Reading §
- Explain why schizophrenia is viewed as one of the most serious, disabling, and complex mental disorders
- Schizophrenia is a psychotic disorder that may affect both men and women in late adolescence and early adulthood.
- The disorder is complex and heterogeneous in its clinical presentation, course, and outcome.
- Approximately 50 percent of patients with schizophrenia improve over time and in response to treatment, but few achieve their social and occupational potential, and many require lifelong support and remain at risk for suicide.
- Direct and indirect social and health care costs of schizophrenia approach $7 billion a year in Canada.
- Identify the steps involved in a DSM-5 diagnosis of schizophrenia and the strengths and weaknesses of this approach
- Schizophrenia involves characteristic symptoms that must be present for diagnosis, including hallucinations, delusions, thought and language disorder, bizarre behaviour, and withdrawal.
- The diagnosis requires evidence of a decline in social and occupational functioning.
- Having psychotic symptoms for one day does not mean a person has schizophrenia; these symptoms must persist for at least a month unless successfully treated.
- Mood disorders such as depression and other medical and developmental disorders may complicate the diagnosis of schizophrenia and must be ruled out.
- here is no objective test that confirms whether a person has schizophrenia.
- Disorders such as schizophrenia may result from many interacting biological and psychosocial influences rather than from a single cause or event.
- Explain why the concept of diathesis, or vulnerability, is so important in theories of schizophrenia
- Biological and psychosocial processes may increase or decrease the probability that a vulnerable person develops schizophrenia.
- Most theorists argue that both a vulnerability, or diathesis, and environmental stress are required to cause schizophrenia.
- Having a parent with schizophrenia significantly increases the chances that a young person will develop the disorder.
- Describe reasons why genes influence but do not determine who develops schizophrenia
- The influence of parents on the development of schizophrenia in their children is biological and genetic in nature.
- Many genes are implicated in schizophrenia, but their individual effects are very small.
- Epigenetic processes that turn genes on and off may be as important in causing schizophrenia as the genes themselves.
- Identify the most common cognitive and neurobiological abnormalities associated with schizophrenia.
- Slow processing of information; poor coordination; and deficient attention, perception, and learning are characteristic of most people with schizophrenia.
- Abnormalities of the frontal and temporal lobes of the brain are among the most studied features of schizophrenia, but no single brain abnormality occurs in everyone with the disorder.
- Neuroscience research methods provide increasingly accurate and sophisticated information about the structure and physiology of the brain.
- The most frequently implicated neurochemical abnormality in schizophrenia involves the neurotransmitter dopamine.
- Identify and explain the effectiveness of antipsychotic medication and psychosocial therapies in the treatment of schizophrenia
- Chlorpromazine was the first effective antipsychotic medication used with schizophrenia patients, reducing the severity of positive and, to a lesser degree, negative symptoms.
- Newer generations of antipsychotic medications claim to provide therapeutic benefits with fewer side effects.
- Antipsychotic medications have little or no effect on the cognitive impairments associated with schizophrenia.
- Significant advances have been made in the application of psychological interventions, such as cognitivebehaviour therapy (CBT), family therapy, and cognitive remediation training.
- Cognitive remediation training has potential value for addressing cognitive impairment and may also reduce some symptoms and improve social functioning in people with schizophrenia.
- Early intervention, whereby medication and psychological therapies are provided before a person develops prolonged psychosis, has become a new and promising focus for clinical researchers.
- Integrated psychosocial and medical therapies offer the most hope for improving the lives of people with schizophrenia.
Lecture §
- Prevalence and related facts
- 1% of general population
- Typical onset is 15-45
Female = Male
- What is heterogeneity and how does it relate to Schizophrenia
- Heterogeneity: a tendency for people with the disorder to differ from each other in symptoms, family and personal background, response to treatment, and ability to live outside of hospital
- Makes diagnostic difficult and causes stigma
- Diagnostic criteria for Schizophrenia
- >2, and >1 ★ for a significant portion of time during 1-month
- ★ Delusion: false perceptions (thoughts)
- Persecutory (conspiracy)
- Referential (taking personally)
- Somatic (about body)
- Religious (demons)
- Grandiose (special powers)
- ★ Hallucination: misinterpretation of sensory perception
- ★ Disorganized speech
- Disorganized behaviour
- Deficits in psychomotor functioning, ranging from agitation to immobility.
- Negative symptoms
- Avolition: manifest as apathy (personal hygiene habits)
- Anhedonia
- Level of functioning is below level before onset
- Work, interpersonal, self-care
- Continuous signs for >6 month, must include the 1 month of symptoms in (A)
- Rule out: Schizoaffective Disorder and MDD or Bipolar Disorder
- What is defined as positive and negative symptoms
- Positive: distortion and additional behaviour
- Negative: absence of normal behaviour
- | Positive | Negative |
|-------------------------------|--------------------------------------|
| Hallucinations | Sparse speech and langauge |
| Delusions | Avolition |
| Disorganized speech & thought | Anhedonia |
| Disorganized psychomotor | Diminished attention & concentration |
- What is the overlap between Bipolar Disorder and Schizophrenia
- What is the diagnostic criteria for Schizoaffective Disorder
- What is the important differential diagnosis between BD, MDD, and Schizoaffective Disorder