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some prognostic factors that tell us
whether or not a patient with
schizophrenia is going to do really well
or not so well our things such as the
onset of the illness okay if somebody is
presenting with an illness a little bit
older they're gonna have a better
prognosis than if they're presenting at
a very young tender age also having good
social supports from family friends
psychiatrists primary care providers all
of these things are gonna lead towards a
better prognosis and when it comes to
symptomatology we know that having
positive symptoms so things like
paranoia hallucinations delusions
thought disorder these things actually
all trend towards a better prognosis we
think of them as a little bit easier to
treat than somebody who has negative
symptoms that leads to a little bit of a
worse prognosis somebody who has mood
symptoms is also going to have a better
prognosis than somebody without mood
symptoms mood disorder can be treated
and therefore if that's targeted a
person can have a good outcome and
usually females tend to do a little bit
better than males in terms of prognosis
and any patient who is diagnosed with
schizophrenia will probably experience
and hopefully experience remissions from
their disorder however relapses are
possible but for those patients who have
very few and far between relapses
they're going to do much better in the
long run than a patient who's having
very frequent relapses of their disorder
and another key variable is what the
premorbid functioning was for a patient
so somebody say like mr. B who is doing
really well before their symptoms
in college engaged with their family
having hobbies etc that person's going
to be more likely to do really well and
have a good prognosis overall here's an
important question for you
our patients with schizophrenia more
likely to be violent actually no
individuals with schizophrenia are more
likely to be victims of violence than
perpetrators a very important point to
remember so when you think about mr. B
what is your prognosis for him this
young college student who has found
himself diagnosed with schizophrenia
well he actually shows some really good
prognostic factors and these are very
important to emphasize to both him and
his family so some of the factors
supporting a favorable outcome for him
include being enrolled at college this
indicates he has a high intelligence and
a good premorbid functioning beyond that
there's the presence of his supportive
family which is very hopeful and this
appears to be mr. B's first episode of
psychosis and with the right treatment
and compliance he might not have many
future episodes and can actually do very
well despite his illness let's talk
about the behavioral therapy treatment
in schizophrenia
this is aimed to improve a patient's
ability to do well and actually function
within society so therapy is aimed at
developing social skills
self-sufficiency and also an ability to
act appropriately in public and this is
all the aim of behavioral therapy
there can be cognitive problems
associated with schizophrenia can you
think of what any of those are well
deficits and processing of complex
information can occur maintaining a
steady focus of attention working memory
can be impaired distinguishing between
relative and irrelevant stimuli can also
happen and abstract thinking can also be
disrupted when it comes to social skills
training what limitations are there in
training persons with schizophrenia well
there is a difficulty
in generating information learned or
sorry there is a difficulty in
generalizing information learned into
real-life settings for some patients the
best approach in terms of being a
therapist and working with a patient who
has schizophrenia is to be direct and
straightforward take an active and
assertive posture to provide structure
and when it comes to group therapy note
that it's not very well tolerated and
individuals with psychosis because of
the over stimulation only very
high-functioning and stable persons can
tolerate insight oriented groups some
other syndromes that are important to be
aware of are as follows Capgras syndrome
this is the delusion that imposters have
replaced familiar people for goalies
syndrome is a delusion that a persecutor
is taking on a variety of faces like an
actor like Anthropy is a delusion of
being a werewolf
Judis copy is a false belief that one
has a double
guitard syndrome this is the delusional
belief that an individual has lost
everything including their body organs
and if all you do is a shared psychotic
disorder or shared delusion between more
than one person this summarizes
schizophrenia and some other related
psychotic disorders very important to
note the history background epidemiology
the causes of schizophrenia and the
treatment
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