Mind Map: Psychotic Disorders

1. Types of Psychotic Disorders

Schizophrenia

Definition: A disorder with abnormal behavior, thoughts, perceptions.

Symptoms: Delusions, hallucinations, disorganized speech/behavior.

Schizophreniform Disorder: Similar to schizophrenia but shorter duration.

Schizoaffective Disorder: Symptoms of both schizophrenia and mood disorders.

Delusional Disorder: Persistent delusions without other schizophrenia symptoms.

Brief Psychotic Disorder: Short-term psychotic symptoms, often stress-related.

Substance-Induced Psychosis: Caused by drugs or alcohol.

2. Historical Figures in Schizophrenia

Morel: Termed "dementia praecox."

Emil Kraepelin: Believed in organic causes, popularized "dementia praecox."

Eugen Bleuler: Coined "schizophrenia," viewed as psychological disorder.

3. DSM-5 Diagnostic Criteria for Schizophrenia

Requires two or more symptoms:

Delusions, hallucinations, disorganized speech, disorganized behavior, negative symptoms.

Duration: Symptoms must persist for at least 6 months.

Exclusions: Symptoms not due to substances or medical conditions.

4. Symptoms of Schizophrenia

Positive Symptoms:

Hallucinations, delusions, thought disorders.

Typically respond well to treatment.

Negative Symptoms:

Avolition, anhedonia, alogia, poor self-care.

Seen in chronic phases, less responsive to treatment.

Cognitive Symptoms:

Memory issues, attention problems, impaired thought processing.

5. Schneider’s First-Rank Symptoms

Delusional Perception: Forming a delusion from a real event.

Auditory Hallucinations:

Third-person voices, running commentary, thought echo.

Thought Interference:

Thought insertion, withdrawal, broadcasting.

Delusion of Control: Belief that external forces control actions or thoughts.

6. Subtypes of Schizophrenia (ICD-10)

Paranoid: Mainly delusions and hallucinations.

Hebephrenic (Disorganized): Disorganized behavior and affect.

Catatonic: Motor symptoms (stupor, posturing, waxy flexibility).

Simple: Social withdrawal, apathy, loss of motivation.

7. Epidemiology and Risk Factors

Lifetime Prevalence: Approximately 1%.

Incidence: 15 per 100,000 per year.

Onset: Earlier in men (15-25 years), later in women (25-35 years).

Risk Factors: Low socioeconomic status, urban residency, immigrant status.

8. Etiology of Schizophrenia

Genetic Factors:

Higher risk with family history, especially for monozygotic twins (50% risk).

Biochemical Factors:

Dopamine hypothesis (overactivity), serotonin, glutamate.

Psychosocial Factors:

Early trauma, high expressed emotion (EE), recent life stressors.

9. Treatment Approaches

Medications:

Typical Antipsychotics: Effective for positive symptoms, risk of extrapyramidal symptoms (EPS).

Atypical Antipsychotics: Treat positive and some negative symptoms, lower EPS risk but may cause weight gain.

Psychotherapy:

Cognitive-behavioral therapy (CBT): Addresses distorted thoughts.

Social skills training: Enhances social interactions.

Preventive Measures:

Regular medication adherence, supportive social environment, low EE in family.

10. Prognosis and Future Directions

Better Prognosis Factors: Later onset, female gender, good social support.

Poorer Prognosis: Early onset, prominent negative symptoms, low social support.

Future Treatments:

Personalized medicine, digital mental health tools, focus on early intervention.

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