Introduction Of Schizophrenia- Basic Psychiatric Illness History Of Schizophrenia Early Sign Of Schizophrenia Symptoms Of Schizophrenia Types Of Schizophrenia ICD 10 And 11 Codes Medication & Psychotherapy Created By Sankara Narayanan MA(Psy) Psychologist Siva Counseling Clinic, Tirunelveli

1. Psychiatric Illness
Psychosis
Schizophrenia Bipolar
Neurosis
Anxiety
Panic Attack
OCD

2. • PSYCHOTIC DISORDER

3. India: Schizophrenia
According to the latest WHO data published in 2020 Schizophrenia Deaths
in India reached 0 or 0.00% of total deaths. The age adjusted Death Rate is
0.00 per 100,000 of population ranks India #183 in the world.

4. • Schizophrenia Literally
• Schizo Means – Split
• Phrenia Means – Mind
• It Is Not Multiple
Personality

5. • Schizophrenia refers to a
condition and to a
spectrum of disorders that
all involve a disconnection
from reality,

6. Louis Wain

7. Louis Wain
• He specialized in drawing animals
•worked for several journals
including the Illustrated Sporting
and Dramatic News
• The Illustrated London News
•In 1886, Wain's first drawing
of anthropomorphized cats, "A
Kitten's Christmas Party," was
published in the Christmas issue of
the Illustrated London News.
•It depicted 150 cats

8. Emily Richardson
•At 23, Wain married, Emily Richardson
•after the success of “A Kitten’s Christmas
Party,” Emily passed away on January 2, 1887
•After her death, Wain began to suffer from
depression and cats soon became an obsession
for him.
•his cats began to walk upright, smile broadly
and use other exaggerated facial expressions,
and wear sophisticated, contemporary
clothing. He illustrated cats playing musical
instruments, serving tea, playing cards, fishing,
smoking, and enjoying nights at the opera.
•In 1898 and 1911 he was chairman of
the National Cat Club

12. • Wain's presumed
schizophrenia
• no longer cope with
his erratic, and
sometimes violent
behaviour, Wain was
committed to a
pauper ward at
the Springfield Mental
Hospital in Tooting.

13. • Wain was transferred to
the Bethlem Royal
Hospital in Southwark, and
again,
• in 1930, he was transferred
to Napsbury
Hospital near St Albans in
Hertfordshire, north of
London.
Bethlem Royal Hospital
Napsbury Hospital

14. Emil Kraepelin
German psychiatrist
• History OF Schizophrenia
• The term ‘dementia praecox’
was coined by the popular
German psychiatrist, Emil
Kraepelin. The term was
popularized in an 1893
publication of a book written
by him. In particular, he is
noted for laying down early
ideas on the causes and risk
factors that can contribute to
the emergence of
schizophrenia.2

15. In 1911, the Swiss
psychiatrist Eugen
Bleuler revised this idea,
renaming 'dementia
praecox' to schizophrenia.
Nevertheless, the separation
of affective disorders from
schizophrenic psychosis as
two distinct entities formed
the basis for the
understanding of psychiatric
illnesses for more than a
century.
Eugen Bleuler
Swiss psychiatrist

16. • The most common early warning
signs include:
• Depression, social withdrawal
• Hostility or suspiciousness,
extreme reaction to criticism
• Deterioration of personal
hygiene
• Flat, expressionless gaze
• Inability to cry or express joy or
inappropriate laughter or crying
• Oversleeping or insomnia;
forgetful, unable to concentrate
• Odd or irrational statements;
strange use of words or way of
speaking
Early Warning
Signs Of
Schizophrenia

17. Symptoms Of Schizophrenia
Positive Symptom Negative Symptom
positive symptoms – any change in
behaviour or thoughts, such as
hallucinations or delusions
negative symptoms – where
people appear to withdraw
from the world around then,
take no interest in everyday
social interactions, and often
appear emotionless and flat
Cognitive Symptoms
What are Cognitive Symptoms.
Cognition is the mental process of
learning, understanding, and
communicating.

18. • Hallucinations
• Delusions
• Confused thoughts and
disorganized speech
• Trouble concentrating
• Movement disorders.
Positive Symptoms

19. • Lack of pleasure(Alogia)
• Trouble with speech(Avolition)
• Flattening(Affect)
• Withdrawal(Anhedonia)
• Struggling with the basics of
daily life
• No follow-through
Negative Symptoms

20. • disorganized thinking.
• slow thinking.
• difficulty understanding.
• poor concentration.
• poor memory.
• difficulty expressing thoughts.
• difficulty integrating thoughts,
feelings and behavior.
Cognitive
Symptoms of
Schizophrenia

21. Brain Chemicals
•Dopamine
Reward chemical
•Oxytocin
Love Hormone
•Endorhin
Pain Killer
•Serotonin
Mood Stabilizer
It plays a role in many important body functions, including movement, memory and
pleasurable reward and motivation

22. Dopamine
• Dopamine receptors play an
essential role in daily life functions.
This hormone and its receptors
affect movement, emotions and
the reward system in the brain.
• Dopamine receptors are expressed
in the central nervous system,
specifically in the hippocampal
dentate gyrus and subventricular
zone. Dopamine receptors are also
expressed in the periphery, more
prominently in kidney and
vasculature,
• There are five types of dopamine
receptors, which include D1, D2,
D3, D4, and D5. Each receptor has
a different function.
many different
diseases involve
increased or
decreased
dopamine
leading to
differenteffects

23. Function
• The function of each dopamine
receptor[4]:
• D1: memory, attention, impulse
control, regulation of renal function,
locomotion
• D2: locomotion, attention, sleep,
memory, learning
• D3: cognition, impulse control,
attention, sleep
• D4: cognition, impulse control,
attention, sleep
• D5: decision making, cognition,
attention, renin secretion

24. Two Primary Condition
Increased or Decreased Dopamine Receptor
Parkinson Disease
Schizophrenia

25. • F20 Schizophrenia
– F20.0 Paranoid schizophrenia
– F20.1 Disorganized
schizophrenia
– F20.2 Catatonic schizophrenia
– F20.3 Undifferentiated
schizophrenia
– F20.5 Residual schizophrenia
– F20.8 Other schizophrenia
• F20.81 Schizophreniform
disorder
• F20.89 Other schizophrenia
– F20.9 Schizophrenia,
unspecified
ICD -10 Codes

26. – Schizophrenia
– Schizoaffective disorder
– Acute and transient
psychotic disorder (ATPD)
– Schizotypal disorder
– Delusional disorder
– Other primary psychotic
disorders
– Unspecified primary
psychotic disorders
The overall structure
being proposed for
the ICD-11 block on
“Schizophrenia
spectrum and other
primary psychotic
disorders” is as
follows:

27. • Schizophrenia is a kind
of psychosis, which means your
mind doesn't agree with reality. It
affects how you think and behave.
This can show up in different ways
and at different times, even in the
same person. The illness usually
starts in late adolescence or young
adulthood.
• People with paranoid delusions are
unreasonably suspicious of others.
This can make it hard for them to
hold a job, run errands, have
friendships, and even go to the
doctor.
• Although it's a lifelong illness, you
can take medicines and find help to
stop symptoms or make them
easier to live with.
Schizophrenia is
a kind
of psychosis

28. • Delusions are fixed beliefs that seem
real to you, even when there's strong
evidence they aren't. Paranoid
delusions, also called delusions of
persecution, reflect profound fear and
anxiety along with the loss of the ability
to tell what's real and what's not
real. They might make you feel like:
• A co-worker is trying to hurt you, like
poisoning your food.
• Your spouse or partner is cheating on
you.
• The government is spying on you.
• People in your neighborhood are
plotting to harass you.
Paranoid Symptoms(F20.0)

29. Paranoid Symptoms(F20.0)
• These beliefs can cause trouble in your
relationships. And if you think that
strangers are going to hurt you, you may
feel like staying inside or being alone.
• People with schizophrenia aren't usually
violent. But sometimes, paranoid
delusions can make them feel
threatened and angry. If someone is
pushed over the edge, their actions
usually focus on family members, not
the public, and it happens at home.
• You could also have
related hallucinations, in which your
senses aren’t working right. For
example, you may hear voices that
make fun of you or insult you. They
might also tell you to do harmful things.
Or you might see things that aren’t
really there. Learn more about
the symptoms of paranoia

30. F20.1 Disorganized
schizophrenia
• Also known as ‘disorganised
schizophrenia’, this type of
schizophrenia typically develops
when you’re 15-25 years old.
Symptoms include disorganised
behaviours and thoughts,
alongside short-lasting delusions
and hallucinations. You may
have disorganised speech
patterns and others may find it
difficult to understand you.
• People living with disorganised
schizophrenia often show little
or no emotions in their facial
expressions, voice tone, or
mannerisms.
Hebephrenic
schizophrenia

31. • The etiology of catatonia is
multifactorial. One theory
is that GABAergic (gamma-
aminobutyric acid)
neurotransmitters, which
regulate both emotional
and cognitive functions,
become disrupted, leading
to catatonic symptoms
F20.2 Catatonic
schizophrenia

32. • Catatonia again is a complex
combination of psychomotor
abnormalities and mood and
thought processes. There are
at least forty different signs
and symptoms that have
been associated with
catatonia. The Diagnostic and
Statistical Manual V has
criteria for catatonia with
specifiers, including that for
schizophrenia. Three of the
twelve symptoms must be
present.[15]
Catatonic

33. • Catalepsy (i.e., passive induction of posture
held against gravity)
• Waxy flexibility (i.e., slight and even
resistance to positioning)
• Stupor (no psychomotor activity; not
actively relating to the environment)
• Agitation, not influenced by external stimuli
• Mutism (i.e., no or little, verbal response
but this is not applicable if there is
established aphasia)
• Negativism (i.e., opposing or not responding
to external stimuli)
• Posturing (i.e., spontaneous and active
maintenance of a posture against gravity)
• Mannerisms (i.e., odd caricature of normal
actions)
• Stereotypies (i.e., repetitive, abnormally
frequent, non-goal-directed movements)
• Grimacing
• Echolalia (i.e., mimicking another's speech)
• Echopraxia (i.e., mimicking another's movements)
Catatonic Symptoms

34. MEDICATION & THERAPY

35. Types of Antipsychotic Medications
• There are two groups of
antipsychotics. Doctors call the
older group of medications
cs.
Some common ones are:
• Chlorpromazine (Thorazine)
• Fluphenazine (Prolixin)
• Haloperidol (Haldol)
• Perphenazine (Trilafon)
• Thioridazine (Mellaril)
• Thiothixene (Navane)
• Trifluoperazine (Stelazine)

36. second-generation” or
“atypical” antipsychotics
• The newer ones are called “second-
generation” or “atypical” antipsychotics.
Examples of these medicines include:
• Aripiprazole (Abilify)
• Aripiprazole lauroxil (Aristada)
• Asenapine (Saphris)
• Brexpiprazole (Rexulti)
• Cariprazine (Vraylar)
• Clozapine (Clozaril)
• Iloperidone (Fanapt)
• Lumateperonee (Caplyta)
• Lurasidone (Latuda)
• Olanzapine (Zyprexa)
• Olanzapine/samidorphan (Lybalvi)
• Paliperidone (Invega Sustenna)
• Paliperidone palmitate (Invega Trinza)
• Quetiapine (Seroquel)
• Risperidone (Risperdal)
• Ziprasidone (Geodon)

37. • Lamotrigine (Lamictal)
• Lithium
• Carbamazepine (Tegretol)
• Valproic acid (Depakote)
Mood stabilizers
include:

38. • The most frequently
prescribed types of
antidepressants are called
selective serotonin
reuptake inhibitors or
SSRIs. They include:
• Citalopram (Celexa)
• Fluoxetine (Prozac)
• Paroxetine (Paxil, Pexeva)
• Sertraline (Zoloft)
• Escitalopram (Lexapr)
selective
serotonin
reuptake
(SSRIs)

39. • Individual psychotherapy
• Cognitive behavior therapy
(CBT)
• Cognitive enhancement
therapy (CET)-Remediation
Types of
Psychotherapy

40. • Social skills training
• Rehabilitation
• Family education
• Self-help groups
• Coordinated specialty care
• Assertive community treatment
• Social recovery therapy
Types of
Psychosocial
Therapy

41. • Schizophrenia causes psychosis and is
associated with considerable disability
and may affect all areas of life
including personal, family, social,
educational, and occupational
functioning.
• Stigma, discrimination, and violation of
human rights of people with
schizophrenia are common.
• More than two out of three people
with psychosis in the world do not
receive specialist mental health care.
• A range of effective care options for
people with schizophrenia exist and at
least one in three people with
schizophrenia will be able to fully
recover.
disclosure of information

43. A.SANKARA NARAYANAN ,MA(PSY),
PSYCHOLOGIST,
SIVA COUNSELING CLINIC,
ANNAPOORNA HOTEL OPPOSITE,
PALAI MARKET,
TIRUNELVELI
MOBILE NO : 8122282429
E-MAIL : rsasankar@gmail.com