Range of Symptoms of Schizophrenia
Disturbances in content of thought, form of thought, perception, affect, sense of self, motivation, behavior, and interpersonal functioning.
History of schizoprenia
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Kraepelin and Dementia praecox
- (premature degeneration)
- thought to be a degeneration of the brain that began at a relatively young age and ultimately led to disintegration of the entire personality.
Bleuler's term of schizophrenia
Split, lack of integration among the person's psychological functions.
(The disturbance needs to last 6 months for the diagnosis of schizophrenia)
- -Prodromal phase (progressive deterioration)
- - Active phrase (showing delusions, hallucinations, etc.. or negative symptoms)
- - Residual phase (the symptoms are less prominent.
Risk Factors seen in early life (CASIS)
Cognitive deficits, affects, social isolation, etc.
Symptoms of schizophrenia
- Positive (excesses)
- Negative (deficits)
- Pages 279-183
Psychotic, negative and disorganized.
Course (estimates of recovery)
- 20% - 67% recover
- depends on individuals behavior age and gender.
Age differences in schizophrenia
- - Develope disorder ages 18-25, women are most likely at 25 - mid30's
- - Women develope it later than men.
Gender differences with schizophrenia
- - Women are more likely to have paranoid delusions, hallucinations, and intense affective symptoms.
- - Men have more experience to negative symptoms such as flat affect and social withdrawal.
- -Prognosis (recovery) in better for women than men
Cultural features (differences in schizophrenia)
In U.S. schizo is more common in African Am. and Asian Am.
Brief psychotic disorder
psychotic symptoms for at least 1 day but less than a month, has sudden onset and considered to be reactive - that is- appearing following a stressful event. It is possible that genetic vulnerability mediates the reaction to an environmental stressor.
- Symptoms are similar to schizophrenia except for it lasts less than 6 months.
- -The patients function normally when not experiencing a psychotic episode.
The person experiences a mood disorder at the same time of meeting the diagnostic criteria of schizophrenia.
- -A single, striking psychotic symptom expressed as non-bizarre delusions. In other areas of their lives such people function quite well.
- -Types: Erotomanic, grandiose, jealous, persecutory, mixed, and unspecified.
Shared psychotic disorder: (Folie-a-deux)
When a person otherwise mentally sound develops a delusional system because of close relationship with another person (the disturbed person). Note the mutlifactor model p 291
Despite major advances we do not fully understand the essence and cause of this disorder.
Biological perspectives: Enlarged Ventricles
Using brain imaging it is found that people with schizophrenia has enlarged ventricles.
Coritcal atrophy (brain of schizophrenia)
Enlarged ventricles is accompanied by cortical atrophy which is a wasting away of brain tissue.
Dopamine hypothesis (brain of schizophrenia)
Over activity of neurons that communicate via dopamine.
Note 2 lines of evidence for dopamine
- 1- the observation of the impact of the anti-psychotic drugs, that reduce the frequency of hallucinations and delusions by blocking dopamine receptors.
- 2- drugs that are chemically related to dopamine (such as amphetamine) increase the frequency of psychotic symptoms. NOte recent findings (p291)
Genetics: Concordance rates of identical twins & attempt to locate specific gene involved
- Concordance rates of identical twins: Highest rate- close to 48%
- - Locating specific gene
- -1- there must be a connection between genes thought to be involved in the faulty brain function
- -2- even though there is a high heritability of schizo the could still be environmental factors
Bio-behavioral abnormalities that are not direct symptoms of the disorder, but have been found to be associated. They include abnormalities of cognitive processes, such as difficulties and inability to track with smooth eye movements (p 292-293)
-"downward drift" hypothesis
- Downward drift-The illness itself causes a decrease in social and economic status.
- -Expressed emotion- negative family communication and climate may affect the amount of time the person with schizophrenia can stay out of the hospital.
Treatment: antipsychotic drugs
- -Psychological treatment bases on behavioral principles, primarily aimed at improving functioning in areas of self-cares : like economy and social skills.