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Schizo2A
Schizo2A
Schizo2A
Group 2A (2014)
• Environment
• Those with history of childhood central
nervous system infection.
• history of obstetric complications •
Dopamine Hypothesis
DOPAMINE HYPOTHESIS
Neurons that use the transmitter ‘dopamine’ fire too often and transmit too
many messages or too often.
Certain D2 receptors are known to play a key role in guiding attention.
Lowering DA activity helps remove the symptoms of schizophrenia
ROLE OF DRUGS
Falkai et al 1988
Autopsies have found that people with
schizophrenia have a larger than usual number
of dopamine receptors.
Increase of DA in brain structures and receptor
density (left amygdala and caudate nucleus
putamen)
• Concluded that DA production is abnormal for
schizophrenia
SIGNS AND SYMPTOMS
In general, the symptoms of schizophrenia can be divided into
three catogories:
Positive
Negative
cognitive symptoms.
Delusions
Hallucinations
Disorganised speech/thinking (thought disorder or loosening of
associations)
Grossly disorganised behaviour
Catatonic behaviours
Other symptoms:
• Affect inappropriate to the situation or stimuli
• Unusual motor behaviour (e.g. pacing and rocking)
• Depersonalisation
• Derealisation
• Somatic preoccupations
Negative symptoms are less obvious and often persist even after the
resolution of positive symptoms.
COGNITIVE SYMPTOMS
2. Psychotic
• Perceptual disturbances, delusions, and disordered thought process/content
3. Residual
• occurs between episodes of psychosis
• It is marked by flat affect, social withdrawal, and odd thinking or behaviour
(negative symptoms)
• Patient can continue to have hallucinations even with treatment
Scheinder’s symptoms of first rank’
The sensation of alien thoughts being put into the subject’s mind by some external
agency (thought insertion) or of their own thoughts being taken away (thought
withdrawal)
The sensation that the subjects thinking is no longer confined to their own mind,
but is instead shared by, or accessible to, others (thought broadcasting)
The sensation of feelings, impulses, or acts being experienced or carried out under
external control, so that the subject feels as if they were being hypnotised or had
become a robot (delusion of control)
DSM-V Criteria
Two or more of the following must be present for at least 1 month:
1. Delusions
2. Hallucinations
3. Disorganized speech (e.g Frequent derailment or incoherence)
4. Grossly disorganized or catatonic behaviour
5. Negative symptoms (e.g Diminished emotional expression or avolition)
- One of the two symptoms must be delusions, hallucinations,
or disorganized speech.
2) Acute phase
-Positive symptoms appear
-With adequate treatment, the symptoms will disappear in most patients.
-However, negative symptoms may persists
3) Relapse prevention
4) Stable phase
- After 10 years, patient become more stable with sign of improvement
• Electroconvulsive therapy
o To achieve rapid and short- term improvement of
severe symptoms after an adequate trial of other
treatment options has proven ineffective and/ or when
the condition is considered to be life- threatening. Eg:
i) catatonic schizophrenia
ii) shcizophrenia with prominet affective symptoms
iii) schizophrenia with previous improvement with
ECT
Psychosocial therapies
• Objectives:
o Enable persons who are severely ill to develop social and vocational
skills for independent living
o To improve individual’s ability to handle stressful life events
o Increase adherence to medications
o Promote better communication and coping skills
o Enhance quality of life
o Promote recovery
• Types of psychosocial therapies:-