BES31412 Finals: Schizophrenia and Other Psychotic Disorders

Emil Kraepelin

• Generally credited for producing the first coherent definition of schizophrenia called dementia praecox.

  • He used the term dementia because schizophrenic people have the tendency to be forgetful (which is a primary symptom of dementia).

Dementia praecox

First coherent definition of Schizophrenia, coined by Emil Kraepelin (1919).

Eugene Bleuler

• Renamed dementia praecox to schizophrenia, which means the splitting of the psychic processes.

• Included the four symptoms:

  • Autism - They have their own world

  • Affective blunting - No emotions

  • Ambivalence

  • Disturbance of the association

Autism, Affective Blunting, Ambivalence, Disturbance of the association

The four symptoms of Schizophrenia, according to Eugene Bleuler

Kurt Schneider

• “First rank severe psychotic disorder which includes thought insertion, withdrawal, thought broadcasting, voices communicating, delusions of being externally controlled.”

• This person influenced the DSM3 and DSM4.

25 to 35 years old

Onset of schizophrenia in women

15 to 25 years old

Onset of schizophrenia in men

female; male

Outcome (or prognosis) for _____ patients is better than _____ patients.

Schizophrenia

• Found in all cultures and socioeconomic status groups.

• Large number in low SES (Socioeconomic Status) groups in industrialized nations.

• Equally prevalent in men and women.

• 50% obtain treatment.

6 months

Schizophrenia requires at least ______ months of continuous signs of disturbance.

Positive Symptoms

These symptoms add something to the patient’s experience of the world.

Negative Symptoms

These symptoms take something away from the patient’s abilities.

Delusions, Hallucinations, Disorganized speech, Disorganized behavior

4 Positive Symptoms of Schizophrenia

Anhedonia, Difficulty communicating with others, Withdrawal from family and friends, Difficulty structuring and organizing activities, Neglecting things

5 Negative Symptoms of Schizophrenia

drugs

The disturbance caused by Schizophrenia must not be attributed to ______.

delusion, hallucination, disorganized speech

During at least 1 month of said period, at least 2 of the following symptoms are present and at least 1 symptom must be ____, ______, or _______.

Erotomanic, Grandiose, Jealous, Persecutory, Somatic, Mixed

6 different types of delusions

Erotomanic Type

Different Types of Delusions

• A person usually of a higher status is in love with the patient.

• Usually occurs in females.

• Usually more romantic than sexual.

Grandiose Type

Different Types of Delusions

• Inflated self-worth, power, knowledge, identity, or special relationship with a deity or an important person.

Jealous Type

Different Types of Delusions

• False belief that the patient’s sexual partner is unfaithful.

• Usually occurs in males.

• May result in assault, suicide, or homicide.

Persecutory Type

Different Types of Delusions

• Belief that a patient or someone close to the patient is being malevolently treated in some way.

Somatic Type

Different Types of Delusions

• False belief of having a physical defect or general medical condition.

• Patterns include concerns about:

  • Parasites or insect infestation

  • Body, nose, face, or hair has been altered

  • Emission of foul odors

Mixed Type

Different Types of Delusions

• More than one of the five types are present.

Schizophreniform Disorder, Brief Psychotic Disorder, Schizoaffective Disorder, Delusional Disorder

4 other types of Psychotic Disorder

Schizophreniform Disorder

Other Psychotic Disorders

If a person has experienced at least a month but less than 6 months of schizophrenia symptoms.

Brief Psychotic Disorder

Other Psychotic Disorders

If a person has experienced at least 1 day but less than 1 month of schizophrenia symptoms.

Schizoaffective Disorder

Other Psychotic Disorders

If a person who meets the criteria for schizophrenia also experiences major mood disturbances (either major depressive episodes or manic episodes).

Delusional Disorder

Other Psychotic Disorders

• If a person experiences only delusions whether bizarre or non-bizarre.

• Has never met the full criteria for schizophrenia.

• Functioning level is not markedly impaired.

12%

Chance of child acquiring Schizophrenia if one parent has it

40%

Chance of child acquiring Schizophrenia if both parents have it

Double Bind

Children receive conflicting parental messages about their behavior, attitude, and feelings.

Expressed Emotion (EE)

Overt-criticism and over-involvement towards the patient.

Genes, Chemical imbalance in the brain, Changes in the brain structure and function, Psychological factors (Double Bind, Expressed Emotion or EE)

4 possible causes of schizophrenia

Antipsychotic drugs

Medication for Schizophrenia and psychotic disorders

Talk Therapy

Pathway to Recovery

• This treatment allows patients to clarify confusing thoughts.

• Also allows patients to verbalize thoughts and emotions.

Medication

Pathway to Recovery

Antipsychotic drugs (novel and conventional with side effects)

Family and Group Therapy

Pathway to Recovery

• Provide care and support for the patient’s family.

• Enables family to help patient more efficiently.

• Allows patients to improve social skills.

Psychoeducation

Pathway to Recovery

• The patient’s symptoms are due to illness and not a weakness of character.

• The patient’s illness is not only because of upbringing but an interaction of several factors namely, biological, psychological, and social.

Medications, Talk Therapy, Family and Group Therapy, Psychoeducation

4 types of treatment for Schizophrenia and Psychotic Disorders