Schizophrenia, A split personality.

1. G
The GreatPersonality
SCHIZOPHRENIA
SPLIT PERSONALITY

2. G V GANAPATHI
P H A R M D I V Y E A R
1 9 3 5 3 D 1 0 09
J AYA M U K H I C O L L E G E O F P H A R M A C Y

3. CONTENTS….
• INTRODUCTION
• DEFINITIONS
• INCIDENCE
• AETIOLOGY
• RISK FACTORS
• CLINICAL FEATURES
• PATHOPHYSIOLOGY
• TYPES
• DIAGNOSIS
• MANAGEMENT
• PREVENTION OF SCHIZOPHRENIA
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INTRODUCTION
• Schizophrenia is a group of severe mental
disorders characterized by reality
distortions resulting in unusual thought
patterns and behaviors.
• Because there is often little or no logical
relationship b/w the thoughts and feelings
of a person with schizophrenia.
• Although it is a psychiatric disorder, it
stems from a physiologic malfunctioning
of the brain.
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DEFINITIONS
• Schizophrenia is any group of severe mental disorders that have in
common symptoms such as hallucinations, delusions, blunted
emotions, disorganized thinking, and withdrawal from reality.
• It is a brain disorder that is characterized by bizarre mental experience
such as hallucinations and severe decrement in social cognitive, and
social functioning.
• Schizophrenia is marked by splitting or disintegration of personality
• Schizophrenia is a brain disorder that affects the way a person acts,
thinks, and sees the world. People with schizophrenia have an altered
perception of reality, often a significant loss of contactwith reality.
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INCIDENCE
HISTORY
The term Schizophrenia was coined by a German Psychiatrist, Eugen Bleuler in
1908.
• Onset of symptoms typically occurs in late adolescence or young adulthood.
• No laboratory test for schizophrenia currently exists.
• The average life expectancy of people with the disorder is 10 to 12 years due to
increased physical heath problems and a higher suicide rate [about 5%].
• Common in urban areas with those who are unemployed, poor, and homeless.
• In mental hospital about half of the beds occupying by Schizophrenia patients
• The prognosis worsens with each acute episode.
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AETIOLOGY
• 1. BIOLOGICAL FACTORS
a] neurological changes – Increased Dopamine activity in the mesolimbic
pathway of the brain is consistentlyfound in schizophrenia individuals.
✓Norepinephrine and serotonin systems have also been implicated in the
causation of schizophrenia .
✓The Dopamine hypothesis posits that an excessive amount of the
neurotransmitter dopamine allows nerve impulses to bombard the mesolimbic
pathway, the part of the brain normally involved in arousal and motivation.
✓Normally cell communicationis disrupted, resulting in the development of
hallucinations and delusions.

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AETIOLOGY CONTINUES…
b] Endocrine factors –
✓Changes in prolactin, melatonin, and
thyroid functions have been found in
Schizophrenia.
C] Brain structural changes –
✓CT, MRI, studies have shown
decreased volume and density in
limbic and frontal areas in
schizophrenic patients.
Others –
✓Genetics , vitamin deficiency etc…

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AETIOLOGY CONTINUES…
• 2. PSYCHOLOGICAL FACTORS
a] personality traits – personality characteristics of an individual, such as
withdrawn, extreme quietness and shyness , highly dependent and obedient ,
having temper tantrums, and always looking sad and miserable, is a recipe for
schizophrenia.
b] cognitive biases – Especially when under stress or in confusing situations
• 3. Environmental /social factors
✓Use of drugs, alcohol.
✓Childhood experiences of abuse or trauma .
✓Social – living in an urban environment
- poor housing conditions
- racial discrimination

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RISK FACTORS
• Certain factors seem to increase the risk of developing or triggering
schizophrenia,
Including…
❑Having a family history of schizophrenia
❑Experience to viruses, toxins or malnutrition while in the womb, particularly in
the first and second trimesters.
❑Stressfullife circumstances
❑Older paternal age
❑Taking psychoactive drugs during adolescence and young adulthood.

11. CLINICAL FEATURES
.
Positive /Active symptoms
• Delusions
• Hallucinations [auditory]
• Thought disorder
• Disorganized behavior
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12. CLINICAL FEATURES
.
Negative / Deficit Symptoms
• Flat or blunted affect and emotions
• Alogia – poverty of speech
• Anhedonia – inability to experience pleasure
• Asociality – lack of desire to form relationship
• Avolition – lack of motivation
• Isolation – social withdrawal
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13. CLINICAL FEATURES
.
Cognitive symptoms
• It includes thought processes
• Problems with making sense of information
• Difficulty in paying attention
• Memory problems
• Neglects personal hygiene or ignores health
needs
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14. PATHOPHYSIOLOGY

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TYPES
1] PARANOID SCHIZOPHRENIA
- Common form of schizophrenia
- Prominent hallucinations and delusions
- Speech and emotions may be unaffected
- Risk of suicidal or violent behavior under
influence of delusions
2] CATATONIC SCHIZOPHRENIA
- Rarer than other types
- At risk for malnutrition, exhaustion or self injury
- Catatonia – unable to talk
- Unusual movements,
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TYPES
3] Hebephrenic/Disorganized schizophrenia
- Behavior is disorganized and without purpose
- thoughts are disorganized, difficult to understand by
other
- pranks, giggling, health complaints, grimacing and
mannerisms are common
- Delusions and hallucinations are fleeting
- Usually develops b/w 15 – 25 years age
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TYPES
4] Undifferentiated Schizophrenia
• Some characteristics of paranoid, hebephrenic or
catatonic schizophrenia, but does not obviously fit
one of these types.
5] Residual schizophrenia
• Past History of psychosis but only having negative
symptoms
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DIAGNOSIS
1] Psychiatric Evaluation:
• A doctor or mental health professional checks mental statusby observing
appearance, demeanor and asking about thoughts, moods and awareness .
• A person may be diagnosed if they have at least 2 of the following over a month
- Delusions, Hallucinations, Disorganized behavior
- Disorganized speech and thought processes
- Catatonic behavior, Negative symptoms,
2] Medical History:
- Blood tests, imaging – CBP , MRI , CT.

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MANAGEMENT

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PREVENTION OF SCHIZOPHRENIA
➢ Seek early treatment
➢ Stick to treatment plan
➢ Avoid illegal drug and alcohol use
➢ Reducing stress
➢ Getting enough sleep
➢ Avoid social isolation
➢ Avoid head injuries
➢ Eat healthy diet with a lot of vegetables, fish with omega 3 fatty acids.
➢ Vitamin – D supplements

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REFERENCES…
• J T DIPIRO, Pharmacotherapy 8th Edition pg. no. 1147
• https://www.webmd.com/schizophrenia/mental-health-
schizophrenia
• https://www.psychiatry.org/patients-
families/schizophrenia/what-is-schizophrenia
• https://www.mayoclinic.org/diseases-
conditions/schizophrenia/symptoms-causes/syc-20354443
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24. Thank You.
• ganapathigreat@gmail.com
G
The GreatGanapathi