2. • Schizophrenia is a mental disorder characterized
by abnormal social behavior and failure to recognize what
is real. Common symptoms include false beliefs, unclear or
confused thinking, hearing voices, reduced social engagement
and emotional expression, and a lack of motivation.
• People often have additional mental health problems such
as major depression, anxiety disorders, or substance use
disorder. Symptoms typically come on gradually, begin in young
adulthood, and last a long time.
• The cause of schizophrenia is believed to be a combination
of genetic and environmental factors. Possible environmental
factors include cannabis use, poor nutrition during pregnancy,
being raised in a city, parental care, and certain infections.
3. Self-portrait of a person with schizophrenia, representing that individual's
perception of the distorted experience of reality in the disorder
4. • Schizophrenia occurs with regular frequency nearly everywhere in the
world in 1 % of population and begins mainly in young age (mostly around
16 to 25 years).
• Schizophrenia is often described in terms of positive and negative (or
• Positive symptoms are those that most individuals do not normally
experience but are present in people with schizophrenia. They can include
delusions, disordered thoughts and speech
and tactile, auditory, visual, olfactory and gustatory hallucinations, typically
regarded as manifestations of psychosis. Positive symptoms generally
respond well to medication.
• Negative symptoms are deficits of normal emotional responses or of other
thought processes, and are less responsive to medication. They commonly
include flat expressions or little emotion, poverty of speech, inability to
experience pleasure, lack of desire to form relationships, and lack of
motivation. Negative symptoms appear to contribute more to poor quality
of life, functional ability, and the burden on others than do positive
symptoms. People with greater negative symptoms often have a history of
poor adjustment before the onset of illness, and response to medication is
5. My eyes at the moment of the apparitions by German
artist August Natterer who had schizophrenia
6. Cause and pathogenesis
• A combination of genetic and environmental factors play a role in the development of
schizophrenia. People with a family history of schizophrenia who have a transient
psychosis have a 20–40% chance of being diagnosed one year later.
• A number of attempts have been made to explain the link between altered brain
function and schizophrenia. One of the most common is the dopamine hypothesis, which
attributes psychosis to the mind's faulty interpretation of the misfiring of dopaminergic
• The dopamine hypothesis of schizophrenia or the dopamine hypothesis of psychosis is
a model, attributing symptoms of schizophrenia (like psychoses) to a disturbed and
hyperactive dopaminergic signal transduction. The model draws evidence from the
observation that a large number of antipsychotics have dopamine-receptor antagonistic
effects. The theory, however, does not say dopamine overabundance as a complete
explanation for schizophrenia. Rather, the over activation of D2 receptors is one of the
reason for this disorder.
• Psychotic symptoms are related to dopaminergic hyperactivity in the brain. Hyperactivity
of dopaminergic systems during schizophrenia is result of increased sensitivity and
density of dopamine D2 receptors in the different parts of the brain.
8. Diagnostic Process for Schizophrenia
• Imaging (CT, MRI, PET) are seldom helpful in diagnosis.
• The diagnosis is commonly made from history and the mental status
• There are currently no reliable biomarkers for diagnosis or severity.
9. Pharmacological Treatment of Acute
• Antipsychotic medications are effective for decreasing the severity of
psychotic symptoms. E.g. Chlorpromazine, haloperidol.
• Nearly all patients on antipsychotic medications will experience some
burden from side effects such as Blurred vision, Dry mouth,
Drowsiness, Muscle spasms or tremors, Weight gain.
• Antipsychotics are relatively ineffective for negative symptoms and
10. Long-term treatment of schizophrenia
• Antipsychotic medications are effective for preventing relapse
in stabilized patients
• Effective no pharmacological treatments include patient and
family education, skills training, supported employment,
cognitive behavior therapies, and psychotherapies
• For most individuals, antipsychotic medications control the
symptoms while non-pharmacological treatments address the
impairments in social, vocational, and educational
11. John Nash, an American mathematician and joint winner of the 1994 Nobel
Prize for Economics, who had schizophrenia. His life was the subject of the
2001 Academy Award-winning film A Beautiful Mind.