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Transcript of Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved. Schizophrenia.
Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved.
Schizophrenia
Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved.
Chapter 11
A beautiful mind
• 1st half of movie• Interview with John Nash and his family
Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved.
Chapter 11
DSM-IV Criteria for Schizophrenia
A. Two or more core symptoms (next slide)B. Significant impairment in work, academic performance,
interpersonal relationships, and/or self-careC. Continuous signs of the disturbance for at least 6
months
Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved.
Chapter 11
Core Symptoms (Positive)
1. Delusions --1. Persecutory2. Delusions of Reference3. Grandiose Delusions4. Delusions of Thought Insertion
2. Hallucinations3. Disorganized Thought and Speech4. Disorganized or Catatonic Behavior
Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved.
Chapter 11
Core symptoms (negative)
5. Negative Symptoms– Affective Flattening (or Blunted Affect)– Alogia: Severe reduction or complete absence of
speech– Avolition: Inability to persist at common, goal-
oriented tasks
Video clips to demonstrate some of these symptoms
Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved.
Chapter 11
Biological Aspects of Schizophrenia
OVERVIEW Neuroanatomy -- brain changes /
tissue loss Genetics Viral theories Neurotransmitters
Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved.
Chapter 11
Biological Aspects of Schizophrenia
Secret Life of the Brain (episode 3)
Loss of brain tissue (NYTimes video clip)
Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved.
Chapter 11
Biological Aspects of Schizophrenia
Structural Brain Abnormalities (tissue loss – excessive pruning)– Parietal cortex deficits (sensory experience)– Frontal lobe deficits: Reduced volume and neuron
density in frontal cortex cause cognitive and emotional deficits (perhaps especially negative symptoms)
– Loss of myelin sheath?
Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved.
Chapter 11
Biological Aspects of Schizophrenia, continued
Genetic Theories– Polygenetic influence– May be inheriting a general risk for psychosis– Epigenetics – environment + gene interaction
(e.g., Finnish study of children adopted away at birth; Tienari et al., 2004): “Disordered” home environment increases risk
Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved.
Chapter 11
Biological Aspects of Schizophrenia, continued
Birth Complications & Prenatal Viral Exposure– Podcast from “All in the mind” 11/2/07 on viruses
and immune system (4’’ – 14.30’’)
Neurotransmitter Theories– Imbalances in levels of or receptors for dopamine
cause symptoms; serotonin, GABA, and glutamate may also play roles
Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved.
Chapter 11
Psychosocial Perspectives on Schizophrenia
Social drift Stress and relapse
Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved.
Chapter 11
Treatments for Schizophrenia
Biological Treatments: Antipsychotic drugs (next slide)
Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved.
Chapter 11
Most are dopamine receptor antagonists Older neuroleptics: Haldol & Thorazine Newer (“atypical”): Clozaril, Seroquel,
Risperdal, Zyprexa Somewhat of Trial and Error approach
Most are dopamine receptor antagonists Older neuroleptics: Haldol & Thorazine Newer (“atypical”): Clozaril, Seroquel,
Risperdal, Zyprexa Somewhat of Trial and Error approach
Antipsychotics Antipsychotics
Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved.
Chapter 11
Side Effects: Neuroleptics and Atypicals can cause Sedation, weight gain “Extrapyramidal” (Parkinsonian) side
effects, like tremor, akinesia (e.g., shuffling of feet) Tardive Dyskinesia (long-term, irreversible --
irregular/involuntary muscle movements) Anticholinergic (dry mouth/eyes, blurred vision,
etc.) Orthostatic hypotension
Side Effects: Neuroleptics and Atypicals can cause Sedation, weight gain “Extrapyramidal” (Parkinsonian) side
effects, like tremor, akinesia (e.g., shuffling of feet) Tardive Dyskinesia (long-term, irreversible --
irregular/involuntary muscle movements) Anticholinergic (dry mouth/eyes, blurred vision,
etc.) Orthostatic hypotension
Side Effects
Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved.
Chapter 11
Treatments for Schizophrenia
Behavioral, Cognitive, and Social Interventions: Recognition of demoralizing attitudes they may have toward their illness, operant conditioning, modeling, family therapy, token economies, self-help groups, assertive community treatment programs.
