复旦大学：《医学遗传学 Medical Genetics》课程教学资源（学习报告）Schizophrenia 精神分裂癥

Schizophrenia 精神分裂癥 牛康衛08301016018 復旦大學上海醫學院2009.12

牛康衛 08301016018 復旦大學上海醫學院 2009.12

What is schizophrenia? a a psychiatric disorder that makes the patient have an altered sense of reality a Sx must have been present for one month in a period of six months of dysfunction Anything shorter than this is a schizophreniform disorder

 A psychiatric disorder that makes the patient have an altered sense of reality  Sx must have been present for one month in a period of six months of dysfunction. ◼ Anything shorter than this is a schizophrenifom disorder

Signs and Symptoms 口 Positive sx auditory and visual hallucinations paranoid delusions disorganized speech 口 Negative sx Flat affect Alogia(speech poverty) Anhedonia Asociality Avolition a significant social or occupational dysfunction a word salad (incoherent speech) 口 avolition( apathy)

 Positive Sx ◼ auditory and visual hallucinations ◼ paranoid delusions ◼ disorganized speech  Negative Sx ◼ Flat affect ◼ Alogia (speech poverty) ◼ Anhedonia ◼ Asociality ◼ Avolition  significant social or occupational dysfunction  word salad (incoherent speech)  avolition (apathy)

Diagnosis a In the United States, the aPas dsm-Iv-tR is used. while in much of the rest of the world, the who's icd-10 is used to determind the criteria. (Although the two mostly overlap) a DSM-IVdiagnosis of schizophrenia must Have 2+ of aforementioned Sx for a the better part of a mon th Have signs of the disturbance for at least D AGNO MANINDA GaS STATISTICAL MENTAL DISORI 6 months (with at least one month of Sx) TEXT REVISION Must have social or occupational DSM-IV-TR dysfunction (or dysfunction in self-care)

 In the United States, the APA's DSM-IV-TR is used, while in much of the rest of the world, the WHO's ICD-10 is used to determind the criteria. (Although the two mostly overlap)  DSM-IVdiagnosis of schizophrenia must: ◼ Have 2+ of aforementioned Sx for a the better part of a month ◼ Have signs of the disturbance for at least 6 months (with at least one month of Sx) ◼ Must have social or occupational dysfunction (or dysfunction in self-care)

Diagnosis a The dsm-iv and icd-10 have defined subtypes of schizophrenia Paranoid type -only with delusions and hallucinations Disorganized type -thought d/o and flat affect are present at the same time Catatonic -immobile or have purposeless movement Undifferentiated type- psychotic Sx are present, but above not met Residual type -Sx are present, but with low intensity Post-schizophrenic depression Simple schizophrenia- progressive development of negative Sx with no prior psychotic episodes

 The DSM-IV and ICD-10 have defined subtypes of schizophrenia: ◼ Paranoid type - only with delusions and hallucinations ◼ Disorganized type - thought d/o and flat affect are present at the same time ◼ Catatonic type - immobile or have purposeless movement ◼ Undifferentiated type - psychotic Sx are present, but above not met ◼ Residual type - Sx are present, but with low intensity ◼ Post-schizophrenic depression ◼ Simple schizophrenia- progressive development of negative Sx with no prior psychotic episodes

Who is most at risk to have Schizophrenia? a Family history or ties to schizophrenia 口 Prenatal problems e.g., mother was malnourished, had viral infection, took medications (diuretics, etc) a Family member has history of psychotic disorder (such as delusional disorder) a You have problems with drug or alcohol Shizophrenia causes problems? Problems cause schizophrenia? 口 Age of onset: Late adolescence and early adulthood

 Family history or ties to schizophrenia  Prenatal problems ◼ e.g., mother was malnourished, had viral infection, took medications (diuretics, etc)  Family member has history of psychotic disorder (such as delusional disorder)  You have problems with drug or alcohol ◼ Shizophrenia causes problems? ◼ Problems cause schizophrenia?  Age of onset: ◼ Late adolescence and early adulthood

What causes Schizophrenia? 口 Dopamine imbalance This is the most commonly researched a Genetics (our focus) a Prenatal and early environment 口 Neurobiology a All factors interact to trigger the manifestation of schizophrenia

 Dopamine imbalance ◼ This is the most commonly researched  Genetics (our focus)  Prenatal and early environment  Neurobiology  All factors interact to trigger the manifestation of schizophrenia

Possible causes of Schizophrenia: A Comparison Odds Ratio 0 3 5 6 8 910 Place/time of birth Winter Urban Influenza Respiratory Infection Rubella Poliovirus CNS Famine Bereavement Prenatal Flood Unwantedness Maternal depr Rh incompatibility Hypoxia Obstetric CNS damage Low birth weight Pre-eclampsia Family history

What causes Schizophrenia? 口 Genetics must be considered in conjunction with environmental factors Multifactorial (caused by interactions of several genes) a It is still an area that is new and open to much more further study Though it is considered to be a major contributing cause, studies have only begun to be performed to determine the genetic effects with respect to schizophrenia

 Genetics ◼ must be considered in conjunction with environmental factors ◼ Multifactorial (caused by interactions of several genes)  It is still an area that is new and open to much more further study ◼ Though it is considered to be a major contributing cause, studies have only begun to be performed to determine the genetic effects with respect to schizophrenia