1. emil kraepelin (1898) eugene bleuler (1908)
dementia praecox “premature dementia”
paranoia (all delusions)
hebephrenia
catatonia
eugene bleuler (1908)
schizophrenia
“split mind”

2. 6 mo course includes prodromal or residual period
schizophrenia
1 month of at least two of the following:
delusions
positive/psychosis
hallucinations
disorganized speech
disorganized
disorganized behavior
negative symptoms
negative
6 mo course includes prodromal or residual period

3. 5 MO 1 MO 5 MO 6 mo course includes prodromal or residual period
prodromal symptoms
schizophrenia symptoms
residual symptoms
5 MO
1 MO
5 MO
6 mo course includes prodromal or residual period

4. delusions What types of schizophrenic delusions have you heard of?
persecution
grandeur
control
reference

5. hallucinations
What kinds of schizophrenic hallucinations have you heard of?

6. disorganized speech A.K.A. THOUGHT DISORDER tangentiality derailment
neologisms
clanging

7. disorganization inappropriate affect bizarre behavior
DISORGANIZED BEHAVIOR
inappropriate affect
bizarre behavior

8. negative symptoms alogia (few words) affective flattening
avolition (lack of motivation)
social withdrawal

9. stats age of onset 1% prevalence equal sex ratio
course: better for women
age of onset

10. brain abnormalities STRUCTURAL enlarged ventricles
cytoarchitecture of frontal lobe
FUNCTIONAL
“hypofrontality”
cognitive deficits of frontal lobe

11. cognitive deficits endophenotypes working memory perseveration
disinhibiton
executive functions
endophenotypes
biological markers for disease genes
e.g. eye tracking

12. genetics disease risk in family & twin
(also, equal risk in offspring of discordant MZ twins)

13. environmental stressor
neurodevelopmental hypothesis
prenatal
brain
defect
environmental stressor
in early adulthood SZ + =

14. 2nd trimester Flu Epidemics 1957 Kochi Japan 1949-1981 France
40 yr study Finland & Denmark
Starvation
WWII Dutch Winter
famine in China

15. DA pathways nigrostriatal substantia nigra > striatum mesocortical
VTA > all cortical areas
mesolimbic
VTA > limbic system

16. medication ANTIPSYCHOTICS (A.K.A. neuroleptics) TYPICAL ATYPICAL
treats + & - symptoms?
treats + symptoms
side effect:
tardive dyskinesia
less side effects?
10x price
74% noncompliance w/in 18 mo
extrapyramidal side effects
Parkinsonian symptoms
tardive dyskinesia

17. therapy “token economy” – operant conditioning
teach social skills & give insight
manage medication
identify signs of impending relapse