PROBLEM 4: I SEE, I SEE, WHAT YOU DON’T SEE
Learning goals:
Case 1:
What type of hallucinations are there?
What is a psychosis?
What is schizophrenia? (clinical features/epidemiology)
Case 2:
What causes schizophrenia? (= aetiology)
What is dopamine and what does it have to do with schizophrenia?
Which biological and environment factors are involved in the development of schizophrenia?
Case 3:
Is cognitive behavioural therapy common to treat schizophrenia? And will this help?
What are effective treatments for schizophrenia?
What is the progress of/prognosis of schizophrenia? (can it be ‘cured’?)
Schizophrenia
Psychosis: loss of contact with reality (the hallmark of schizophrenia)
Schizophrenia: “split mind”
Most severe and common type of psychotic disorder
Consists of clear moments but also extreme thinking/perceptions
- Extreme oddities in perception, thinking, action, sense of self, manner of relating to others
Epidemology
Risk of developing = 0.7%
o 1/140 people who survive until age 55
o Those who have parents with it have statistically higher risk
Ethnicity:
Rates are higher in first and second generation immigrants (especially black Caribbean and black
African countries who live in white communities
0.5-2% of the population
Lifespan: 10 years shorter than average
o Suffers from infectious and circulatory diseases at higher rates
o 10-15% commit suicide
, Onset: mostly in late adolescence or early adulthood
o Earlier onset for males= late teens - early 20s
More severe
o Later onset for females = peaks at the same age, late 20s to early 30s but peak is less
marked
But oestrogen in women may affect regulation of dopamine or differences in prenatal
brain development (slower in males)
o Sometimes found in children but that is rare
Gender:
- More common in males
- For every 3 men, 2 women
- Women have less severe form but more symptoms of depression
o May either not be diagnosed at all or be diagnosed with other disorder
Recovery?
- 38% patients have favourable outcome and thought of being recovered
- Do not return to how they were before but can function well
Clinical picture
DSM-V criteria
Schizoaffective disorder and depressive or bipolar disorder
Two or more: with psychotic features have been ruled out:
- Delusions No major depressive or manic episodes have occurred
- Hallucinations concurrently
- Disorganized speech If mood episodes have occurred during active-phase
- Grossly disorganized or symptoms, they have been present for a minority of the
catatonic behaviour total duration of the active and residual periods of the
- Negative symptoms illness.
The disturbance is not attributable to the physiological
Disturbance in level of functioning effects of a substance (e.g., a drug of abuse, a medication)
in one or more major areas or another medical condition.
- Work/ academics
- Interpersonal relations
- Self-care
- Occupational functioning
Learning goals:
Case 1:
What type of hallucinations are there?
What is a psychosis?
What is schizophrenia? (clinical features/epidemiology)
Case 2:
What causes schizophrenia? (= aetiology)
What is dopamine and what does it have to do with schizophrenia?
Which biological and environment factors are involved in the development of schizophrenia?
Case 3:
Is cognitive behavioural therapy common to treat schizophrenia? And will this help?
What are effective treatments for schizophrenia?
What is the progress of/prognosis of schizophrenia? (can it be ‘cured’?)
Schizophrenia
Psychosis: loss of contact with reality (the hallmark of schizophrenia)
Schizophrenia: “split mind”
Most severe and common type of psychotic disorder
Consists of clear moments but also extreme thinking/perceptions
- Extreme oddities in perception, thinking, action, sense of self, manner of relating to others
Epidemology
Risk of developing = 0.7%
o 1/140 people who survive until age 55
o Those who have parents with it have statistically higher risk
Ethnicity:
Rates are higher in first and second generation immigrants (especially black Caribbean and black
African countries who live in white communities
0.5-2% of the population
Lifespan: 10 years shorter than average
o Suffers from infectious and circulatory diseases at higher rates
o 10-15% commit suicide
, Onset: mostly in late adolescence or early adulthood
o Earlier onset for males= late teens - early 20s
More severe
o Later onset for females = peaks at the same age, late 20s to early 30s but peak is less
marked
But oestrogen in women may affect regulation of dopamine or differences in prenatal
brain development (slower in males)
o Sometimes found in children but that is rare
Gender:
- More common in males
- For every 3 men, 2 women
- Women have less severe form but more symptoms of depression
o May either not be diagnosed at all or be diagnosed with other disorder
Recovery?
- 38% patients have favourable outcome and thought of being recovered
- Do not return to how they were before but can function well
Clinical picture
DSM-V criteria
Schizoaffective disorder and depressive or bipolar disorder
Two or more: with psychotic features have been ruled out:
- Delusions No major depressive or manic episodes have occurred
- Hallucinations concurrently
- Disorganized speech If mood episodes have occurred during active-phase
- Grossly disorganized or symptoms, they have been present for a minority of the
catatonic behaviour total duration of the active and residual periods of the
- Negative symptoms illness.
The disturbance is not attributable to the physiological
Disturbance in level of functioning effects of a substance (e.g., a drug of abuse, a medication)
in one or more major areas or another medical condition.
- Work/ academics
- Interpersonal relations
- Self-care
- Occupational functioning
