SCHIZOPHRENIA

DEFINITION

Schizophrenia is a chronic,

severe, debilitating mental

illness

DEFINITION

Characterized by:

– Psychotic symptoms

(delusions, hallucinations)

– Disorganization symptoms

– Negative symptoms and,

sometimes,

– Cognitive impairment

INCIDENCE

Affects about 1% of the

population over the age of 18

or, in other words, at any one

time as many as 51 million

people worldwide

INCIDENCE

• Is one of the only disorders

known to exist in every

culture and society around

the world.

• Affects men and women

equally.

TYPES

TYPES

The ICD-10 further defines two

additional subtypes:

TYPES

• Post-schizophrenic

depression

A depressive episode arising in

the aftermath of a

schizophrenic illness where

some low-level

schizophrenic symptoms

may still be present

• Simple Schizophrenia

SIGNS & SYMPTOMS

-Delusions

-Hallucinations

-Disorganized speech

-Disorganized behaviors

-Catatonic behaviors

• Positive, more overtly psychotic symptoms

SIGNS & SYMPTOMS

-Inhibition of facial expressions

-Lack of speech

-Lack of motivation

• Negative, potentially less overtly psychotic symptoms

SIMPLE SCHIZOPHRENIA

• Simple schizophrenia is classified F20.6 in ICD-10

• An uncommon disorder in which there is an

insidious and progressive development of

prominent negative symptoms with no history

of psychotic episodes

SIMPLE SCHIZOPHRENIA

Delusions and hallucinations

are not evident, and the

disorder is less obviously

psychotic than the

disorganized, paranoid, and

catatonic subtypes of

schizophrenia

SIMPLE SCHIZOPHRENIA

The characteristic “negative”

features of residual

schizophrenia (e.g. blunting of

affect, loss of volition) develop

without being preceded by any

overt psychotic symptoms.

DIAGNOSTIC CRITERIA

Slowly progressive

development over a period of

at least one year, of all three of

the following:

DIAGNOSTIC CRITERIA

1(a) Loss of drive and interests, aimlessness, self-absorbed attitude and

social withdrawal that progress.

(b) Gradual appearance and deepening of negative symptoms such as

marked apathy, lack of speech, under activity, blunting of affect,

passivity and lack of initiative, and poor non-verbal

communication.

(c) Marked decline in social, scholastic or occupational performance.

DIAGNOSTIC CRITERIA

2

Absence, at any time, of

hallucinations and well

formed delusions of any

kind

3

Absence of evidence of

dementia or any other

organic disorder

DIAGNOSTIC CRITERIA

The only primary symptom is the withdrawal of the person from

social and work related situations.

ARE ANY TESTS NEEDED?

• Blood and urine tests may

be done to rule out physical

causes of the symptoms or

drug/alcohol use.

• Chronic Cannabis use leads

to Amotivational syndrome.

MANAGEMENT

There is no cure for

schizophrenia, but consistent

ongoing compliance with a

multifaceted treatment

program can often effectively

control symptoms and prevent

relapses of acute episodes of

symptoms.

MANAGEMENT

TREATMENT INCLUDES:

• Medications

• Psychotherapy

• Rehabilitation

ANTIPSYCHOTIC MEDICATION

• Antipsychotic drugs tend to

work best to ease positive

symptoms, and tend not to

work so well to ease negative

symptoms

• Due to the lack of positive

symptoms in simple

schizophrenia, the scope of

antipsychotic medications are

limited

PSYCHOLOGICAL TREATMENTS

•Cognitive BehaviouralTherapy (CBT)

The patient may be asked to keep

a diary of important events in

their life and the way they feel

about them. The therapist may

challenge their beliefs and ask

them to explain. They may be

asked to try out new ways of

behaving and reacting

PSYCHOLOGICAL TREATMENTS

•Cognitive BehaviouralTherapy (CBT)

Studies have found that, on

average, CBT reduces the

chance of being admitted or

readmitted to hospital, can

reduce symptom severity

and can improve social

functioning

PSYCHOLOGICAL TREATMENTS

This may be offered and

consists of about 10 therapy

sessions for relatives of

patients with schizophrenia

• FAMILY INTERVENTION

PSYCHOLOGICAL TREATMENTS

It has been found to reduce

hospital admissions and the

severity of symptoms for up to

two years after treatment

• FAMILY INTERVENTION

VOCATIONAL REHABILITATION

• Rehabilitation is the tertiary prevention process of helping the person who has a serious mental

illness return to the highest possible level of functioning

• Vocational Rehabilitation would not be complete without

assistance with job training, finding and retraining

• Retraining is a significant component of vocational

rehabilitation. Schizophrenics sometimes want to go back to school to retrain for something new or to finish something they

have already started

VOCATIONAL REHABILITATION

• A point to keep in mind is to remind families and

friends to value whatever the individual spends his

or her time at

• The structured routine that employment offers

provides a welcome diversion from unpleasant

preoccupations

SOCIAL AND COMMUNITY SUPPORT

• Families, friends and local

support groups are major

sources of help

ENCOURAGING PHYSICAL HEALTH

• People with schizophrenia,

along with everyone else in

the population, are

encouraged to adopt a

healthy lifestyle - not to

smoke, to take regular

exercise, to eat healthily,

etc.

LIVING WITH SCHIZOPHRENIA

• Many people diagnosed with

schizophrenia are still able to

live normal, happy lives

• For those diagnosed with the

disorder, it is very important

that they continue to take

their medication and abstain

from drugs and drinking