SCHIZOPHRENIA

WHAT IS SCHIZOPHRENIA? One of the most heavily researched disorders Literally means “split mind”

A split from reality (not multiple personalities)

Series of disorders characterized by disorganized thinking, disturbed perceptions, and inappropriate emotions and actions

Has both positive and negative symptoms Positive: presence of… Negative: absence of…

It is a psychotic disorder: out of touch with reality

DISORGANIZED THINKING “This morning I was at Hillside [hospital], I was

making a movie. I was surrounded by movie stars…I’m Mary Poppins. Is this room painted blue to get me upset? My grandmother died four weeks after my eighteenth birthday.”

Thinking is bizarre, fragmented, and often distorted by delusions Delusions: false beliefs, often of persecution or grandeur,

that may accompany many psychotic disorders Those with paranoid tendencies are prone to delusions of

persecution

May result from a breakdown in selective attention Can’t filter out the other things!

DISTURBED PERCEPTIONS

May have hallucinations (sensory experiences without sensory stimulation) Seeing, hearing, feeling, tasting, smelling Most are auditory – hearing voices making

insulting remarks or giving orders

INAPPROPRIATE EMOTIONS AND ACTIONS Laughing when hearing of death Crying when others laugh Some have “flat affect” – emotionless

state Motor behaviors may be inappropriate

Senseless, compulsive acts (rocking, rubbing an arm)

Catatonia: may remain motionless for hours and then become agitated

TYPES OF SCHIZOPHRENIA

Paranoid Disorganized Catatonic Undifferentiated Share some common features Also have some distinguishing symptoms

(see textbook)

EFFECTS OF SCHIZOPHRENIA

Disrupt social relationships Makes it difficult to hold a job Often live in a private inner world With support, some may recover to enjoy

a normal life or only experience bouts of schizophrenia intermittently

ONSET AND DEVELOPMENT OF DISORDER

Strikes those who are developing into adulthood

Afflicts 1 in 100 people (.5-1%) Knows no national boundaries Affects both males and females

Men are often struck earlier, more severely, and slightly more often

Does it develop quickly or slowly? Both For some, appears suddenly, as a reaction to stress For others, develops gradually

SLOW OR RAPID DEVELOPMENT

When it is slow-developing(chronic or process schizophrenia), recovery is doubtful Often have negative symptoms

Those who develop rapidly (acute or reactive schizophrenia), often following life stresses, recovery is much more likely Often have positive symptoms Respond better to drug therapy

WHAT CAUSES SCHIZOPHRENIA?

CAUSES: BRAIN ABNORMALITY Excess of receptors for dopamine

May intensify brain signals, which would create the positive symptoms of hallucinations and paranoia

Drugs that block dopamine receptors often lessen positive symptoms Drugs that increase dopamine activity (amphetamines and cocaine)

can intensify them But dopamine is also linked to Parkinson’s disease, so patients who

take drugs to block dopamine develop Parkinson’s like symptoms

Dopamine blocking drugs have little effect on negative symptoms

Investigating the role of glutamate (excitatory neurotransmitter) Drugs that interfere with glutamate receptors can produce

schizophrenia-like negative symptoms

CAUSE: BRAIN CONT. People with schizophrenia have abnormal brain

activity in several areas NOT one isolated area Low brain activity in frontal lobes PET scans during hallucinations showed activity in the thalamus Temporal lobe is activated during auditory hallucinations People with paranoia showed increased activity in the amygdala

Brain size Enlarged, fluid-filled areas in brains of patients Smaller cerebral cortex Smaller thalamus Can show these BEFORE onset!

What causes these abnormalities? Mishap during prenatal development or delivery Famine during pregnancy

MATERNAL VIRUS DURING PREGNANCY

GENETIC FACTORS If your parent or siblings have schizophrenia, your

odds of developing it are 1 in 10 If your identical twin has it, your odds are 1 in 2

(even when reared apart) Those who share a placenta have an increased risk

Children adopted by someone who develops schizophrenia, seldom “catch” the disorder

Genes could affect dopamine levels or production of myelin

Identifying specific genes is difficult Other factors (viruses, oxygen deprivation at birth, etc) may “turn

off” or “turn on” the genes that predispose people to the disease

GENAIN QUADRUPLETS

All have schizophrenia

Two of the sisters have more severe forms Environmental factors!

PSYCHOLOGICAL FACTORS

“No environmental causes have been discovered that will invariably, or even with moderate probability, produce schizophrenia in persons who are not related to a person with schizophrenia” Susan Nicol and Irving Gottesman in 1983

EARLY WARNING SIGNS Study of “at risk” children/young adults who had

relatives with schizophrenia A mother whose schizophrenia was severe and

long lasting Birth complications, often involving oxygen

deprivation and low birth weight Separation from parents Short attention span and poor muscle coordination Disruptive or withdrawn behavior Emotional unpredictability Poor peer relations and solo play