Week 4 Post 1: Schizophrenia

 Schizophrenia:  

*1 in 5 people experience a mental illness—only half receive an intervention 

Schizophrenia: psychotic and episodic mental illness 

- prevalence rate is between 0.5%-1% 

- referred to as “prototypical psychotic disorder” 

- one of the HIGHEST IMPACT disorders 

- onset most common between ages 15-35 (uncommon before 10 or after 40) 

^ males earlier (average of 21 years old), females later (average 27 years old) 

- lifetime risk for suicide is about 5% 

^risk factors include being male, younger, high level of education, family history of suicide, comorbid substance use 

- many people die earlier than expected, about 40% of premature mortality 

- some evidence shows that having lower socioeconomic status is a factor associated with schizophrenia 

- one of the most expensive mental disorders (2012 England cost was 15 billion US dollars) 

 

Expenses: 

Direct Costs (resources used to treat an individual)- hospital, medication, accommodation, service and agency involvements 

Indirect Costs (lost production of patients)- employment struggles, informal career, lost revenue, transfer payments, absenteeism 

Disability Adjusted Life Years (DALYs)- sum of years of potential life lost due to premature mortality and years of productive life lost due to disability 

 

Diagnosis: 

-Diagnostic and Statistical Manual of Mental Disorders (DSM) 

-International Classification of Diseases 

Criterion A: 6+ months w/ 1 month of active symptoms; delusions, hallucinations, disorganized speech, Grossly disorganized or catatonic behavior, Negative symptoms, most show 2+ symptoms 

 

Positive Symptoms: behaviors or experiences making up symptoms happen too much 

• Delusions: specifically related to the content of thought; having a false belief 

Persecution delusions: a focal point of paranoia (like someone being out to get you) 

Grandeur delusions: believing that you have a quality or attribute that makes you superior to others 

• Disorganized Speech: a disturbance in the form of thought 

Neologism: making up a word that is not mainstream and gives no meaning (often is combining two words) 

Word salad: words tossed together that make no sense 

Tangentiality: disturbance in associative thought patterns (changing topics often without return) 

• Hallucinations: disturbance of perception; a false sensory experience 

Auditory: hearing something that is not there (most common) 

Visual: seeing something that is not there 

Olfactory: smelling something that is not there 

Gustatory: tasting something that is not there 

Tactile: sense of physical contact with a stimulus that is not there 

• Disorganized or abnormal motor behavior: childish silliness, psychomotor agitation, excessive purposeless activity, self-initiated bizarre postures, lack of response to all stimuli, catatonia (becoming immoble—very uncommon) 

 

Negative Symptoms: behaviors in deficit (such as emotion, speech, motivation) 

• Flat Effect: a person’s tone of voice and facial expressions are reduced 

• Alogia: poverty of speech—reflects impoverished thought processes 

• Avolition: depression, lack of self-care or personal hygiene 

 

Course of Schizophrenia: 

Prodromal Phase: characterized by a decline in functioning (negative symptoms) 

Active Phase: positive and/or negative symptoms start to appear 

Residual Phase: positive symptoms have remitted with medication, some negative symptoms remain 

 

Aetiology: 

• 1st degree biological relative—chances increase by 10% 

• Patients are found to have structural brain abnormalities, biochemical abnormalities (neurotransmitter dopamine—>chemical imbalance) 

• Patients may have experienced pregnancy or birth complications that structurally damaged the brain 

• Social dislocations  

• Expressed emotion (high negative emotions in a household) can increase chances of relapse 

 

Diathesis-stress Model: there is an underlying vulnerability related to a genetic predisposition, may only convert to an illness with the impact of environmental factors 

 

Treatment: 

• Up to one quarter of people don’t show improvement with medication 

• Patients with more positive symptoms react better to anti-psychotic medication 

• Can also include strategies like psycho-education and CBT (but small range of improvements)