Open the Doors Volume 2
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Transcript of Open the Doors Volume 2
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Introduction
Schizophrenia is a serious mental illness that can devastate the lives of
people who suffer from it and the lives of their families. It usually strikes
adolescents and young adults, disrupting their pursuit of educational and
occupational goals and drastically reducing their quality of life. It occurs
in all countries of the world and is among the ten leading causes of dis-
ability in those 18 to 44 years old (Murray and Lopez 1996).
Schizophrenia is associated with a significant amount of stigma and
discrimination, which further increases the burden on patients and their
families. Individuals with schizophrenia often face social isolation, dis-
crimination in housing, education, and employment opportunities, and
other forms of prejudice. The stigma often also extends to family members
and to those who provide health care services to patients with schizophre-
nia. The treatments patients receive may also increase the stigma associated
with the illness, especially if they produce the debilitating motor side effects
that can result from treatment with certain antipsychotic medications.
Today, there is new hope for those who suffer from schizophrenia. In
recent years, an array of new antipsychotic medications and psychosocialinterventions has been developed that are helping many individuals with
schizophrenia reintegrate into the community, improve their quality of
life, and pursue their life goals. However, the stigma and discrimination
associated with serious mental illness often make it more difficult for
people with schizophrenia to benefit fully from these new treatments and
can thus derail their recovery.
For this reason, the World Psychiatric Association (WPA) has
launched this worldwide programme to reduce the stigma and discrimina-
tion because of schizophrenia. This volume brings together informationabout the diagnosis, epidemiology, and treatment of schizophrenia and
relates it to how stigma develops and how it can best be combated. To
facilitate the use of this information in the development of programmes
designed to combat stigma and discrimination, marginal annotations are
included throughout the volume explaining the particular relevance of the
information for reducing stigma and discrimination.
VOLUME IIInformation about SchizophreniaRelevant to Programme Implementation
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IA. What is Schizophrenia?
One of the best ways to eliminate the stigma and reduce the discrimina
associated with schizophrenia is to clear up common misconceptions
about the illness and replace them with clear accurate information.This section covers the following topics:
Symptoms and diagnosis of schizophrenia
Causes of schizophrenia
Onset, course, and outcome of schizophrenia
Volume II is organized in two parts:
Part I. What Is Schizophrenia (IA) and How Is It Treated (IB)?
This section provides information on the diagnosis, epidemiology, and
treatment of schizophrenia that can be adapted for use in targeted
anti-stigma campaigns.Part II. Decreasing Stigma.This section describes the nature, origins,
and consequences of stigma, prejudice, and discrimination and then
describes the types of initiatives that can be most effective in reducing
stigma and discrimination.Although the material in this section focuses
specifically on schizophrenia, much of the information is also applicable
to the stigma and discrimination associated with other serious mental
illnesses.
[1] Murray CJL, Lopez AD. The Global Burden of Disease. Geneva:World Health Organization;
1996: 270.
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Appendix B
ICD-10 Subtypes of Schizophrenia
Appendix C
Common Standard Antipsychotic Medications
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ICD 10 Subtypes of Schizophrenia
Undifferentiated schizophreniacombines features of two of the follow-
ing types: paranoid, hebephrenic, and catatonic. The persons symptoms
meet the diagnostic criteria for schizophrenia but do not fully conform to
any one of the main subtypes.
Residual schizophreniadescribes a stage in the disorder in which
there has been a clear-cut episode of schizophrenia in the past and promi-
nent negative symptoms are still present. However, the intensity or fre-
quency of other psychotic symptoms, such as delusions, hallucinations, or
catatonic symptoms, is reduced.
Post-schizophrenic depressiondescribes the common situation inwhich a person develops mainly depressive symptoms following an acute
psychotic episode, although negative or positive symptoms may still also
be present.
Common Standard Antipsychotic Medications
Common Standard (Traditional) Antipsychotic Medications*
Benperidol Levomepromazine
Bromperidol Oxypertine
Butaperazine Penfluridol
Chlorpromazine Perazine
Chlorptothixene Periciazine
Clopenthixol Perphenazine
Clotiapine Pimozide
Droperidol Pipamperone
Fluanisone Promazine
Flupentixol Promethazine
Fluphenazine Sulpiride
Fluspiriline Thioridazine
Haloperidol Trifluoperazine
*Product names vary from country to country and more than one product name may be used for
same drug within one country.When participating in this program, it will be helpful to obtain a list
common product names in use in the country where the project is being undertaken.
Appendix DNovel Antipsychotic Drugs That Are Currently Available in Selected Countries
Amisulpiride Risperidone
Clozapine Sertindole
Olanzapine Zotepine
Quetiapine
Four Main Subtypes of Schizophrenia
Subtype Target systems Typical Symptoms Comments
Paranoid Thinking, perception Delusions (mostly of persecution), Commonest type
hallucinations
Hebephreni c ( di so rgan ised ) Emoti ons, vol it ion I nappropria te a ff ec t, s ill iness, f orma l Typi cal ly beg ins in
thought disorder, mental f ragmentation adolescence
Catatonic Volition, motor activity Stupor, agitation, posturing, mannerism, Becoming rare
negativism
Simple Volition, personality Social withdrawal, flat emotions, poverty Insidious onset of
of ideas, decreased drive and motivation behavioural problems
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