Schizophrenia

• 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

• 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

• 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 **.

• 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

• 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

• COGNITIVE - info pro. **** 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

• 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