Schizophrenia
 Characterized by:
confused & disordered thoughts & perceptions
 Most debilitating of the mental disorders
 Deterioration of adaptive behavior
Schizophrenia…symptoms
Bizarre behaviors (catatonia, others)
Affect (inappropriate, flat)
Delusions
Speech (disorganized, incoherent)
Hallucinations
Inability to care for self or function
Negative symptoms
Positive vs. Negative Sx
POSITIVE SYMPTOMS
– Presence of something abnormal
– Examples:
DELUSIONS, HALLUCINATIONS,
DISORGANIZED SPEECH, ODD BODY MVMTS,
CATATONIA
NEGATIVE SYMPTOMS
– Absence of something normal
– Examples:
AVOLITION, ALOGIA, ANHEDONIA, FLAT AFFECT
POSITIVE SYMPTOMS
•DELUSIONS
•HALLUCINATIONS
•DISORGANIZED SPEECH
•ODD BODY MOVEMENTS
•CATATONIA
POSITIVE SYMPTOMS
DELUSIONS
– False beliefs maintained in the face of
contrary evidence
–Types
Grandeur
Identity
Persecution
Reference
Control
HALLUCINATIONS
– Sensations in the absence of external stimuli
– Types: visual, auditory, tactile, olfactory,
gustatory
Of these positive symptoms delusions, in particular, can be broken
down into smaller subsets:
Persecutory delusions – False beliefs that one’s self
or one’s loved ones are being persecuted,
watched, or conspired against by others.
Delusions of being controlled – Belief that one’s
thoughts, feelings, or behaviors are being imposed
or controlled by some external force
Thought broadcasting – Belief that one’s thoughts
are being broadcast from one’s mind for others to
hear
Thought insertion – Belief that another person or
object is inserting thoughts into one’s head
Of these positive symptoms delusions, in particular, can be broken
down into smaller subsets:
Thought withdrawal – Belief that thoughts are
being removed from one’s head by another
person or object
Delusions of guilt or sin – False belief that one
has committed a terrible act or is responsible for
come terrible event
Somatic delusions – False belief that one’s
appearance or part of one’s body is diseased or
altered
Grandiose delusions – False belief that one has
great power, knowledge, or talent or that one is
a famous and powerful person
Colleen D. Gjefle
NEGATIVE SYMPTOMS
–AVOLITION:
–ALOGIA:
–ANHEDONIA:
–FLAT AFFECT:
–ASOCIALITY:
“No Initiative”
“Speech is Vacant”
“No Pleasure”
“The Mask”
“No Social Interest”
SUBTYPES
1. Paranoid
2. Disorganized
3. Catatonic
4. Undifferentiated
5. Residual
Paranoid
•Delusions & Hallucinations
•Intact Cognition and Affect
•No Disorganized Speech
•Best Prognosis
Disorganized
•Disorganized Speech
•Disorganized Behavior
•Flat or Inappropriate Affect
•Delusions & Hallucinations
~Fragmented or lacking a theme
•Often Chronic
Catatonic
•Disorganized Speech
•Disorganized Behavior
•Waxy Flexibility, Rigidity, Odd Mannerisms, Mimicry
•Flat or Inappropriate Affect
•Delusions & Hallucinations
•Fragmented or lacking a theme
•Often Chronic
Undifferentiated
•Beginnings of Breakdown
•Major symptoms of Schizophrenia
•Do NOT meet other criteria
•“Waste Basket” philosophy
Residual
•Have had one episode
•Now mostly symptom-free
>Q: Once a schizophrenic always a schizophrenic?
CAUSES
Causes of Schizophrenia
•Genetic Predisposition
–Twin study evidence
•Neurotransmitters
–Dopamine hypothesis
•Brain Structure & Function
•Family & Interactions
–Double-bind theory
–Schizophrenogenic mother
TREATMENT/THERAPIES
MAPPING THE BRAIN
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.
MORE CHARTS
Approximate number of people in the
United States suffering from:
•Schizophrenia: Over 2.2 million
•Multiple Sclerosis: 400,000
•Insulin-dependent Diabetes: 350,000
•Muscular Dystrophy: 35,000
FACTS & FIGURES
After 10 years, of the people diagnosed with schizophrenia:
25% Completely Recover
25% Much Improved, relatively independent
25% Improved, but require extensive support
15% Hospitalized, unimproved
10% Dead (Mostly Suicide)
After 30 years, of the people diagnosed with schizophrenia:
25% Completely Recover
35% Much Improved, relatively independent
15% Improved, but require extensive support
10% Hospitalized, unimproved
15% Dead (Mostly Suicide)
Where are the People with Schizophrenia?
…Approximately:
6% are homeless or live in shelters
6% live in jails or prisons
5-6% live in Hospitals
10% live in Nursing homes
25% live with a family member
28% are living independently
20% live in Supervised Housing
(e.g. group homes, etc.)
Approximately 200,000 individuals with
schizophrenia or manic-depressive illness are
homeless, constituting 1/3 of the approximately
600,000 homeless population
(total homeless population statistic based on data from Department of Health and Human Services).
The 45 percent who acknowledged that they needed
treatment
~(and thus had awareness of their illness)
~but still were not receiving treatment cited
many reasons for this.
These included (respondent could check several reasons):
32% "wanted to solve problem on own"
27% "thought the problem would get better by itself"
20% "too expensive"
18% "unsure about where to go for help"
17% "help probably would not do any good"
16% "health insurance would not cover treatment
DISEASE
FY 1999 NIH research
expenditures
Prevalence:
Individuals
with this
disease
NIH research
dollars per
person
affected
HIV (including AIDS)
$1,792,700,000
800,000
$2,240.88
Lung cancer
$163,100,000
342,457
$476.26
Cervical cancer
$75,200,000
231,064
$325.45
Multiple sclerosis
$96,300,000
350,000
$275.14
Breast cancer
$474,700,000
2,197,504
$216.02
Colorectal cancer
$175,900,000
1,041,499
$168.89
Parkinson’s disease
$132,300,000
1,000,000
$132.30
Prostate cancer
$177,500,000
1,637,208
$108.42
Alzheimer’s disease
$406,500,000
4,000,000
$101.62
Schizophrenia
$196,515,000
2,632,396
$74.65
Bipolar disorder
$57,805,000
2,227,412
$25.95
Depression
$199,600,000
10,732,076
$18.60
Panic disorder
$19,049,000
3,239,872
$5.88
Obsessive-Compulsive disorder
$12,693,000
4,859,808
$2.61