PSYB32H3 Study Guide - Psychosis, Cannabis Use Disorder, Comorbidity
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Chapter 11 – Schizophrenia
- Diagnosis for schizophrenia has existed for over a century and spawned more research than any other
- Schizophrenia is a psychotic disorder characterized by major disturbances in thought, emotion, and
behavior: disordered thinking in which ideas are not logically related, faulty perception and attention, flat
or inappropriate affect, and bizarre disturbances in motor activities.
- People with schizophrenia withdraw from other people and reality, often into a fantasy life of delusions
- 0.2%-2% prevalence in the general population; lifetime prevalence is 1%
- There may be real variation in schizophrenia across geographical regions around the world, Asian
populations having the lowest prevalence rates.
- Incidence is higher in males than in females.
- Can sometimes begin in childhood, but usually in late adolescence or early adulthood; somewhat earlier
for men than women.
- People with schizophrenia usually have a number of acute episodes of their symptoms and between
these episodes; they have less severe but still very debilitating symptoms.
- Usually treated in the community, but sometimes hospitalization is necessary.
- About 10% of schizophrenics commit suicide.
- The chronic disability can be attributed to symptoms inherent to schizophrenia, as well as the comorbid
disorder from which approximately 50% of those with schizophrenia suffer from.
- Early treatment adaptations in case of early non-remission are mandatory.
Schizophrenia and Comorbidity
- Comorbid conditions appear to play a role in the development, severity, and course of schizophrenia.
- Comorbid personality disorders are common and have implications for the course and clinical
management of schizophrenia, and treatment should include evaluation of co-occurring substance use
disorders & attention to associated mood & anxiety syndrome may be important for optimal outcomes.
- Comorbid substance abuse is a major problem for people with schizophrenia.
- In a study, 40% of the patients suffering from schizophrenia were also depressed relative to a non-
depressed group, were more likely to use relapse-related mental health services; to be a safety concern;
to have substance-related problems; and to report poorer life satisfaction, quality of life, mental
functioning, family relationships, and medication adherence.
- OCD and PTSD are also comorbid (PTSD for veterans with schizophrenia).
- Prospectively identified prodromal individuals (developing phase of schizophrenia) experience a wide
variety of comorbid psychiatric syndromes, especially MDD and cannabis dependence; cannabis use may
be causal in terms of subsequent psychotic symptoms.
Clinical Symptoms of Schizophrenia (353)
- Symptoms involve disturbances in several major areas: thought, perception, and attention; motor
behavior; affect or emotion; and life functioning.
- Schizophrenia is a very heterogeneous disorder, more so than many other disorders.
- Two main categories of symptoms: Positive and negative. There are also symptoms that do not fit neatly
into these two categories.
Positive Symptoms (353)
- Comprise excess or distortions, such as disorganized speech, hallucinations, and delusions. They are
what define, for the most part, an acute episode of schizophrenia. They are the presence of too much of a
behavior that is not apparent in most people.
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