SCHIZOPHRENIA
WHAT IS SCHIZOPHRENIA?
One of the most heavily researched disorders
Literally means “split mind”
 A split from reality (not multiple personalities)
Series of disorders characterized by disorganized thinking,
disturbed perceptions, and inappropriate emotions and
actions
Has both positive and negative symptoms
 Positive: presence of…
 Negative: absence of…
It is a psychotic disorder: out of touch with reality
DISORGANIZED THINKING
 “This morning I was at Hillside [hospital], I was making a movie. I
was surrounded by movie stars…I’m Mary Poppins. Is this room
painted blue to get me upset? My grandmother died four weeks
after my eighteenth birthday.”
Thinking is bizarre, fragmented, and often distorted by
delusions
 Delusions: false beliefs, often of persecution or grandeur, that may
accompany many psychotic disorders
 Those with paranoid tendencies are prone to delusions of persecution
May result from a breakdown in selective attention
 Can’t filter out the other things!
DISTURBED PERCEPTIONS
May have hallucinations (sensory
experiences without sensory stimulation)
 Seeing, hearing, feeling, tasting, smelling
 Most are auditory – hearing voices making insulting
remarks or giving orders
INAPPROPRIATE EMOTIONS AND
ACTIONS
Laughing when hearing of death
Crying when others laugh
Some have “flat affect” – emotionless state
Motor behaviors may be inappropriate
 Senseless, compulsive acts (rocking, rubbing an arm)
 Catatonia: may remain motionless for hours and then
become agitated
TYPES OF SCHIZOPHRENIA
Paranoid
Disorganized
Catatonic
Undifferentiated
Share some common features
Also have some distinguishing symptoms (see
textbook)
EFFECTS OF SCHIZOPHRENIA
Disrupt social relationships
Makes it difficult to hold a job
Often live in a private inner world
With support, some may recover to enjoy a normal
life or only experience bouts of schizophrenia
intermittently
ONSET AND DEVELOPMENT OF DISORDER
Strikes those who are developing into adulthood
Afflicts 1 in 100 people (.5-1%)
Knows no national boundaries
Affects both males and females
 Men are often struck earlier, more severely, and slightly more often
Does it develop quickly or slowly?
 Both
 For some, appears suddenly, as a reaction to stress
 For others, develops gradually
SLOW OR RAPID DEVELOPMENT
When it is slow-developing(chronic or process
schizophrenia), recovery is doubtful
 Often have negative symptoms
Those who develop rapidly (acute or reactive
schizophrenia), often following life stresses, recovery is
much more likely
 Often have positive symptoms
 Respond better to drug therapy
WHAT CAUSES
SCHIZOPHRENIA?
CAUSES: BRAIN ABNORMALITY
 Excess of receptors for dopamine
 May intensify brain signals, which would create the positive symptoms of
hallucinations and paranoia
 Drugs that block dopamine receptors often lessen positive
symptoms
 Drugs that increase dopamine activity (amphetamines and cocaine) can intensify them
 But dopamine is also linked to Parkinson’s disease, so patients who take drugs to
block dopamine develop Parkinson’s like symptoms
 Dopamine blocking drugs have little effect on negative symptoms
 Investigating the role of glutamate (excitatory neurotransmitter)
 Drugs that interfere with glutamate receptors can produce schizophrenia-like
negative symptoms
CAUSE: BRAIN CONT.
 People with schizophrenia have abnormal brain activity in several
areas
 NOT one isolated area
 Low brain activity in frontal lobes
 PET scans during hallucinations showed activity in the thalamus
 Temporal lobe is activated during auditory hallucinations
 People with paranoia showed increased activity in the amygdala
 Brain size
 Enlarged, fluid-filled areas in brains of patients
 Smaller cerebral cortex
 Smaller thalamus
 Can show these BEFORE onset!
 What causes these abnormalities?
 Mishap during prenatal development or delivery
 Famine during pregnancy
MATERNAL VIRUS DURING PREGNANCY
GENETIC FACTORS
 If your parent or siblings have schizophrenia, your odds of
developing it are 1 in 10
 If your identical twin has it, your odds are 1 in 2 (even when
reared apart)
 Those who share a placenta have an increased risk
 Children adopted by someone who develops schizophrenia,
seldom “catch” the disorder
 Genes could affect dopamine levels or production of myelin
 Identifying specific genes is difficult
 Other factors (viruses, oxygen deprivation at birth, etc) may “turn off” or “turn
on” the genes that predispose people to the disease
GENAIN QUADRUPLETS
All have schizophrenia
Two of the sisters have
more severe forms
 Environmental factors!
PSYCHOLOGICAL FACTORS
“No environmental causes have been discovered
that will invariably, or even with moderate
probability, produce schizophrenia in persons who
are not related to a person with schizophrenia”
 Susan Nicol and Irving Gottesman in 1983
EARLY WARNING SIGNS
 Study of “at risk” children/young adults who had relatives with
schizophrenia
 A mother whose schizophrenia was severe and long lasting
 Birth complications, often involving oxygen deprivation and low
birth weight
 Separation from parents
 Short attention span and poor muscle coordination
 Disruptive or withdrawn behavior
 Emotional unpredictability
 Poor peer relations and solo play