Schizophrenia
Kimberley Clow
kclow2@uwo.ca
http://instruct.uwo.ca/psychology/155b/
Outline
• What is Schizophrenia?
– Positive Symptoms
– Negative Symptoms
– Subtypes
– Phases
• Development
• Causes
• Treatment
What Is Schizophrenia?
• Most severe of adult
psychiatric disorders
– Interferes with the ability
to think, manage
emotions, & relate to
others
• History
– Kraepelin
– Bleuler
1
Course of
Schizophrenia
Schizophrenia
• Psychotic Disorder
– Characterized by major disturbances in
thought, emotion, and behaviour
• Positive symptoms
• Negative symptoms
– 3 Main Clusters
• Withdrawal
• Magical Thinking
• Disorganization
Positive Symptoms
• Excesses or Distortions
• Disorganized or Catatonic Disorder
• Disorganized Speech
– Loose Associations
– Tangential Thinking
– Word Salad
• Hallucinations
• Delusions
2
• Types of Delusions
– Persecutory delusions
– Delusions of being controlled
– Thought broadcasting
– Thought insertion
– Thought withdrawal
– Delusions of guilt or sin
– Somatic delusions
– Grandiose delusions
First of all thank you very much for your desire to help me. I am twenty
eight years old Men. My specialty is theoretical physic, I have finished
university in spite of the fact that deficit of conscious mental acts means
sharp reduction of creative activity and on the other hand it very impedes
social communications (I do not know how modern psychiatrists call my
disturbance, thinking not clearly?). From childhood I was very active and
creative boy, I studded in the physic and mathematical school and
participated in many Olympiads.
At the beginning reduction of psychic activity took place very slowly and
mental exercise which required learning (for example studding of verses or
text by heart) facilitate my deficit of subjective psychic activity but one day
(in one second) occurred sharp lowering of intentionality. My age was
sixteen years then and since my disturbance remains without any change. I
was treated by best psychiatrist of my country and Russian. At the beginning
they think I have depersonalization disorder but then they changed their
opinion and now think that I have “schizophrenic ego-dysfunction”. Of
course, they do not mean that I have schizophrenia. I tried risperidone and
zyprexa and I am sure they cannot be effective for treatment my
disturbance, moreover probably my disturbance is not linked with
hypoactivity of the cortico-striato-thalamo-cortical network and as Andreasen
thinks disturbance of creative activity is not characteristic for schizophrenia
at all. There are not neither books nor journals in my country, I have read
only abstract of your article from Behavioral and Brain Science and decided
to ask you advice.
Negative Symptoms
•
•
•
•
•
Blunted Affect
Alogia
Avolition
Impaired Social Skills
Withdrawal &
Antisocial
• Anhedonia
3
Development of Schizophrenia
• Process Schizophrenia • Reactive Schizophrenia
– Chronic
– Slow onset, develops
gradually over time
– evidences of oddity
from early in childhood
– poor prognostic outlook
– Acute
– Sudden and dramatic
onset marked by intense
emotional and
intellectual upheaval
– Diathesis-Stress Model
Phases of Schizophrenia
Subtypes
• Are there really subtypes?
• Seem to be some grouping of
symptoms
– Disorganized
– Catatonic
– Paranoid
• Other categories
– Undifferentiated
– Residual
4
What is Going On?
Eye Tracking
• Excessive amounts of
dopamine in frontal lobes
• Differences in Processing
Information
– Novelty processing
– Difficulty inhibiting stimuli
– Smooth pursuit eye
movements disrupted
Myths
• False assumptions about
schizophrenia
–
–
–
–
–
Violence
Multiple personalities
Homelessness
Due to frigid mother
Due to conflicting
messages
– Due to conflict resolution
in relationships
– Sex abuse
Causes
• Biology
– Genetics
• Heritability
– Neurotransmitters
• Dopamine
– Abnormal brain
structures
– Infection
5
• Psychological Stress
– Social Class
• Sociogenic Hypothesis
• Social Selection Theory
– Cannabis
– The Family
• Expressed Emotion (EE)
Treatment
• Biological
– Antipsychotic Drugs
• Akinesia
• Akathesis
• Tardive Dyskinesia
• Cognitive-Behavioural Therapy
– Target bizarre behaviour
– Counter irrational thoughts
– Social-Skills Training
• Family Therapy
– Attempt to reduce expressed emotion
• General Trends
– Families and patients can be given realistic
and scientifically sound information
– Medication is only part of treatment
– Early intervention affects course and
treatment
– Integrated treatment is not widely
available
6
Concluding Remarks
• It is an all consuming disorder
– Thoughts, feelings & behaviour
• Drug therapy is most common
– Nasty side-effects
– Life-long treatment
• With current treatments
– About 25% of schizophrenics recover fully
– About 10% have chronic deterioration
– About 65% have partial recoveries
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