Chapter 13: Schizophrenia Spectrum and other Psychotic Disorders

Schizophrenia

Characterized by a broad spectrum of cognitive and emotional dysfunctions.

Emil Kraeplelin

Used the term demntia praecox to describe schizophrenic syndrome.

Early subtypes of schizophrenia

Catatonia, hebephrenia and paranoia.

Eugene Bleuler

Introduced the term “schizophrenia”

• identified the different variants that were all included within a spectrum.

Positive symptoms

Having experiences that are not usual.

Delusions

Unchangeable belief in something that is not true.

Hallucinations

Seeing, hearing or feeling something that is not there.

Negative symptoms

Not having experiences that are usual.

Avolition

Inability to initiate and persist in activites.

Alogia

Absence of speech.

Anhedonia

Lack of interest or pleasure.

Asociality

Lack of motivation for social interactions/relationships.

Flat affect

Not showing emotions when emotions would normally be expected.

Tangential Speech

Constantly going off on tangents with no clear line of thought in what the person is saying and not returning to the topic.

Loose associations/derailment

Abruptly changing the topic to something completely unrelated.

Word Salad

Using a mix of random words/phrases that do not make sense.

Inappropriate Affect

Laughing or crying at inappropriate times.

Disorganized behavior

Includes wildly exaggerated movements and immobility (catatonic immobility).

Schizophreniform Disorder

Psychotic symptoms lasting between 1 and 6 months.

• associated with relatively good functioning.

• most patients resume normal lives.

• lifetime prevalence is about 0.2%

Schizoaffective Disorder

Symptoms of schizophrenia and additional experience of a major mood episode.

• psychotic symptoms must also occur outside of the mood disturbance.

• prognosis is similar for people with schizophrenia.

  • psychosis then mood — schizoaffective

  • mood then psychosis — MDD or bipolar with psychotic features.

Delusional Disorder

Characterized by delusions that are contrary to reality.

• lack other positive and negative symptoms.

• better prognosis than schizophrenia

Erotomanic delusion

Belief that another person is in love with you.

Grandiose delusions

Conviction of having some great talent or insight or hvaing made some important discovery.

Jealous delusions

Delusion that spouse/partner is unfaithful.

Persecutory delusions

Delusion that the person is being persecuted.

Somatic delusions

Delusion about bodily functions/sensations.

Catatonia

Unusual motor responses, particularly immobility or agitation and odd mannerisms.

• severe and rare

Brief psychotic disorder

Characterized by positive symptoms of schizophrenia or disorganized symptoms.

• lasts less than a month

• briefest duration of all psychotic disorders.

• typically precipitated by trauma or stress.

Attemtuated Psychosis Syndrome

Refers to individuals who are at high risk for developing schizophrenia or beginning to show signs of schizophrenia.

Endophenotypes

Basic processes linked to the disorder that should be strongly linked to genes rather than the disorder itself.

Dopamine hypothesis

Schizophrenia is partially caused by overactive dopamine.

Tardive Dyskinesia

Involuntary repetitive movements in the body.