schizophrenia + psychotic disorders Flashcards
Delusions, Hallucinations, Disorganized thinking (formal thought disorders), Disorganized abnormal motor behavior (catatonia), Negative symptoms
Schizophrenia and other Psychotic Disorders
Usually begins before age 25
Diagnosis based on psychiatric history and mental status examination
No laboratory tests
Schizophrenia
Demence precoce
Described deteriorated patients whose illness began in adolescence
BENEDICT MOREL (1809-1873)
Dementia precox- change in cognition and early onset (precox) of disorder
Long term deteriorating course and clinical symptoms of hallucinations and delusions
EMIL KRAEPELIN (1856-1926)
Schizophrenia
Schism- “separation”
Presence of schism among thought, emotion and behavior
EUGENE BLEULER (1857-1939)
Identified 4 primary symptoms (4As) of Eugene Bleuler
Associations
Affect
Autism
Ambivalence
Prevalence of Schizphrenia
0.3-0.7%; US 1%
M=F
Peak age of onset of Schizophrenia
10-25yo in M; 25-35 yo and onset after 40 yo (bimodal) in F
Onset before age 10 and after 60 is extremely rare
Type I
Normal brain structures by CT scan
Relatively good response to treatment
Hallucination, delusions, bizarre behavior and positive formal thought disorder
Positive Symptoms of Schizophrenia
Type II
Structural brain abnormalities by CT scan
Poor treatment response
Diminished emotional expression
Avolition, Alogia, Anhedonia, Asociality
Negative Symptoms of Schizophrenia
decrease in motivated self-initiated purposeful activities
Avolition
diminished speech output
Alogia
apparent lack of interest in social interactions
Asociality
Criterion A for schizophrenia has never been met.
Apart from the impact of the delusion(s) or its ramifications, functioning is not markedly impaired, and behavior is not obviously bizarre or odd.
Delusional Disorders
Types of Delusional Disorder
Erotomanic, Grandiose, Jealous, Persecutory, Somantic
This subtype applies when the central theme of the delusion is that another person is in love with the individual.
Erotomanic type
This subtype applies when the central theme of the delusion is the conviction of having some great (but unrecognized) talent or insight or having made some important discovery.
Grandiose type
This subtype applies when the central theme of the individual’s delusion is that his or her spouse or lover is unfaithful.
Jealous type:
This subtype applies when the central theme of the delusion involves the individual’s belief that he or she is being conspired against, cheated, spied on, followed, poisoned or drugged, maliciously maligned, harassed, or obstructed in the pursuit of long-term goals.
Persecutory type:
This subtype applies when the central theme of the delusion involves bodily functions or sensations.
Somatic type
Most common type of delusional disorder
Persecutory type
Duration of an episode of the disturbance is at least 1 day but less than 1 month, with eventual full return to premorbid level of functioning
Brief Psychotic Disorder
At least one of these 3 symptoms should be present in brief psychotic disorder
Delusions
Hallucinations
Disorganized Speech (e.g., frequent derailment or incoherence)
onset of brief psychotic disorder
at least 1 day but less than 1 month
An episode of the disorder lasts at least 1 month but less than 6 months. When the diagnosis must be made without waiting for recovery, it should be qualified as “provisional”
Schizophrenic Disorder
