SCHIZOPHRENIA

PRESENTED BY: 
ARWA NABEEL,  ASFAHAN A. ALVI,  LAAIBAH  WAQAR,  USWAH SAFDAR,  TAIMOOR,  EMAAN SALAHUDDIN,  MARIAM ZAHID 
 • Schizophrenia is a chronic and severe
mental disorder that affects how a person
thinks, feels, and behaves.
• It was first described in 1896 by Emil
Kraepelin, who called it “Dementia
INTRODUCTION Praecox”.

& H I S TO RY • In 1908, Eugen Bleuler coined the term

“Schizophrenia," which is the term that is
used today.
• Schizophrenia was first recognized in the
DSM-3, published in 1980 and ICD-10,
published in 1992.
 Diagnosis of schizophrenia requires the
presence of at least two of the following
symptoms for a significant portion of time :
• Delusions
• Hallucinations
DIAGNOSIS OF
SCHIZOPHRENIA IN • Disorganized Speech
THE LIGHT OF • Grossly Disorganized or Catatonic Behavior
DSM-V TR
• Negative Symptoms

The symptoms must also persist for at least six

months, with at least one month of active
symptoms.
Disorder  Duration  Symptoms

Schizophrenia Continuous signs of Delusions, hallucinations, disorganized speech, disorganized

disturbance persist least 6 or catatonic behavior, negative symptoms
months

Delusion disorder Symptoms present for 1 Apart from the impact of the delusion(s) or its ramifications,
month or longer functioning is not markedly impaired, and behavior is not obviously
bizarre or odd.

Schizophreniform At least 1 month but less than 6 Delusions, hallucinations, disorganized speech, disorganized

Disorder months(significant portion of time) or catatonic behavior, negative symptoms

Schizoaffective Disorder At least 2 weeks Delusions, hallucinations, disorganized speech or behavior,

mood disorder symptoms

Brief Psychotic Disorder At least 1 day, not more than 1 month. Delusions, hallucinations, disorganized speech or behavior
Subject returns to premorbid levels after 1
month maximum.

Substance/Medication- Variable Delusions, hallucinations, disorganized speech or behavior

Induced Psychotic
Disorder
Psychotic Disorder Due Variable Delusions, hallucinations, disorganized speech or behavior
to Another Medical
Condition
 SYMPTOMS OF SCHIZOPHRENIA

Positive symptoms Negative symptoms

Delusions Diminished emotional expression

Hallucinations Avolition
Disorganized Thinking & Speech Anhedonia
Grossly Disorganized or Catatonic Behavior Alogia
Ideas of References & Grandiosity Social withdrawal
 ETIOLOGY
There are many explanations for Schizophrenia, however, the biological explanation has received the most research support. 

Behavior Genetics Research

Molecular Genetics Research

Biological
Genetic Factors 
Explanation
The Role of Neurotransmitters

Behavior Genetics Research

Family Studies Identical Twins Adoption Studies 

• The closer the genetic • Twins (MZ) are at a risk • Elevated risk of
relation to the person of 44% individuals with a
with Schizophrenia, the • Twins (DZ) are at a risk biological parent with
higher the risk.  of 12% schizophrenia.
• Negative symptoms may • Non-
have stronger genetic schizophrenic parental
component.  environment did not
eliminate heightened
risk. 
 Association study: Occurrence of a particular gene in association with a
particular phenotype
• Four genes
1. DTNBPI: encodes a neuronal protein. Also called as schizophrenia-
susceptibility gene.
2. NGRI: linked with neurotransmitter glutamate’s NMDA- process of
myelination
MOLECULAR 3. COMT: linked with executive functions performed by the prefrontal
GENETIC cortex
4. BDNF: polymorphic gene linked with the cognitive functions
RESEARCH • GWAS

Genome-wide association studies – find rare mutations that are associated with
schizophrenia such as CNV.
• Rare
• Very few people with these mutations have schizophrenia
• They are not just specific to schizophrenia

Are these genome studies useless?

 Dopamine Theory​
THE ROLE OF 
NEURO-
Antipsychotic drugs
Schizophrenia excess Hyper-dopamine TRANSMITTERS
of dopamine activity associated
inhibit D2 receptors-
receptors/ with positive
dopamine activity is
oversensitive symptoms
reduced
dopamine receptors of schizophrenia

Less or no influence
Mesolimbic pathways Mesocortical pathway
on negative symptoms
 OTHER
NEUROTRANSMITTERS
Glutamate:
Serotonin: 
Widespread neurotransmiter in
Regulate dopamine neurons in
the mesolimbic pathway  the human brain that is involved
in various neural processes

Dysregulation of these neurotransmitters can impact dopamine activity and

disrupt neural communication.
 BRAIN The Prefrontal Cortex
Speech, Decision Making, Goal Directed Behavior
STRUCTURE & • MRI studies indicate a significant reduction in gray matter
FUNCTION • Low glucose metabolic rate is observed
• Loss of “Dendritic Spines”
• Loss of communication between neurons > disconnection syndrome
• Speech & Behavioral Disorganization

The Temporal Cortex & Surrounding Areas

• Reduced hippocampus
• Related people also have a smaller hippocampus
• HPA axis is closely connected to this area
• Stress is associated with low hippocampus volume
BRAIN STRUCTURE &
FUNCTION
Enlargement of the Ventricles
MRI studies of MZ twins (one had schizophrenia, one did
not)
• Consequences:
• Impaired performance on neuropsychological test
• Poor functioning prior to the onset of the disorder
E N V I R O N M E N TA L FA C T O R S I N F L U E N C I N G
THE DEVELOPING BRAIN

•Damage to the brain during gestation or birth > Loss of cortical gray matter
•Maternal infections during pregnancy

“If the development of the brains of people with schizophrenia goes awry very early, why does the
disorder begin many years later?”
 • People with schizophrenia do not
appear to experience more stress in
daily life than people without
schizophrenia (Phillips, Francey,
Edwards, et al. , 2007; Walker et
PSYCHOLOGICAL al. , 2008).
FA C T O R S A N D
• Research on psychological factors in
SOCIOECONOMIC the development and relapse of
S T AT U S schizophrenia has focused on
socioeconomic status and family.
• The correlation between Socio
Economic Status and schizophrenia is
consistent.
 • Early theories blamed families,
particularly mothers, for causing
schizophrenia.
F A M I L Y- R E L AT E D
• Genetic predisposition and a noxious
AND
family environment are necessary to
D E V E L O P M E N TA L increase risk for psychopathology.
FA C T O R S • Expressed Emotions (EE) in families.
• Retrospective Studies and Prospective
Studies.
 SCHIZOPHRENIA MEDICAL AND
P S Y C H O L O G I C A L T R E AT M E N T

Medical treatment for Schizophrenia

• Antipsychotics are prescribed to treat delusions and hallucinations.

(Seeing or hearing things that are not there).

• Most antipsychotic drugs are tablets, cases or fluid required consistently. Some antipsychotic drugs are
accessible as an infusion.
• Antipsychotic drugs do not cause any addiction. Amesulpride, olanzapine, quetiapine, and risperidone
are all examples of antipsychotic medications.
 CBT (Cognitive Behavior Therapy)

ECT (Electroconvulsive Therapy)

Family therapy
PSYCHOLOGICAL Social Skills Training
T R E AT M E N T F O R
Cognitive remediation therapies
SCHIZOPHRENIA
Case Management

Psychoeducation

Residential Treatment
THANK YOU

QUESTIONS?
 REFERENCES
• American Psychiatric Association. (2022). DSM-5-TR(tm) classification. American Psychiatric Publishing.
• Kring, A. M., Johnson, S. L., Davison, G. C., & Neale, J. M. (2012). Abnormal psychology. Wiley.
• Rhesus Medicine. (2022, August 15). Schizophrenia Explained (Includes DSM-5 Criteria & Delusion Examples) [Video].
YouTube. https://www.youtube.com/watch?v=0zHU6fiM2KY
• Sandy. (2022, February 14). Schizophrenia. NeuRA Library. 
https://library.neura.edu.au/schizophrenia/diagnosis-and-assessment/schizophrenia-3/index.html#:~:text=Both%20the%20
DSM%20and%20ICD,over%20a%20one%2Dmonth%20period
• Schizophrenia. (n.d.). National Institute of Mental Health (NIMH). https://www.nimh.nih.gov/health/topics/schizophrenia
• Vithal Panday, M.D. (2022, May 11). Schizophrenia | DSM-5 Diagnostic Criteria [Video].
YouTube. https://www.youtube.com/watch?v=eQX4CHj6aTM
• What treatments are there for schizophrenia? (n.d.). Mind. https://www.mind.org.uk/information-support/types-of-mental-
health-problems/schizophrenia/treatment/