Schizophrenia o Residual type Absence of key symptoms organized thoughts no delusions or hallucinations But they have evidence of the disorder blunted emotionally lacking motivation withdrawn isolated negative symptoms Unusual because no signs of it until later in life adulthood Glial cells and dopamine are involved dopamine antagonist reduces Genetic risk of schizophrenia if a family member has it o What causes it Primarily a brain disorder Genetic contributions Anatomical abnormalities schizophrenia o Genes Especially in identical twins 45 Fraternal twin 12 Sibling 10 Lower than bipolar disorder o Environmental factors Stress can be early on schizovirus a virus that increases the risk of a child developing schizophrenia if the pregnant mother has it earlysplitting monozygotic twins Latesplitting monozygotic twins have a higher chance of correlation than Adopted children in healthy vs disturbed families Healthy none psychotic Disturbed some did become psychotic Urban environment higher risk of schizophrenia perhaps more stressful noisy etc perhaps higher risk of schizovirus Higher risk of schizophrenia if born in late winter early spring We don t know what causes what gene dopamine dysfunction or other way o Dopamine Some sort of dysfunction around A dopamine antagonist blocks the receptor o The ventricle story schizophrenia less tissue o Video on woman talking about schizophrenia the brain Marian Krauss schizophrenic Firefighter in the navy Then started having paranoid delusions Looking at brain structure larger ventricles in monozygotic twins that have They think early damage to brain may cause schizophrenia The frontal lobe and the hippocampus are abnormal Comparing experiences to the past doesn t function correctly in schizophrenics An abnormal hippocampus may cause disorder in the frontal lobe Tested this by damaging the hippocampi of rats o Similar results as in humans Different from bipolar disorder people with schizophrenia feel like their brain is disintegrating Lose memory based framework Seem like they re a different person o Hippocampus Perhaps the neurons are disorganized The way they link things together with disorganized thought is different o Sensory overload e g hearing an orchestra that s not there o Schizophrenogenic mothers The type of mothering may cause schizophrenia conditioning psychotic thinking This is probably not real o Cause of relapse Expressed emotion EE schizophrenics have a hard time processing high levels of expressed emotion from family members This predicts a relapse of schizophrenia In a study With medication and placebo medication and low EE low relapse High EE low contact w family low relapse w medication mid w placebo High EE high contact w family mid w meds high relapse w placebo o Don t know exactly what causes schizophrenia but combined liability diathesis stress model Potential causes Specific genes General genetic inheritance Environment Protective genes Etc o Medication treatment that is dramatically effective Haloperidol Haldol cheap controls hallucinations sedative effect Giving a shot effective if administered once a month then they aren t as likely to want to stop medication Chlorpromazine a pill Effective in getting people out of the hospital Sedated Control auditory hallucinations Similar symptoms to Parkinson s disease ticks had trouble with motor skills Tardive dyskinesia another side effect ticks facial spasms tongue protruding New medication Chlorpromazine old vs Clozapine Positive symptoms drop significantly with Clozapine vs a bit Negative symptoms also drop with Clozapine vs almost not at all w chlorpromazine w Chlorpromazine Unfortunately doesn t work for all patients Medication is important and works for many but not all patients with schizophrenia However family support and other treatments are important too Nothing reduces relapse to 0 but a combination of treatments reduces the risk of relapse significantly Meds 40 relapse Meds social skills 20 Meds family therapy 20 Meds social skills family therapy nearly 0 o Family therapy for schizophrenia Education it s not their fault and they can t talk their family member out of schizophrenia like their delusions it s better to just listen to them o Brain tissue actually deteriorates in people with schizophrenia though we don t know o Note all of the other disorders can happen in childhood as well but these are diseases what causes what Childhood disorders specific to children o Two common ones Autism Impaired language and social functioning Recognizable early on don t respond the same as other children E g can t maintain eye contact Sometimes limited cognitive abilities yet sometimes advanced Restrictive repetitive behaviors o Some have to wear helmets because they bang their heads against objects o Rocking behavior Symptoms o Verbal and nonverbal communication issues o Routine based difficulty with transition tantrums if there is a change o Play activities are restricted they only want to do one activity e g only watching and reading about the Titanic o Trouble with theory of mind realizing others have different Asperger s o high functioning autism thoughts than you o Trouble with social interactions Biology o 70 90 concordance in MZ twins genetic o Brain develops fast when young and then very slow when adolescent unusual Attention deficit hyperactivity disorder ADHD Impaired attention concentration hyperactive impulsive Seems biologically based Have trouble in school sitting in class and focusing Trouble with friendship because of impulsiveness More boys than girls diagnosed 11 of boys 4 of girls Increased diagnosis lately don t know if there are actually more kids or if we are requiring more attention of children now 55 concordance in monozygotic twins Perhaps issue with frontal lobe and limbic system o Video on autism Children would hit themselves nearly to death They did this because they didn t know how to communicate their thoughts Created a system of teaching Progress is reinforced and rewarded instantly The earlier this education starts the better You can essentially rewire the brain and they will be almost normal brain plasticity High intensive behavioral reinvention