Module 25: Schizophrenia Flashcards
John Haslam
superintendent of a British Hospital who outlined a description of the symptoms of Schizophrenia in his book Observations on Madness and Melancholy
Philippe Pinel
French physician who described cases of schizophrenia
Benedict Morel
used the term demence precoce meaning early or premature loss of mind to describe schizophrenia
Emil Kraepelin
+ unified the distinct categories of schizophrenia under the name Dementia Praecox
+ Combined several symptoms of insanity that had usually been viewed as reflecting separate and distinct disorders
+ Distinguished dementia praecox
+ Also noted the numerous symptoms in people with dementia praecox, including hallucinations, delusions, negativism, and stereotyped behavior
What are some symptoms of insanity/schizophrenia that Emil Kraepelin identified?
- Catatonia
- Hebephrenia
- Paranoia
Catatonia
alternating immobility and excited agitation
Hebephrenia
silly and immature emotionality
Paranoia
delusions of grandeur or persecution
Eugen Bleuler
+ introduced the term schizophrenia (“splitting of mind”)
+ Associative Splitting
Positive Symptoms
- Delusions
- Hallucinations
Delusions
misrepresentation of reality (disorder of thought content)
What are the different types of delusions?
- Persecutory
- Referential
- Grandiose
- Erotomaniac
- Nihilistic
- Somatic
- Thought Withdrawal
- Thought Insertion
- Delusions of Control
- Capgras Syndrome
- Cotard’s Syndrome
- Clerambault Syndrome
Persecutory Delusions
belief that one is going to be harmed, harassed and so forth
Referential Delusions
certain gestures, comments, environmental cues, and so forth are directed at one-self
Grandiose Delusions
when an individual believes that he or she has exceptional abilities, wealth, or fame
Erotomanic Delusions
when an individual believes falsely that another person is in love with him or her
Nihilistic Delusions
conviction that a major catastrophe will occur
Somatic Delusions
focus on preoccupations regarding health and organ function
Thought Withdrawal Delusions
thoughts have been “removed” by outside force
Thought Insertion Delusions
thoughts have been put into one’s mind
Delusions of Control
one’s body or actions are being acted on or manipulated by some outside force
Capgras Syndrome
person believes someone he or she knows has been replaced by a double
Cotard’s Syndrome
the person believes he or she is dead
Clerambault Syndrome
characterized by the delusional idea, usually in a young woman, that a man whom she considers to be of higher social and/or professional standing is in love with her
Fregoli Syndrome
a person holds a delusional belief that different people are in fact a single person who changes his or her appearance or is in disguise
Motivational View of Delusions
look at these beliefs as attempts to deal with and relieve anxiety and stress
Deficit View of Delusions
sees these beliefs as a resulting from brain dysfunction that creates these disordered cognitions or perceptions
Hallucinations
experience of sensory events without any input from the surrounding environment
What are the types of hallucination?
- Auditory hallucination
- Autoscopic hallucination
- Hypnagogic hallucination
- Ictal hallucination
- Hypnopompic hallucination
Auditory Hallucination
most common form experienced by people with schizophrenia
Autoscopic Hallucination
individual experiences, all or part of the person’s own body appeared within the external space, viewed from his/her physical body
Hypnagogic Hallucination
happens during sleep
Ictal Hallucination
associated with temporal lobe foci
Hypnopompic Hallucinations
happens when waking up
What is the most active part of the brain during hallucination?
Most active part during Hallucination is Broca’s Area (speech production)
Negative Symptoms
usually indicate absence or insufficiency of normal behavior
What are the different negative symptoms?
- Avolition
- Anhedonia
- Asociality
- Flat Affect/Affective Flattening
Avolition
inability to initiate and persist activities
Anhedonia
lack of pleasure
Asociality
lack of interest in social interactions
Flat Affect/Affective Flattening
do not show emotions when you would normally expect them to
Disorganized Symptoms
- Disorganized Speech
- Inappropriate Affect
- Grossly Disorganized or abnormal motor behavior
Disorganized Speech
individual may switch from one topic to another (derailment or loose associations) or answers to questions may be related or completely unrelated (tangentiality)
What are the different types of disorganized speech?
- Circumstantiality
- Concrete Thinking
- Clang Associations
- Loose Association
- Neologism
- Word Salad
Circumstantiality
excessive and irrelevant detail in descriptions with the person eventually making his/her point
EXAMPLES: “Kumuha ako ng Koko Crunch sa sm, katabi ng honey gold flakes, nasa taas niya yung kellogs, color green yung milo.. masarap yung Koko Crunch,”
Concrete Thinking
unable to abstract and speaks in concrete, literal terms
EXAMPLE: Kapag sinabihan mo siya ng “Break a leg”, iisipin niya na babaliin niya dapat ang legs niya
Clang Associations
are groups of words chosen because of the catchy way they sound, not because of what they mean
“Gusto ko ng arrozcaldo, na apurado pero
bugbog sarado na may champorado at biglang dehado,”
Loose Association
a loose connection between thoughts that are often unrelated
EXAMPLE: “Umuwi ako ng probinsya. Favorite ko ang Speak Now TV. Ay! Malamig pala sa North Pole. Eto nga pala anak ko. Ang sakit mo naman sa puso,”
Neologism
creating a new word meaning only to that person
EXAMPLE: Lathyzoid. Oh, hindi mo alam meaning diba? that’s the point.
Word Salad
combination of words that have no meaning
EXAMPLE: “Mine enchanted why sparks fly grow superman.”
Inappropriate Affect
laughing or crying at improper times
Grossly Disorganized or abnormal motor behavior
childlike silliness to unpredictable agitation
When do the severe symptoms of schizophrenia occur?
More severe symptoms of schizophrenia first occur in late adolescence or early adulthood
Prodromal Stage
1-2 year period before the serious symptoms occur but when less severe yet unusual behaviors start to show themselves
What is the biological explanation behind schizophrenia?
+ Schizophrenia is partially the result of excessive stimulation of striatal dopamine d2 receptors
+ It appears that several brain sites are implicated in the cognitive dysfunction observed among people with schizophrenia, especially prefrontal cortex, various related cortical regions and subcortical circuits, including thalamus and the striatum
Schizophrenogenic Mother
used for a time to describe a mother whose cold, dominant, and rejecting nature was thought to cause schizophrenia in her children
Double bind communication
used to portray communication style that produced conflicting messages, which caused schizophrenia to develop
When does hostility rise in families for individuals with schizophrenia?
Families with high expressed emotion view the symptoms of schizophrenia as controllable and that the hostility arises when family members think that patients just do not want help themselves
What are the different types of schizophrenia?
- Delusional Disorder
- Brief Psychotic Disorder
- Schizophreniform Disorder
- Schizophrenia
- Schizoaffective Disorder
Delusional Disorder
+ one or more delusions for at least 1 month
+ persistent belief that is contrary to the reality in the absence of other characteristics of schizophrenia
+ tend not to have flat affect, anhedonia, or other negative symptoms
+ socially isolated due to being suspicious
+ absence of active phase of schizophrenia (Attenuated Psychosis Syndrome)
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
What kind of delusions may individuals with delusional disorder have?
Erotomanic, Grandiose, Jealous, Persecutory, Somatic, Mixed, Unspecified
Who functions better? An individual with delusional disorder or an individual with schizophrenia.
Delusional disorder; functioning is better than what is observed in Schizophrenia
What can delusional disorder develop into?
eventually develop schizophrenia
Brief Psychotic Disorder
+ presence of one of the ff: delusions, hallucinations, disorganized speech, catatonic behavior for at least 1 day but less than 1 month, with eventual full return to premorbid level of functioning
+ typically experience emotional turmoil or overwhelming confusion
+ can experience relapse
When can an additional diagnosis of brief psychotic disorder can be given to someone who has a personality disorder?
if psychotic symptoms persist for at least 1 day in PD, an additional diagnosis of Brief Psychotic Disorder may be appropriate
Schizophreniform Disorder
two or more of the following, present during a 1-month period: delusions, hallucinations, disorganized speech, catatonic behavior, negative symptoms
How long should the duration of the symptoms be for schizophreniform to be diagnosed?
at least 1 month BUT less than 6 months
To which disorder is the development of schizophreniform similar to?
development similar to schizophrenia
Schizophrenia
+ two or more of the following, present during 1-month period: delusions, hallucinations, disorganized speech, catatonic behavior, negative symptoms
+ disturbance in one or more major areas
+ abrupt or insidious
+ too much use of regression
How long should the duration of symptoms for schizophrenia be for it to be diagnosed?
at least 6 months
What is the prognosis of schizophrenia influenced by?
prognosis is influenced both by duration and by severity of illness and gender
When does the psychotic experience become reduced in schizophrenia?
possible reduced psychotic experience during late life
Schizoaffective Disorder
major mood ep + delusions or hallucinations for 2 or more weeks
Over time, what are the disorders that schizoaffective disorder may eventually develop into?
some individuals tend to change diagnosis into mood disorder or to schizophrenia over time
What is common in schizoaffective disorder?
Anosognosia (poor insight) common in
schizoaffective but less severe than in schizophrenia
