Schizophrenia symptoms symptoms of schizophrenia

Schizophrenia

• symptoms

symptoms of schizophrenia

• disturbances in thought,

• perception,

• attention,

• motor behavior,

• affect,

• life functioning

CHARACTERIZATIONS OF SYMPTOMS

• Symptoms are typically characterized as positive, negative, or disorganized. Positive symptoms include excesses and distortions such as delusions and hallucinations. Negative symptoms refer to behavioral deficits, such as flat affect, avolition, alogia, and anhedonia. Disorganized symptoms include disorganized speech and bizarre behavior. Other symptoms are catatonia and inappropriate affect.

Positive Symptoms

• Hallucinations – severe sensory distortions, such as:

• Hearing voices

• Seeing things

• Feeling things

• Smelling things that happen in the absence of sensory stimulation

CHARACTERIZATIONS OF SYMPTOMS

• Delusions – belief systems that are contrary to reality. May take various forms,

• such as:

• Delusions of persecution

• Delusions of someone putting thoughts in your head or that one’s thoughts are broadcast to others

• Delusions of grandeur

Negative Symptoms

• Avolition" is when a person lacks energy, spontaneity and initiative.

• "Anhedonia" is a term used for describing a lack of pleasure or interest in activities that the patients once enjoyed.

• alogia, or poverty of speech, is a general lack of additional, unprompted content seen in normal speech.

• Flat Affect –little or no outward expression of emotion

• Asociality – impairment of social relationships; few or no friends, poor social skills, no interest in others.

Disorganized symptoms

• Disorganized speech (difficulty being coherent) – aka thought disorder.

• The difficulty of organizing and expressing one’s ideas and thoughts.

• Can be heard as incoherence, loose associations, derailment

Catatonia

• Catatonia is a condition marked by changes in muscle tone or activity associated with a large number of serious mental and physical illnesses. There are two distinct sets of symptoms that are characteristic of this condition. In catatonic stupor the individual experiences a deficit of motor (movement) activity that can render him/her motionless. Catatonic excitement, or excessive movement, is associated with violent behavior directed toward oneself or others.

Catatonic stupor

• In catatonic stupor, motor activity may be reduced to zero. Individuals avoid bathing and grooming, make little or no eye contact with others, may be mute and rigid, and initiate no social behaviors. In catatonic excitement the individual is extremely hyperactive although the activity seems to have no purpose. Violence toward him/herself or others may also be seen

Other symptoms

• Inappropriate affect –

• Silly in serious situations, or emotional responses occurring out of context.

Subtypes

• DSM-IV-TR includes several subtypes of schizophrenia, including disorganized, catatonic, and paranoid. These subtypes are based on the prominence of particular symptoms (e.g. delusions in the paranoid subtype) and reflect the variations in behavior found among people diagnosed with schizophrenia. However, there is considerable overlap among the subtypes, and they have little predictive validity.

Genetic Predisposition

• The data on the genetic transmission of schizophrenia are impressive. Most importantly, adoption studies show a strong relationship between having a schizophrenic parent and the likelihood of developing the disorder, typically in early adulthood.

• The genetic predisposition to develop schizophrenia may have biochemical correlates. It appears that an increased sensitivity of dopamine receptors in the limbic area of the brain is related to the positive symptoms of schizophrenia. The negative symptoms may be due to dopamine underactivity in the prefrontal cortex. Other neurotransmitters, such as serotonin, may also be involved.

Antipsychotic drugs

• Antipsychotic drugs, especially the phenothiazines, have been widely used to treat schizophrenia since the 1950s. Newer medications, such as clozapine and risperidone, are also effective and produce fewer side effects. Drugs alone are not a completely effective treatment because patients with schizophrenia need to be taught or retaught ways of dealing with the challenges of everyday life. Furthermore, most antipsychotic drugs have serious side effects, such as tardive dyskinesia, especially after long-term use, and many patients with schizophrenia do not benefit from them.

tardive dyskinesia

• Drug side effects from drugs associated with schizophrenia, schizoaffective disorder, bipolar disorder: involuntary movement of the tongue, lips, face, trunk, and extremities,

Treatment of Schizophrenia

• Psychoanalytic theory assumes that schizophrenia represents a retreat from the pain of childhood rejection and mistreatment, and the analyst attempts to offer the patient a safe haven in which to explore repressed traumas. However, the efficacy of analytic treatments has not been supported by evidence.

Treatment of Schizophrenia

• In contrast, family therapy aimed at reducing high levels of expressed emotion has been shown to be valuable in preventing relapse. In addition, social skills training and various cognitive-behavioral therapies have helped patients to meet the inevitable stresses of family and community living or to lead more ordered and constructive lives within an institution. Recent efforts to change the thinking of people with schizophrenia are showing promise as well.

Treatment of Schizophrenia

• The most promising approaches today emphasize the importance of both pharmacological and psychological interventions. Unfortunately, such integrated treatments are not widely available