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What is psychosis?
What characterizes psychotic disorders?
Emotions
Flat affect Inappropriate affect Cognitions Delusions Disorganized thoughts Behaviors Hallucinations Catatonia Avolition
Schizophrenia
Schizophrenia
A psychotic disorder/ group of related disorders Lifetime prevalence: 1% of U.S. population
DSM-IV-TR Criteria
2 or more (or 1 if bizarre delusions/auditory hallucinations) during 1month period Delusions Hallucinations Disorganized speech Disorganized/catatonic behavior Negative symptoms Continuous sx for 6 months (at least 1 month active phase) Significant disturbance/ impairment in daily functioning Not due to affective disorder, substance or medical condition
As you watch the clip, note symptoms and characteristics of the disorder that are portrayed.
Positive symptoms
What are positive symptoms of schizophrenia? Excessive or overt Unusual thoughts or perceptions, thought disturbances,
bizarre behavior
Delusions Irrational beliefs Fixed/resistant Types Persecutory Control Grandiose Referential Somatic
Negative symptoms
Deficits in behavior or absence of normal behaviors Flat affect Alogia Believed to reflect slowed cognitive processes, or to
result from cognitive overload (being overloaded with other sx) Avolition Anhedonia Lack of insight regarding mental condition
Cognitive symptoms
Difficulties with concentration and memory Disorganized thinking Slow thinking Difficulty comprehending Poor concentration and memory Difficulty expressing thoughts Difficulty integrating thoughts, feelings, behavior
Risk factors for suicide in individuals with schizophrenia: Single Unemployed Socially isolated Male Violence towards others not typical More likely to harm self than others More likely to be victims of crime (e.g., rape or robbery)
Phases of schizophrenia
Prodromal phase Occurs before onset Symptoms typical of depression Psychotic prophase First full-blown positive symptoms appear May be triggered by stressful event Active phase 6 months or longer of positive and negative symptoms
Residual phase Less prominent symptoms, similar to prodromal phase May constitute the majority of life for individuals with
schizophrenia
Long-term outcomes
Complete remission not likely
15 year study 40% showed periods of improvement Sizable minority were not on medication Long-term outcome may be more positive than
portrayed in DSM-IV-TR
Paranoid subtype
Marked by paranoia
Paranoia may lead to difficulties in relationships Long term prognosis: better than other subtypes; less
disordered cognition and behavior
Disorganized subtype
Disorganized speech and behavior
Catatonic subtype
Characterized by abnormal motor symptoms Immobility Excessive movement Odd postures maintained, motor unresponsiveness Waxy flexibility: others can move their posture, and
they will maintain it Echolalia or echopraxia
Residual Occurs after active phase of schizophrenia Usually involves more negative symptoms Continuance of symptoms like social withdrawal,
blunted affect, odd beliefs or unusual perceptions (not full blown delusions or hallucinations), odd speech tendencies
Schizoaffective disorder Symptoms of schizophrenia and mood disorder Primary symptoms of schizophrenia Depressive type Bipolar type