophrenic might respond that they are all polysyllabic or use letters with closed loops instead of saying they are fruits. They are focused on the concrete elements of the words and sounds instead of seeing what is to the other observer the simple answer of them being similar types of foods. The normal listener knows to disregard the structure or pronunciation of the words because they are irrelevant to the question, just as a normal listener can correctly interpret the meaning of "Yes, John resigned." from the context of the rest of the conversation despite completely contradictory meanings. These types of abstract linguistic leaps are very easy for most speakers but are lost on schizophrenics, resulting in an entirely different, and disorganized, communication style. One effective test for schizophrenia is the proverb test. Proverbs like "birds of a feather flock together" or "a rolling stone gathers no moss" will be explained in a literal fashion by a schizophrenic (i.e. a stone that is rolling can't get moss on it because it's moving.) Dr. Sapolsky Stanford University
Concreteness of thought: loose lips sink ships, giant lips attacking ships.
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7. Symptoms of Schizophrenia
Positive symptoms: the presence of inappropriate behaviors (hallucinations, disorganized or delusional talking)
Negative symptoms: the absence of appropriate behaviors (expressionless faces, rigid bodies)
Sapolsky vid. 23:16
Dr. Saplolsky describes a Masai Schizophrenic
4 Schizophrenics 9:23
Preview Question 11: What patterns of thinking, perceiving, feeling, and behaving characterize schizophrenia?
The difference between "positive" and "negative" symptoms is not whether they are bad--they all are.
The difference is whether they are "visible."  The positive symptoms are delusions, hallucinations, disorganized speech, disorganized behavior and catatonia.  The negative symptoms are lack of emotional responsiveness, extreme apathy--not visible.
AM The Brain #26 schizophrenia, the symptoms
AM The Brain #27 schizophrenia: etiology
28. Schizophrenia: Pharmacological Treatment
Vid used to be at
2/17/15
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8. Disorganized & Delusional Thinking
This morning when 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.”
Delusions – false beliefs
Delusions of persecution
‘they’re out to get me’
paranoia
Delusions of grandeur
GOD COMPLEX
Megalomania
Thinking they have been part of historical events
Delusions of being controlled
the CIA is controlling my brain with a radio signal
Scott & Lisa Cravens-Brown
Word Salad
Disorganized speech
overinclusion - jumping from idea to idea without the benefit of logical association
paralogic - on the surface, seems logical, but seriously flawed
e.g., Jesus was a man with a beard, I am a man with a beard, therefore I am Jesus
Link to you tube
Part 2
(Sheehan, 1982)
Other forms of delusions include, delusions of persecution (“someone is following me”) or grandeur (“I am a king”).
This monologue illustrates fragmented, bizarre thinking with distorted beliefs called delusions (“I’m Mary Poppins”).
Link Gerald 8:12
Part 2 7:11
Female Schizophrenic
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9. Religious –Any delusion with a religious or spiritual content.
Kinds of delusions
Control –another person, group of people, or external force controls one's thoughts, feelings, impulses, or behavior.
Somatic – Usually the false belief is that the body is somehow diseased, abnormal, or changed. An example of a somatic delusion would be a person who believes that his or her body is infested with parasites.
Nihilistic – Belief that something is about the to end. You or the world
Grandiose –An individual exaggerates his or her sense of self-importance and is convinced that he or she has special powers, talents, or abilities. Sometimes, the individual may actually believe that he or she is a famous person (for example, a rock star or Christ). More commonly, a person with this delusion believes he or she has accomplished some great achievement for which they have not received sufficient recognition.
Religious –Any delusion with a religious or spiritual content.
Persecutory –These are the most common type of delusions and involve the theme of being followed, harassed, cheated, poisoned or drugged, conspired against, spied on, attacked, or obstructed in the pursuit of goals.
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10. Spree Killers are schizophrenic?
Most killing sprees are committed by individuals who suffer from psychosis, not psychopathy. Recall that psychosis is a fragmentation of the thinking processes in the brain that leads to symptoms like hallucinations and delusions.
Kent A. Kiehl PhD
Epidemic of Spree Killings
Tragic crimes like those committed by Gribble are unfortunately far too common. It seems that every few weeks there is a mass killing committed by some disturbed young person. Eric Harris and Dylan Klebold at Columbine High School; Seung-Hui Cho at Virginia Tech University; Jared Loughner at a political rally in Tucson, Arizona; James Holmes in a movie theater in Aurora, Colorado; and Adam Lanza at Sandy Hook Elementary School in Newtown, Connecticut, are just a few examples of the type of heinous spree killings that plague society.
I am often asked whether the perpetrators of such crimes are psychopaths. Certainly, the act of mass killing can be described as psychopathic, but does that clinical label fit the personality of the attacker? For the vast majority of spree killer cases, the answer is no—the offender was not a psychopath. Most killing sprees are committed by individuals who suffer from psychosis,, not psychopathy. Recall that psychosis is a fragmentation of the thinking processes in the brain that leads to symptoms like hallucinations and delusions.
Hallucinations come in all modalities—a patient with psychosis might hear voices that are not there (auditory hallucinations), see things that are not real (visual hallucinations), feel things that are not real (touch or somatosensory hallucinations), smell things that are not there (olfactory hallucinations), and taste things that are not real (gustatory hallucinations). All sensory modalities can be affected in a psychotic illness. Hallucinations can take many forms, but the most dangerous types are known as auditory command hallucinations. Command hallucinations are voices that the patient hears…
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11. It is important to recognize that most patients with psychosis do not harm others. But psychotic symptoms do increase an individual’s risk for committing homicide.
Schizophrenia is one of the main disorders associated with psychosis. The prevalence of schizophrenia is estimated to be below 1 percent of the general population, but patients with schizophrenia comprise between 5 and 20 percent of all homicide offenders.9 A worldwide study found that 1 in 629 patients in his or her first episode of psychosis ended up committing a homicide.10 In comparison, only 1 in 25,000 individuals in the general population of the United States will commit homicide. Thus, psychosis is associated with a fortyfold increased risk for homicide than that found in the rest of the population. The average age of onset of psychosis in men is eighteen and in women it is twenty-five, and research shows that the vast majority of homicides committed by such patients occur within the first year of illness onset.
However, if psychotic patients receive treatment, the risk for homicide drops from 1 in 629 to 1 in 9, The most effective way to prevent homicide in patients with psychosis is to get them early and effective evidence-based treatment. Unfortunately, as has been well documented in the cases in Arizona, Virginia, and Colorado, despite ample evidence the perpetrators were mentally ill prior to the commission of their crimes, they did not receive good treatment.
In summary, the majority of spree killers who go on rampages suffer from some sort of psychotic illness that includes command hallucinations and delusions. As we have reviewed, personality traits, especially psychopathic personality traits, are based on one’s…  
The Psychopath Whisperer: The Science of Those Without Conscience by Kent A. Kiehl PhD
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12. 3 Jesuses walk into a…mental hospital
This slide used to say 3 Jesuses walk into a bar but I thought that might be offensive…
…this is not a joke.
In 1959, the social psychologist Milton Rokeach gathered three psychiatric patients to live together in Ypsilanti State Hospital in Michigan. Each of the patients believed he was Jesus Christ. Since at least two of them had to be wrong, Rokeach wondered how they would process this idea. There were precedents. In a famous seventeenth-century case a fellow named Simon Morin was sent to a madhouse for making the same claim. There he met another Jesus and "was so struck with the folly of his companion that he acknowledged his own” Unfortunately, he subsequently reverted to his original belief and, like Jesus, ended up being killed-in this case, burned at the stake for blasphemy. No one was burned in Ypsilanti. One patient, like Morin, relinquished his belief; the second saw the others as mentally ill, but not himself; and the third managed to dodge the issue completely. So in this case, two out of the three patients managed to hang on to a self-image at odds with reality. The disconnect may be less extreme, but the same could be said to be true even of many of us who don't believe we can walk on water. If we probed-or, in many cases, simply bothered to pay attention-most of us would notice that our self-image and the more objective image that others have of us are not quite in sync.
From Subliminal: How your unconscious mind rules your behavior.
I must not be Jesus
Huh?
You guys are crazy, I am Jesus
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13. Disorganized & Delusional Thinking
Unable to focus or attend
Psychologist Jordan Peterson has proposed that the individual predisposed to schizophrenia may suffer from an influx of experiential sensations and possess insufficient executive functioning to cope with the influx, whereas the healthy individual low in LI and open to experience may be better able to use the information effectively while not becoming overwhelmed or stressed out by the incongruity of the situation. Indeed, this idea of "sensory gating" has been quite influential in the literature on schizophrenia.
Many psychologists believe disorganized thoughts occur because of selective attention failure (fragmented and bizarre thoughts).
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14. Great book about a girl whose friend “turns schizophrenic” while they are backpacking in China.
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15. Disturbed Perceptions
A schizophrenic person may perceive things that are not there (hallucinations). Most such hallucinations are auditory and lesser visual, somatosensory, olfactory, or gustatory.
Art by schizophrenics
“I felt like I was walking through a dream…”
Psychotic disorders frequently involve perceptions of nonexistent sensory stimulation, such as voices. Symptoms such as these are called (AP99)
(A) Delusions
(B) paraphilias
(C) Hallucinations
(D) Paranormal images
(E) Psychic phenomena
68. Hallucinations are characteristic of (AP12)
A. fugue
B. clinical depression
C. panic attacks
D. psychotic disorders
E. personality disorders
Hearing voices is the most common hallucination…we may be more accustomed to broken visual stimuli (meaning that schizophrenic patients don’t notice that as much)
The voices are structured, they are not just hearing random noise
Jesus
Satan
President
Most antipsychotics aimed at hallucinations, not disordered thinking which does not respond well to medication.
Sapolsky,…I think….
Photos of paintings by Krannert Museum, University of Illinois at Urbana-Champaign
August Natter, Witches Head. The Prinzhorn Collection, University of Heidelberg
L. Berthold, Untitled. The Prinzhorn Collection, University of Heidelberg
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16. In three other cases, Zulueta’s patients had disordered thoughts or heard voices in the language they had learned first and used most. Using a language that they spoke less frequently overall and learned later dismissed their delusions. In another case, a patient was equally psychotic in Italian and English, but heard voices only in Italian, her mother tongue. Not only that—in English she denied that she heard voices at all, whereas in Italian, she readily admitted hearing them. Other patients hear friendly voices in their native languages, hostile ones in their second languages. A subsequent researcher quipped that the more competent an insane person was in a language, the higher their degree of psychosis. Some scientists have suggested that the extra effort of using a second language jolts people out of a deluded state into reality. Others suggest that the deeper relationship to your first language makes you less inhibited, and so more likely to express what's troubling you. In a language learned later, you can hide from your true self. Babel No More by Michael Erard
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17. …of Korean using a term, paran sekj, or "blue, to refer to a greener, less purple color than Korean-English bilinguals think of as "blue." Other scientists have since seen how bilinguals categorize common containers and even conceptualize time differently from monolinguals. But this evidence is controversial, and the effects of language on cognition haven’t been isolated precisely. One question that polyglots don't get asked is, "When you go crazy, what language do you go crazy in? Which is too bad, because it's been demonstrated that psychotic polyglots, it turns out, aren't equally disordered in each of their languages. In one case recorded by British psychiatrist Felicity de Zulueta, her psychotic patient, a native English speaker, switched into Spanish because he knew that Zulueta also spoke the language. Both were then surprised that his hallucinations and disordered thoughts disappeared. "In Spanish ... he felt he was 'sane,' but when he spoke in English, he went mad," Zulueta wrote. From Babel No More
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18. …schizophrenics can tickle themselves because of a problem with their timing that does not allow their motor actions and resulting sensations to be correctly sequenced.
This predictability that you develop between your own actions and the resulting sensations is the reason you cannot tickle yourself. Other people can tickle you because their tickling maneuvers are not predictable to you. And if you'd really like to, there are ways to take predictability away from your own actions so that you can tickle yourself. Imagine controlling the position of a feather with a time-delay joystick: when you move the stick, at least one second passes before the feather moves accordingly. This takes away the predictability and grants you the ability to self-tickle. Interestingly, schizophrenics can tickle themselves because of a problem with their timing that does not allow their motor actions and resulting sensations to be correctly sequenced.
Incognito: The Secret Lives of the Brain, David Eagleman
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19. Before tackling this profound question, we first need to consider why not all people can make you feel ticklish. It probably requires that it be a person that you feel positive about. Thus, you're five and there's no one who can evoke ticklish feelings in you like your nutty uncle who chases you around the room first. Or you're twelve and it's the person in junior high school who's making your stomach feel like it's full of butterflies and making other parts of your body feel all mysterious and weird. It's why most of us probably wouldn't get the giggles if we were tickled by, say, Slobodan Milosovic. Most of us feel fairly positive about ourselves. So why can't we tickle ourselves? Philosophers have ruminated on this one through the ages, and have come up with some speculations. But theories about self-tickling are a dime a dozen. Finally, a scientist has tackled this mystery by doing an experiment. Sarah-Jayne Blackmore of the University College of London first theorized that you can't tickle yourself because you know exactly when and where you're going to be tickled. There's no element of surprise. So she set out to test this by inventing a tickling machine. It consists of a lever attached to a foam pad where, thanks to various pulleys and fulcrums run by a computer, when you move the lever with one hand, the foam pad almost instantaneously strokes the palm of the other hand, moving in the same direction as the movement of the lever.
Being a hard-nosed scientist Blackmore quantified the whole thing, coming up with a Tickle Index. Then reinvent the wheel if someone else operates the lever, it tickles you; if you do, nope. No element of surprise. You can't tickle yourself, even with a tickle machine. Then Blackmore tested her theory by removing the sense of predictability from the self-tickling process. First, remove the sense of predictability about when the tickling occurs the person moves the lever and, unexpectedly, there's a time lag until the foam pad moves. Anything more than three-tenths of a second delay and it scores as high of a Tickle Index as if someone else had done it.
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20. Now, remove the sense of predictability about where the tickling occurs the person moves the lever, say, forward and back, and, unexpectedly, the foam pad moves in a different direction. Anything more than a 90-degree deviation from where you expected the pad to move, and it feels as ticklish as if someone else had done it.* Now we've gotten somewhere. Being tickled doesn't feel ticklish until there is an element of surprise. Of unpredictability. Of lack of control. And suddenly, our beautiful world of tickle science is shattered around us. We spent a whole bunch of time some pages back learning about how the cornerstones of psychological stress are built around a lack of control and predictability. Those were bad things, yet most of us like being tickled by the right person. Hey, wait a second more pieces of our grand edifice begin to crumble we stand in long lines to see movies that surprise and terrify us, we bungee jump and go on roller coasters that most definitely deprive us of a sense of control and predictability. We pay good money * An experiment this elegant and clever and eccentric makes me proud to be a scientist.
A brief digression into tickling political correctness. I once read some weird screed about how no one actually likes being tickled, that it is all about power and control on the part of the tickler, particularly when children are involved, and how the laughing isn't really pleasurable but is reflexive, and the requesting to be tickled is some sign of their acquiescence to their subordinance and loving of their chains, and soon terms like "phallocentric" and "dead white male" and fake quotes from Chief Seattle were being bandied about.
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21. Why Zebras Don’t Get Ulcers, By Dr. Robert Sapolsky
As a biologist, one of the first things you do when confronting a puzzle like this is to go for the Phylogenetic Precedent to gain insight into a human phenomenon do other species do this? Because if other, closely related species do the same thing, that weakens arguments about how the whole phenomenon is embedded in human culture. I can report here that chimps love to be tickled. All those chimps who get trained in American Sign Language one of the first words they master is "tickle" and one of the first sentences is "tickle me." In college, I worked with one of those chimps. He'd do the "tickle me" sequence correctly, and you'd tickle him like mad chimps curl up and cover their ribs and make this fast, soundless, breathy giggle when they're being tickled. Stop, he sits up, catches his breath, mops his brow because of how it's all just too much. Then he gets a gleamy look in his eye and it's, "Tickle me," all over again.
Why Zebras Don’t Get Ulcers, By Dr. Robert Sapolsky
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22. A 20th-century artist, Louis Wain, who was fascinated by cats, painted these pictures over a period of time in which he developed schizophrenia.
The pictures mark progressive stages in the illness and exemplify what it does to the victim's perception.
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23. Wikipedia on Louis Wain
Dr. Michael Fitzgerald disputes the claim of schizophrenia, indicating Wain more than likely had Asperger syndrome (AS). Of particular note, Fitzgerald indicates that while Wain's art takes on a more abstract nature as he grew older, his technique and skill as a painter did not diminish as one would expect from a schizophrenic.[7] Moreover, elements of visual agnosia are demonstrated in his painting, a key element in some cases of AS. If Wain had visual agnosia, it may have manifested itself merely as an extreme attention to detail.[8]
A series of five of his paintings is commonly used as an example in psychology textbooks to putatively show the change in his style as his psychological condition deteriorated. However, it is not known if these works were created in the order usually presented, as Wain did not date them. Rodney Dale, author of Louis Wain: The Man Who Drew Cats, has criticized the belief that the five paintings can be used as an example of Wain's deteriorating mental health, writing: "Wain experimented with patterns and cats, and even quite late in life was still producing conventional cat pictures, perhaps 10 years after his [supposedly] 'later' productions which are patterns rather than cats."[9]
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25. Inappropriate Emotions & Actions
A schizophrenic person may laugh at the news of someone dying or show no emotion at all (flat affect).
Some recover, some remain isolated
Patients with schizophrenia may continually rub an arm, rock a chair, or remain motionless for hours (catatonia).
Childhood schizophrenia at 20/20 9:18
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26. Onset and Development of Schizophrenia
Nearly 1 in a 100 suffer from schizophrenia, and throughout the world over 24 million people suffer from this disease (WHO, 2002).
Preview Question 12: What forms does schizophrenia take?
Men struck earlier, 4 years (Rasanen) & slightly more often (Aleman).
If your parent is schizophrenic your chances of being schizophrenic are 1 in 10.
No gender or socio-economic differences according to Dr. Sapolsky
Schizophrenia strikes young people as they mature into adults. It affects men and women, but men suffer from it more severely than women.
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27. Schizophrenia: Course
Group 1
15% have only a single episode of illness with no subsequent impairment
Social withdrawal is also typical. Sadly the majority of the psychiatric drugs given to schizophrenics aim to eliminate the hallucinations but do little to alleviate the social isolation. And, of course, the more socially isolated you are, the more estranged your thoughts and beliefs will become. He points out that while stories of schizophrenics gone mad and bloody make for good news, the actual rate of violence is low, lower than with normal folks, with the exception of self-injury. Half of schizophrenics attempt suicide and suicide attempts are more common among those that have more periods of remission/clarity that permit them to assess how awful the experience truly is.
Dr. Sapolsky Stanford University
Group 2
25% have repeated episodes of illness with no impairment between episodes
Group 3
30% have repeated episodes of illness with some impairment between episodes
Group 4
30% have repeated episodes of illness with gradually declining impairment between episodes

28. He notes that schizophrenia typically begins in the late teen years and into the early 20's. The typical victim is someone who was always a little odd, a little isolated and who had lots of imaginary friends at an age when others had let their imaginary friends go. This person then encounters a massive stressor and on comes the problem. This is around the same time that the frontal cortex gets its last big burst of growth. A line of thinking is that whatever prompts the schizophrenia has to do with this section basically getting kicked one too many times, creating a cascade of other problems. Schizophrenia is rooted in the cortex (the cortex being responsible for coordination of thoughts, self control, reasoning, etc.)
Dr. Sapolsky Stanford University
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29. Chronic and Acute Schizophrenia
When schizophrenia is slow to develop (chronic/process) recovery is doubtful. Such schizophrenics usually display negative symptoms.
Slow developing schizophrenics tend to be on the lower end of social levels due to their long histories of social inadequacy.
If you suddenly “went crazy” someone would notice, but if you had been going crazy a bit at a time for many years it might slip by…
When schizophrenia rapidly develops (acute/reactive) recovery is better. Such schizophrenics usually show positive symptoms.
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30. Understanding Schizophrenia
Schizophrenia is a disease of the brain exhibited by the symptoms of the mind.
Preview Question 13: What causes schizophrenia?
6x more dopamine receptors (Seeman).
Drugs that block dopamine reduce symptoms (Swerdlow)
One suspected cause of schizophrenia is the abnormal increase of which of the following neurotransmitters in the brain? (AP99)
(A) Acetylcholine
(B) Somatotropin
(C) Dopamine
(D) Norepinephrine
(E) Serotonin
Which of the following has been most effective in the treatment of schizophrenia? (AP94)
(A) Administration of L-dopa
(B) Prefrontal lobotomy
(C) Psychoanalytic therapy
(D) Drug therapy that blocks neurotransmitter sites
(E) Drug therapy that increases the activity of limbic system neurons
AM the Brain #28
Schizophrenia: pharmacological treatment
Brain Abnormalities
Dopamine Overactivity: Researchers found that schizophrenic patients express higher levels of dopamine D4 receptors in the brain.
Drugs that block these sites help schizophrenic patients.
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31. Evidence FOR the Dopamine Theory of Schizophrenia:
Neurotransmitters
Many studies have investigated the possible role of brain neurotransmitters in the development of schizophrenia. Most of these studies have focused on the neurotransmitter called dopamine. The "dopamine theory of schizophrenia" states that schizophrenia is caused by an overactive dopamine system in the brain. There is strong evidence that supports the dopamine theory, but there are also some data that do not support it
Evidence FOR the Dopamine Theory of Schizophrenia:
Drugs that block dopamine reduce schizophrenic symptoms.
Drugs that block dopamine have side effects similar to Parkinson's disease. Parkinson's disease is caused by a lack of dopamine in a parts of the brain called the basal ganglia.
The best drugs to treat schizophrenia resemble dopamine and completely block dopamine receptors.
High doses of amphetamines cause schizophrenic-like symptoms in a disorder called "amphetamine psychosis." Amphetamine psychosis is a model for schizophrenia because drugs that block amphetamine psychosis also reduce schizophrenic symptoms. Amphetamines also make the symptoms of schizophrenia worse.
Children at risk for schizophrenia may have brain wave patterns similar to adults with schizophrenia. These abnormal brain wave patterns in children can be reduced by drugs that block dopamine receptors.
Evidence AGAINST the Dopamine Theory of Schizophrenia:
Amphetamines do more than increase dopamine levels. They also alter other neurotransmitter levels.
Drugs that block dopamine receptors act on receptors quickly. However, these drugs sometimes take many days to change the behavior of people with schizophrenia.
The effects of dopamine blockers may be indirect. These drugs may influence other systems that have more impact on the schizophrenic symptoms.
New drugs for schizophrenia, for example, clozapine, block receptors for both serotonin and dopamine.
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32. Possible Side Effects of Antipsychotic Drugs
Generic Name
Trade Name
Comments
Aripiprazole
Abilify
New antipsychotic medication that may work on dopamine and serotonin systems.
Chlorpromazine
Thorazine
The first antipsychotic medication developed
Chlorprothixene
Taractan
Clozapine
Clozaril
Does not have "tardive dyskinesia" (see below, side effects) as a side effect, but there is a 1-2% chance of developing a low white blood cell count
Fluphenazine
Prolixin
A phenothiazine type drug
Haloperidol
Haldol
Loxapine
Loxantane
NOT a phenothiazine type drug
Mesoridazine
Serentil
Molindone
Moban
Olanzapine
Zyprexa
Blocks serotonin and dopamine receptors
Perphenazine
Trilafon
Quetiapine
Seroquel
Blocks some serotonin and dopamine receptors; Introduced in 1997
Risperidone
Risperdal
Blocks some serotonin and dopamine receptors
Thioridazine
Mellaril
Also used as a tranquilizer
Thiothixene
Navane
Trifluoperazine
Stelazine
Also used to control anxiety and nausea
Possible Side Effects of Antipsychotic Drugs
1. Parkinson's disease-like symptoms - tremor, muscle rigidity, loss of facial expression
2. Dystonia - contraction of muscles
3. Restlessness
4. Tardive dyskinesia - involuntary, abnormal movements of the face, mouth, and/or body. This includes lip smacking and chewing movements. About 25-40% of patients who take antipsychotic mediations for several years develop these side effects.
5. Weight gain
6. Skin problems
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33. Abnormal Brain Activity
Brain scans show abnormal activity in the frontal cortex, thalamus, and amygdala of schizophrenic patients.
Low brain activity in frontal lobes (Morey)
Decline in brain waves that reflect synchronization in frontal lobes (Speinier) may disrupt neural networks.
Neuroreport Jun 3;10(8):
Elevated endogenous cannabinoids in schizophrenia.
Leweke FM, Giuffrida A, Wurster U, Emrich HM, Piomelli D.
SourceDepartment of Clinical Psychiatry and Psychotherapy, Medizinische Hochschule Hannover, Germany.
Abstract
Evidence suggests that cannabinoid receptors, the pharmacologcial target of cannabis-derived drugs, and their accompanying system of endogenous activators may be dysfunctional in schizophrenia. To test this hypothesis, we examined whether endogenous cannabinoid concentrations in cerebrospinal fluid of schizophrenic patients are altered compared to nonschizophrenic controls. Endogenous cannabinoids were purified from cerebrospinal fluid of 10 patients with schizophrenia and 11 non-schizophrenic controls by high-performance liquid chromatography, and quantified by isotope dilution gas-chromatography/mass-spectrometry. Cerebrospinal concentrations of two endogenous cannabinoids (anandamide and palmitylethanolamide) were significantly higher in schizophrenic patients than non-schizophrenic controls (p < 0.05). By contrast, levels of 2-arachidonylglycerol, another endogenous cannabinoid lipid, were below detection in both groups. The findings did not seem attributable to gender, age or medication. Elevated anandamide and palmitylethanolamide levels in cerebrospinal fluid of schizophrenic patients may reflect an imbalance in endogenous cannabinoid signaling, which may contribute to the pathogenesis of schizophrenia.
PMID: [PubMed - indexed for MEDLINE]
Paul Thompson and Arthur W. Toga, UCLA Laboratory of Neuro
Imaging and Judith L. Rapport, National Institute of Mental Health
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34. Module 39 02 20 15 http://news.bbc.co.uk/2/hi/health/1563291.stm
Mapping Brain Tissue Loss in Adolescents with Schizophrenia. This map reveals the 3-dimensional profile of gray matter loss in the brains of teenagers with early-onset schizophrenia, with a region of greatest loss in the temporal and frontal brain regions that control memory, hearing, motor functions, and attention. Using novel image analysis algorithms, dramatic reductions in the profiles of gray matter were detected, based on a database of 96 images from schizophrenic patients scanned repeatedly with MRI. The parallel extraction of anatomical models from all patients in the image database required 60 CPU hours, when running in parallel on an SGI RealityMonster with 32 internal CPUs. [Image by Paul Thompson, Christine Vidal, Judy Rapoport, and Arthur Toga].
Grey matter loss
The Californian team used a new way of analyzing MRI images to reveal very subtle changes in brain matter.
They found that in healthy teenagers, approximately 1% of tissue called "grey matter" is lost each year from a part of the brain called the parietal regions - the outer regions of the brain.
Professor Paul Thompson, UCLA
However, in schizophrenics, they detected accelerated grey matter loss - over six years, the patients lost 10% in the parietal region.
In addition, this destructive process spread to other parts of the brain, with areas such as the temporal lobe, and areas which control the senses and movement - particularly eye movement, particularly affected.
The brain fields responsible for eye movement lost as much as 5% of their grey matter a year.
These findings would tally with many of the symptoms, such as involuntary eye movement, frequently felt by schizophrenics.
Professor Paul Thompson, at UCLA, said: "This is the first study to visualize how schizophrenia develops in the brain.
"Scientists have been perplexed about how schizophrenia progresses and whether there are any physical changes in the brain.
"It moved across the brain like a forest fire, destroying more tissue as the disease progressed."
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35.
Frontal composite variability of normal and schizophrenia brains by gender
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36.
Image Source: UCLA Laboratory of Neuro Imaging, UCLA, Derived from high-resolution magnetic resonance images (MRI scans), the above images were created after repeatedly scanning 12 schizophrenia subjects over five years, and comparing them with matched 12 healthy controls, scanned at the same ages and intervals. Severe loss of gray matter is indicated by red and pink colors, while stable regions are in blue. STG denotes the superior temporal gyrus, and DLPFC denotes the dorsolateral prefrontal cortex. Note: This study was of Childhood onset schizophrenia (defined as schizophrenia diagnosed in children under the age of 13 or so) which occurs in approximately 1 of every 40,000 people and is frequently a significantly more aggressive form of schizophrenia (than regular schizophrenia that typically begins when people are aged 15 to 25 (slightly later for women) - and impacts approximately 1 of every 100 people).
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37. Abnormal Brain Morphology
Schizophrenia patients may exhibit morphological changes in the brain like enlargement of fluid-filled ventricles.
Found in people who would later develop Schizophrenia (Pantelis)
The more the shrinkage of the tissue the greater the disorder
The cortex is smaller than normal.
Thalamus smaller than normal, possible difficulty filtering sensory information, difficulty attending
Enlarged ventricles are not diagnostic. (Dr. Kiehl, psychopath whisperer)
Which of the following is associated with schizophrenia? (AP04)
(A) Enlarged, fluid filled areas in the brain
(B) Damage to the medulla
(C) Malfunction of the endocrine system
(D) Impairment of the spinal reflexes
(E) Injury to the parasympathetic nervous system
Both Photos: Courtesy of Daniel R. Weinberger, M.D., NIH-NIMH/ NSC
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38. Dr. Sapolsky Stanford University
The image to the left shows an MRI image of unaffected and schizophrenic identical twins. The brain structures pointed out are the ventricles (which are much larger in the person affected by schizophrenia)
The brain's ventricles are enlarged and they exert pressure on the frontal cortex. They also have fewer hippocampal neurons and neurons pointing in the wrong direction. Some studies have shown fewer neurons and less glia in the frontal cortex.
Dr. Sapolsky Stanford University
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39. Risk Factors - Viral Infection
Schizophrenia has also been observed in individuals whose mothers contracted a viral infection (flu) during the middle of their fetal development.
Risk factors…
Low birth weight
Difficult births (Scott & Lisa Cravens-Brown)
Oxygen deprivation during delivery (Buka)
Conception during famine (St. Claire)
Fetal development during flu epidemic = increased risk (Mednick)
Born after flu season = increased risk (Torrey)
Patterns in N. Hemisphere reversed in S. Hemisphere (McGrath)
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40.
Overview: Use of street drugs (including LSD, methamphetamine, marijuana/hash/cannabis) and alcohol have been linked with significantly increased probability of developing psychosis and schizophrenia. This link has been documented in over 30 different scientific studies (studies done mostly in the UK, Australia and Sweden) over the past 20 years. In one example, a study interviewed 50,000 members of the Swedish Army about their drug consumption and followed up with them later in life. Those who were heavy consumers of cannabis at age 18 were over 600% more likely to be diagnosed with schizophrenia over the next 15 years than those did not take it. (see diagram below). Experts estimate that between 8% and 13% of all schizophrenia cases are linked to marijuna / cannabis use during teen years.
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41. “Marijuana has been vaguely associated with schizophrenia over the years. People who abuse marijuana in their younger years have higher risk for it later in life,” Jones said. Furthermore, he said, symptoms of schizophrenia manifest in some adults who receive a dose of THC.
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42. Genetic Factors
The likelihood of an individual suffering from schizophrenia is 50% if their identical twin has the disease (Gottesman, 2001).
Schizophrenia gene mutation found; target for new drugs
February 2, 2011 In a major advance for schizophrenia research, an international team of scientists, led by Jonathan Sebat, PhD, assistant professor of psychiatry and cellular and molecular medicine at the University of California, San Diego School of Medicine, has identified a gene mutation strongly linked to the brain disorder – and a signaling pathway that may be treatable with existing compounds.
The latest study goes much further. Researchers scanned for CNVs in the genomes of 8,290 individuals with diagnosed cases of schizophrenia and 7,431 healthy controls. "We found very strong links to multiple sites in the genome," said Sebat. "Some had been picked up before in earlier studies, but we uncovered a very important new finding: duplications at the tip of chromosome 7q were detected in individuals with schizophrenia at a rate 14 times higher than in healthy individuals. These CNVs impact a gene that is important for brain development – the neuropeptide receptor VIPR2."
Identical
Both parents
Fraternal
One parent
Sibling
Nephew or niece
Unrelated
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43. Genetics and the Risk of Schizophrenia
Bernstein
James D. Laird and Nicholas S. Thompson, Psychology. Copyright © 1992 by Houghton Mifflin Company. Reprinted by permission.
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44. This gene doubles your risk
Figure 1: A so-called “linkage study,” showing a number of places in the human genome where pieces of DNA are inherited along with risk for the illness. It shows one of each of the 23 pairs of chromosomes, and the red dots indicate regions where a piece of DNA has been shown to be inherited along with the risk for schizophrenia in certain families and certain studies.
In fact in a September, 2004 presentation Dr. Daniel Weinberger, Director of the Genes, Cognition and Psychosis Program, at the National Institute of Mental Health" stated that he estimated the current number of genes variations linked to schizophrenia was approximately 10. The gene variations that have been identified as being linked to schizophrenia are common in every population - but he believes that it is likely that if a person has a number of these gene variations then the risk of developing schizophrenia begins to rise. The more of these gene variations that a person has, the greater the risk of developing schizophrenia. For example, in 2002 researchers led by NIMH’s Dr. Daniel Weinberger linked a gene on chromosome 22 to a near-doubled risk of schizophrenia.
This gene doubles your risk
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45. Genetic Factors
The following shows the prevalence of schizophrenia in identical twins as seen in different countries.
A third example comes from the observation that smoking cannabis (marijuana) as a teenager increases the probability of developing psychosis as an adult. But this connection is true only for some people, and not for others. By this point, you can guess the punch line: a genetic variation underlies one's susceptibility to this. With one combination of alleles, there is a strong link between cannabis use and adult psychosis; with a different combination, the link is weak.
From Incognito: The Secret Lives of the Brain, David Eagleman
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46.
When the gene, called COMT, is abnormal, it effectively depletes the frontal lobes of the neurochemical dopamine. That can both unleash hallucinations and impair the brain’s reality check.
Given the constant interplay of genes and environment - the greater the exposure to schizophrenia-linked environmental factors (e.g. lead exposure during pregnancy, birth complications, extremely high stress experiences in life while young, drug use while a teenager, etc.) the greater the likelihood that a person with a given level of genetic predisposition will actually develop schizophrenia. A person with fewer of the gene variants linked with schizophrenia, if exposed to more environmental factors linked with schizophrenia - may pass the threshold for development of schizophrenia just as a person with more gene variants, and lower environmental factor exposure could also pass the threshold to develop schizophrenia. Research is still being done on the risk contribution to the development of schizophrenia that is associated with the different gene variations and environmental impacts.
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47.
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48. Psychological Factors
Psychological and environmental factors can trigger schizophrenia if the individual is genetically predisposed (Nicol & Gottesman, 1983).
Two twins were more severe than others, thus there are contributing environmental factors.
Less industrialized countries have better rates of recovery than industrialized countries
families tend to be less critical of the schizophrenic patients
less use of antipsychotic medications, which may impair full recovery
think of schizophrenia as transient, rather than chronic and lasting disorder
Scott & Lisa Cravens-Brown
The genetically identical Genain
sisters suffer from schizophrenia.
Courtesy of Genain Family
Genain Sisters
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49. Differences in How Schizophrenia Impacts Men and Women
Differences in How Schizophrenia Impacts Men and Women
There are many ways in which schizophrenia affects men and women differently. For example, some of the well known facts are that schizophrenia tends to begin in men/boys at an earlier age than women/girls; men who have schizophrenia generally begin showing signs of the illness between ages 15 and 20, compared to ages 20 to 25 for women. Additionally, men overall are less responsive to medication and schizophrenia also tends to have a larger impact on men than on women - the long term outcome tends to be worse for men than women. Researchers have hypothesized that estrogen may play a protective role in women against schizophrenia.
Recent research also tends to suggest that schizophrenia is more prevalent in men than women - with women developing schizophrenia at a rate of approximately 50% to 75% that of men, overall. Women, however, have a rate of developing schizophrenia almost twice that of men for people over the age of 45 years. Again, a protective effect of estrogen may be involved here, researchers suggest. Following are some stories and resources on the differences of schizophrenia's impact in men and women. As this is a relatively new area of research, we'll be adding more information here in the future.
Why Schizophrenia Impacts Men harder than Women?
Book: (Scientific Book): Women and Schizophrenia , Edited by David J. Castle, John McGrath and Jayashri Kukarni, 151 pages ; Publisher: Cambridge University Press; 1st edition (September 15, 2000) , ISBN:
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50.
Indeed, schizophrenia is not as rare as some people think. It has been estimated that anywhere from 0.3 to 0.7 percent of the population is afflicted with it. For a country like the United States, that's anywhere from 940,000 to 2,200,000 people. And the costs are enormous, estimated at $62.7 billion per year in the U.S. alone. Yet, schizophrenia receives only a small fraction of the amount of medical research dollars that go into other serious diseases and disorders.
If we have 2300 students at our school that means that 16 will develop schizophrenia (.7%),…it is twice as common as alzheimers, 5x more likely than MS, 6x more likely than Diabetes….
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51. End Schizophrenia documentary 10:51
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