Lesson 10 - Schizophrenia and Other Psychotic Disorders

Who are the two psychologists important in diagnosing Schizophrenia for the first time?

Emil Krapeline and Eugen Bleular

Who first used the name Schizophrenia for the first time?

 Eugene Bleular

What did a scientist named Thomas Wills call this disease?

Dementia praecox

What are some definitions of Schizophrenia?

• "Schizophrenia can be simply defined as the breakdown of a person's mental functioning or the breakdown of intelligence and impulses in one's mind.“ 

• "Schizophrenia is a group of mental illnesses characterized by delusions, hallucinations, irregular speech, and fruitless behaviors." 

• "Schizophrenia is a complex mental disorder characterized by difficulty in distinguishing between reality and non-reality, inability to think logically, difficulty in responding emotionally in general, and difficulty in behaving normally in certain social situations." 

• "Schizophrenia is a distortion of thoughts and perception and a distortion of moods caused by irrational behavior and social isolation."

When do men with this condition often show symptoms?

From an early age and can be clearly diagnosed during adolescence. 

When do women with this condition often show symptoms?

They are more likely to get the disorder in middle age.

What is schizophrenia?

A mental disorder characterized by disturbances in thought processes, cognition, emotional responsiveness, and social interaction.

At what age are initial symptoms detected?

At the age of 23 years for men and 28 years for women

What are the symptoms of Schizophrenia?

Positive symptoms –Excesses of thought, emotions and behavior 

Negative symptoms- Deficits of thought , emotions, and behavior 

Psychomotor symptoms- Unusual movements or gestures

What are the positive symptoms of schizophrenia?

They are exaggerated thoughts, perceptions, or actions that make the person unable to tell what is true. 

• Delusions 

• Hallucinations 

• Disorganized thinking and speech 

• Trouble concentrating

What are delusions?

They are unrealistic strong beliefs that exist in a person that are difficult to get rid of.

What is persecutory delusion?

A delusion in which a person or group of people believe that they are trying to harm, kill, or embarrass them. A person with this condition may lash out in anger at a stranger in public if they think the person is following or stalking them.

What are Grandiose delusions?

They are unfounded or false beliefs that one has special powers, wealth, mission, or identity. For example, 

• They are a king

• Believed to be a creative genius 

• Or their extreme generosity could end poverty in the world.

What are Referential delusions?

A delusion in which the patient believes that suspicious events in the environment refer to him or her personally. For example, certain news publications have direct reference to them that the music playing on the radio is playing for them. That car license plates have meaning attached to them. Patients may believe that after a cup falls on the floor, they are given a cue to leave. 

What are Erotomanic delusions?

A psychiatric syndrome characterized by the delusional belief that one is loved by another person, usually of a higher social status. A person spends his free time finding out everything he can about a famous actor, singer or political figure he believes he loves. 

What are Nihilistic delusions?

The delusional belief that one will die, decay or perish, lose one's inner senses, or cease to exist as a human being altogether.

What are Somatic delusions?

A somatic delusion is a false belief that a person has a physical defect or physical abnormality. They believe that someone has done something bad to him etc.

What are the delusions of control?

According to the patient's narrative, his thoughts, feelings, perceptions or actions are under the control of another agent: Either another person, spirit, machine or unknown force thinks that he is being controlled.

What are the hallucinations?

What you hear, see, smell, taste or feel seems real but exists only in your mind. It is their belief that certain things are perceived by the sense organs without stimulation from the external environment.

What are auditory hallucination?

Parakusia, is the sensory perception of hearing in the absence of an external stimulus. These can refer to many sounds (music, animal voices, telephone ringing).

What are tactile hallucination?

They are sensations of touch without any physical stimulus. Some people may experience sensations of touch or movement on the skin or in the body. Hallucinations are just perceptions created by the mind that seem real to the person experiencing them. 

What is somatic hallucination?

They are defined as physical sensations experienced in the body, when there is no objective source or cause. Examples include sensations like snakes biting in the stomach.

What are visual hallucination?

Seeing images when there is nothing in the environment is a visual hallucination. Simple optical illusions can include flashes or geometric shapes. Complex visual hallucinations can be seen as faces, animals or scenes.

What are gustatory hallucinations?

These hallucinations often involve strange or unpleasant tastes. A relatively common symptom for people with epilepsy is gustatory hallucinations (often with a metallic taste). 

What are olfactory hallucinations?

These causes you to detect odors in your environment that are not actually there.

What are disorganized thinking and speech?

This positive symptom creates a series of disjointed thoughts, making it difficult to follow or understand what a loved one with schizophrenia is trying to say.

What are psychomotor symptoms?

They are abnormal behaviors and movements: being unusually active, exhibiting silly childlike behavior, engaging in repetitive and aimless movements, or exhibiting strange facial expressions and gestures. 

What is catatonia?

It is a set of symptoms that can develop in some patients with schizophrenia. It may include periods when the person moves very little and does not respond to instructions.

What are the negative symptoms of schizophrenia?

A lack of things that most people have. This includes things like facial expressions, emotional response, and less interest in the world.

What are some negative psychological symptoms?

• There seems to be no interest in the world 

• Reluctance to interact with other people (social withdrawal) 

• Inability to feel or express happiness 

• Inability to act spontaneously 

• Loss of sense of purpose. 

• Lack of motivation 

• Doesn't talk much 

• Difficulty speaking due to disorganized thinking

What are some negative physical symptoms?

• A nondescript or blank face 

• Lack of gestures in communication 

• Lack of eye contact 

• Physical inactivity 

• Solitude

What is common among people with schizophrenia?

Suicidal thoughts and behavior.

What is the diagnostic criteria for Schizophrenia?

Must show two or more of the following symptoms for more than a month. 

• Delusions 

• Hallucinations 

• Disorganized speech 

• Disorganized or catatonic behavior 

• Negative symptoms 

If symptoms appear within one month, symptoms must persist for up to six consecutive months

What are the causes of Schizophrenia?

The exact cause of schizophrenia is unknown.

Research shows that a combination of physical, genetic, psychological and environmental factors predispose a person to develop the condition.

What is the biological view?

1. Genetic Factors

2. Biochemical abnormalities

3. Viral problems

4. Pregnancy and birth complications

5. Abnormal brain structures

What is the psychological factors?

1. Various problems faced by the person

2. Social Environment

3. Economic Status

4. Family

5. Socio-cultural factors

What are the causes of drug use?

• Studies have shown that the use of drugs, especially marijuana, cocaine, LSD or amphetamines, can increase the risk of developing schizophrenia, psychosis or a similar illness.

• It is not clear whether the use of drugs directly causes symptoms in people with schizophrenia, or whether they are more likely to use drugs. If people have had previous episodes of psychosis or schizophrenia, drug use can cause them to relapse or stop symptoms from getting better.

What is the treatment for Schizophrenia?

Schizophrenia requires life-long treatment, even when the symptoms go away. Treatment with medication and psychosocial therapy can help manage the condition. In some cases, hospitalization may be necessary. 

What is the needed medication for Schizophrenia?

It is the mainstay of schizophrenia treatment, and antipsychotics are the most commonly prescribed medications. They are thought to control symptoms by affecting the neurotransmitter dopamine in the brain.

What is the psychosocial intervention?

After psychosis resolves, in addition to continued medication, psychological and social (psychosocial) interventions are important.

What is individual therapy?

Psychotherapy helps normalize thought patterns. Also, learning to cope with stress and recognizing early warning signs of relapse can help people with schizophrenia manage their illness.

What is social skills training?

This focuses on improving communication and social interaction and improving the ability to participate in daily activities.

What is family therapy?

This provides support and education for families dealing with schizophrenia.

What are vocational rehabilitation and support jobs?

This focuses on helping people with schizophrenia prepare for, find and keep employment.

What is Hospitalization?

In times of crisis or severe symptoms, hospitalization may be necessary to ensure safety, proper nutrition, adequate sleep and basic hygiene.

What is electroconvulsive therapy?

It may be considered for adults with schizophrenia who do not respond to drug therapy.

What is coping and support?

• Learn about schizophrenia 

• Focus on goals 

• Avoid alcohol and drug use 

• Ask about social service support 

• Learn to relax and manage stress

What are schizophrenia spectrum and other psychotic disorders?

1. Schizophrenia

2. Delusional Disorder

3. Brief Psychotic Disorder

4. Schizophreniform Disorder

5. Schizoaffective Disorder

6. Substance-Medication Induced Psychotic Disorder

What is the criteria for Schizoaffective Disorder?

1. An uninterrupted period of illness during which there is a major mood episode (major depressive or manic) concurrent with Criterion A of schizophrenia. 

Note: The major depressive episode must include Criterion A1: Depressed mood.

How long should schizoaffective disorder take place to be diagnosed?

Delusions or hallucinations for 2 or more weeks in the absence of a major mood episode (depressive or manic) during the lifetime duration of the illness.

What is the criteria for Schizophreniform Disorder?

Two (or more) of the following, each present for a significant portion of time during a 1-month period (or less if successfully treated). At least one of these must be (1), (2), or (3): 

1. Delusions. 

2. Hallucinations. 

3. Disorganized speech (e.g., frequent derailment or incoherence). 

4. Grossly disorganized or catatonic behavior. 

5. Negative symptoms (i.e., diminished emotional expression or avolition).

How long should schizoaffective disorder take place to be diagnosed?

An episode of the disorder lasts at least 1 month but less than 6 months. When the diagnosis must be made without waiting for recovery, it should be qualified as “provisional.”

What is the criteria for Delusional Disorder?

The presence of one (or more) delusions with a duration of 1 month or longer.

Apart from the impact of the delusion(s) or its ramifications, functioning is not markedly impaired, and behavior is not obviously bizarre or odd.

How long should Delusional Disorder take place to be diagnosed?

Duration of 1 month or longer

What is criteria for Brief Psychotic Disorder?

Presence of one (or more) of the following symptoms. At least one of these must be (1), (2), or (3): 

1. Delusions. 

2. Hallucinations. 

3. Disorganized speech (e.g., frequent derailment or incoherence). 

4. Grossly disorganized or catatonic behavior. 

How long should Brief Psychotic Disorder take place to be diagnosed?

At least 1 day but less than 1 month