Debunking Schizophrenia Myths

Common Myths about Schizophrenia

• Myth #1: Schizophrenia does not mean "split personality"
• Myth #2: It is not caused by bad parenting
• Myth #3: It is not caused by drug experimentation
• Myth #4: It is not a lack of motivation
• Myth #5: The incidence of schizophrenia is not rising
• Myth #6: It does not always lead to institutionalization and disability
• Myth #7: It is not related to low intelligence
• Myth #8: People with schizophrenia are not always dangerous and violent

Famous People with Schizophrenia

• John Nash, a Nobel Prize winner in Math
• Van Gogh, a famous artist

Medical Management

• Antipsychotic medication: clozapine, risperidone, asenapine, and olanzapine
• These medications decrease positive symptoms, but do not cure schizophrenia
• Side effects: autonomic nervous system signs, endocrine side effects, weight gain, and skin changes
• Close monitoring of drug trials is essential
• A major concern is non-compliance with medication

Assessment

• Goal setting: using the Canadian Occupational Performance Measure (COPM)
• ADL: Assessment of ADL of Personal Life Skills (PLS) using the Milwaukee Evaluation of Daily Living Skills (MEDLS)
• Leisure: Leisure and Activity Configuration, Activity Card
• Motor skills: Assessment of Motor and Process Skills (AMPS)
• Emotional: The Hospital Anxiety and Depression Scale (HADS)
• Function: The Functional Levels Outcome Measure (FLOM)

Goal Setting

• SMART goals
• Based on functional activities
• Integrates goals from patients and family members
• Takes into consideration the expected prognosis (positive vs. negative)

Schizophrenia Definition

• Primarily a disorganization of thinking
• Can result in grossly disorganized behavior, hallucinations, delusions, and deterioration of ADL skills

Schizophrenia Symptoms

• Positive symptoms: delusions, hallucinations, disorganized thinking, and grossly disorganized behavior
• Negative symptoms: reduced emotional expression, alogia, anhedonia, asociality, avolition, and inattention

Other Symptoms of Concern to OT

• Lack of interest in eating (delusions may be an interfering factor)
• Abnormalities of psychomotor activity
• Concentration, attention, and memory difficulties
• Poor psychosocial functioning
• Depersonalization and derealization
• Somatic concerns, such as digestive or weight problems
• Anxieties and phobias
• Hallucinations, which can lead to profound dysfunction in daily life
• Suicide (10% of people with schizophrenia succeed, and 20-40% attempt)

Etiology of Schizophrenia

• Structural anomalies in the brain, including lesions in the brain stem, enlargement of the ventricles, brain atrophy, and abnormalities in the limbic structures, cerebellum, and corpus callosum
• Excess of dopamine or an excessive quantity of dopamine receptors
• Possible cause: exposure to certain viruses prenatally
• Heredity and excessive stress are also contributing factors

Epidemiology

• 6.2 per 1000 persons (Orrico-Sanchez, 2020)
• Greater prevalence in men than women
• Women tend to have a later onset and a more benign course

Prognosis

• A 20-year longitudinal study showed different rates of recovery for those with negative compared to positive symptoms of schizophrenia
• The negative syndrome represents a persistently impaired subsample of schizophrenia patients
• Factors associated with recovering from schizophrenia: shorter durations of untreated psychosis, coping and problem-solving skills, and cultural and environmental influences.