Schizophrenia and Other Psychotic Disorders Chapter 10 Copyright © 2012 by Pearson Education, Inc. All rights reserved

Schizophrenia and Other Psychotic Disorders

Chapter 10

Copyright © 2012 by Pearson Education, Inc. All rights reserved.

Psychotic Disorders

Characterized by unusual thinking, distorted perceptions, and odd behaviors

Psychosis – a severe mental condition characterized by a loss of contact with reality

Delusion – a false belief

Hallucination – a false sensory perception


What Is Schizophrenia?

A severe psychological disorder characterized by disorganization in thought, perception, and behavior

-First defined over 100 years ago by German psychiatrist Emil Kraepelin

-Dementia praecox

-Dementia (pervasive disturbances of perceptual and cognitive faculties)

-Praecox (early life onset)

-Schizophrenia vs. DID


Schizophrenia in Depth: Positive Symptoms

Group of symptoms including unusual thoughts, feelings, and behaviors

Persecutory delusionsDelusions of influenceLoose associationsThought blockingClang associationsCatatonia and waxy flexibility



Schizophrenia in Depth: Negative Symptoms

Behaviors, emotions, or thought processes that are absent in people with schizophrenia

Blunted affectAnhedoniaAvolitionAlogiaPsychomotor retardationCognitive impairments



Functional Impairment of Schizophrenia

Symptom severity equals the level of impairment

Significant human toll on the individual and the family (quality of life)

One of the top ten most debilitating conditions in the world (DALY)

Cultural factorsViolence


In 2002 schizophrenia cost $62.7 billion

dollars.

Epidemiology of SchizophreniaPrevalence rates averages

1% to 0.3 to 1.6% of U.S. general population

16 to 40 of every 100,000 people develop schizophrenia

Gradual onset (some deterioration of functioning)

Prodromal phase (social withdrawal or deterioration in hygiene)

Acute phase (starts to exhibit positive symptoms)

Residual phase (psychotic symptoms are no longer present but negative symptoms remain)

The onset for schizophrenia could be acute or gradual, meaning the individual could have the disorder for years before actively showing psychotic symptoms.

How do you explain that?


Sex, Race, Ethnicity, and DevelopmentWomen (develop schizophrenia at a later age and tend to

have milder forms)

Developmental factorsHormonal and sociocultural implicationsSymptoms common across racial and ethnic

groupsAfrican Americans (more likely to be diagnosed than

white and Latino patients)

EOS (schizophrenia that develops before the age of 18)


Paranoid Schizophrenia is the most common subtype at 39.8% and

Catatonic subtype is more rare at 6.7%.


Etiology Biological

-Dopamine hypothesis (the presence of too much dopamine in the neural synapse)

-Neurotransmitters

-Genetics

-Neuroanatomy (structural and functional abnormalities in the brain)

-Viral theories and prenatal stressors

-Synaptic pruning (process in which weaker synaptic contacts in the brain are eliminated and stronger connections strengthened)


Genetics and Environment: Schizophrenia

Let’s examine the evidence

1. A research study found that 36.8% of the biological children of schizophrenic mothers who were raised in “disordered” family environment developed a “schizophrenic spectrum disorder.”

Fact: Both genetic and environmental factors increase the risk of psychotic disorders, but even without the genetic risk and “healthy family environment,” 4.8% of individuals still develop the disorder.

Evidence: The research shows both factors play a role.

How might you explain these differences?

How would you explain this study to a female patient who wants to have a child?


Figure 10.1 Ventricles of the Brain


Figure 10.2 Neurodevelopmental Model of Schizophrenia


Etiology Family Influences

-The cause of the disorder is not the same as what people believe is responsible for their suffering

-Expressed emotion (describes the level of emotional involvement and attitudes that exist within a family of a patient with schizophrenia)

-A variety of cultural explanations for the disorder (biological, social, supernatural, and family environment)

-Gene-environment correlation (the same person who provides one’s genetic make-up also provides the environment in which one lives)


Treatment of SchizophreniaPharmacological

-Antipsychotics (a class of medications that block dopamine receptors)

-Typical antipsychotics (medications that reduce the positive symptoms)

-Atypical antipsychotics (medications that treat positive symptoms, less likely to produce side effects, and affect negative symptoms and cognitive impairments)

-Side effects

-Tardive dyskinesia (abnormal and involuntary motor movements of the face, mouth, limbs, and trunk)


Treatment of SchizophreniaPsychosocial

-Psychoeducation (both patient and family members are educated about disorder)

-CBT (used to reduce or eliminate psychotic symptoms)

-Social skills training (teaches the basics of social interaction and both verbal and nonverbal skills)

-Supported employment (a psychosocial intervention that provides job skills)


Research Hot Topic: Transcranial Magnetic Stimulation (TMS)

Goal (provide stimulation to a targeted area of the cerebral cortex to change brain activity)

Use of small coil placed over the scalp to induce electrical current

Based on neuroimaging studiesDecreases (temporarily) the

frequency of hallucinations

Reduction in positive symptoms (reduced frequency of voices and reduced distraction)

Does not reduce delusions

Time-limited results and need for further studies


Documents

Schizophrenia and Other Psychotic Disorders Chapter 10 Copyright © 2012 by Pearson Education, Inc. All rights reserved