Schizophrenia精神分裂症.ppt

Copyright 2005 John Wiley Sons, NY Chapter 11 Schizophrenia Schizophrenia精神分裂症 One of the psychotic disorders Major disturbances in: Thought Emotion Behavior Disordered thinking Faulty perception and attention Inappropriate or flat emotions Bizarre motor activity Disrupted interpersonal relationships Schizophrenia Disorder impacts families friends Difficult to live with someone who experiences delusions, hallucinations, and paranoia. Social skills deficits common Isolation, few social contacts Symptoms impact employability Often lead to unemployment homelessness Substance abuse suicide rates high Schizophrenia Lifetime prevalence ~1% Occurs equally in men and women Onset typically late adolescence or early adulthood Men diagnosed at a slightly earlier age Diagnosed more frequently in African Americans May reflect diagnostician bias Comorbidity: substance abuse Clinical Description of Schizophrenia No single essential symptom Heterogeneity of symptoms across patients Positive negative symptoms ? positive , disorganized negative symptoms Positive Symptoms: excesses distortions Delusions Firmly beliefs held contrary to reality Resistant to disconfirming evidence Persecutory delusions common : 65% Hallucinations Sensory experiences in the absence of sensory stimulation from the environment More often auditory (74%) than visual Patients misattribute their own voice as being someone else’s voice Increased levels of activity in Broca’s area during hallucinations problem in the connections between the frontal lobe areas ( the production of speech) and the temporal lobe areas (the understanding of speech) Negative Symptoms: Behavioral deficits These symptoms tend to endure beyond an acute episode Avolition Lack of interest and drive Alogia Poverty of speech Poverty of content Anhendonia Inability to experience pleasure Flat affect: 66% Exhibits little or no affect in face or voice Asociality Inability to form close personal relationships Beginning in childhood