Training Program

In
Clinical Psychology
 Day 9
Psychopathology 6
 SCHIZOPHRENIA
Schizophrenia occurs in people from all
cultures and from all walks of life. The
disorder is characterized by an array of
diverse symptoms, including extreme oddities
in perception, thinking, action, sense of self,
and manner of relating to others.

However, the hallmark of schizophrenia is a

significant loss of contact with reality, referred
to as psychosis. Although the clinical
presentation of schizophrenia differs from one
patient to another.
HISTORY
German psychiatrist Emil Kraepelin (1856–1926) who is best known for his careful description of what
we now regard as schizophrenia.

It was a Swiss psychiatrist named Eugen Bleuler (1857– 1939) who gave us the diagnostic term we still use
today. In 1911, Bleuler used schizophrenia (from the Greek roots of sxizo, pronounced “schizo” and meaning
“to split or crack,” and phren, meaning “mind”) because he believed the condition was characterized
primarily by disorganization of thought processes, a lack of coherence between thought and emotion, and an
inward orientation away (split off) from reality.

What’s it like to live with Schizophrenia?

https://www.youtube.com/watch?v=EvN7R1oRuOI
CLINICAL PICTURE

Positive Symptoms:

● Hallucinations

● Delusions
Negative Symptoms:
● Emotional flattening

● Poverty of speech

● Asociality

● Apathy

● Anhedonia

Disorganized Symptoms:
● Bizarre behavior

● Disorganized speech
Five Types of Schizophrenia
(not used anymore)
 CAUSES
Genetic Factors

Prenatal Exposures

- Early Nutritional Deficiency

- Maternal Stress & Illness

- Pregnancy and Birth Complications

A Neurodevelopmental Perspective Current thinking is that schizophrenia is a disorder in which the development of
the brain is disturbed very early on. Risk for schizophrenia may start with the presence of certain genes that, if turned
on, have the potential to disrupt the normal development of the nervous system.
Structural and Functional Brain Abnormalities
 TREATMENT
1. Pharmacology - Antipsychotics
and other medications as per the
cases.

2. Psychotherapy - Family
Therapy, Social-Skills Training,
Case Management,
Cognitive-Behavioral Therapy.
 Case Discussion
An adult male who was seen at a psychiatric unit complained of hearing voices for the past 10 months and loss of appetite. He also
complained that he roamed around town, and even though he returned home, he was sometimes physically abusive to his mother
and sister. The patient further added that he felt unsafe and thought that people wanted to harm him.
His social history revealed that he lived in the city with his mother and sister. He had a girlfriend who stayed at a different suburb
of the city. His past medical history included a history of paranoid delusions. There was no family history of mental or physical
illness. He had a premorbid personality of being introvert.
Symptoms: The patient experienced auditory hallucinations. He complained of hearing voices and engaged in third person
conversations involving both a man and a woman. The patient also complained that he heard people talking about him and
insulting him, some of whom he knew. He was therefore suspicious and felt uneasy with others. As a result, the patient said that he
had been spending the night with a friend and refused to return to his parents’ house because he was not safe there. He believed
that he had been targeted. The patient’s sister said he often complained that people wanted to harm him and as such felt unsafe.
She also added that he often complained of receiving death threats through phone calls from an unfamiliar telephone number.
Case Discussion
James, 22 year old client is being discharged from his first hospital admission with schizophrenia to
the home; he shares with his father and his two sisters. Mark has been alienated from his mother
since his parents’ divorce when he was 17 years old.

Mark’s mother has failed to show up for the discharge conference. The mental health team has
recommended family therapy to the James family. You perceive what you think is annoyance on Mr.
James’s face, and one of Mark’s sisters appears embarrassed. Although you would not be the James
family therapist because you are not a clinical specialize, you recognize how important Mark’s
family can be to his progress.

What actions can you take to address the family's unspoken concerns and needs?
Any Questions ???