Schiz2006(国外T.H.McGlashan M.D.博士关于精神分裂症的精彩幻灯).ppt

Schizophrenia Features, Diagnosis, Epidemiology, Etiology, Treatment, Neurochemistry Jack Foust, MD Assistant Professor, Department of Psychiatry and Behavioral Sciences Medical University of South Carolina Features of Schizophrenia - Positive Symptoms Hallucinations Disorganized speech/thinking/behavior Delusions Features of Schizophrenia - Negative Symptoms Affective flattening Alogia Avolition Anhedonia Social Withdrawal Features of Schizophrenia - Cognitive Deficits Attention Memory Executive functions (organization, planning) Schizophrenia - DSM Diagnostic Criterion “A” Characteristic Sxs (2 + for 1 month) delusions hallucinations disorganized speech grossly disorganized or catatonic behavior negative Sxs (flat affect, alogia, avolition) (Only one element required if delusions bizarre, or hallucinations commentary 2 voices conversing ) Schizophrenia - DSM Diagnostic Criteria B - F Social/occupational dysfunction (decline) Duration - 6 months total, 1 month “A” Sxs Exclusion - SAFD, mood d/o Exclusion - sub abuse, gen med condition PDD/Autism - at least 1 month delusions or hallucinations Schizophrenia - Comorbid Conditions Depression Anxiety Aggression Substance use disorder Schizophrenia: Who is at Risk? Lifetime prevalence Epidemiologic Catchment Area Study: 1.3% National Comorbidity Survey: 0.7% Demographic characteristics Age - typical onset late teens/early twenties Gender - earlier age of onset among men Marital status - less likely to be married Schizophrenia: Who is at Risk? Predisposing factors Season of birth Pregnancy and birth complications Genetic background Precipitating factors Stress Substance Abuse Genetic Risk Factors Etiology: Neurodevelopmental Hypothesis Possible insult during gestation, environmental influences Disturbance in normal brain maturation Reduced size medial temporal lobe structures - amygdala, hippocampus Disturbed cytoarchitecture in hippocampus, entorhinal cortex Treatment: Psychosocial Interventions Supp