Lesson 7: Schizoprenia & Psychotic Disorders (copy)

Schizoprenia

Major Disturbances in thought, emotion, and behavior

Disordered Thinking

Ideas not logically related, faulty perception and attention

Lack of emotional expressiveness

Inappropriate or flat emotions

Disturbances in movement or behavior

Disheveled appearance

TRUE

T or F: Schizophrenia can disrupt interpersonal relationships, diminish capacity to work or live independently

Suicide and Death

Schizophrenia significantly increased rates of _____ and _____

Men, Women

Affects ____ slightly more often than _____

Late adolescence or Early adulthood

Onset of schizophrenia typically ______ or _____ wherein men are diagnosed at a slightly earlier age.

African Americans

Schizophrenia is diagnosed more frequently among ______

Emil Kraepelin

Unified the distinct categories of schizophrenia under the name Dementia Praecox (old name for schizophrenia); distinguished dementia praecox and noted numerous symptoms (hallucinations, delusions, negativism, stereotyped behavior)

1. Catatonia

2. Hebephrenia

3. Paranoia

Combined several symptoms of insanity that had usually been viewed as reflecting separate and distinct disorders:

Catatonia

Alternating immobility and excited agitation

Hebephrenia

Silly and immature emotionality

Paranoia

Delusions of grandeur (thinking of being the highest) or persecution (fear of being killed or rejected by people around them)

2 or more symptoms for at least 1 month (6 months or more); 1 symptom should be either 1, 2, or 3:

1. Delusions

2. Hallucinations

3. Disorganized speech

4. Disorganized (catatonic) behavior

5. Negative Symptoms (diminished motivation or emotional expression)

Criteria for Schizophrenia

1. Positive Symptoms

2. Negative Symptoms

3. Disorganized Symptoms

3 Major Clusters of Symptoms of Schizophrenia

Positive Symptoms

Delusions and Hallucinations; Most obvious

Negative Symptoms

Avolition, Alogia, Anhedonia, Blunted affect, Associality; Usually indicate absence or insufficiency of normal behavior

Disorganized Symptoms

Disorganized behavior and disorganized speech

1. Prodromal

2. Active

3. Residual

Stages of Schizophrenia

Prodromal

Noticeable psychotic symptoms with awareness of changes (Normal but with sense of awareness that there is changes in them)

Active

Exhibit positive symptoms (can be diagnosed)

Residual

Fewer symptoms but with negative symptoms; no positive symptoms

Delusions

Mispresentation of reality (disorder of thought content)/firmly held beliefs (beliefs that are out of reality)

1. Persecutory

2. Referential

3. Grandiose

4. Erotomanic

5. Nihilistic

6. Somatic

Types of Delusions

Persecutory

Belief that one is going to be harmed, harassed and so forth.

Referential

Certain gestures, comments, environmental cues, and so forth are directed at one-self. (Feeling niya siya pinag-uusapan ng lahat)

Grandiose

When an individual believes that he or she has exceptional abilities, wealth, or fame

Erotomanic

When an individual believes falsely that another person in in love with him or her (nag tanong lang, feeling niya in love na sakanya)

Nihilistic

Conviction that a major catastrophe will occur (tornado, earthquake, etc); can have other beliefs about objects.

Somatic

Focus on preoccupations regarding health and organ function (feeling nila may sakit sila, may nawawalang part ng katawan, or nagpapalit palit parts ng katawan)

Hallucinations

Experience of sensory events without any input from the surrounding environment (Negative input of senses)

Auditory Hallucinations

Most common form experienced by people with schizophrenia (feeling nila may bumubulong sakanila pero sarili lang nila yon = repressed thoughts nila)

Broca’s Area

Most active part during Hallucination, speech production.

Disorganized Speech

Individual may switch from one topic to another

Derailment or loose associations

Sentences are not matched

Tangentiality

Answers to questions may be related or completely unrelated.

Word Salad

Mixed up words (ex: kumain umaga kagabi adobo bukas)

Clang associations

Are groups of words chosen because of the catchy way they sound, not because of what they mean

Inappropriate Affect

Laughing or crying at improper times (tatanong mo then biglang tatawa or sisigaw or iiyak)

Grossly Disorganized or Abnormal Motor Behavior

Childlike silliness to unpredictable agitation

Capgras Syndrome

Person believes someone he or she knows has been replaced by a double

Cotard’s Syndrome

Person believes he or she is dead

Clerambault Syndrome

Characterized by the delusional idea, usually in a young woman, that a man is inlove with her (feeling niya lahat inlove sakanya); same with erotomanic

Avolition

Inability to initiate and persist activities (no interest to do basic daily tasks)

Anhedonia

Lack of pleasure (hobbies)

Asociality

Lack of interest in social interactions

Affective Flattening/Flat Affect (Blunted affect)

Do not show emotions when you would normally expect them to (taas kilay lang as response)

Alogia

Reduction in speech (cant interact dahil sa lack of speech)

TRUE

T or F: Relatives of individual with schizophrenia are at increased risk

TRUE

T or F: Negative symptoms have stronger genetic component

TRUE

T or F: Children of non-schizophrenic twin were more likely to develop schizophrenia (9.4% vs. 1% in general population)

12% Risk

Identical Twins: 44% Risk :: Fraternal Twins: ____

TRUE

T or F: For Fraternal twins, ONLY ONE has schizo, for Identical twins, BOTH have schizo.

Dopamine and Serotonin

Neurotransmitters related to schizophrenia

Ventricle enlargement, Dorsolateral Prefrontal Cortex

If an individual has schizophrenia, there is ______ in the brain and deficiency in ________

TRUE

T or F: An individual can have schizophrenia if a parent had infection (like influenza) or when a mother intakes marijuana/cannabis.

1. Medication

2. Therapy

3. Family Intervention

4. Rehabilitation

Treatment for Schizophrenia

1. Delusional Disorder

2. Shared Psychotic Disorder (Folie a deux)

Other Psychotic Disorders

Delusional Disorder

Persistent belief that is contrary to reality in the absence of other characteristics of schizophrenia; Persistent delusion that is not result of brain seizures or of any severe psychosis; Socially isolated due to being suspicious; some can still function

1. At least 1 month

2. No other psychotic symptoms, delusional only

3. Suspicious

Criteria/Signs and Symptoms of Delusional Disorder

Shared Psychotic Disorder (Folie a deux)

Condition in which an individual develops delusions simply as a result of a close relationship with a delusional individual (nahawaan ng delusional disorder yung vulnerable person kasi naging close sila ng may delusional disorder)

1. Erotomanic

2. Grandiose

3. Jealous (they feel like their sexual partner is unfaitful and are highly suspicious, tamang hinala kahit wala naman ginagawa)

4. Persecutory

5. Somatic

6. Mixed (sabay sabay or lahat meron)

Subtypes & Explain each

Brief Psychotic Disorder

Presence of one or more positive symptoms lasting a month or less. May appear in adolescence or early adulthood. Can experience relapse

At least 1 day in PD

If psychotic symptoms persist for ______, an additional diagnosis of Brief Psychotic Disorder may be appropriate

1. Symptom duration of 1 day to 1 month

2. Often triggered by extreme stress, such as bereavement

3. Symptoms must include either hallucinations, delusions, or disorganized speech

Criteria for Brief Psychotic Disorder

Schizophreniform Disorder

Some people who experience the symptoms of schizophrenia for a few months only. Development similar to schizophrenia. Presence of positive and negative symptoms, there is impairment in functioning.

1. Same symptoms as schizophrenia

2. Symptom duration greater than 1 month but less than 6 months

3. Symptoms must include either hallucinations, delusions, or disorganized speech

Criteria for Schizophreniform Disorder

Schizoaffective Disorder

Symptoms of both schizophrenia and either a depressive or manic episode. Symptoms of a major mood episode are present for a majority of the duration the illness. Typical onset is early adulthood. Some individuals will have a change in diagnosis from schizoaffective disorder to a mood disorder or to schizophrenia over time.

1. Positive and negative symptoms + impairment in functioning + mood affective disorders

2. More than 6 months

Criteria for Schizoaffective Disorder