Chapter 13Schizophrenic Disorders.ppt

Chapter 13Schizophrenic Disorders Overview Schizophrenia is a severe, progressive disorder than often starts in adolescence and generally has a poor outcome affects 1% of the population 221,000 Canadians in 1996 Canadian health care: $ billions annually Overview Similar prevalence for men and women - men are slightly higher for men onset is age 15-25 - average 21.9 for women onset is age 25-35 - average 26 71% will experience their 1st symptoms by 25 y/o Key feature: psychotic symptoms - profound disturbance in thought, reality-testing, and affect. Course of Schizophrenia Prodromal – (usually in adolescence) - decreased level of functioning, social withdrawal, peculiar behaviours, neglect hygiene, changes in emotion Active – full spectrum of psychotic symptoms - i.e., hallucinations, delusions, disorganized speech Residual –return to prodromal but may also be mild delusions/ hallucinations/ continuing negative symptoms and impairment Symptoms and Features Positive symptoms look for presence of delusions and hallucinations Hallucinations: sensory experiences not caused by external stimulus includes voices commenting on client’s behaviour or giving instruction 60% of all hallucinations are auditory Positive Symptoms Hallucinations auditory: often insulting or instructing tactile (e.g., something crawling under skin) somatic (e.g., an alien residing in the stomach) Positive Symptoms Delusions: idiosyncratic beliefs that are rigidly held despite their logical nature defended even when shown contradictory evidence person is preoccupied with the beliefs Positive Symptoms Delusions: persistent psychotic beliefs persecutory (e.g., “others are spying on me”) reference objects, people, events given personal significance (e.g., “the radio announcer is mocking me”) grandeur (e.g., “I am Jesus”) Symptoms and Features Negative symptoms look for absence: poverty of speech, thought, hygiene, movement causes social withdrawal Negative Symptoms Affective Disturb