To split
Mind
He outlined a description of the symptoms of schizophrenia.
He described cases of schizophrenia.
He coined the term "dementia precox" which means premature loss of the mind.
He unified the distinct categories of schizophrenia under the name dementia praecox.
He coined the term schizophrenia ("split of the mind").
Major disturbances in thought, emotion, and behavior.
- Flat or inappropriate affect
- Disordered thinking in which ideas are not logically/semantically related
- Faulty perception and attention
- Bizzare disturbances in motor activity
- lasts 1-2 years before the official diagnosis of schizophrenia
- 85% of patients with schizophrenia experience it
- Unusual ideas of reference, magical thinking, increased anxiety, attention problems...
The idea of self-reference in neutral events. Ex.: believing that everyone in the city is talking about them; believing that a television news segment has to do with them...
Due to its high rate of completed suicide.
After the onset of symptoms for 1-2 years (aka Prodromal phase)
Because we are generally ill-equipped to deal with this disorder and it's highly stigmatized.
The use of illicit drugs, comorbidity, and poor family/social support.
Depression
Social anxiety
Substance abuse
- First episode of multiple
- Continuous
- Unspecified
- With catatonia
Positive: presence of too much of a behavior that isn't present in most people
Negative: the absence of a behavior that should be evident in most people
Delusions
Hallucinations
Disorganized speech
It's a five point scale (0-4) with 0 being not severe and 4 being very severe symptoms
Disorganized thoughts will lead to disorganized speech and neologisms (new words that client makes up)
Cognititve slippage, incoherence, derailment, not making any sense, sentences are not properly syntaxed and follow no semantic order.
Erroneous belief that is fixed and firmly held despite any clear contradictory evidence.
Its the Latin word for "to play" and refers to delusions as playing tricks on the mind
Mania and delusional depression
- Delusions of body changes: organs don't work or were removed
- Delusion of reference: neutral environment is believed to have some personal and special meaning
- Thought insertion: thoughts are being inserted into one's mind by some external agency
Hallucinations are sensory while delusions are mainly maladaptive thoughts.
Broca's area (speech production) and the visual center
- Reduced expressive behavior
- Reductions in motivation or in the experience of pleasure.
- Affect
- Alogia
- Avolition
- Anhedonia
- Asociality
No emotional response and no stimulus can elicit a response; lifeless expression; still experiencing plenty of internal emotions but doesn't show it; present in most people with illness
Poverty of speech (amount is greatly reduced) and poverty of content of speech (amount of speech is reasonable bit it tends to be vague and repetitive).
Lack of interest and motivation; inability to intiate or persist in goal-directed activity; apathy; bad hygiene; poor life functioning.
Diminished ability to experience pleasure; lack of interest in activities and sex; clients are aware of this and normally report it.
Childhood social troubles; poor social skills; severely impaired social relationships; greater shyness
It's a specifier that can be present in diagnosis but doesn't need to be. Catatonia is the characterized by severe motor abnormalities and is similar to mania. Bizarre gestures, repeated movements, increase of level of activity.
adopting unusual postures and holding them for long periods of time. In waxy flexibility, another person can position them, and they will hold that posture the same.
- Disorganized
- Catatonic
- Paranoid
- Undifferentiated
- Residual
Repeating other people's words over again.
Repeating other people's gestures.
- Delusions of persecution
- Grandiose delusions
- Grandiose jealousy
- Ideas of reference
Disorganized
- Higher concordance in monozygotic twins
- Negative symtpoms (5A's) have a genetic component
- 10% prevalence in first-degree relatives of a proband with schizophrenia
Thoery that the mother was to blame for her child's psychiatric problem due to her dominant and conflict-inducing parenting behavior.
After 21 years, the index adoptees developed more schizophrenia and schizophrenia-like symtpoms than did the controls
Gene-environment interaction.
Drugs are successful in treating schizophrenia by decreasing dopamine levels; amphetamines induce symtpoms of psychosis that closely resembles paranoid schizophrenia
It might not be excess in dopamine, but rather oversensitive dopamine receptors; HVA is not found in greater amoutns in people with schizo
Negative symptoms (5A's)
Positive symptoms (delusions, hallucinations, disorganized speech)
R\Pregnancy complications and birth defects; Malnutrition; Gene-environment interaction
increased stress leads to increased likelihood of relapse. Low socio-economic status leads to increased stress
A genetic/environmental predisposition to stress and a related diagnosis
- Less dopamine neurons
- reduction in grey matter
- less activation
Stressors associated with low SES may contribute to development of schizo
It's a huge domino effect. They're social deficits will increase with the development of their psychosis, which may drift them toward poverty-ridden areas of the city. Their cognitive and motivational problems will impair their ability to work and make a living. They will end up isolating themselves and escaping from relationships.
Antipsychotic medication (first generation neuroleptics) (Dopamine antagonists (D2))
Because the side effects are unpleasant (like uncontrolled motor movement). Psychoeducation may help as well as social encouragement
- First: effect on positive symptoms vs. Second: effect on both negative and positive
- less side effects
- Blocks more receptors, not just D
Psycho-social and cognitive-behavioral
- Social skills training: helps with employment, fostering relationships, breaking down tasks to make them easier
- Family therapy and Reducing expressed emotion: high amount of perceived criticism and low warmth leads to low medication adherence and stigmatization.
Works on dysfunctional attitudes and internalizing stigma. Works on interpreting thoughts and feelings.
The person believes they are being commanded to do something.
Psychoeducation to family members as well as psychiatric professional; increase education in younger people to devleop a greater understandng and acceptance earlier on.