Schizophrenia

delusional disorder

the presence of 1 or more delusions with a duration of 1 month or longer

• criterion A for schizophrenia has never been met

delusions

• false personal beliefs that are inconsistent w/ the person’s intelligence or cultural background

• assessing individuals from a variety of cultural backgrounds can be difficult

• some religious & supernatural beliefs may be viewed as bizarre & possibly delusional in some cultural contexts

• elevated religiosity can be a feature of many presentations of psychosis

persecutory

most common delusion; belief that one is going to be harmed, harassed, & so forth by an individual, organization, or other group

referential

common delusion; belief that certain gestures, comments, environmental cues, & so forth are directed at oneself

grandiose

type of delusion; when an individual believes that he or she has exceptional abilities, wealth, or fame

erotomanic

type of delusion; when an individual believes falsely that another person is in love with him/her

nihilistic

type of delusion; the conviction that a major catastrophe will occur

somatic

type of delusion; preoccupations regarding health & organ function

jealous

type of delusion; his or her spouse/lover is unfaithful

mixed

type of delusion; no one delusional theme predominates

unspecified

type of delusion; dominant delusional belief can’t be clearly determined or is not described in the specific types

hallucinations

perception-like experiences that occur w/o an external stimulus

auditory

most common hallucination; voices, clicks, noises, music, & other noises

• command voices that commands for violence to self or others

visual

type of hallucination; people or flashes of light

tactile

type of hallucination; the sensation that something is crawling on or under the skin

gustatory

type of hallucination; unpleasant taste

olfactory

type of hallucination; smell

derailment or loose association

the individual may switch from one topic to another

tangentiality

answers to questions may be obliquely related to completely unrelated

incoherence or word salad

severely disorganized speech & incomprehensible

grossly disorganized behavior

• manifest in a variety of ways, ranging from childlike “silliness” to unpredictable agitation

• in any form of goal-directed behavior, leading to difficulties in performing ADL

catatonic behaviors

marked decrease in reactivity to the environment

• resistance to instruction (negativism)

• to maintaining a rigid, inappropriate or bizarre posture

• to a complete lack of verbal & motor responses (mutism & stupor)

• purposeless & excessive motor activity w/o obvious cause (catatonic excitement)

• repeated stereotyped movements, staring, grimacing, & echoing of speech

negativism

type of catatonic behavior; resistance to instruction

mutism & stupor

type of catatonic behavior; to a complete lack of verbal & motor responses

catatonic excitement

type of catatonic behavior; purposeless & excessive motor activity w/o obvious cause

negative sx

diminished emotional expression (common)

avolition

common negative sx; decrease in motivated self-initiated purposeful activities

alogia

negative sx; diminished speech output

anhedonia

negative sx; decreased ability to experience pleasure

asociality

negative sx; apparent lack of social interactions