Schizophrenia
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Presentation reviewing key features of schizophrenia, causal theories, clinical course and presentation, treatments and outcomes.
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Schizophrenia
- 1. Lisa Scharff-Abnormal Psychology (PSY 345)-Spring 2015-University of Alaska, Fairbanks
- 2. Presentation Overview • General Overview Of Disorder • Diagnosis Criteria • Subtypes • Etiology • Treatment Options • Outcomes • Summary
- 3. Schizophrenia General Overview • Neuro-Psychiatric Disease • Thought/Motor/Mood • Variety of Symptoms • positive symptoms • negative symptoms • disorganized symptoms • Subtypes • Causative Theories • Clinical Course
- 4. Symptoms • Positive • Delusions • Hallucinations • Negative • Flat Affect • Arolition (apathy) • Alogia (lack of speech) • Anhedonia (indifference) • Disorganized • Disorganized speech • Disorganized behavior (affect) • Disorganized movement • Catatonia
- 5. Diagnosis DSM V Criteria • The patient must have experienced at least 2* of the following symptoms • Delusions* • Hallucinations* • Disorganized speech* (derailment or incoherence) • Disorganized or catatonic behavior • Negative symptoms • Continuous signs for at least 6 months and least 1 month of active symptoms • Social or occupational deterioration problems not be attributable to another condition.
- 6. Subtypes •Paranoid • Persecutory • Suspicious •Disorganized (Hebephrenic) • Thought blocking/Derailment • Immaturity •Catatonic • Immobility • Pacing
- 7. “Other” Psychotic Disorders •Schizophreniform •Schizoaffective Disorder •Delusional Disorder (7 types) •Brief Psychotic Disorder •Schizotypal Personality Disorder
- 8. Causes and Analysis • Genetic – Twin and adoption studies • Environmental • Viral • Obstetric Stress • Chronic Early Cannabis Use • Neurobiological • Various NT (Dopamine, Glutamate) ??? • Brain Structure • Psychological/Social Influences • Stress • Social Environment • Gene-Environment Interaction • Stress Vulnerability Model
- 9. Clinical Course • Premorbid • Prodromal • Psychotic • Onset/Deterioration • Chronic/Stable Phase
- 10. Treatment Options •Psychopharmacology • Antipsychotics (Neuroleptics) • Mech of Action: Dopamine Antagonists •Electroconvulsive Therapy (ECT) •Therapy and Counseling •Integrative Approach
- 11. Stats and Outcomes • Age of Onset • General Population • Gender • Race • Socioeconomic • Life Expectancy • Chronic Course • Relapse Common • Suicide and Accidental Death
- 12. Summary
- 13. References • Atypical Psychotics. http://psychcentral.com/lib/atypical- antipsychotics-for-schizophrenia/0001422, Retrieved 10 Apr. 2015 • Barlow, D., & Durand, V. (2015). Abnormal psychology: An integrative approach (3rd ed.). Belmont, CA: Wadsworth/Thomson Learning. • Boundless. “Explaining Schizophrenia.” Boundless Psychology. Boundless, 03 Jul. 2014. Retrieved 12 Apr. 2015 • Brian Charnley. http://www.bryancharnley.info/index.htmRetrieved 10 Apr. 2015 • Diagnostic and Statistical Manual of Mental Disorders: DSM-5. (5th ed.). (2013). Washington, D.C.: American Psychiatric Association. • Schizophrenic Art. http://www.viralnova.com/schizophrenic- art/Retrieved 07 Apr. 2015
Editor's Notes
- Bryan Charnley Bryan Charnley was an artist whose work vividly portrays the effects of schizophrenia. Bryan Charnley intended his work to show the common humanity of the sufferer and how the artist can transform the most negative situations into the basis for creative inspiration. Bryan Charnley was born on 20th September 1949 in Stockton on Tees. With his twin brother he grew up in London, Chiselhurst in Kent, Cranfield, where his father worked as a Senior Lecturer and finally in Bromham in Bedford. In 1967, aged 17 he suffered a nervous breakdown but was able to study at Leicester School of Art in 1968. He gained as place at Central School of Art and Design in Holborn, London in 1969 but was unable to complete the course due to another breakdown later diagnosed as acute schizophrenia. From 1971 until 1977 he lived at home with his parents between periods of hospitalisation and treatment including ECT. In 1978 he moved to Bedford and began painting. The first paintings were representational works including large flower paintings. From 1982 onwards his work began to address his inner life, dreams and mental states particularly the nature of schizophrenia. In 1984 four of his paintings were purchased by the Bethlem Royal Hospital for their permanent collection. He had a solo exhibition at the Dryden Street Gallery, Covent Garden in London 1989 and exhibited two paintings at the Visions exhibition at the Royal College of Art in 1990. However the little recognition he received was outweighed by the day to day problems of his illness and the heavy medication he was prescribed to counter it. His final work, The Self Portrait Serieswas painted as he experimented with varying dosages of medication. The 17 portraits show graphically the terrible suffering of mental illness. In July 1991 Bryan Charnley commttited suicide. Subsequently the Self Portrait Series was exhibited at the National Portrait Gallery in 1992 and the paintings are now at the Prince of Wales International Centre for SANE research in Oxford. 18th May l991 From 10th May I had cut down to one anti-depressant (tryptisol) and so was not sleeping so much. My mind seemed to be thought broadcasting very severely and it was beyond my will to do anything about it. I summed this up by painting my brain as an enormous mouth, acting independently of me. The trouble seemed to me rightly or wrongly, to stem from a broken heart on my left so I painted a great mass of gore there to express this. The foot that connects to this is pushing the mouth open for the thoughts to be broadcasted. I feel I am always divided against my self by myself. Again the nail in the mouth expresses my social ineptitude and an in ability to socialise which makes me a target. Still I feel I am giving off strong personality vibrations, hence the wavy lines emanating from my head.
- This piece captures the auditory hallucinations associated with the disease. Positive-obvious signs of psychosis Negative-absence of normal behavior (often vague or transient) Schizophrenia is a severe neuro-psychiatric disease that affects approximately 1% of the world's population. It is characterized by a wide variety of symptoms that include positive symptoms, such as hallucinations and delusions, and negative symptoms, such as lack of emotion or motor control. While many factors have been associated with developing schizophrenia, including genetics, early environment, neurobiology, and psychological and social processes, the exact cause of the disease is unknown . Source: Boundless. “Explaining Schizophrenia.” Boundless Psychology. Boundless, 03 Jul. 2014. Retrieved 12 Apr. 2015 from https://www.boundless.com/psychology/textbooks/boundless-psychology-textbook/psychological-disorders-18/schizophrenia-94/explaining-schizophrenia-359-12894/
- To The Farm 1986 Delusion; Disorder of thought Hallucinations; Sensory events without input from surrounding envinment
- This piece, entitled "Motifs of Mania," depicts schizophrenia as a shadowy menace. Pg 481
- Charney; Madness and Creativity. A syringe is stuck into the base of the cross supporting the two straitjackets. 1990 Removed from DSM-5 and no longer used Patients move in and out of these and they exist more as symptoms than categories of static classification
- May 1991-suicide in July “I really tire of having to explain my paintings. It is very much my tragedy that people cannot understand the straight forward poetic use of symbols I am employing”; “I continued my retreat from social contact.” Delusional Disorder subtypes Erotomanic type Grandious type Jealous Type Persecutory Type
- Charnley 1985 Dopamine; A neurotransmitter associated with movement, attention, learning, and the brain's pleasure and reward system. Europe better for studies due to socialized medicine – better availability of date he vulnerability-stress-coping model provides “framework for understanding of interrelationship of causes” In schizophrenia, vulnerability may include genetic predisposition, birthing complications, and CNS viral infections. Stressful life events (e.g. being fired from work, terminating a relationship, or moving to a foreign environment) and biological stressors (e.g. substance abuse) may exacerbate the illness by triggering the emergence or reoccurrence of symptoms
- A series of paintings of cats by Louis Wain from the early 1900's. They capture a slow descent into varying levels of schizophrenic episodes.
- "Electricity Makes You Float" by Karen Blair, a woman living with schizophrenia. Integrative Approach Pharmacological Intervention Community Support Family Education and Support Supportive Employment Illness Management Skills Duel Diagnosis treatment
- Painted in the summer before Bryan went to art college in Leicester. 1968 Lifetime prev 1% Men higher risk Older + less rick for men But More women than men later in life (after 40) Women better outcomes
- This drawing was found in an old asylum, its artist was a paranoid schizophrenic. Russell Crowe
- Bryan painted this image after his breakdown in the summer before going to art college.
- Charney 1949-1991 41 yrs. old