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Psychology

1. SCHIZOPHRENIA
BY: MEGHANA PUJARI
HERAMB MANE
ASHWANI KORI

2. INTRODUCTION
•Schizophrenia is a complex mental disorder characterized by
disturbances in thinking, perception, emotions, and behavior. It often
involves symptoms such as hallucinations, delusions, disorganized
thinking, and impaired social functioning.Historically, schizophrenia was
once believed to be a form of "split personality," but that misconception
has been debunked. The term itself, "schizophrenia," was coined by
Eugen Bleuler in 1911, derived from Greek roots meaning "split mind."
Bleuler used this term to describe the fragmentation of thought processes
and emotions seen in the disorder.Prevalence-wise, schizophrenia affects
about 1% of the global population, with rates varying across different
countries and cultures. It typically emerges in late adolescence or early
adulthood and can have a significant impact on individuals, families, and
society.
•Schizophrenia is a complex mental disorder characterized by
disturbances in thinking, perception, emotions, and behavior. It often
involves symptoms such as hallucinations, delusions, disorganized
thinking, and impaired social functioning.Historically, schizophrenia was
once believed to be a form of "split personality," but that misconception
has been debunked. The term itself, "schizophrenia," was coined by
Eugen Bleuler in 1911, derived from Greek roots meaning "split mind."
Bleuler used this term to describe the fragmentation of thought processes
and emotions seen in the disorder.Prevalence-wise, schizophrenia affects
about 1% of the global population, with rates varying across different
countries and cultures. It typically emerges in late adolescence or early
adulthood and can have a significant impact on individuals, families, and
society.

3. SYMPTOMS
Schizophrenia symptoms can be categorized into three main groups:
1.Positive Symptoms - Hallucinations: Perceiving things that aren't real, like hearing voices. - Delusions: False beliefs that are not based on reality, such as believing one has special powers or is being persecuted.
2.Negative Symptoms- Apathy: Lack of interest or enthusiasm in activities and life in general. - Social Withdrawal: Avoidance of social interactions and difficulty in forming and maintaining relationships.
3.Cognitive Symptoms - Disorganized Thinking: Thoughts may be fragmented and difficult to follow, leading to disjointed speech or behavior. - Poor Concentration: Difficulty focusing and maintaining attention, which can affect daily tasks and functionin

4. DIAGNOSIS AND
CLASSIFICATION
•1.DSM-5 Criteria- The Diagnostic and Statistical Manual of Mental
Disorders, Fifth Edition (DSM-5), is the standard classification system
used by mental health professionals to diagnose schizophrenia. - To
meet the DSM-5 criteria for schizophrenia, a person must exhibit two
or more of the following symptoms for a significant portion of time
during a one-month period (or less if successfully treated): -
Delusions - Hallucinations - Disorganized speech - Grossly
disorganized or catatonic behavior - Negative symptoms (e.g.,
diminished emotional expression, avolition) - Additionally, at least one
of these symptoms must be either delusions, hallucinations, or
disorganized speech. - The symptoms must cause significant
impairment in social, occupational, or other important areas of
functioning. - The disturbance must persist for at least six months,
with at least one month of active-phase symptoms.
•2.Differential Diagnosis- Schizophrenia must be differentiated from
other mental health disorders that share similar symptoms, such
as: - Bipolar disorder with psychotic features - Schizoaffective
disorder - Delusional disorder - Substance-induced psychotic
disorder - Psychotic disorders due to medical conditions - A
thorough assessment, including a detailed history, mental status
examination, and possibly medical tests, is essential to rule out other
potential causes of psychotic symptoms and arrive at an accurate
diagnosis.

5. CATEGORIES
•1.Paranoid Schizophrenia - Characterized by prominent delusions and
hallucinations, often with themes of persecution or grandiosity. -
Individuals with paranoid schizophrenia may retain relatively intact
cognitive functioning and may not exhibit as much disorganized behavior.
•2.Disorganized Schizophrenia (formerly Hebephrenic) - Marked by
disorganized thinking, speech, and behavior. - Individuals may have
difficulty organizing their thoughts, making coherent conversation, or
completing tasks. - Flat or inappropriate affect (emotional expression) is
common.
•3.Catatonic Schizophrenia - Involves disturbances in movement and
behavior, ranging from immobility (catatonic stupor) to excessive,
purposeless activity (catatonic excitement). - Individuals may exhibit
peculiar postures or repetitive movements.
•4.Undifferentiated Schizophrenia - When symptoms do not clearly fit into
one of the specific subtypes mentioned above. - Individuals may have a
mix of symptoms from various types of schizophrenia.
•5.Residual Schizophrenia - Refers to a chronic stage of schizophrenia
where the most severe symptoms have improved, but some residual
symptoms persist. - These residual symptoms may include social
withdrawal, odd beliefs, or unusual perceptual experiences.It's worth
noting that the DSM-5 no longer formally recognizes subtypes of
schizophrenia (like paranoid, disorganized, etc.) but instead emphasizes a
dimensional approach to diagnosis based on the presence and severity
of various symptoms. However, these traditional subtypes are still widely
used for clinical and research purposes.

6. NEUROBIOLOGY OF
SCHIZOPHRENIA
•1.Brain Structure and Function- Enlarged Ventricles:Many
individuals with schizophrenia have enlarged brain ventricles,
indicating reduced brain volume, especially in areas like the
prefrontal cortex and hippocampus. - Hypofrontality:Reduced
activity in the prefrontal cortex, which is involved in decision-
making, planning, and emotional regulation. - Dysfunctional
Connectivity:Alterations in the connectivity between different brain
regions, affecting communication and integration of information.
•2.Neurotransmitter Systems - Dopamine Hypothesis: The most
established theory suggests that schizophrenia results from
excessive dopamine activity, particularly in the mesolimbic
pathway. This hyperactivity is linked to positive symptoms like
hallucinations and delusions. - Glutamate Hypothesis:
Dysfunction in the glutamate system, specifically NMDA receptor
hypofunction, is also implicated. Glutamate is an excitatory
neurotransmitter involved in learning and memory. Reduced
activity at NMDA receptors disrupts neural communication and is
associated with negative and cognitive symptoms of
schizophrenia.These neurobiological factors interact with genetic
predispositions and environmental stressors to contribute to the
development and progression of schizophrenia. Understanding
these mechanisms is crucial for developing more effective
treatments targeting the underlying biology of the disorder.

7. TREATMENT APPROACHES
•1. Medication (Antipsychotics) - Antipsychotic Medications: These drugs are the cornerstone of schizophrenia treatment,
primarily targeting positive symptoms like hallucinations and delusions. - Typical Antipsychotics: Older medications that
primarily block dopamine receptors. Examples include haloperidol and chlorpromazine. - *Atypical Antipsychotics:* Newer
medications that also affect serotonin receptors. They are often preferred due to fewer side effects. Examples include
risperidone, olanzapine, and quetiapine. - *Long-Term Medication:* Treatment typically involves long-term use of antipsychotic
medication to prevent relapse and manage symptoms. Dosage and medication choice may vary based on individual response
and side effects. - *Side Effects:* Common side effects include weight gain, sedation, movement disorders, and metabolic
issues. Regular monitoring by healthcare professionals is essential to manage these side effects.
2. Psychosocial Interventions - Therapy:Various forms of therapy, including cognitive-behavioral therapy (CBT) and family
therapy, can be beneficial in managing symptoms, improving insight, and enhancing coping skills. - Social Support: Building a
supportive network of family, friends, and community resources can provide crucial support and assistance in managing daily
life and reducing isolation. - Rehabilitation Programs: Vocational training, educational support, and rehabilitation programs can
help individuals with schizophrenia reintegrate into society and improve their quality of life. - Psychoeducation: Providing
education about schizophrenia and its treatment to individuals and their families can improve understanding, adherence to
medication, and coping strategies.Combiningmedication with psychosocial interventions offers the most comprehensive
approach to treating schizophrenia, addressing both the biological and psychosocial aspects of the disorder. Treatment plans
should be tailored to each individual's needs and regularly reassessed to ensure effectiveness.

8. CHALLENGES
•1.Medication Adherence- Complexity of Medication Regimens:Many antipsychotic medications require daily dosing,
which can be challenging for individuals with schizophrenia, especially if they struggle with organization or memory. -
Side Effects:Side effects such as weight gain, sedation, and movement disorders can be distressing, leading some
individuals to discontinue their medication. - Lack of Insight: Some individuals with schizophrenia may not believe
they have an illness or need medication, leading to non-adherence. - Social and Economic Factors: Limited access to
healthcare, lack of insurance, and financial constraints can also impact medication adherence
•2..Stigma:- *Public Misconceptions:Misunderstandings about schizophrenia, such as associating it with violence or
seeing it as a character flaw, contribute to stigma. - Self-Stigma: Individuals with schizophrenia may internalize
negative stereotypes and feel shame or low self-esteem, which can lead to avoidance of treatment or social
withdrawal. - Barriers to Employment and Housing: Stigma can lead to discrimination in areas such as employment
and housing, limiting opportunities for individuals with schizophrenia to lead fulfilling lives. - Impact on Treatment
Seeking: Fear of stigma may deter individuals from seeking help or disclosing their diagnosis to others, delaying or
preventing access to treatment.Addressing these challenges requires a multifaceted approach that includes education,
support, and advocacy to reduce stigma, as well as interventions to improve medication adherence through education,
simplification of regimens, and support systems. It's crucial to promote understanding and acceptance of
schizophrenia as a treatable medical condition and to provide resources and support to both individuals with
schizophrenia and their families.

9. PSYCHOSOCIAL IMPACT OF SCHIZOPHRENIA
•1. Family Dynamics: - Caregiver Stress:*Family members often take on the role of caregivers, providing
emotional and practical support to individuals with schizophrenia. This can lead to high levels of stress and
burnout. - *Disruption of Family Life: Schizophrenia can disrupt family routines and relationships, leading to
tension, conflict, and a strain on family dynamics. Stigma and Isolation:* Families may experience social
stigma due to misconceptions about schizophrenia, leading to feelings of isolation and difficulty accessing
support.2. *Occupational and Social Functioning:* - *Impact on Employment:* Schizophrenia can impair
cognitive functioning, affect motivation, and lead to periods of instability, making it challenging to maintain
employment. Unemployment rates among individuals with schizophrenia are high. - *Social Withdrawal:*
Negative symptoms such as social withdrawal and apathy can limit individuals' ability to engage in social
activities and form relationships. - *Stigmatization:* Discrimination and stigma in the workplace and society
can further hinder individuals' opportunities for employment and social integration. - *Financial Strain:*
Difficulty maintaining employment can lead to financial strain, making it challenging to afford basic
necessities and access healthcare.Addressing the psychosocial impact of schizophrenia requires a
comprehensive approach that includes support for individuals with schizophrenia and their families:-
*Psychoeducation:* Providing information and resources to help families understand schizophrenia and
develop coping strategies.- *Family Therapy:* Therapy sessions involving the individual with schizophrenia
and their family can help improve communication, reduce conflict, and strengthen family relationships.-
*Supported Employment Programs:* Programs that offer job training, placement assistance, and ongoing
support can help individuals with schizophrenia find and maintain employment.- *Community Support
Services:* Access to community resources such as support groups, vocational training, and housing
assistance can provide essential support for individuals with schizophrenia and their families

10. RECOVERY AND REHABILITATION
•1. *The Role of Rehabilitation Programs:* - *Psychosocial Rehabilitation:* Rehabilitation programs focus on improving functioning, independence, and
quality of life for individuals with schizophrenia. - *Vocational Training:* Programs offer job skills training, assistance with resume building, and support
in finding and maintaining employment. - *Education Support:* Programs provide educational resources and support to help individuals pursue
academic goals. - *Social Skills Training:* Training helps individuals develop and improve social skills necessary for building relationships and
navigating social interactions. - *Cognitive Remediation:* Interventions aim to improve cognitive abilities such as memory, attention, and problem-
solving skills. - *Housing Support:* Assistance is provided in finding stable and supportive housing, which is crucial for recovery and stability. -
*Community Integration:* Programs help individuals integrate into the community through participation in recreational activities, volunteer work, and
social events.2. *Strategies for Recovery:* - *Medication Adherence:* Encouraging and supporting consistent medication use is vital for managing
symptoms and preventing relapse. - *Therapy and Counseling:* Participating in therapy, such as cognitive-behavioral therapy (CBT) or supportive
counseling, can help individuals address challenges, improve coping skills, and build resilience. - *Peer Support:* Connecting with others who have
experienced similar challenges can provide understanding, empathy, and encouragement. - *Setting Realistic Goals:* Setting and achieving realistic
goals, whether related to employment, education, or personal growth, can boost confidence and motivation. - *Healthy Lifestyle:* Maintaining a healthy
lifestyle through regular exercise, nutritious diet, adequate sleep, and avoiding substance abuse can support physical and mental well-being. - *Self-
Advocacy:* Learning to advocate for one's needs and rights within the healthcare system and community is empowering and can improve access to
resources and support. - *Continued Learning:* Engaging in lifelong learning, whether through formal education, hobbies, or skills development, fosters
personal growth and fulfillment.Recovery from schizophrenia is a unique journey for each individual, and it often involves a combination of support,
empowerment, and perseverance. With the right interventions and support systems in place, many individuals with schizophrenia can lead meaningful
and fulfilling lives.

11. CASE STUDY
•John, a 20-year-old college student, began experiencing symptoms of schizophrenia during his late teens. He started withdrawing from social activities, experiencing
difficulty concentrating in class, and expressing paranoid beliefs about being followed by unknown people. His family noticed changes in his behavior, including
increased isolation and talking to himself. John's academic performance declined, and he eventually dropped out of college.Diagnosis: John was diagnosed with early-
onset paranoid schizophrenia based on his symptoms of social withdrawal, paranoid delusions, and decline in functioning.Treatment: John was prescribed an atypical
antipsychotic medication, which helped reduce his positive symptoms. He also participated in cognitive-behavioral therapy (CBT) to address his paranoid beliefs and
improve coping skills. His family received education and support to understand his condition and provide necessary support.Outcome: With ongoing treatment and
support, John's symptoms improved, and he was able to return to college part-time. He continued to manage his symptoms with medication and therapy, and although
challenges persisted, he regained a sense of stability and hope for the future.---*Case Study 2: Sarah - Residual Schizophrenia*Sarah, a 35-year-old woman, was
diagnosed with schizophrenia in her early 20s. Despite initially experiencing severe positive symptoms, such as hallucinations and delusions, she responded well to
treatment with antipsychotic medication and therapy. Over the years, her positive symptoms improved, but she continued to struggle with negative symptoms,
including social withdrawal, apathy, and difficulty maintaining relationships.Diagnosis: Sarah was diagnosed with residual schizophrenia, characterized by the presence
of some symptoms of schizophrenia despite a significant reduction in positive symptoms.Treatment: Sarah continued to take antipsychotic medication to manage
residual symptoms and prevent relapse. She participated in social skills training and therapy focused on improving motivation and coping with negative symptoms.
Supportive housing and vocational assistance were also provided to help her maintain stability and independence.Outcome: While Sarah's negative symptoms
remained challenging, she learned to manage them more effectively with support. She found purpose through part-time work and volunteer activities, and although she
experienced occasional setbacks, she maintained a relatively stable and fulfilling life.---These case studies illustrate the varied presentation and trajectory of
schizophrenia, as well as the importance of comprehensive treatment approaches tailored to individual needs. Early intervention, medication, therapy, and support
services play crucial roles in helping individuals with schizophrenia achieve stability and improve their quality of life.

12. THANKYOU
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