Schizophrenia
Schizophrenia is a chronic, severe, disabling
brain disease that interferes with a person’s
ability to think clearly, to distinguish reality
from fantasy, to manage emotion, to make
decisions, and to relate to others.
• Not split-personality disorder
• Greek roots describe the fragmented thinking.
- “schizo” means split
- “prene” means mind
• Schizophrenia can be traced back to old Pharaonic Egypt (2nd
millennium before Christ).
• It was thought to be caused by evil spirits who possessed the
bodies of schizophrenics.
• Treatment was exorcism.
- Innocent methods = playing religious music
- Dangerous methods = trephination
• 1887 – Dr. Emile Krapelin first identified the disorder as a
discrete mental illness called dementia praecox.
• Dementia praecox is Latin and means “out of one’s mind for
one’s time.”
• 1911 - The word schizophrenia was coined by a Swiss
psychiatrist named Eugen Bleuler.
Positive Symptoms
1. “Positive” – extra, beyond what normal people experience
 Hallucinations
 Hearing voices that are not really there (most common)
 Seeing people or objects that are not really there
 Smelling scents that do not really exist
 Thinking he/she is being touched
 Delusions
 Delusions of persecution – believe people are trying to harm
him/her
 Delusions of reference – believe TV characters or books are
specifically talking to him/her
 Delusions of influence – believe he/she are being controlled by
external forces like aliens or demons
 Thought disorders
 Movement disorders
Negative Symptoms
2. “Negative” – lacking from what normal people experience
 Lack of interest
 Lack of pleasure
 Flat effect
Cognitive Symptoms
3. “Cognitive”
 Poor ability to understand information and use it to
make decisions
 Trouble focusing or paying attention
 Problems with “working memory” (the ability to use
information immediately after learning
Types
1. Paranoid Schizophrenia
 #1 type of schizophrenia (40%)
 Characterized by delusions and hallucinations
2. Disorganized Schizophrenia
 Characterized by very confused speech, social silliness,
and neglect of cleanliness
3. Catatonic Schizophrenia
 Becoming rare
 Characterized by very disturbed motor behavior
Onset and Prevalence
• Affects 1 in every 100 people
• Men typically develop schizophrenia ages 16-25.
• Women typically develop it ages 25-30.
Possible Causes
• Genes
pregnant
• Cannabis Use
• Infection in womb
• Age of Father
• Stress during childhood or
earlier development
• Being born during winter
months
• Sickness of mother while
• Elevated levels of
neurotransmitters
Paranoia
&
hallucinations
Auditory
hallucinations
Visual
hallucinations
Disorganized
thoughts
Emotional issues
Memory &
learning
problems
More Brain
• Increased blood flow to some areas
• Decreased blood flow to other areas
• Extra grey matter lost
• Enlarged Ventricles
• Reduction in brain tissue
Treatments
• Americans spend nearly 63 billion a year treating
schizophrenia
• Antipsychotics “neuroleptic medications”
1. Typical antipsychotics (affect dopamine)
2. Atypical antipsychotics (affect dopamine & serotonin)
• Shock Treatments
1. Insulin
2. Electroconvulsive
Outlook for Schizophrenics
• There are more untreated schizophrenics on the streets than
receiving care in hospitals.
• 5% of schizophrenics live their lives in hospitals.
• 6% are homeless or live in shelters.
• 6% live in jails or prisons.
• 10% live in nursing homes.
• 20% live in supervised homes.
• 25% live with a family member.
• 28% live independently.
• Schizophrenics have a 50x higher risk of attempting suicide
than the public.
• 40% attempt suicide at least once in their lives.
• 10-13% actually kill themselves.
• Suicide is the #1 premature cause of death among
schizophrenics.
Future Treatments
• Drugs to lower levels of the STEP enzyme
• Drugs to reduce glutamate (a neurotransmitter that excites
dopamine release)
• Drugs that affect the NMDA receptor (deals with glutamate)
• Drugs that affect the mGluR receptors (also deal with glutamate)
• Drugs that play a role in the receptors for
- Serotonin
- Nicotine
- GABA
• Drugs to slow the loss of gray matter during pruning