Schizophrenia
Presentation by A.J. Littleton
Definition
Schizophrenia is characterized by profound disruption in cognition and emotion, affecting the most fundamental human attributes: language, thought, perception, affect, and sense of self. The array of symptoms, while wide ranging, frequently includes psychotic manifestations, such as hearing internal voices or experiencing other sensations not connected to an obvious source (hallucinations) and assigning unusual significance or meaning to normal events or holding fixed false personal beliefs (delusions). No single symptom is definitive for diagnosis; rather, the diagnosis encompasses a pattern of signs and symptoms, in conjunction with impaired occupational or social functioning.
Prevalence
The prevalence rate for schizophrenia is approximately 1.1% of the population over the age of 18 or, in other words, at any one time as many as 51 million people worldwide suffer from schizophrenia, including;
– 6 to 12 million people in China (a rough estimate based on the population) – 4.3 to 8.7 million people in India (a rough estimate based on the population) – 2.2 million people in USA – 285,000 people in Australia – Over 280,000 people in Canada – Over 250,000 diagnosed cases in Britain
Prevalence Cont.
Rates of schizophrenia are generally similar from country to country—about .5% to 1 percent of the population (there are variations - but the variance is difficult to track due to differing measuring standards in many countries, etc.) Another way to express the prevalence of schizophrenia at any give time is the number of individuals affected per 1,000 total population. In the United States that figure is 7.2 per 1,000. This means that a city of 3 million people will have over 21,000 individuals suffering from schizophrenia.
Incidence
The number of people who will be diagnosed as having schizophrenia in a year is about one in 4,000. So about 1.5 million people will be diagnosed with schizophrenia this year, worldwide. About 100,000 people in the United States will be diagnosed with schizophrenia this year Schizophrenia is a disease that typically begins in early adulthood; between the ages of 15 and 25. Men tend to get develop schizophrenia slightly earlier than women; whereas most males become ill between 16 and 25 years old, most females develop symptoms several years later, and the incidence in women is noticeably higher in women after age 30.
Incidence Cont.
The average age of onset is 18 in men and 25 in women. Schizophrenia onset is quite rare for people under 10 years of age, or over 40 years of age. The diagram demonstrates the general "age of onset" trends for schizophrenia in men and women, from a representative study on the topic.
Incidence Cont.
The diagram below represents the differences in needs for hospitalizations, at different ages, for men and women who have schizophrenia. As shown in the diagram, schizophrenia tends to hit younger males hardest, with a much higher rate of hospitalization required between the ages of 15 and 40.
Causes
Like many other illnesses, schizophrenia is believed to result from a combination of environmental and genetic factors. All the tools of modern science are being used to search for the causes of this disorder.
Genetic Factors
Scientists have long known that schizophrenia runs in families. It occurs in 1 percent of the general population but is seen in 10 percent of people with a first-degree relative (a parent, brother, or sister) with the disorder. People who have second-degree relatives (aunts, uncles, grandparents, or cousins) with the disease also develop schizophrenia more often than the general population. The identical twin of a person with schizophrenia is most at risk, with a 40 to 65 percent chance of developing the disorder.
Environmental Factors
Exposure to viruses or malnutrition in the womb Problems during birth Psychosocial factors; like stressful environmental conditions.
Other Physical Causes
An imbalance in the chemical reactions of the brain involving the neurotransmitters dopamine and glutamate and others play a role in schizophrenia. The fluid-filled cavities at the center of the brain, called ventricles, are larger in people with schizophrenia. Some areas of the brain have less or more metabolic activity. A theory states that problems during brain development can lead to faulty connections that lie dormant until puberty.
Symptoms
Positive symptoms are unusual thoughts or perceptions, including hallucinations, delusions, thought disorder, and disorders of movement. Negative symptoms represent a loss or a decrease in the ability to initiate plans, speak, express emotion, or find pleasure in everyday life. These symptoms are harder to recognize as part of the disorder and can be mistaken for laziness or depression. Cognitive symptoms (or cognitive deficits) are problems with attention, certain types of memory, and the executive functions that allow us to plan and organize. Cognitive deficits can also be difficult to recognize as part of the disorder but are the most disabling in terms of leading a normal life.
Positive Symptoms
Hallucinations: A hallucination is something a person sees, hears, smells, or feels that no one else can see, hear, smell, or feel. Delusions: Delusions are false personal beliefs that are not part of the person's culture and do not change, even when other people present proof that the beliefs are not true or logical
Positive Symptoms Cont.
Thought Disorder: People with schizophrenia often have unusual thought processes. Disorders of Movement: People with schizophrenia can be clumsy and uncoordinated. They may also exhibit involuntary movements and may grimace or exhibit unusual mannerisms.
Treatment
medication. Psychosocial treatment.
Antipsychotic
Antipsychotic Medication
Have been available since the mid-1950s. Alleviate the positive symptoms of schizophrenia. These drugs have greatly improved the lives of many patients, they do not cure schizophrenia.
Psychosocial Treatment
Illness Management Skills. Integrated Treatment for Co-occurring Substance Abuse. Rehabilitation. Family Education. Cognitive Behavioral Therapy. Self-Help Groups.