![Page 1: CHAPTER THIRTEEN Schizophrenic Disorders. OVERVIEW Psychosis - profoundly out of touch with reality Most common symptoms: changes in the way a person](https://reader035.vdocuments.net/reader035/viewer/2022081514/56649e3f5503460f94b308b7/html5/thumbnails/1.jpg)
CHAPTER THIRTEEN
Schizophrenic Disorders
![Page 2: CHAPTER THIRTEEN Schizophrenic Disorders. OVERVIEW Psychosis - profoundly out of touch with reality Most common symptoms: changes in the way a person](https://reader035.vdocuments.net/reader035/viewer/2022081514/56649e3f5503460f94b308b7/html5/thumbnails/2.jpg)
OVERVIEW Psychosis - profoundly out of touch with reality Most common symptoms: changes in the way
a person thinks, feels, and relates to other people and the outside environment.
Involves disruptions of mental functions
![Page 3: CHAPTER THIRTEEN Schizophrenic Disorders. OVERVIEW Psychosis - profoundly out of touch with reality Most common symptoms: changes in the way a person](https://reader035.vdocuments.net/reader035/viewer/2022081514/56649e3f5503460f94b308b7/html5/thumbnails/3.jpg)
Schizophrenia
Affects people from all walks of
life
Characterized by an array of diverse
symptoms
Usually begins in late adolescence or early adulthood
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.
![Page 4: CHAPTER THIRTEEN Schizophrenic Disorders. OVERVIEW Psychosis - profoundly out of touch with reality Most common symptoms: changes in the way a person](https://reader035.vdocuments.net/reader035/viewer/2022081514/56649e3f5503460f94b308b7/html5/thumbnails/4.jpg)
Epidemiology
Risk• Lifetime prevalence• Age of father• Onset age• Gender• Among mental disorders, the second
leading cause of disease burden.
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.
![Page 5: CHAPTER THIRTEEN Schizophrenic Disorders. OVERVIEW Psychosis - profoundly out of touch with reality Most common symptoms: changes in the way a person](https://reader035.vdocuments.net/reader035/viewer/2022081514/56649e3f5503460f94b308b7/html5/thumbnails/5.jpg)
Figure 13.1: Age Distribution of Onset of Schizophrenia
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.
![Page 6: CHAPTER THIRTEEN Schizophrenic Disorders. OVERVIEW Psychosis - profoundly out of touch with reality Most common symptoms: changes in the way a person](https://reader035.vdocuments.net/reader035/viewer/2022081514/56649e3f5503460f94b308b7/html5/thumbnails/6.jpg)
Clinical Picture
• Delusions• Hallucinations• Disorganized speech and
behavior• Negative Symptoms
Hallmark symptoms
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.
![Page 7: CHAPTER THIRTEEN Schizophrenic Disorders. OVERVIEW Psychosis - profoundly out of touch with reality Most common symptoms: changes in the way a person](https://reader035.vdocuments.net/reader035/viewer/2022081514/56649e3f5503460f94b308b7/html5/thumbnails/7.jpg)
Positive and Negative Symptoms
• Excess or distortion in normal repertoire of behavior and experience
Positive symptoms of schizophrenia
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.
![Page 8: CHAPTER THIRTEEN Schizophrenic Disorders. OVERVIEW Psychosis - profoundly out of touch with reality Most common symptoms: changes in the way a person](https://reader035.vdocuments.net/reader035/viewer/2022081514/56649e3f5503460f94b308b7/html5/thumbnails/8.jpg)
Delusions
• Erroneous belief• Fixed and firmly held despite
clear contradictory evidence• Disturbance in the content of
thought• Grandeur• Persecution• Reference• Nihilistic• Thought Broadcasting
Delusions
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.
![Page 9: CHAPTER THIRTEEN Schizophrenic Disorders. OVERVIEW Psychosis - profoundly out of touch with reality Most common symptoms: changes in the way a person](https://reader035.vdocuments.net/reader035/viewer/2022081514/56649e3f5503460f94b308b7/html5/thumbnails/9.jpg)
Hallucinations
• False Sensory experiences/Perceptual disturbances
• Seems real but occurs in absence of any external perceptual stimulus
• Can occur in any sensory modality
Hallucinations
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.
![Page 10: CHAPTER THIRTEEN Schizophrenic Disorders. OVERVIEW Psychosis - profoundly out of touch with reality Most common symptoms: changes in the way a person](https://reader035.vdocuments.net/reader035/viewer/2022081514/56649e3f5503460f94b308b7/html5/thumbnails/10.jpg)
Disorganized Speech
• Failure to make sense • Despite conforming to
semantic and syntactic rules of speech
• Disturbance in form (not content) of thought
Disorganized speech
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.
![Page 11: CHAPTER THIRTEEN Schizophrenic Disorders. OVERVIEW Psychosis - profoundly out of touch with reality Most common symptoms: changes in the way a person](https://reader035.vdocuments.net/reader035/viewer/2022081514/56649e3f5503460f94b308b7/html5/thumbnails/11.jpg)
Disorganized Behavior
• Impairment of goal-directed activity
• Occurs in areas of daily functioning
• Catatonia • Catatonia stupor
Disorganized and Catatonic Behavior
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.
![Page 12: CHAPTER THIRTEEN Schizophrenic Disorders. OVERVIEW Psychosis - profoundly out of touch with reality Most common symptoms: changes in the way a person](https://reader035.vdocuments.net/reader035/viewer/2022081514/56649e3f5503460f94b308b7/html5/thumbnails/12.jpg)
Negative Symptoms
• Affective flattening, Blunted affect• Anhedonia – inability to experience
pleasure.• Apathy - Socially withdrawn
• Both a symptom and coping strategy
• Avolition – lack of will, motivation• Alogia – impoverished thinking,
poverty of speech.
Absence or deficit of normally present
behaviors
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.
![Page 13: CHAPTER THIRTEEN Schizophrenic Disorders. OVERVIEW Psychosis - profoundly out of touch with reality Most common symptoms: changes in the way a person](https://reader035.vdocuments.net/reader035/viewer/2022081514/56649e3f5503460f94b308b7/html5/thumbnails/13.jpg)
Other Psychotic Disorders
• Schizoaffective disorder• Schizophreniform disorder• Delusional disorder• Brief psychotic disorder• Shared psychotic disorder
Other psychotic disorders
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.
![Page 14: CHAPTER THIRTEEN Schizophrenic Disorders. OVERVIEW Psychosis - profoundly out of touch with reality Most common symptoms: changes in the way a person](https://reader035.vdocuments.net/reader035/viewer/2022081514/56649e3f5503460f94b308b7/html5/thumbnails/14.jpg)
Genetics
TWIN STUDIES ADOPTION STUDIES The average concordance
rate for MZ twins is 48%, whereas the comparable figure for DZ twins is 17%.
Suggests strong genetic factors.
Also compelling evidence for the importance of environment.
Genain quadruplets
• Genetic factors play role in development of the disorder (Heston)
![Page 15: CHAPTER THIRTEEN Schizophrenic Disorders. OVERVIEW Psychosis - profoundly out of touch with reality Most common symptoms: changes in the way a person](https://reader035.vdocuments.net/reader035/viewer/2022081514/56649e3f5503460f94b308b7/html5/thumbnails/15.jpg)
Figure 13.2: Risk of Developing Schizophrenia Based on Shared Genes
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.
![Page 16: CHAPTER THIRTEEN Schizophrenic Disorders. OVERVIEW Psychosis - profoundly out of touch with reality Most common symptoms: changes in the way a person](https://reader035.vdocuments.net/reader035/viewer/2022081514/56649e3f5503460f94b308b7/html5/thumbnails/16.jpg)
Prenatal Exposures
Prenatal exposures:
Prenatal infection
Rhesus incompatibility
Early nutritional deficiencies and maternal stress
Pregnancy and birth complications
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.
![Page 17: CHAPTER THIRTEEN Schizophrenic Disorders. OVERVIEW Psychosis - profoundly out of touch with reality Most common symptoms: changes in the way a person](https://reader035.vdocuments.net/reader035/viewer/2022081514/56649e3f5503460f94b308b7/html5/thumbnails/17.jpg)
Genes and Environment in Schizophrenia: A Synthesis
Current thinking emphasizes interplay
Multiple genetic factors
Environmental factors
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.
![Page 18: CHAPTER THIRTEEN Schizophrenic Disorders. OVERVIEW Psychosis - profoundly out of touch with reality Most common symptoms: changes in the way a person](https://reader035.vdocuments.net/reader035/viewer/2022081514/56649e3f5503460f94b308b7/html5/thumbnails/18.jpg)
A Neurodevelopmental Perspective
Brain lesion lies dormant until
normal developmental changes occur
Changes expose problems resulting
from this brain abnormality
Developmental precursors may
include variety of abnormalities
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.
![Page 19: CHAPTER THIRTEEN Schizophrenic Disorders. OVERVIEW Psychosis - profoundly out of touch with reality Most common symptoms: changes in the way a person](https://reader035.vdocuments.net/reader035/viewer/2022081514/56649e3f5503460f94b308b7/html5/thumbnails/19.jpg)
Other Biological Factors
Many brain areas are abnormal in schizophrenia
• Decreased brain volume• Enlarged ventricles• Frontal lobe dysfunction• Reduced volume of the thalamus• Abnormalities in temporal lobe
areas
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.
![Page 20: CHAPTER THIRTEEN Schizophrenic Disorders. OVERVIEW Psychosis - profoundly out of touch with reality Most common symptoms: changes in the way a person](https://reader035.vdocuments.net/reader035/viewer/2022081514/56649e3f5503460f94b308b7/html5/thumbnails/20.jpg)
Disorder seems to affect many different regions of the brain.Enlarged lateral ventriclesDifferences (decreased size) in parts of the limbic system.
![Page 21: CHAPTER THIRTEEN Schizophrenic Disorders. OVERVIEW Psychosis - profoundly out of touch with reality Most common symptoms: changes in the way a person](https://reader035.vdocuments.net/reader035/viewer/2022081514/56649e3f5503460f94b308b7/html5/thumbnails/21.jpg)
Other Biological Factors Implicated in Schizophrenia
Neurotransmitters
• Dopamine• Glutamate• Serotonin
Cytoarchitecture
• Overall organization of cells in brain may be compromised
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.
![Page 22: CHAPTER THIRTEEN Schizophrenic Disorders. OVERVIEW Psychosis - profoundly out of touch with reality Most common symptoms: changes in the way a person](https://reader035.vdocuments.net/reader035/viewer/2022081514/56649e3f5503460f94b308b7/html5/thumbnails/22.jpg)
Figure 13.8: Cytoarchitecture and Neural Development
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.
![Page 23: CHAPTER THIRTEEN Schizophrenic Disorders. OVERVIEW Psychosis - profoundly out of touch with reality Most common symptoms: changes in the way a person](https://reader035.vdocuments.net/reader035/viewer/2022081514/56649e3f5503460f94b308b7/html5/thumbnails/23.jpg)
Neurocognition
Neurocognitive deficits found in
people with schizophrenia
Attentional and working memory
deficits
Eye-tracking dysfunctions
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.
![Page 24: CHAPTER THIRTEEN Schizophrenic Disorders. OVERVIEW Psychosis - profoundly out of touch with reality Most common symptoms: changes in the way a person](https://reader035.vdocuments.net/reader035/viewer/2022081514/56649e3f5503460f94b308b7/html5/thumbnails/24.jpg)
Figure 13.11: A Diathesis-Stress Model of Schizophrenia
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.
![Page 25: CHAPTER THIRTEEN Schizophrenic Disorders. OVERVIEW Psychosis - profoundly out of touch with reality Most common symptoms: changes in the way a person](https://reader035.vdocuments.net/reader035/viewer/2022081514/56649e3f5503460f94b308b7/html5/thumbnails/25.jpg)
Psychosocial and Cultural Aspects
Families and relapse
Urban living
Immigration
Cannabis abuse
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.
![Page 26: CHAPTER THIRTEEN Schizophrenic Disorders. OVERVIEW Psychosis - profoundly out of touch with reality Most common symptoms: changes in the way a person](https://reader035.vdocuments.net/reader035/viewer/2022081514/56649e3f5503460f94b308b7/html5/thumbnails/26.jpg)
Treatments and Outcomes
Treatment and outcomes
Prognosis before 1950s
Introduction of antipsychotic drugs in 1950s
15-25 years outcomes
Long-term institutionalization rate
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.
![Page 27: CHAPTER THIRTEEN Schizophrenic Disorders. OVERVIEW Psychosis - profoundly out of touch with reality Most common symptoms: changes in the way a person](https://reader035.vdocuments.net/reader035/viewer/2022081514/56649e3f5503460f94b308b7/html5/thumbnails/27.jpg)
Pharmacological Approaches
Pharmacologicalapproaches
First-generation antipsychotic drugs
Second-generation antipsychotics
Side effects
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.
![Page 28: CHAPTER THIRTEEN Schizophrenic Disorders. OVERVIEW Psychosis - profoundly out of touch with reality Most common symptoms: changes in the way a person](https://reader035.vdocuments.net/reader035/viewer/2022081514/56649e3f5503460f94b308b7/html5/thumbnails/28.jpg)
Psychosocial Approaches
Psychosocial
approaches
Family therapy
Case management
Social-skills training
Cognitive remediation
Cognitive-behavioral therapy
Other forms of individual treatment
© 2014, 2013, 2010 by Pearson Education, Inc. All rights reserved.