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  • - [Instructor] Schizophrenia is a disorder of the brain.

  • What it is absolutely not,

  • it has nothing to do with multiple personalities.

  • When we think about the brain, we think

  • about things that can cause schizophrenia

  • and there are likely to be many different causes,

  • but we know that it's likely to be a combination

  • of genetics and environmental causes that will be at play,

  • and when I say environmental, that may include things

  • like the experience in the womb

  • and also growing up, childhood experiences,

  • so it's really a combination of these two big factors

  • that leads to abnormalities in the brain,

  • and these abnormalities in the brain can actually

  • be picked up by some of the tests that we have today.

  • Some of our brain imaging tests can show some

  • abnormal changes in some individuals with schizophrenia.

  • We know that some of the neurotransmitters,

  • the brain chemicals, are also abnormal in schizophrenia.

  • In particular, there is a neurotransmitter called dopamine

  • that is often thought to be too high or elevated

  • in certain parts of the brain in schizophrenia,

  • and quite a number of the medicines I use

  • to treat schizophrenia, the anti-psychotic medicines,

  • aim to work against dopamine.

  • Unfortunately, brain scans, measuring neurotransmitters,

  • none of these tests ever diagnose schizophrenia.

  • Schizophrenia is actually diagnosed

  • based on a clinical interview,

  • and that means taking a history,

  • hearing from the patient or their family

  • exactly what's been happening over time,

  • and also observing the patient.

  • Well, why would we observe the patient?

  • Because we know that these brain changes may actually

  • cause changes in how a patient behaves.

  • Their behavior may be altered,

  • and we can further break this down

  • into changes in the way they think

  • and changes in the way they act, and we think about ways

  • that people with schizophrenia may think differently.

  • We start to think about having abnormal beliefs,

  • something that we actually call delusions,

  • and they may also happen to see and hear things that

  • aren't there, something that we refer to as hallucinations.

  • Now, people can have delusions and hallucinations

  • in other conditions, but these are

  • some of the symptoms of schizophrenia.

  • Also, the way that they act may be different.

  • They may isolate themselves socially.

  • They may be somewhat disorganized

  • or somewhat confused in their actions,

  • especially to people looking at them from a distance.

  • They may have something that we call a flat affect,

  • and that basically means they lack emotions on their face.

  • This is by no means an exhaustive list,

  • but we can start to see that the way that they think

  • and the way that people with schizophrenia act,

  • there's a lot of changes here that people would

  • start to feel maybe abnormal or different.

  • Now, let's think a little more widely about schizophrenia.

  • How common is this condition?

  • Well, we know that approximately one percent

  • of people have schizophrenia.

  • The exact number is actually a little bit less than that

  • in the US; it's actually 0.7%,

  • and we know that males are typically affected

  • as much as females, and we know

  • that this is a condition that affects people

  • between the age of 16 and 30.

  • Although it can happen in childhood

  • and in older individuals, this is the most common age group,

  • with males being affected at a younger age than females.

  • When we think about schizophrenia,

  • we should also think about the fact

  • that there is something called the prodrome

  • and the prodrome represents a period of time

  • before schizophrenia, the symptoms are fully present,

  • but it's actually a kind of deterioration

  • in a person's behavior and functioning.

  • Things are starting to go downhill

  • and in the prodrome, typically what may happen is

  • that people will start to demonstrate

  • some of the signs of schizophrenia,

  • but what you will notice is their academic or schoolwork

  • may suffer, and I say schoolwork because if you think about

  • between 16 and 30, and if the prodrome precedes that,

  • you're talking about individuals

  • that are often still in the educational system,

  • but if they're working, the work can suffer.

  • Also, their relationships may suffer.

  • They may exhibit some paranoia

  • or suspiciousness towards other people.

  • Some of their thoughts may be

  • that people are working against them,

  • so they may develop some of these delusional ideas

  • and they may start to act differently.

  • The prodrome then often leads to schizophrenia

  • and we know that if somebody has schizophrenia,

  • they are at risk of having lots of different consequences.

  • For example, they're at a higher risk of suicide,

  • a higher risk of being homeless,

  • and a higher risk of being in prison or in jail.

  • So these are some basics to think about

  • when we start to hear the word schizophrenia.

  • Schizophrenia is a brain disorder that's neurodevelopmental,

  • a combination of genetics and environment,

  • and we can notice that there's differences

  • in brain scans and neurotransmitters,

  • but it's really diagnosed on clinical interview

  • and it affects how people think and act.

  • It's preceded by this prodrome period

  • where we notice a decrease in functioning

  • and schizophrenia has a lot of repercussions.

  • It stops people engaging in society, results in higher rates

  • of suicide, homelessness and incarceration.

- [Instructor] Schizophrenia is a disorder of the brain.

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B1 中級

統合失調症について (Schizophrenia | )

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    Amy.Lin に公開 2021 年 01 月 14 日
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