emil kraepelin (1898)
DESCRIPTION
emil kraepelin (1898). dementia praecox “premature dementia”. paranoia (all delusions). hebephrenia. catatonia. eugene bleuler (1908). schizophrenia. “split mind”. schizophrenia. 1 month of at least two of the following:. delusions. positive/psychosis. hallucinations. - PowerPoint PPT PresentationTRANSCRIPT
emil kraepelin (1898)
dementia praecox “premature dementia”
• paranoia (all delusions)
• hebephrenia
• catatonia
eugene bleuler (1908)
schizophrenia
• “split mind”
schizophrenia
1 month of at least two of the following:
• delusions
• hallucinations
• disorganized speech
• disorganized behavior
• negative symptoms
positive/psychosis
6 mo course includes prodromal or residual period
disorganized
negative
1 MO 5 MO5 MO
schizophrenia symptoms
residual symptoms
prodromal symptoms
6 mo course includes prodromal or residual period
delusions
What types of schizophrenic delusions have you heard of?
persecutiongrandeurcontrol
reference
hallucinations
What kinds of schizophrenic hallucinations have you heard of?
disorganized speech
• tangentiality
• derailment
• neologisms
• clanging
A.K.A. THOUGHT DISORDER
disorganization
DISORGANIZED BEHAVIOR
inappropriate affect
bizarre behavior
negative symptoms
alogia (few words)
affective flattening
avolition (lack of motivation)
social withdrawal
age of onset
stats
• 1% prevalence• equal sex ratio• course: better for women
brain abnormalities
STRUCTURAL • enlarged ventricles• cytoarchitecture of frontal lobe
FUNCTIONAL• “hypofrontality” • cognitive deficits of frontal lobe
cognitive deficits
working memory
perseveration
disinhibiton
executive functions
endophenotypes
biological markers for disease genese.g. eye tracking
genetics disease risk in family & twin
(also, equal risk in offspring of discordant MZ twins)
neurodevelopmental hypothesis
prenatalbrain defect
environmental stressorin early
adulthood
+ = SZ
2nd trimester
Flu Epidemics
1957 Kochi Japan1949-1981 France40 yr study Finland & Denmark
Starvation
1944-1945 WWII Dutch Winter1959-1961 famine in China
DA pathways
mesocortical
mesolimbic
nigrostriatal
substantia nigra > striatum
VTA > all cortical areas
VTA > limbic system
medicationANTIPSYCHOTICS (A.K.A. neuroleptics)
treats + symptoms
side effect:tardive dyskinesia
TYPICAL ATYPICAL
treats + & - symptoms?
less side effects?
10x price
• 74% noncompliance w/in 18 mo • extrapyramidal side effects
Parkinsonian symptomstardive dyskinesia
therapy
• “token economy” – operant conditioning
• teach social skills & give insight• manage medication• identify signs of impending relapse