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schizophrenia,

simulated

insert video

schizophrenia
mental
 disorder
 characterized
 by
 a
 total

disintegration
 of
 nearly
 every
 aspect
 of
 human

psychology,
 including
 thought,
 perception,

behavior,
 language,
 emotion
 &
 communication;

disturbances
 usually
 manifest
 in
 visual
 &
 auditory

hallucinations,
 paranoid
 delusions,
 disorganized

speech
 &
 complete
 social
 dysfunction


schizophrenia
mental
 disorder
 characterized
 by
 a
 total

disintegration
 of
 nearly
 every
 aspect
 of
 human

psychology,
 including
 thought,
 perception,

behavior,
 language,
 emotion
 &
 communication;

disturbances
 usually
 manifest
 in
 visual
 &
 auditory

hallucinations,
 paranoid
 delusions,
 disorganized

speech
 &
 complete
 social
 dysfunction


schizophrenia
the
 deep
 end
 in
 the
 pool
 of
 mental
 disorders

schizophrenia spectrum disorders


schizophrenia
6 months or more

schizophreniform

disorder
1 - 6months

brief
 psychotic

disorder
1 day - 1 month

delusional

disorder
delusions only

schizoaffective

disorder
+ mood disorder episode

attenuated

psychosis

syndrome*
for further review

etiology
imbalances in
amino acids,
DTNBP1 proteins & Dopamine
NGR1
Serotonin
neurotransmittersGABA
COMT

Genetic

Factors
BDNF
Glutamate

stress
ses status
urban living
high ee family
cannabis use

Social
 &
Environmental

enlarged ventricles
prefrontal cortex
temporal cortex
hippocampal volume

Brain

Abnormalities

obstetric complications
prenatal infections (flu)
excessive pruning
early parental loss or separation
low oxygen level due to prolonged
labour, premature birth or low birth
weight

Developmental

Factors

symptoms
delusions
hallucinations
disturbances of
perception

positive

symptoms

avolition
asociality
anhedonia
blunted affect
alogia

disorganized
speech
behavior
symptoms

motor

immobility
abnormalities
catatonia

negative
symptoms

treatments: biopsychosocial
MEDICATION

social
 skills

training

CB

therapy

spiritual

therapy

psycho

education

cognitive
 remediation

therapy

psycho

analysis

family

therapy

residential

treatment

case

management

case: vw

VW, 43yo
Gender: Male
Religion: Roman Catholic
Birthplace: Toledo, Cebu
Civil Status: Widower
Education: 3rd year College, Marine Transportation
Occupation: Fisherman
Remarks: Found wandering streets, talking to himself,

laughing by himself, untidy appearance, eyes wide


open
1

Background:

Imprisoned for 5mos: accidental murder


unusual gestures
refused sleep & food
would talk to & laugh by himself

Assessment:

Diagnosed with schizoaffective disorder


delusions & hallucinations
major depressive episode

Presenting Symptoms:

Disorganized thoughts
Low self-esteem
Feelings of guilt
Thoughts of self-destruction
Absence of flat affect

Treatment:

Antipsychotic medication
(Vicente Sotto Memorial Med Center)
Behavior modification program
Discharged after 2mos of daily
intervention by nurses

Recommendations:

Psychotherapy
Psychological interventions

family therapy for


schizophrenia

FIDD: Family Intervention for Dual Diagnosis

Engagement Stage

Persuasion Stage

Active Treatment Stage

Relapse Prevention Stage

Gottlieb, J., Mueser, K., & Glynn, S. (2012). Family therapy for schizophrenia: co-occuring psychotic and substance use
disorders. Journal of Clinical Psychology: In Session,Vol. 68(5), 490501.

family therapy for


schizophrenia
Jessica

Robert
schizophrenia and
substance Abuse

upset but also


perpetuates some
behaviors

engagement & psychoeducation


goal setting & treatment planning
communication training
problem-solving strategies
relapse prevention planning
Gottlieb, J., Mueser, K., & Glynn, S. (2012). Family therapy for schizophrenia: co-occuring psychotic and substance use
disorders. Journal of Clinical Psychology: In Session,Vol. 68(5), 490501.

family therapy for


schizophrenia

New behaviors were implemented with


support from the family - both positive
and negative.

Gottlieb, J., Mueser, K., & Glynn, S. (2012). Family therapy for schizophrenia: co-occuring psychotic and substance use
disorders. Journal of Clinical Psychology: In Session,Vol. 68(5), 490501.

case: prof. elyn saks

Elyn Saks, 57yo


Gender: Female
Religion: Jewish
Birthplace: Suburban North Miami
Civil Status: Married (Will, Librarian)
Education: Law Graduate, Post Grad in Philosophy, et al
Occupation: Assoc. Dean for Research, USC Gould School of Law
Remarks:

High-functioning person with schizophrenia


Notable work in mental health & criminal cases
1

Background:

Oldest of 3 children
Parents: Lawyer& housewife
Affectionate, middle-class family
Normal & privileged childhood
Maternal Uncle Norm: clinically depressed

Assessment:

Diagnosed with chronic schizophrenia


Prognosis: grave
Institutionalized 3x: released AMA; 3rd time: by force
Outpatient for almost 30 years

Presenting Symptoms:

Word salad
Minimal self-care
(+) paranoid delusions; hallucinations
(-) apathy, withdrawal, poor social skills
Others: NSSI, hypochondriasis
Current symptoms: transient psychotic thoughts
Others:

Anorexic & tried cannabis when she was younger


Chain-smoker

Treatment:

Medication: Clozapine
Psychoanalysis - daily
Intensive Talk Therapy

Success Factors:

Adjustments in lifestyle
Work as therapy
Exercise
Personality: inherent intelligence + attitude
Resources & talented professionals
4

case study: crystal

CRYSTAL AMAYA, 46yo


Gender: Female
Religion: Roman Catholic
Birthplace: Vigan, Ilocos Sur
Civil Status: Single
Education: 2nd Yr College, BS HRM
Occupation: Never Employed
Remarks: In-patient for second time at NCMH.

Behavior has not improved (Dec 27, 2001)

Presenting Symptoms:

Disorganized behavior
Socially withdrawn & flat affect
Flight of ideas, incoherent speech
Hubad!
Kamukha mo si ERAP!
Ayoko sa mga puti gusto ko sa maiitim!

Presenting Symptoms:

Disorganized behavior
Socially withdrawn & flat affect
Flight of ideas, incoherent speech
Hubad!
Kamukha mo si ERAP!
Ayoko sa mga puti gusto ko sa maiitim!

Presenting Symptoms:

Morning ritual: measures face


Denies her age
Hallucinations:
Visual (demons & angels)
Auditory (pet cat and deceased grandmother)

Presenting Symptoms:

Morning ritual: measures face


Denies her age
Hallucinations:
Visual (demons & angels)
Auditory (pet cat and deceased grandmother)

Presenting Symptoms:

Morning ritual: measures face


Denies her age
Hallucinations:
Visual (demons & angels)
Auditory (pet cat and deceased grandmother)

Assessment

Disorganized Schizophrenia
(DSM-IV-TR)
paranoia symptoms

Assessment

Disorganized Schizophrenia
(DSM-IV-TR)
paranoia symptoms

crystal amaya
Early Life Experiences
Personality

Early Learning

Coping Style
witchcraft
Social Factors
no friends
mom & school
principal were
best friends

Mental Health
Problem
DISORGANIZED
SCHIZOPHRENIA

Biochemistry

Life Events
cat died
grandmother
died
parents
separated
boyfriend left
her
failed college
Medical Conditions

Family History

Adapted from Fadden, G., James, C., Pinfold, V. (2012) Caring for Yourself self-help for families and friends supporting people with
mental health problems. Rethink Mental Illness and Meriden Family Programme. Birmingham: White Halo Design.

Treatment:

Antipsychotic medication
(highest possible dosage)
Socialization activities : games
(cognitive, psychomotor,
recreational & expressive tasks)

Recommendations:

ECT
worked for her before
CBT

Treatment:

Antipsychotic medication
(highest possible dosage)
Socialization activities : games
(cognitive, psychomotor,
recreational & expressive tasks)

Recommendations:

ECT
worked for her before
CBT

Medication
4

ECT

CBT

crystal
Socialization

spirituality & schizophrenia

creating a

Spirituality Matters Group (SMG)

Assessments

Spirituality Status Questionnaire

Self-Efficacy Scale for Schizophrenia

Quality of Life Interview

Herth Hope Index

time and

place for hope

Revheim N., Greenberg, W., & Citrome, L. (2010) Spirituality, schizophrenia, and state hospitals: program description and
characteristics of self-selected attendees of a spirituality therapeutic group. Nathan S. Kline Institute for Psychiatric Research.

spirituality & schizophrenia

creating
a
Psychospirituality can be

beneficial for people with


schizophrenia, as praying
proves to be a powerful
coping mechanism

time and

place for hope

Revheim N., Greenberg, W., & Citrome, L. (2010) Spirituality, schizophrenia, and state hospitals: program description and
characteristics of self-selected attendees of a spirituality therapeutic group. Nathan S. Kline Institute for Psychiatric Research.

spirituality & schizophrenia

creating
a
Psychospirituality can be

beneficial for people with


schizophrenia, as praying
proves to be a powerful
coping mechanism

time and

place for hope

Revheim N., Greenberg, W., & Citrome, L. (2010) Spirituality, schizophrenia, and state hospitals: program description and
characteristics of self-selected attendees of a spirituality therapeutic group. Nathan S. Kline Institute for Psychiatric Research.

schizophrenia
q&a

people with
schizophrenia

people with
schizophrenia