Schizophrenia with features and symptoms: The different explanations biological and non biological. Treatments: antipsychotics and family therapy with plenty of evidence/studies
Unipolar depression with features and symptoms: The different explanations biological and cognitive with Plenty of e...
Positive symptoms: Not found in normal people e.g. Hallucinations
Negative symptoms: The absence of normal levels of functioning e.g. Alogia ( ack of speech)
flattened/ absence of normal emotions.
DSM-5, 5 main diagnostic criteria in which the individual needs to exhibit at least 2 of the
following first 3*:
- Hallucinations*
- Delusions*
- Disorganized speech*
- Disorganised/ catatonic behaviour
- Negative symptoms e.g. social withdrawal
Hallucinations- Hearing or seeing things that aren’t there i.e. critical voices=running
commentary on what they’re doing.
Delusions- False beliefs, refers to a person thinking their movements are being controlled by
someone else
Disorganised speech- Losing track of thoughts and speaking incoherently.
Negative symptoms: easier to measure then the ones mentioned above-
Social withdrawal lack of energy lack of pleasure Flatness of emotions
Cognitive symptoms: Poor working memory. Difficulty in paying attention/ concentration.
( Symptoms and features are a holistic and reductionist approach)
Feature of schizophrenia ( different types of Sz: paranoid Sz and Disorganised Sz)
Psychosis: separation from reality
Average life expectancy: 10 or more years less than average ( high suicide rates)
Social problems, that make schizophrenia a likely development: - poverty – unemployment
– possibly homelessness
Duerr 2013- Adolescents with psychotic symptoms, nearly 70 times more likely commit
suicide.
, Biological explanation of Schizophrenia : Biochemical explanation
The dopamine Hypothesis: Schizophrenia Is caused by excessive activity at synapses that use
dopamine as their primary neurotransmitter.
Wein and Stein 1973:
Schizophrenia patients who died in accidents showed normally abnormal low levels of
dopamine beta- hydroxylase (DBH) in the brain fluid. DBH is an enzyme whose function is to
breakdown dopamine neurotransmitter after release.
Barlow and Durand 1995:
Chlorpromazine ( blocks Dopamine receptors) is effective in reducing Schizophrenia
symptoms in about 60% of cases. Most impact on positive symptoms and the treated
patients may still suffer from the negative symptoms.
Janowski et al 1972: Responses to Amphetamines (increase dopamine, interrupt its uptake
at the synapse) in Schizophrenia vs non- Schizophrenic patients ( both had the same
dosage). Findings= low dosage had a slight increase in psychomotor agitation (normal) vs
substantial exacerbation of symptoms in those with Schizophrenia.
Biological explanation of Schizophrenia: The glutamate hypothesis
When glutamate activity increases, dopamine activity decreases thus having an inhibitory
effect on dopamine activity. Schizophrenia is assumed to be the result of excessive
dopamine activity that results in too little dopamine after all.
Javitt and Zukin 1991:
PCP/ Ketamine blocks activity of NMDA glutamate receptors. Sufficient dosage=
psychological change that mimics negative and cognitive symptoms of Schizophrenia
Hu et al 2014:
Post-mortem studies comparing brain tissues of Schizophrenics with controls= structural
differences in areas related to glutamate (decreased glutamate receptors, decreased
volume of parts of the dorsolateral prefrontal cortex, decreased dendritic branching).
Biological explanation: Structural abnormalities in the brain
Ventricular enlargement: Fluid filled spaces in the brain called ‘ ventricles’ are enlarged in
Schizophrenia patients.
Gaser et al 2000:
Compared the brain MRI scans of MZ twins and found that the affected twin had enlarged
ventricles and reduced brain volume compared to the unaffected twin. (point to consider=
variability between people who are not Schizophrenic, normally some may have larger
ventricles then Schizophrenic patients who may have them smaller)
Cellular disarray: Disorganized behaviour, due to disorganised neurones
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