1 Schizophrenia and Other Psychotic Disorders
2 学习目标 1．Definition 2．Epidemiology 3．Symptoms(have ability to assess the key aspects of mental state in schizophrenia) 4. Causes 5.Treatment
3 Part one Introduction
4 The definition of Schizophrenia in CCMD-3 Schizophrenia comprises a group of psychotic disorders of unknown specific etiology often presented with a gradual onset of abnormalities in perception, thought, motion and behavior since young adulthood. Consciousness is usually maintained. Intelligence is intact, but in some cases, there is some degree of cognitive impairment. The natural course of the disorder is chronic remitting but sometimes deteriorating
5 Epidemiology (1) Prevalence： – Point prevalence in China (1982): 4.75‰（rural area 3.42‰，urban 6.06 ‰ )。 – Total prevalence in China(1982):5.69‰，(6.55 ‰ 1999)。 – Lifetime prevalence in USA（1988）13‰
6 Epidemiology( 2) • Incidence – USA: 0.43‰~0.69‰ – China : 0.11‰~0.35‰ • The reasons of these reported differences may be include: – diagnostic criteria – areas – methods of case finding, migration
7 Epidemiology( 3) • Age：the age of onset in 50% of patients is 20~30 year old，over 80% of patients is 16~35year old. • Gender： – Schizophrenia occurs equally in men and women(in abroad) – The prevalence in men is more than women (1.6:1) in China. – The mean age of onset is about 2 to 5 years earlier in men than women
8 Outcome evaluation(multi-dimensions) • Clinical outcome • Social function • Quality of life • Living condition • Family condition • others
9 History（1） 1. Demence precoce(Morel,1857) 2. Hebephrenia(Hecker,1871) 3. Catatonia(Kzhlbaum,1874) 4. Kraepelin(1896)thought all above descriptions are different types of the same disease-dementia praecox
10 History（2） E.Bleuler(1911)suggested that splitting of thought and affect was the central feature of the illness – schizophrenia He found that the outcome of this illness was neither universally poor nor associated with severe dementia. M.Bleuler- 4A symptoms： ▪ Association disorder ▪ Apathy ▪ Ambivalence ▪ Autism