Psychosis and Schizophrenia

Historical Shift:

psychosis was originally called "dementia praecox" because of its chronic and deteriorating nature.

now has its own spectrum and signs.

the DSM-5 views it as a thought disorder

Symptom Clusters in psychosis

Positive Symptoms: "Additions" to normal experience. the most recognizable features of psychosis.

negative symptoms; "Absences" or Diminutions of Normal Function

disorganized symptoms: disruption of typical actions and behaviors 

general symptoms: symptoms found in multiple disorders 

Delusions: positive symptom

 fixed, false beliefs that cant be changed in light of new evidence 

types of delusions—Persecutory:

The most common type; belief that one is being harmed, harassed, or conspired against.

types of delusions—-erotomanic:

the belief that a person you’ve never met is madly in love with you

types of delusions—-referrential:

the delusion that there are secret messages in television, social media, and news cast that are meant for you 

types of delusions——Somatic

the belief that there is something wrong with your body. (your body parts are from a corpse) 

typos of delusions: control 

being controlled by outside forces, there are thoughts transmitted to me, i can send messages to others, thought deletions

types of delusions—-nihilistic ideas

the belief that you don’t exist. 

positive symptoms: suspisciousness/persecutory ideas

the belief that people are trying to harm you for nefarious reasons, sometimes a general suspiciousness of other people’s actions

positive symptoms: grandiose ideas

the belief that you have special powers/a person of great importance

different from mania because in mania, this would likely have the person think they’re "godlike”   

positive symptoms: hallucinations

seeing, hearing, feeling, or smelling things that are not there (can be vague or fully formed) 

80% of patients have auditory hallucinations—-most often, just loud noises

disorganized communication: psychosis

unable to organize thought, speech, and communication

disorganized speech: neogism

 creation of a word that doesn’t exist/doesnt make sense

disorganized speech: word salad 

mixed word order that doesn’t make sense (salad went bed hop broom fog)

disorganized communication: clang 

when you are trying to find a specific word, but you can only find words that rhyme, not the actual word. (headache = bed, tread, dread)

disorganized communication: derailment 

jumping topics/inability to maintain a topic when the topics are nonexistent.

EX: talking about favorite movies, mention someone who likes the movie, list the schools they went to. 

negative symptoms: Avolition

lack of motivation (no impulse to open your eyes when waking up)

negative symptoms: Anhedonia

Inability to experience pleasure from previously enjoyable activities.

negative symptoms: Alogia

reduced speech

negative symptoms: Asociality

social withdrawal

negative symptoms: Affective Flattening

lack of emotional expression. (they experience emotions normally, this is just their norm)

disorganized symptoms:

disruption in purposeful behavior and action

disorganized symptoms: Catalonia

a lack of movement. a position can be held for a VERY long time w/o verbal or motor actions (standing in the corner for hours)

disorganized symptoms: Catatonic excitement

repeated, nonfunctional movements. This is unattached to any emotion that is being experienced 

disorganized symptoms: Bizarre thinking

 sometimes magical thinking (no real association to think this way) 

disorganized symptoms: MISC 

lack of focus/ attention 

impairment of personal hygiene 

generalized symptoms

sleep disturbances

dysphoric mood

motor disturbances 

unable to cope with stress 

diagnosis

1 month of symptoms, 6 months of functional disturbances and 2 symptoms that are negative, disorganized, or general 

prevalence 

about 1% of the population 

• males onset: late adolescence to early adulthood (1.4x higher than females) but resolves later on to be equal 

• HIGH homotypic continuity (80% of diagnosed children have it in adulthood) 

difference between schizophrenia and Psychosis 

thought broadcasting

The delusions schizophrenic patients have are more bizarre while the delusions for psychosis is mainly related to thoughts 

normative spectrum of psychosis-like experiences 

cocktail party event: hearing your name when you didn’t 

hypnagogia: when you’re falling asleep and you see something 

floaters: seeing a little light in your eye 

Genes

5-80% heritability (WIDLY vary)

• Monozygotic twins: 40% chance if twin is doganosed 

•  Dizygotic twin 5% risk (up from base line 1%)

candidate gene: 21 q deletion syndrome 

• causes brain dev/structure issues

25+ candidate genes that are also associated with ADHD and IQ disorders