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Living with schizophrenia WMHD 2014
- 1. LIVING WITH SCHIZOPHRENIA Dr Jaimon P M Assistant Professor ESIC Medical College Parippally, Kerala
- 3. HEALTH World Health Organization-WHO State of complete physical, mental and social well being Not merely the absence of disease Other dimensions; Spiritual Intellectual Emotional
- 4. MENTAL HEALTH Successful performance of mental functions, in terms of thought, mood and behavior Results in productive activities Fulfilling relationship with others Ability to adapt to changes To cope with adversity
- 5. MENTAL HEALTH Mental health is a state of emotional and social well-being. Numerous factors affect ones mental health Biological Factors Physical abilities and disabilities Social and environmental conditions and stressors 5
- 6. WMHD 2014 Introduce a quantified national reduction in premature mortality a major health inequality is people with mental ill health dying 20 years younger than the general population Everyone should have access to high quality, safe and speedy access to crisis care and be able to access psychological therapies
- 7. SCHIZOPHRENIA Distortions of thinking & perception and inappropriate/blunted affect. Clear consciousness & intellectual capacity are usually maintained.
- 8. SCHIZOPHRENIA Emil Kraeplin (1856-1926) Eugene Bleuler (1857-1939) Kurt Schneider (1887-1967)
- 9. EPIDEMIOLOGY Life time prevalence- 1% All societies/all classes Male= female Onset earlier in males Peak age - 10-25 yrs Males - 25-35 yrs Females Bimodal peak females- > 40 yrs
- 10. ETIOLOGY Biological Factors Genetic Neurochemical Neuropathological Neurocircuitory Brain metabolism Evoked potential Psychoneuroimmunology Psychoneuroendocrinology Other theories Psychosocial Factors
- 11. FAMILY STUDIES General population -1 % Non-twin sibling of F20 - 8% Child with one parent with F20 - 12% Dizygotic twin of F20 - 12% Child of two parents with F20 - 40% Monozygotic twin of F20 - 47% Paternal age >60 yrs
- 12. NEUROCHEMISTRY Dopamine Serotonin Glutamate GABA Nor Epinephrine
- 13. BIOLOGICAL FACTORS Abnormal DST Decreased LH/FSH Blunted response to Prolactin/GH Autoimmune pathology IL-2 decrease Decreased peripheral lymphocytes Retroviral infection Eye movement dysfunction
- 14. BIOLOGICAL FACTORS Winter births Birth complications Influenza epidemic in 2nd trimester Maternal starvation Rh incompatibility
- 15. PSYCHOSOCIAL THEORIES Sigmund Freud: early fixation leading to intrapsychic conflicts and ego defect Magret Mahler: distortion of reciprocal relationship between mother& infant Learning theory: Children learn irrational reaction& abnormal ways of thinking by imitating parents
- 16. PSYCHOSOCIAL THEORIES Adolf Meyer: reaction to adverse life events Double blind theory: Gregory Bateson& Donald Jackson-conflicting parental messages about their behaviour, attitudes, and feelings Expressed Emotions
- 17. SOCIAL FACTORS 40%- alcohol abuse 90%- Nicotine Cannabis 6 times risk Population density> I million Increased economical burden
- 18. SIGNS & SYMPTOMS Impaired sleep Impaired appetite Impaired personal care Unprovoked irritability Self talking/Muttering Self laughing Poor social interaction Difficulty in concentration
- 19. SIGNS& SYMPTOMS Suspiciousness Fearfulness Irrelevant talk Irregular job pattern Hoarding behavior Wandering tendency Suicidal tendency Abusiveness/destructiveness
- 20. SIGNS& SYMPTOMS Thought echo/insertion/ withdrawal/broadcasting Delusions of control/influence/passivity Running commentary/ 3rd person AH/hallucinatory voices from body Bizarre delusions Other Hallucinations Neologisms Catatonic behaviour Negative symptoms
- 21. SIGNS& SYMPTOMS Depressive/euphoric mood changes Anhedonia Autistic thinking Affective flattening Association loosening Ambivalence Avolition Attentional disturbances
- 22. MANAGEMENT Hospitalization Confirm diagnosis Safety of the patient Initiation &Stabilization of medication Care of basic needs Psycho education Effective association with community Improve Quality of Life Employment Social relationship
- 23. MANAGEMENT Acute stage Antipsychotics BZD Maintenance stage Improve level of function Prevent psychotic relapse Manage Non compliance Manage side effects Health monitoring
- 24. MANAGEMENT Psychological interventions Psycho education Social skills training Cognitive Behavior Therapy Individual Psychotherapy Vocational Therapy Managing Expressed Emotions Family oriented therapy
- 25. 犂犁犂犂萎冠犂逗患犂鉦憾犂 犂朽姦犂犁犂む歓犂謹犂犂逗瓦犁犂朽 犂犁犂迦完犁犂む犂l, 犂犂鉦犂犂, 犂 犂鉦寛犂逗犁犂犁 犂犂犂鉦l 犂む犁犂犂犁犂犂逗姦 犂犁犂犂犁犂逗寒 犂犁犂犂朽犂む犂む歓犂犂橿犂犁犂犁 犂犁犂犂犂鉦憾犂犂犁犂犂朽歓犂犁犂犁犂犁犂犂朽完犂鉦犂鉦 犂犂逗寛 犂犂萎款犂犂逗. 犂犂む犂犂朽歓犂謹患犂鉦憾犂 犂朽犂犁犂犁犂犁犂む犂む 犂犁犂犂犂犁犂犂犁犂犂犁犂 犁犂朽歓犂む犂 犂犂犂逗犁犂犂n 犂犁犂萎寒犂о歓犂朽款犂 犂犁犂犂朽完犁犂む犂む寒犂犁犂 犂犂萎款犂犂逗犂犁犂犁 犂伍換犂鉦姦犂逗犁犂犁犂犁犂犁. 犂伍款犂犁犂項歓犂犂朽犂 犂犁犂犂む犂鉦幹犂逗寛犁犂犂萎患犁犂犂鉦姦 犂犂萎歓犂謹犂迦寒犂 犂犂迦犂犁犂犁犂犂む犁犂 犂犂む犂逗寒犁犂犁犂犁 犂犂鉦犂犂鉦苅犁.
- 26. 犂犁犂犂萎冠犂逗患犂鉦憾犂 犂犂犂 犂犂犁犂犂犁犂犂 犂犂鉦完犂犂犁犂劇堪犂犂鉦姦犂 犂犂犂犂犂鉦犂逗犁犂犂鉦, 犂 犂鉦寛犂 犂犂犁犂犂犁犂犂 犂犁犂犂犂鉦憾犂 犂犁犂犂鉦苅犁犂犂む 犂犁犂犂犂犁犂鉦 犂犂犁犂犂む犂逗苅犁犂犂犂犁犂犁犁犂逗苅犁犂犂犁犂犂鉦苅犁犂犂犁犂 犂犂萎款犂犂逗犂橿犂犁犂犁 犂犂犂犁犂謹 犂犂迦犂犁犂犁犂犁. 犂犁犂犂む犂鉦幹犂l 犂犂萎歓犂謹犂迦寒犂犂む犂む款犂犁犂犂犂鉦犂 犂犂迦寛犂犂逗寒犁犂む犁 犂 犂犂犂伍犂伍歓l 犂犁犂犂逗姦犁犁犂犂逗犁犂犂鉦寒犁犂橿犂 犂犁犂謹堪犂犁犂犁犂鉦苅犂鉦患犂謹姦犂.
- 27. TIPS TO CARE TAKERS 犂伍犂犂逗犂伍款犂犁犂萎犂犂逗姦 犂犂萎款犂犂逗犁 犂犁犂犂 犁犂朽歓犂む犂犂逗寛犂朽款犂萎 犂犁犂犂犂犁犂犂犁犂犂犂犁犂む犂む犂犁犂犂む犂l 犂犂朽苅犁犂犂 犂犂萎歓犂犂萎歓犂犁犂犁犂犁犂犂朽完犁犂犁犂犁 犂朽犂犁犂犂 犂犁犂犂о款犂犂犂鉦姦 犂犂犁犂犁犁犁. 犂犂謹犂犂犁犂む犂 犂朽歓犁犂犁 犂朽犁犂犂逗苅犁犂犂迦瓦犁犂む犂犁犂 犂犂萎款犂犂逗犂犁犂犁 犂犂萎歓犂犂萎歓犂犁犂犁犂犁犂犂朽完犁犂犁犂犁 犂 犂犂伍犂犂犁犂犂む犂 犂犁犁犂逗犁犂犁 犂朽姦犂犁犂む堪犂鉦姦 犂о款犂萎苅 犂犁犂鉦姦犂逗完犂逗犁犂犂犂. 犂犂萎款犂犂逗 犂朽犁犁犂 犂犂巌姦 犂犂朽憾犁犂ム姦犂逗犂迦犁犂犁 犂犂犂犁犂犂逗犂犂鉦犂鉦寒犁犂橿犂 犂伍款犂о姦犂む犂 犂犁犁犂犁犂犁犂犁犂犂鉦寒犁犂橿犂 犂朽幹犂逗犂犁犂犁犂犁犂犁犁犂逗犁犂犁 犂犂萎歓犂犂鉦完犂r 犂犁犂逗犁犂犂逗完犂逗犁犂犂犂.
- 28. TIPS TO CARE TAKERS 犂犂逗犂逗瓦犁犂伍姦犂l 犂犂犁犂犂鉦犂逗犁犂鉦犁犂犁犂 犂犂萎款犂犁犂犂萎歓犂犂鉦完犂犂萎犂犁犂犁 犂朽犂犁犂犂 犂朽寛犂逗姦 犂犂犁犂犂鉦苅犁犂橿犂橿瓦犁. 犂犂萎犂犁犂犁犂 犂犁犂む犂犂伍堪犂犂む犂む 犂犂迦犂犂鉦寒犁犂 犂犂萎犂犁犂犁犂 犂犂巌歓犂犁犂犂逗苅犁犂犂迦寛犂犁犂犂l 犂犁犂鉦犂鉦患犁犂犁犂 犂犁犂犂謹犂犂犁犂犂犁犂犁犂犁犂犁犁犂逗犁犂犁 犂犂萎款犂犂逗犂犁犂犁 犂犁犂犁犂犁犂犂犂伍犂伍歓犂迦款犂犁犂犂鉦寒犁犂 犂犂萎款犂犁犂犂萎歓犂犂鉦完犂r 犂犁犂謹侃犁犂о歓犂犁犂犂犂. 犂犂謹犂犂犁犂む犂 犂朽歓犁犂 犂犂萎款犂犂逗犂橿犂犁犂犁犂 犂犂む犂逗姦犂鉦姦 犂犂逗犂逗瓦犁犂 犂迦喚犂逗犁犂犁犂犁犂犁犂犁犂犁犂犁犂犁 犂犁犂 犂朽完犁犂む犂む犂犁犂犂む犁犂 犂朽犂犁犂犂 犂犁犂犂о款犂犂犂鉦苅犁.
- 29. TIPS TO CARE TAKERS 犂犂萎犂犁犂犁犂 犂犂逗完犁犂む犂む歓犂犁犂犁犂犁犂犁犂 犂犂萎款犂犂逗犁犂逗寛犁犂 犂む犁犂犂萎犂犂逗犂逗瓦犁犂伍姦犁犂犁犂犁犂犁 犂犂犂鉦犂鉦瓦犁犂む患犂萎歓犂迦犂 犂犂萎款犂犂鉦患犂伍犂 犂む犂逗完犂逗犁犂 犂朽犂犁犂犂犁犂犂鉦. 犂犂逗犂逗瓦犁犂 犂む犁犂犂萎款n 犂犂萎款犂犂逗犂犁犂犁 犂犂犁犂犂萎歓犂犂逗犁犂犁 犂犂逗犂逗瓦犁犂伍姦犂l 犂伍換犂鉦姦犂逗犁犂犁犂犁犂犂む犂逗寛犁犂犁犂犂 犂犂萎歓犂犂鉦完犂犂萎犂犁犂犁 犂犂萎款犂犂逗犁 犂犁犂犂 犁犂朽歓犂む犂 犂犁犂犂犂犁犂犂犁犂犂犂犁犂む犂む款犂犂鉦犁犂.
- 30. TIPS TO CARE TAKERS 犂犂萎犂犁犂犂伍患犂迦瓦犁犂犂犂鉦苅犁犂犂 犁犂朽歓犂犁犂犂n 犂犂萎歓犂犂鉦完犂r 犂犂萎款犂犂逗犂犁犂犁 犂犂犁犂犂萎歓犂犂逗犁犂犂犂 犂犂萎歓犂犂鉦完犂r 犁犂犂犁犂 犂犁犂謹侃犁犂о姦犁犂犁犂橿犂橿患犂萎款犂犂犂 犂犂萎犂犁犂犁犂 犂犁犂む犂犂犂鉦姦犂 犂犂巌歓犂犁犂犂n 犂犂萎款犂犂逗犂犁犂犁 犂犂犁犂犂萎歓犂犂逗犁犂犂犂
- 31. TIPS TO CARE TAKERS 犂犂萎款犂犂逗犁犂l 犂犂む犂犂項瓦犁犂犂鉦勘犁犂犂朽苅犂む犂犁犂犁犂犂 犂犂犁犂犂犁犂む犁犂犂逗寛犁犂 犂伍犂犂犂 犂犂鉦苅犁犂犂犂鉦苅犁犂犂犂犁犂犂l 犂犂犁犂犂鉦完犂犂 犂犂犂犁犂む犂犁犂犂犁犂 犂犂逗犂逗瓦犁犂伍歓犂犁犂犁犂犁犂 犂 犂鉦犁犂犂犁犂犁 犂犁犂逗姦犂逗犂犁犂犁犂む犂鉦苅犁. 犂犂萎歓犂犂鉦完犂r 犂犂萎款犂犂逗犁 犂犁犂犂 犂犂迦寛 犂犁犂犂朽犂む犂む歓犂犂犁犂犁 犂犂犂逗寒犂犁犂犂逗犁犂犁犂犂犁犂 犂犂む犂む完犂 犂犁犂犂朽犂む犂む歓犂 犂む犁犂犂萎犂犁犂犁犂 犂犁犂犂犂犁犂n 犂犂朽苅犁犂犂 犂犂犁犂犂萎歓犂犂逗犁犂犁犂犂犁犂 犂犂朽苅犂.
- 32. TIPS TO CARE TAKERS nAVm BjieL eeVKARiK aTum VirNj AlANm ArN d amKARm
- 33. LIFE SKILLS Decision making Creative thinking Effective communication Self awareness Coping with emotions Problem solving Critical thinking Interpersonal relationship skills Empathy Coping with stress
- 34. S]MXP-P ]側M-FN俗W Xt賊i `c-W-tI-{亮-則 aX-t-Xm-臓 k其-族-tk-mw-K-則 IpSpw-_{io Ab臓q束w km贈-cXm {]h俗-I XpS-則n-b-h hnZym属n-I
- 36. Education is not the amount of information, that is put into your brain and runs riot there undigested - Swami Vivekananda