Schizophrenia Schizophrenia is not multiple personality Sense of reality does not remain intact in schizophrenia It is a severe character disorder that is highlighted by decreased functioning in some cases hallucinating and delusions movement disorders cognitive problems Diagnoses may be based on country of origin In the U S symptoms that lead to a diagnosis need to be present for a month in Europe 6 months Anywhere from 7 1 3 is schizophrenic depending on what you read About 1 is a typical average It occurs in all races ethnicities SES levels It is diagnosed more in the poor It is rare in the tropics more prevalent in Northern climates It may be more prevalent in males it s typically more severe in males and diagnosed a little earlier Early 20s vs late 20s compared to females Schizophrenia is characterized by positive and negative and cognitive symptoms Positive symptoms are manifested by the presence of abnormal behaviors Positive symptoms fall into two clusters The first is the psychotic cluster and this cluster includes hallucinations and delusions The hallucinations are typically auditory and if one sticks a schizophrenic individual into an MRI during a hallucination auditory cortex shows activity Second cluster is a disorganized cluster That can include anything from incoherent speech to bizarre behaviors to thought disorders to inappropriate emotions The negative symptoms are manifested by the absence of normal behaviors Deficits in social interactions deficits in affective speech These negative symptoms tend to be more stable over time and are less responsive to medications Cognitive symptoms are characterized by limitations in thought and reasoning They tend to be very literal cannot think abstractly Working memory problems Different types of schizophrenia Categorized as disorganized schizophrenic These are individuals that exhibit very confused behaviors incoherent speech inappropriate affect Another category is a catatonic schizophrenic They will exhibit wax behavior if one would raise an individual s arm they would hold that arm up for hours and hours just like a wax figure Finally is a paranoid schizophrenic They have delusions and hallucinations delusions tend to involve issues of control delusions of grandeur delusions of persecution They are only dangerous if they have a delusion of persecution and they think you are the one persecuting them otherwise you re fine Schizophrenia can be either chronic or acute 3 phases Prodromal phase Start to see social withdrawal Active phase acute symptoms appear Finally residual phase some recovery functions Some 10 of schizophrenics remain in the residual phase About 65 alternate between the residual and active phases And other 25 recover completely and never suffer from schizophrenia again When it comes to causes of schizophrenia there very likely is not a single schizophrenia and has a number of different causes People have been arguing for years with compelling evidence for a genetic component Twin studies back this up and adoption studies as well Like most things there has not been a single gene or genes identified there are a few suspects There is one theory neuro developmental hypothesis of schizophrenia That theory really states that schizophrenia is due to abnormalities in either pre or neonatal development of the nervous system These abnormalities will lead to later problems Subtle brain differences and behavioral differences as a result of these abnormalities Given the neuro developmental hypothesis it s possible that very stressful environments may exacerbate these abnormalities in a nurturing environment that it will prevent these things from being expressed The neuro developmental hypothesis makes sense for lots of reasons It is the case that there are several disorders that have a negative effect on CNS development neo natally that do result in a diagnosis of schizophrenia later in life Many people with schizophrenia have had those abnormalities since they were infants or children But that s when this information is available It is the case that one can see in some individuals subtle differences when they were children less affect in their facial expressions and do present with some abnormal movements But there s no particular behavior marker that one can pinpoint Prefrontal cortex is involved in schizophrenia And it s not developed until 20s which is when schizophrenia is diagnosed As far as difficulties in development it is the case that one does see diagnoses of schizophrenia following difficult hard births Which involves excessive maternal bleeding prolonged labor and low birth weight All these may be associated with difficulties in development Something else one sees in schizophrenics is the season of birth among them More schizophrenics are born in late winter and early spring than any other time of the year Isn t seen in tropic areas without seasonal changes Thought is that mother is infected with a virus in the second trimester Part of pregnancy one sees a lot of neural development So viral infection of mother at that point could have a very negative effect on brain development Virus may not cross placental barrier But immune response will and can affect fetal development If the mother has a fever that will slow the division of fetal neurons if fever reaches 103 it kills When a woman is pregnant she shouldn t change a cat litter box Many schizophrenics had cats when they were kids Schizophrenia is listed as a psychiatric disorder Neurologically these individuals look brain damaged in many cases Many problems in the brain One can see prefrontal temporal hippocampal amygdala size decreases Fewer neurons and or dendrites Enlarged ventricles is a hallmark of schizophrenia These difficulties are seen in left hemisphere less activity Neurons cell bodies are smaller Number of synapses is less Glial cell development isn t complete Drugs that have been developed to treat schizophrenia have gotten better over the years First major breakthrough in drug treatment occurred in 50s Developed originally as an antihistamine called chlorpromazine Drugs that are used to treat schizophrenia are referred to as antipsychotic meds or neuroleptics They are dopamine antagonists The earlier ones fell into two chemical classes phenothiazines and butyrophenones There is the dopamine theory of schizophrenia Idea is that schizophrenia is due to an excess of dopamine activity Many drugs that are dopamine agonists induce psychosis many