TOPIC 2: Schizophrenia

• BLEULER 4 A’s Schizophrenia

  • Autism
  • Ambivalence
  • Affective Disturbances
  • Associative Looseness
• Denotes the presence of grossly abnormal behavior

  Include thought disorder, delusions, & hallucinations


  ( + ) POSITIVE symptoms
• 15 to 25 years 


  The peak incidence of onset for men.
• 25 to 35 years of age 


  The peak incidence of onset for women.
• Represent the absence of normal behavior

  Flat or blunted affect (i.e lack of emotional expression), apathy, and social withdrawal.


  ( - ) NEGATIVE  symptoms
• diagnosed when the client is severely ill and has a mixture of psychotic and mood symptoms.

  Schizoaffective disorder
• Focus on genetic factors, neuroanatomic and neurochemical factors (structure and function of the brain), and immunovirology (the body’s response to exposure to a virus).

  BIOLOGIC theory
• First, drugs that increase activity in the dopaminergic system, such as amphetamine and levodopa, sometimes induce a paranoid psychotic reaction similar to schizophrenia.

  Neuroanatomic and Neurochemical Factors
• INCIDENCE

  In the Philippines, more than 60% of all mental disorders treated or being treated at the National Center for Mental Health and other psychiatric facilities.
• Weak EGO

  Use of defense mechanisms such as: Regression, Depersonalization, Projection, denial and fantasy

  Four “A” according to Bleuler


  Characteristics of Schizophrenia
• Types of Schizophrenia: Paranoid type

  None of the following is prominent:

  • Disorganized speech
  • disorganized or catatonic behavior
  • flat or inappropriate affect
• characterized by extreme suspiciousness of others and by delusions and hallucinations of a persecutory or grandiose nature.

  often tense and guarded and may be argumentative, hostile, and aggressive.

  Paranoid Schizophrenia
• manifests itself in the form of stupor (marked psychomotor retardation, mutism, waxy fl exibility [posturing], negativism, and rigidity) or excitement (extreme psychomotor agitation, leading to exhaustion or the possibility of hurting self or others if not curtailed).

  Catatonic Schizophrenia
• • Behavior is typically regressive and primitive.
  • Affect is inappropriate, with common characteristics being silliness, incongruous giggling, facial grimaces, and extreme social withdrawal.
  • Communication is consistently incoherent.

  Disorganized Schizophrenia
• is characterized by disorganized behaviors and psychotic symptoms (e.g., delusions, hallucinations, incoherence, and grossly disorganized behavior) that may appear in more than one category.

  Undifferentiated Schizophrenia
• Criteria for prognosis: Favorable prognosis

  1.    Good Socialization
  2.    Late/acute onset
  3.    Adequate support system
  4.    Family history of mood disorder
• Criteria for prognosis: Unfavorable prognosis

  1.     Poor/no socialization
  2.     Early & insidious prognosis
  3.     Few/no support system
  4.     History of chronicity/ many relapse