1. SCH
IZO
PH
R
EN
SCH
IZO
PH
R
EN
IAIA
Jacqueline
Corcoran, Ph.D.
Virginia
Com
m
onwealth
University

2. Schizophrenia
Schizophrenia
abnormal patterns of thought and
perception,
Persist for at least 6 months,
At least one month of at least 2 “active
phase” symptoms
1) Delusions
2) Hallucinations
3) Disorganized speech or disorganized
behavior
http://www.youtube.com/watch?
v=dkB2CGL769o

3. Positive: exaggerations of normal behavior.
Hallucinations: are sense perceptions of external
objects when those objects are not present
Delusions: false beliefs that a person maintains even
though overwhelmingly contradicted by social reality
disorganized thought processes
tendencies toward agitation
Negative: diminution of what would be
considered normal behavior.
flat or blunted affect (the absence of expression)
social withdrawal
non-communication
anhedonia (blandness) or passivity
ambivalence in decision-making.
SYMPTOMS OFSYMPTOMS OF
SCHIZOPHRENIASCHIZOPHRENIA

4. SCHIZOAFFECTIVE DISORDERSCHIZOAFFECTIVE DISORDER
“criterion A” symptoms for Schizophrenia –
At least 2: delusions, hallucinations, disorganized
speech, disorganized or catatonic behavior
And negative symptoms such as flat affect, poverty of
thought, anhedonia, and withdrawal
Symptoms of mood episodes must be present for a
substantial portion of the total duration of the illness.
A manic episode
A major depressive episode, or
A mixed episode
The delusions or hallucinations must persist for at
least 2
weeks in the absence of prominent mood symptoms

5. PR
EVALEN
CE
PR
EVALEN
CE
1% worldwide
1.5% U.S.

6. ComorbidityComorbidity
79.4% meet the criteria for one or more other
disorders
depression (52.6%)
anxiety disorders (62.9%)
substance abuse (26.8%)
schizophrenia is often comorbid with the
schizotypal, schizoid, and paranoid personality
disorders

7. POSSIBLE CAUSES OFPOSSIBLE CAUSES OF
SCHIZOPHRENIASCHIZOPHRENIA
Biological/Genetic Factors
Dopamine and serotonin (and probably
other neurotransmitter) activities
Enlargement of brain ventricles
Small limbic system
Brain trauma (birth complications)
Prenatal viral exposure
Older age of father
Social
Childhood physical and sexual abuse
Low SES

8. CO
UR
SE
CO
UR
SE
AN
D
AN
D
R
ECOVERY
R
ECOVERY
Chronic
Variable course depending
on risk and protective
factors
Premature death
Suicide
Lifestyle factors and risks
related to poverty

9. EFFECTS OF SCHIZOPHRENIA ON THEEFFECTS OF SCHIZOPHRENIA ON THE
FAMILYFAMILYA chronic state of emotional burden develops which is shared by all members of the family.
Common emotional reactions include:
Stress
Grief
Resentment and anger
Depression
Anxiety
Factors which influence the family’s coping well or poorly include:
Severity of the disorder (greater severity implies better coping)
The proactive seeking out of information and assistance
The ability to find time for other activities
The presence of support outside the family

10. Work on dopamine
A reduction in dopamine causes
adverse effects
 akathisia (restlessness and agitation)
 dystonia (muscle spasms)
 parkinsonism (muscle stiffness and tremor)
 tardive dyskinesia (involuntary smooth muscle
movements of the face and limbs)
Anticholinergic medications are often
prescribed to combat these effects, even
though they have their own adverse effects of
blurred vision, dry mouth, and constipation
FIRST GENERATIONFIRST GENERATION
ANTIPSYCHOTICSANTIPSYCHOTICS

11. differentially affects the dopamine receptors, as well as
having an impact on serotonin and other receptors
Risperidone
Olanzapin
may provide marginally significant benefits for
consumers in terms of clinical improvement over the
first-generation antipsychotics
small increased risk for diabetes
22NDND
GENERATIONGENERATION
ANTIPSYCHOTICSANTIPSYCHOTICS

12. Com
pliance
Com
pliance
Discontinuance
74% from
medication
No difference
between 1st
and
2nd
generation

13. PsychosocialPsychosocial
Family Psychoeducation
Case Management – not found effective except
for ACT
Crisis Management
Supported Employment

14. ACT (ASSERTIVE COMMUNITYACT (ASSERTIVE COMMUNITY
TREATMENT)TREATMENT)
 assertive engagement
 "in vivo" delivery of services
 a multidisciplinary team approach
 staff continuity over time
 low staff-to-client ratios (10 to 1), and
frequent client contacts
 In a systematic review of randomized,
controlled studies, ACT reduced hospital
readmittance rates, length of time in
hospital, and improved housing and
employment outcomes over standard
community care, although no differences
between these types of intervention were
found for mental state or social functioning
(Marshall & Lockwood, 2000)

15. CRISIS MANAGEMENTCRISIS MANAGEMENT
 involves a multidisciplinary team
offering intensive services often on a
24-hour basis
 review of randomized, controlled
studies although almost half (45%) of
the crisis/home care group were
hospitalized and no statistical
difference was found between crisis
care and hospitalization, repeat
admission was avoided and family
burden was reduced through crisis
care. Furthermore, patients and their
families found crisis care more
satisfactory.

16. SUPPORTED EMPLOYMENTSUPPORTED EMPLOYMENT
Found more effective than prevocational
programs

17. http://w
w
w
.jacquelinecorco
http://w
w
w
.jacquelinecorco
M
ental Health
in
Social W
ork: A
Casebook on
Diagnosis and
Strengths-Based
Assessm
ent. Allyn
&
Bacon. 2012.