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HAMDALLAH KHALIDRN.BSN.MMS

IBN SINA COLLEGE/PALESTINE

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SCHIZOPHRENIA

Schizophrenia means split mind Refers to personalitydisintegration Introduced by Eugen Bleuler toemphasize that affect (emotions)

and thoughts were disconnectedDoes not refer to split or multiplepersonality (DID)

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Key Historical FiguresEmil Kra epe lin (1899)Dementia pra ecox

~ precocious dementiaImplies mental de t erioration occurring earl y in lifewith no recov ery

Kra epe lins dementia : Poor judgment Apath y Lack of emotional expression Reduction in voluntar y activit y Neglect of responsibiliti es & self-car e Pov ert y of spee ch

Today called negativ e symptoms reflect abs enceof attribut es shar ed by most people

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Eugen Bleuler (1911)Schizophrenia s 4 As1. Associative Loosening2- Affect3. Autistic withdrawal4. Ambivalence

Bleuler

s lasting contribution: Looseassociations, affect disturbance, andinterpersonal relations deficit importantto DSM definition of schizophrenia

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Kurt Schn eide r (1959)Schn eide r s first rank symptoms

(FRS)

Includes what are now considered tobe positive symptoms reflect thepresence of attributes shared by

few; addition of abnormal featurese.g., hallucinations and delusions

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MythsF alse assumptions about schizophrenia

Violence Multiple personalities Homelessness Due to frigid mother Due to conflicting messages Due to conflict resolution in

relationships Sex abuse

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Facts

Schizophrenia is observed in all racesand culturesIt s onset is sudden and intense. Itoften begins with an acute psychoticphase.Schizophrenia can be brought on by

drug use or by a life stressor.Schizophrenia can be successfullytreated with drugs, but the long-term

prognosis is poor

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Schizo phr enia de finitionSchizophrenia is a PSYCHOTIC

DISORDER (i.e., a severe mentaldisorder in which thinking andemotion are so impaired that theindividual is seriously out of contactwith reality).

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EpidemiologyMajor international health problemWorldwide Prevalence ~1%Male/female distribution is equalpeak ages of onset:

for men = 15-25 for women = 25-35

Schizophrenia is a disease that usuallymanifests itself in late adolescence.

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Often chronic with marginaladjustment

Only ~16% recover fully

~38% make good adjustment Around 12% need long termhospitalization

Suicide is very prevalent , 50%attempt and 10-15% will complete it.

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ETIO LOGYBiological factors:Genetic/H ered it y factors:

The concor dance rat e in identical t wins is 50%.The concor dance rat e is 12% in frat ernal t wins.Genetic regions on chromosom es 6and 13 hav e bee n associat ed w ith schizo phr enia.

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Str ess diath esis mode l and genetic influences5% risk to Sz- Winter birth- 20th to 30th weeks of pregnancy

viral infection- Incompatibilities of the Rh between

male and female- Starvation during pregnancy and

complications at birth

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Dopamine hypoth esis:Dopamine is a neurotransmitter which

regulate movement and emotion, so itaffects our mood, thoughts and motor

movement.According to this hypothesis:There is an increased of dopamine levels

in such area of brain such asnigrostriatal tracts; substantial nigra tobasal ganglia2/3 of persons with Sz have increased

dopamine level

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Environmental mode ls:

- Dev elopmental mode l:Sullivan developed the interpersonal theory fordevelopment of Sz Hostil e e nvironment and lack of consensual validation for infant .

- If the child grows up in an environmentof fear and anxiety, the chances tovalidate feelings, thoughts and behaviorare decreased.

- The child s ability to accurately perceivereality will be greatly impaired.Therefore, a personality deficit or Szmight result.

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