- FIRST RANK / POSITIVE / ACUTE / INTERNAL / WORSE
- Thought Disturbances. Insertion/Withdrawal/Broadcasting/External Forces- Auditory Hallucinations. Accusing Voices/Devil/Aliens/Government
- Delusions. Grandeur/Persecution
- SECOND RANK / NEGATIVE / CHRONIC / OUTSIDE- Thought process disorder. Derailment/Word Salad/Literally
- Mood Disturbance. Depersonalised/Flat Moods/Innapropriate Responses
- Motor Disturbance. Cataplexy/Grimacing
- Lack of Violation. Withdrawing from social contact
- No sim between two ranks..misdiag..so many diff types but all same treatment.. uh oh
Issues of classification, diagnosis, validity and
- HETEROGENOUS - really diff
- NO PHYS TESTS- personal account
- SUBJECTIVE- have to compare to 'normal' - BECK
- OVERLAP- Bipolar/Depression
- MANUALS- Diff in Diff countries - US AND UK
- RACIAL BIAS- AC 8x more likely
- MISDIAGNOSIS - innapropriate teatment, self fullfilling prophecy, side effects. ROSENHAN
Biological Explanations for Schiz
- DOPAMINE HYPOTHESIS-
- Dopamine over active in BG
-Post Mortems. Chlorpromazine. Amphetamines and L-dopa.
-But schizo's have low dopamine in FC where we need it do DH can't be whole picture!
- GLUTAMATE HYPOTHESIS-
- Low Gluta in Hippoe is cause of high dope in BG- The Medical Research Council. Yale Study- amph, ket and SS.
- VIRAL INFECTIONS-
-Long known can effect foetus 3mester. Flu cross placenta and migration of neurons.
:( REDUCTIONIST - comp to chem not psycho fact trauma.
:) REDUCTIONIST - obj scientific falsifiable
:) APPLICABLE - serious.. treatments? then QOL especially 1/3 not helped by current meds
Biological Therapies for Schiz
- OLD / TYPICAL NEUROLEPTICS AND ANTIPSYCHOTIC DRUGS
-Chlorpromazine - blocks dope D2 receptors..dope antagonist.:) alleviates pos but neg sympt worse.. :) better than strait
:( 2/3 peeps. :( tranquiliser :( side effects grimacing :( revolving door syndrome 50 and 75 %
- NEW / A-TYPICAL NEUROLEPTICS AND ANTIPSYCHOTIC DRUGS- Chlorazil - works on sero as well as dope. increases sero in PFC and works on neg syp
:) les tranq so community :) fewer side effects not so much RDS.
:( 2% patienst stop WBC :( severe weight gain
Psychological Explanations for Schiz
- COGNITIVE - info pro. Shiz bombarded, cant distinguish important and not. cant supress like normals. so Cognitive bias happens where dangerous stimuli given priority.
- THE STROOP TEST.-Benthal. -FAKE PHOTOS
- Cog for why hear voices - cant distinguish own thought and outside - DRAW PICS SCREEN
- Cog for Word Salad- MAHER.
:( DESCRIPTION- dress up CC. social/psycho better -trauma link with schiz/ Biol better too - TWIN FOETUS
:) APPLICABLE - CBT great with Meds - DRURY.
- PSYCHODYNAMIC - fixated @ oral stage purely selfih Id. Can distinguish self and non self explaining granduer and hallucinations.
-Schizophrenogenis mother- cold and rejects then needy- Double Bind -try and love but reject.
:( NO EVD for psycho sexal stages or schizophrenogen - most lovin
:( LACK APPLIC can do psycho an BC need to be warm
:) APPLICABLE - High EE Fams
Psychological Therapies for Schiz
- COGNITIVE- CBT. good for risk of first **** ep. fam intervention good. Conceptualisation - tirggers, know illness. Skills and Aq- homeworks, specific skills. Application - practise in real life. voices- hospitalised.
:( jump to conclusions :( can;t warm.
:) DRURY fab with meds - QOL :) LEFFS