13 schizophrenia and other psychotic disorders

Psychology homework help
Dissociative Disorders and Trauma
13 schizophrenia and other psychotic disorders

 

learning objectives 13

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· 13.1 What are the symptoms of schizophrenia?

· 13.2 What is the prevalence of schizophrenia and when does it begin? Who is most affected?

· 13.3 What are the risk and causal factors associated with schizophrenia?

· 13.4 How is the brain affected in schizophrenia?

· 13.5 What neurotransmitters are implicated in schizophrenia?

· 13.6 Why is the family environment important for the well-being of patients with schizophrenia?

· 13.7 What is the clinical outcome of schizophrenia and how is it treated?

Emilio: “Eating Wires and Lighting Fires” Emilio is a 40-year-old man who looks 10 years younger. He is brought to the hospital, his 12th hospitalization, by his mother because she is afraid of him. He is dressed in a ragged overcoat, bedroom slippers, and a baseball cap, and he wears several medals around his neck. His affect ranges from anger at his mother (“She feeds me shit … what comes out of other people’s rectums”) to a giggling, obsequious seductiveness toward the interviewer. His speech and manner have a childlike quality, and he walks with a mincing step and exaggerated hip movements. His mother reports that he stopped taking his medication about a month ago and has since begun to hear voices and to look and act more bizarrely. When asked what he has been doing, he says “eating wires and lighting fires.” His spontaneous speech is often incoherent and marked by frequent rhyming and clang associations (where sounds, rather than meaningful relationships, govern word choice).

Emilio’s first hospitalization occurred after he dropped out of school at age 16, and since that time he has never been able to attend school or hold a job. He has been treated with neuroleptics (medications used to treat schizophrenia) during his hospitalizations, but he doesn’t continue to take his medications when he leaves, so he quickly becomes disorganized again. He lives with his elderly mother, but he sometimes disappears for several months at a time and is eventually picked up by the police as he wanders the streets. (Modified from Spitzer et al., 2002 , pp. 189–90.)

The disorder that Emilo has is called schizophrenia. Schizophrenia is a severe disorder that is often associated with considerable impairments in functioning. This chapter describes the pieces of the schizophrenia puzzle as we currently know them. Keep in mind from the outset that not all of the pieces or their presumed interconnections have been found, so our puzzle is far from being solved. As you read through this chapter you will learn just how complex and challenging this disorder is—not only for patients who suffer from it and for their families who try to care for them, but also for the clinicians who attempt to treat it and the researchers who are determined to understand it.

Schizophrenia

Schizophrenia occurs in people from all cultures and from all walks of life. The disorder is characterized by an array of diverse symptoms, including extreme oddities in perception, thinking, action, sense of self, and manner of relating to others. However, the hallmark of schizophrenia is a significant loss of contact with reality, referred to as psychosis . Although the clinical presentation of schizophrenia differs from one patient to another, the case of Emilio is quite typical.

 

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