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Schizophrenia I
Schizophrenia
Schizophrenia is classified as a psychotic
disorder.
Psychosis (from G. psyche mind/soul and
-osis abnormal condition) means a loss of
contact with reality.
Schizophrenia aects approximately 1/100
people in North America. The annual cost of
schizophrenia in the US is estimated at
around $60 billion, due largely to the cost of
treatment and lost wages.
Schizophrenia is a common disease with
severe consequences for patients and their
loved ones, and for this reason, it is an area
that has received a lot of attention from
researchers.
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2. MYTH: People who have schizophrenia have
multiple personalities.
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Characteristics of schizophrenia
The symptoms experienced by people with schizophrenia can be
divided into three basic groups.
Positive symptoms are symptoms that go beyond normally
occurring experiences.
E.g. hallucinations, delusions, paranoia.
Positive symptoms
Delusions: irrational beliefs or paranoia that misrepresents reality.
Delusions expressing a loss of control over mind and body are common.
i.e. Belief that outside forces are inserting thoughts into ones mind, or that
ones body is being manipulated by some outside force.
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Positive symptoms
Hallucinations: the experience
of sensory events without any
input from the surrounding
environment. Hallucinations
can involve any of the senses,
but auditory hallucinations
such as voices are the most
common.
Many hallucinations are simply
a running commentary of
whats going on.
Others can be more sinister.
Command hallucinations
involve voices giving orders.
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Negative symptoms
Apathy: the inability to get started, to perform basic
day-to-day functions.
This can lead to problems with hygiene, keeping a job,
and keeping a place to live.
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Cognitive symptoms
Disorganized speech: people with
schizophrenia have a confusing way of talking.
They often jump about randomly from topic to
topic, or go off on illogical tangents.
A video
http://www.youtube.com/watch?v=gGnl8dqEoPQ
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History
The condition historically known simply as
madness or lunacy likely corresponds to what
we now call schizophrenia.
Emil Kraeplin (1856-1926) was the first to
thoroughly define the symptoms of
schizophrenia, combing several elements of
insanity into one disorder.
Catatonia, hebephrenia (silly and immature
emotionality), and paranoia had previously been as
separate disorders.
He also distinguished schizophrenia from manicdepression (which we now call bipolar disorder)
History
Eugen Bleuler (1857-1939) introduced the term
schizophrenia, replacing Kraeplins dementia
praecox.
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Development
Schizophrenia is usually diagnosed in
late adolescence or early adulthood.
It strikes right as people enter the world
and begin to gain independence, it is a
cruel surprise that deprives people of the
chance of a normal life.
There is usually a lag of 1-2 years
between the first onset of symptoms
and diagnosis.
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Illustration from Barlow & Durand, Abnormal Psychology, 6th ed. Wadsworth, 2012
Etiology - genetics
There is clear evidence for a genetic link
to schizophrenia.
This can be shown by looking at how
the relative risk of developing the illness
changes depending on whether other
people in ones family have
schizophrenia.
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Illustration from Barlow & Durand, Abnormal Psychology, 6th ed. Wadsworth, 2012
Endophenotypes
Endophenotypes are subtle markers of disorder-related genes
that appear in people before overt symptoms.
Illustration from Barlow & Durand, Abnormal Psychology, 6th ed. Wadsworth, 2012
Endophenotypes
Pre-pulse inhibition (PPI)
happens when a startling stimulus
of some kind (a pulse) is
preceded by a warning prepulse.
In healthy people, a pre-pulse
warning reduces their startle
response. This does not happen
in people with schizophrenia, and
it is also reduced in their relatives.
Antipsychotic drugs increase PPI
in people with schizophrenia.
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Etiology
How can it be that even if you possess
100% of your twins schizophrenic
genes, your odds of developing the
disorder are only 48%?
Genetics are somewhat like a loaded
gun. Having bad genes does not
guarantee developing the disorder, but
it certainly raises the risk.
Something else must happen during
life to trigger the illness
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Etiology - stress
Stress seems to be a contributing factor in the development
of schizophrenia in individuals who are susceptible.
Numerous studies have shown that diagnoses of
schizophrenia are often preceded by a stressful life event.
Anecdotal evidence seems in favor of this as well. Schizophrenia
often appears in the midst of the stressful transition to
independent living that young adults undergo.