Schizophrenia
Schizophrenia is commonly defined as a mental disorder
where a person sees or hears things that are not real.
They hallucinate and they become out of touch with the
real world.
Four Types
• Paranoid
- hallucinations and
delusional thoughts of
conspiracy or accusation
• Catatonic
- disturbances in movement
• Disorganized
- disorganized thought
processes
• Undifferentiated
- does not display specific
enough symptoms to be
classified in any one subtype
- Either their symptoms
constantly are changing over
time or simply just do not fit into
one
Essential Features
• Delusions
• Hallucinations
• Disorganized speech
• Catatonic behavior
• Negative symptoms
Associated Features
• Dizziness
• Restlessness
• Sleepiness
• Tremor
• Weight gain
• Substance abuse
• Suicide
• Physical illness
Differential Diagnosis
• Delusional Disorder
- paranoid beliefs
• Schizotypal Personality Disorder
- discomfort in close relationships
- odd thoughts and behaviors
- dismisses any close relationship
- rather be alone
• Paranoid Personality Disorder
- suspicious and distrustful of others
Diagnostic Criteria
• Two or more of the essential features must be present for at least
a month. If the delusions are bizarre or hallucinations consist of a
voice keeping a running commentary of the person’s behavior and
thoughts or two or more voices conversing, then only one of these
may be present to be diagnosed.
• For a significant amount of time, areas of functioning like work,
self-care, academics and interpersonal relations are way below the
level achieved prior to the disorder.
• If continuous signs persist at least 6 months, these 6 months must
include at least one month of periods of prodromal symptoms.
• The disturbance must not be caused by physiological effects of a
substance or general medical condition.
• If the person has history of autism or other pervasive
developmental disorder then schizophrenia is diagnosed only if
delusions or hallucinations are present for at least a month.
Causes
• No definite cause and no way to prevent
• Effects both men and women
- more common in men
- mild in women
• Normally begins as a teenager or young adult
• Symptoms progress slowly over months or years
• Childhood schizophrenia begins after the age of
five but is very rare
- often hard to tell apart from autism or other
developmental disorders
Treatment
• Antipsychotic medication•
- twenty-five percent of
treated patients get better
from six months to two years.
- thirty-five to forty percent
see great improvement after
a longer period of time and
symptoms are reduced
enough to let them live
normal lives outside of
hospitals.
Psychosocial treatment
- psychotherapy helps
teach patients how to
handle their disorder and
act appropriately in the
outside world
Case Study
An example of someone with schizophrenia is twenty-seven year old Jack. He
graduated from high school, lived with his parents and started working at a video
store. After about a half a year of work, he claimed to hear voices that put him
down and told him negative things like saying he was no good. He accused his boss
of planting video cameras in the returned tapes to see if he was making any
mistakes. When work got busy, he became agitated and talked strangely to
customers. “For example one customer asked for a tape to be reserved and Jack
indicated that that tape may not be available because it had "surveillance photos of
him that were being reviewed by the CIA."” After a year, Jack quit his job and
exclaimed he could not handle being constantly watched in the store and at home.
As the symptoms started increasing, his parents finally took him to a hospital. His
psychiatrist prescribed Thorazine, but it had side effects of his muscles twisting and
contracting. His prescription was switched to Haldol; however, sometimes Jack
would stop taking his medication which caused his symptoms to strengthen.
Throughout the past seven years, he has been hospitalized five times. He now
receives Supplemental Security Income (SSI) and has used the help of a case
manager to move into his own apartment. He is a member of a psychosocial
clubhouse for people with mental illnesses, which he attends three times a week. In
addition, Jack is worried about getting a job because of his disorder so he has been
referred to Top Quality Rehabilitation (TQP) to provide supported employment
services.
Movies
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A Beautiful Mind
Donnie Darko
Shutter Island
Black Swan
American Psycho