Schizophrenia

Download as pptx, pdf, or txt
Download as pptx, pdf, or txt
You are on page 1of 54

SCHIZOPHRENIA AND OTHER

PSYCHOTIC DISORDERS
Phases of Schizophrenia
1. The pre-morbid personality often indicates social maladjustment,
social withdrawal, irritability, and antagonistic thoughts and
behavior.
 veryshy and withdrawn, poor peer relationships, doing poorly in school, and
demonstrating antisocial behavior

2. The prodromal phase of schizophrenia begins with a change


from pre-morbid functioning and extends until the onset of frank
psychotic symptoms.
 It has an average length of 2 and 5 years

 The person experiences substantial functional impairment and


nonspecific symptoms such as a sleep disturbance, anxiety,
irritability, depressed mood, poor concentration, fatigue, and
behavioral deficits such as deterioration in role functioning and
social withdrawal.
Phases of Schizophrenia
3. In the active phase of the disorder, psychotic symptoms
are prominent with
Characteristics symptoms such as
 Delusions, hallucinations, disorganized speech, catatonic behavior,
negative symptoms
Social/occupational dysfunction:
Persist for a period not less than 6 months
Schizoaffective and mood disorder exclusion has been ruled
out
Substance/general medical condition has been excluded
4. During the residual phase, symptoms of the acute stage
are either absent or no longer prominent.
Negative symptoms may remain, and fl at affect and
impairment in role functioning are common.
Positive Symptoms
1. Delusions
Delusions are fixed beliefs that are not amenable to change in light of conflicting
evidence. Their content may include a variety of themes (e.g., persecutory,
referential, somatic, religious, grandiose)
2. Persecutory delusions (i.e., belief that one is going to be harmed, harassed,
and so forth by an individual, organization, or other group) are most common.
3. Referential delusions (i.e., belief that certain gestures, comments,
environmental cues, and so forth are directed at oneself) are also common.
4. Grandiose delusions (i.e., when an individual believes that he or she has
exceptional abilities, wealth, or fame) and
5. Erotomanic delusions (i.e., when an individual believes falsely that another
person is in love with him or her) are also seen.
6. Nihilistic delusions involve the conviction that a major catastrophe will
occur, and somatic delusions focus on preoccupations regarding health and
organ function.
 Bizarre Delusions
o they are clearly implausible and not understandable to same culture peers
and do not derive from ordinary life experiences.
o Delusions that express a loss of control over mind or body are generally
considered to be bizarre;
o thought withdrawal (belief that one’s thoughts have been “removed” by
some outside force)
o delusions of control(one’s body or actions are being acted on or
manipulated by some outside force)
e.g., the belief that an outside force has removed his or her internal organs
and replaced them with someone else’s organs without leaving any wounds or
scars.
 Non-Bizarre Delusions
one is under surveillance by the police, despite a lack of convincing evidence.
 2. Hallucinations
o Hallucinations are perception-like experiences that occur without an external
stimulus. They are vivid and clear, with the full force and impact of normal
perceptions, and not under voluntary control. They may occur in any sensory
modality.
o The hallucinations must occur in the context of a clear sensorium;
 those that occur while falling asleep (hypnagogic) or
 waking up (hypnopompic) are considered to be within the range of normal
experience.
Auditory
Visual
Tactile
Gustatory
Olfactory
3. Disorganized Thinking (Speech)
 derailment or loose associations (The individual may switch from one
topic to another)
 Tangentiality (Answers to questions may be obliquely related or
completely unrelated). Tangential thinking involves abrupt changes in
subject matter that are unrelated to the initial topic.
 incoherence or “word salad”(speech may be so severely disorganized
that it is nearly incomprehensible and resembles receptive aphasia in its
linguistic disorganization).
 Circumstantiality. (non-direct thinking or speech that digresses from
the main point of a conversation). The circumstantial type of speech is
superfluous and roundabout. The speaker will go off on irrelevant
tangents before coming back to the main point of the story.
4. Grossly Disorganized or Abnormal Motor Behavior
(Including Catatonia)
manifest itself in a variety of ways, ranging from childlike “silliness” to
unpredictable agitation. Problems may be noted in any form of goal-directed
behavior, leading to difficulties in performing activities of daily living.
 Catatonic behavior
 a marked decrease in reactivity to the environment. This ranges from
resistance to instructions (negativism);
 to maintaining a rigid, inappropriate or bizarre posture; to a complete lack
of verbal and motor responses (mutism and stupor)
 It can also include purposeless and excessive motor activity without
obvious cause (catatonic excitement).
 Other features are repeated stereotyped movements, staring,
grimacing(facial expressions), and the echoing of speech.
Negative Symptoms
1. Avolition
decrease in motivated self-initiated purposeful activities. The
individual may sit for long periods of time and show little interest
in participating in work or social activities.
2. Alogia
manifested by diminished speech output.
3. Anhedonia is the decreased ability to experience pleasure.
Individuals with schizophrenia can still enjoy a pleasurable activity
in the moment and can recall it, but show a reduction in the
frequency of engaging in pleasurable activity.
4. Asociality refers to the apparent lack of interest in social
interactions and may be associated with avolition, but it can also be
a manifestation of limited opportunities for social interactions.
Prognosis
Good Poor
1. Abrupt or acute onset Insidious onset
2. Later onset Younger onset
3. Presence of precipitating factor Absence of precipitating factor
4. Good premorbid personality Poor premorbid personality
5. Paranoid and catatonic subtypes Simple, undifferentiated subtypes
6. Short duration: (<6 months) Long duration:(>2 years)

7. Predominance of positive symptoms Predominance of negative symptoms

8. Family history of mood disorders Family history of schizophrenia

9. Good social support Poor social support


10. Female sex Male sex

11. Married Single, divorced or widowed

12. Out-patient treatment Institutionalization


Risk factors of schizophrenia
Following are the risk factors for developing
schizophrenia.
 Genetics and family history
 Viral infections and immune disorders
 Prenatal and birth complications
 Dense living environment
 Neuro chemical irregularities
 Drug use
 Stressful life events
Genetics and family history
Most common risk factors.
Tends to run in families.
Mutated genes.
Age factor.
Viral infections and immune disorders
Upper respiratory infection
Seasonal viruses
Maternal influenza
Prenatal and birth complications
Complications of pregnancy.
Prolong and traumatic delivery.
Malnutrition, birth weight, low oxygen
Dense living environment
Urban birth.
Low income families
Black immigrants.
Neurochemical irregularities
Chemical and physical changes in brain.
Increase level of dopamine.
Decrease in the size of brain.
Drug abusers
Impact of drug used in adolescence.
cannabis, cocaine, amphetamines, LSD.
Hallucinations.
Stressful life events
Childhood traumas.
Childhood abuse.
Unsupportive and dysfunctional relationships
Aetiology
Structural Changes in the Brain
Enlarge ventricles
Increased loss of gray matter in adolescence
Shrinkage of cerebellar vermis
Thicker corpus callosum

Psychological Factors
Cold, over-protective and domineering mothers
Dysfunctional family system
Poor parent-child relationships
Double-bind communication from parents
Stressful life events
How Schizophrenia can be treated
MEDICATIONS
I. Antipsychotic medications
It control symptoms by affecting the brain neurotransmitter
dopamine.
 These antipsychotic medication also includes
a. First Generation (It posses potentially significant neurological side effects, including
the possibility of developing a movement disorder)

b. Second Generation (Preferred because they pose a lower risk of serious side effects)
Psychosocial interventions and therapies
 It includes

Individual therapy. ( Normalization of


thinking patterns)

Cognitive enhancement therapy (CET)


(cognitive remediation - It teaches people how to better
recognize social cues)

Social skills training (focuses on improving


communication and social interactions)
Psychosocial interventions and therapies
Family therapy (Provide support and education)

Cognitive behavior therapy (CBT) (It


helps the person change their thinking)

 Vocational rehabilitation and supported


employment (focuses on helping to find job)
Electroconvulsive therapy
Individuals who don’t respond to medication ECT may
be considered.

(ECT) i involves passing a carefully controlled electric


current through the brain, which affects the brain's
activity and aims to relieve severe depressive and
psychotic symptoms.
Electroconvulsive therapy
ECT is safe and effective.
It remains for long time period and successful in 80-
85% cases.
Long-acting injectable antipsychotics

Given in the form of intramuscular or subcutaneous


injection.

 Usually given every two to four weeks.

 During severe symptoms, hospitalization may be


necessary to ensure safety, proper nutrition,
adequate sleep and basic hygiene.
How it can be PREVENTED?
Avoid frequent use of street drugs and alcohol.
Strengthen your social skills.
Avoid social isolation.
Intake of folic supplements.
Be a productive individual with your surroundings.
Conclusion

Schizophrenia is a relatively common chronic mental


illness, which results in substantial disability and has a
10% risk of suicide. It has several symptom clusters
including positive symptoms, negative symptoms,
cognitive impairments, and affective dysregulation.

You might also like

pFad - Phonifier reborn

Pfad - The Proxy pFad of © 2024 Garber Painting. All rights reserved.

Note: This service is not intended for secure transactions such as banking, social media, email, or purchasing. Use at your own risk. We assume no liability whatsoever for broken pages.


Alternative Proxies:

Alternative Proxy

pFad Proxy

pFad v3 Proxy

pFad v4 Proxy