Chapter 13 Schizophrenia Spectrum and Other Psychotic Disorders Flashcards
Schizophrenia
- The startling disorder characterized by a broad spectrum of emotional dysfunctions including delusions, hallucinations, disorganized speech and behavior, and inappropriate emotions.
- Disorder characterized by a broad spectrum of cognitive and emotional dysfunctions including hallucination, delusions, disorganized speech and behaviour and inappropriate emotions
- one of the most severe mental illnesses
- effects men more *more women then men later on in life
- no one essential symptom (ex arthur who it came and went)
Clinical description of Schizophrenia
- negative symptoms come first
- onset of positive symptoms “psychotic break”
- negative symptoms are hard to treat
- Positive symptoms dramatic but respond to medication
Course of Schizophrenia
- prodromal phase starts in high school
- 1st active phase in late teens, early 20’s
- residual phase ongoing following treatment for positive symptoms
- additional active phase from time to time if stressor
- recovery is not as good with each successive active phase
- 22% of individuals have one episode and return to premorbid functioning
Prevalence of Schizophrenia
1% of general population, equally common in both men and women, later onset in women, more commonly diagnosed in ethnic minorities
Schizophrenia: Genetic influences
Liklihood someone will develop schizophrenia if they are related to someone who has it tracks very well with genes that are shared
- 48% ID twins
- 46% if both parents have schizophrenia
- 17% dizygotic twin has schizophrenia
- 15% if one parent
- <5% if other relative
Catatonia
- alternating immobility and excited agitaiton
Hebephrenia
silly and immature emotionality
Paranoia
delusions of grandeur or persecution.
Psychotic behavior
- Unusual behaviors, usually involving delusions (irrational beliefs) and/or hallucinations.
Positive symptoms
- Delusions- delusion of grandeur (exaggerated importance), delusions of persecution- “out to get me”,
- Hallucinations- auditory most common (more activity in the Brocas area of the brain), visual, oolfactory, gustatory (taste), and tactile (touch)
- Symptoms that are added to a person’s experience.These are delusions and hallucinations.
- Overt symptoms.
Delusion
- delusion of grandeur (exaggerated importance), delusions of persecution- “out to get me”,
- Disorder of thought content.
- A belief that would be seen by most others as a misrepresentation of reality
- thinking that someone else is putting thoughts into your head
- delusions of grandeur (thinking your someone your not ex. that you can cure all hunger in the world)
- delusions of persecution common (believing others are out to get you)
- Cotards syndrom - person believes part of their body has changed
- Capgras syndrom - believes someone has been replaced by a double
Delusion of grandeur
A mistaken belief that the person is famous or powerful
Delusions of persecution
People are out to get them.
Hallucination
- sensory experience without external stimuli
- hearing, seeing, smelling, tasting, or feeling something that isn t actually present - Experiencing sensory events without the presence of stimuli. Most common is auditory.
- The experience of sensory events without any input from the surrounding environment
- Auditory most common, but can be from any sense like vision (like video)
- Say they feel bugs on them - A psychotic symptom of perceptual disturbance in which something is seen, heard, or otherwise sensed although it is not actually present.
Negative symptoms
- Avolition, Alogia, Anhedonia, and Flat Affect (absence of affect)
- Symptoms that are absent from their experience.
- Behavioural deficits
- Tend to endure beyond acute episodes
- These are behaviors/thoughts/things that are subtracted from a “normal” experience and render it abnormal
- they include emotional and social withdrawal, apathy and poverty of speech or thought
- Less outgoing symptoms such as the absence or insufficiency of normal behaviors.
Avolition
- inability to initiate and persist, lack of motivation
- Lack of energy and absence of interest in or an inability to persist in what are usually routine activities
- usually personal hygiene
- highly associated with poor outcomes compared to other symptoms
Alogia
- absence of speech
- Relative absence of speech, delayed comments or slow responses to questions
- a deficiency in the amount or content of speech.
Anhedonia
- absence of pleasure
- Lack of pleasure experienced
- Loss of interest in or a reported lessening of the experience of pleasure. Included in eating, social interactions and sexual relations. Delay in seeking treatment for schizophrenia
- Inability to experience pleasure.
Affective Flattening/ Flat affect
- No outward expression of emotion. About 2/3 experience this. Respond inside rather then outside, like wearing a mask.
- An apparently emotionless demeanor (including toneless speech and vacant gaze) when a reaction would be expected.
Disorganized speech
- (tangentiality or loose association/ derailment
Inappropriate Affect- crying when something is happy, laughing uncontrollably
Disorganized behavior- agitation and gesturing that its extreme and nonsensical, catatonic immobility and waxy flexibility - Jumping from topic to topic, speaking illogically.
- Disorganized speech, motor behaviour, and emotional reactions
- Inappropriate affect and disorganized behaviour
- Disorganized speech, motor behaviour, and emotional reactions
- Style of talking characterized by incoherence and lack of typical logic patterns, jump from topic to topic
- “associative splitting” or “cognitive slippage”
Disorganized symptom
- Disorganized speech (tangentiality or loose association/ derailment
Inappropriate Affect- crying when something is happy, laughing uncontrollably
Disorganized behavior- agitation and gesturing that its extreme and nonsensical, catatonic immobility and waxy flexibility - Variety of erratic behaviors that affect speech, motor behavior, and emotional reactions.
Disorganized Type
disrupted speech and behavior
- disjointed hallucinations and delusions
- flat or inappropriate affect
Disorganized behaviour
Disorganized Behaviour: Bizarre behaviours. Includes catatonic immobility, waxy flexibility (tendency to keep limbs in position a person puts them in ie. therapist) and hoarding
Inappropriate affect
- crying when something is happy, laughing uncontrollably
- laughing at a funeral. Bizarre behaviors.
- Emotional responses are out of context (laughs at family pet dying, mad at winning the lottery)
- An emotional display that is inappropriate for the situation.
Catatonic immobility
Disturbance of motor behavior in which the person remains motionless, sometimes in an awkward posture, for extended periods
Waxy flexibility
Rigidity, agitation, odd mannerisms