Chapter 11 – Schizophrenia.docx

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Konstantine Zakzanis

Chapter 11 – Schizophrenia - Diagnosis for schizophrenia has existed for over a century and spawned more research than any other psychological problem - 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 and hallucinations. - 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 distortio
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