Schizophrenia andOther Psychotic Disorders
1 Schizophrenia and Other Psychotic Disorders
学习且标1. Definition2.Epidemiology3. Symptoms (haveabilitythekeytoassessaspects of mental state in schizophrenia)4. Causes5. Treatment
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
Part oneIntroduction3
3 Part one Introduction
The definition of Schizophrenia in CCMD-3Schizophrenia comprises a group of psychoticdisorders of unknown specific etiology oftenpresented with a gradual onset of abnormalitiesin perception, thought, motion and behavior sinceyoung adulthood. Consciousness is usuallymaintained. Intelligence is intact, but in somecases, there is some degree of cognitiveimpairment. The natural course of the disorder ischronic remitting but sometimes deteriorating
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
Epidemiology(l)Prevalence:- Point prevalence in China (1982): 4.75%o (ruralarea 3.42%o, urban 6.06 %o)。- Total prevalence in China(1982):5.69%o, (6.55 %o1999)。-Lifetime prevalence in USA （1988）13%o。5
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‰
Epidemiology(2)IncidenceUSA:0.43%~0.69%o China : 0.11%o~0.35%文The reasons of these reported differences maybe include:-diagnostic criteria- areasmethods of casefinding,migration6
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
Epidemiology( 3)Age:the age of onset in 50% of patients is20~30 year old, over 80% of patients is16~35yearold.?Gender:Schizophrenia occurs equally in men andwomen(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 yearsearlierinmenthan women
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
Outcome evaluation(multi-dimensionsClinicaloutcomeSocialfunction.Quality of life·Living condition·Family conditionothers8
8 Outcome evaluation(multi-dimensions) • Clinical outcome • Social function • Quality of life • Living condition • Family condition • others
History (1)1.Demence precoce(Morel,1857)2. Hebephrenia(Hecker,1871)3. Catatonia(Kzhlbaum,1874)4.Kraepelin(1896)thoughtall above descriptionsare differenttypes of the same disease-dementiapraecox9
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
History (2)E.Bleuler(1911)suggested that splitting of thoughtandaffectwas thecentralfeatureof theillness-schizophreniaHe found that the outcomeof this illness was neitheruniversallypoornorassociatedwithseveredementiaM.Bleuler-4A symptoms :Associationdisorder: ApathyAmbivalence- Autism10
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