Podcast
Questions and Answers
What is the primary term used by Bleuler to describe the mental disorder that involves a split in the mind?
What is the primary term used by Bleuler to describe the mental disorder that involves a split in the mind?
What did Kraeplin associate with the concept of 'dementia praecox'?
What did Kraeplin associate with the concept of 'dementia praecox'?
Which of the following describes the 'first rank symptoms' as argued by Schneider?
Which of the following describes the 'first rank symptoms' as argued by Schneider?
Which of the following is NOT covered in the learning objectives regarding psychotic disorders?
Which of the following is NOT covered in the learning objectives regarding psychotic disorders?
Signup and view all the answers
According to historical conceptualizations, what is the significance of the term schizophrenia?
According to historical conceptualizations, what is the significance of the term schizophrenia?
Signup and view all the answers
What is the relationship between high expressed emotion and relapse in patients?
What is the relationship between high expressed emotion and relapse in patients?
Signup and view all the answers
Which of the following is commonly associated with people experiencing psychosis?
Which of the following is commonly associated with people experiencing psychosis?
Signup and view all the answers
What may exacerbate symptoms in individuals with psychosis?
What may exacerbate symptoms in individuals with psychosis?
Signup and view all the answers
What type of delusion involves an individual believing that they are under the influence of an external force?
What type of delusion involves an individual believing that they are under the influence of an external force?
Signup and view all the answers
What is a somatic delusion primarily concerned with?
What is a somatic delusion primarily concerned with?
Signup and view all the answers
How does psychosis affect the quality of life for individuals?
How does psychosis affect the quality of life for individuals?
Signup and view all the answers
Which type of delusion is characterized by believing one's partner is unfaithful?
Which type of delusion is characterized by believing one's partner is unfaithful?
Signup and view all the answers
Which myth about psychosis contributes to stigma?
Which myth about psychosis contributes to stigma?
Signup and view all the answers
Which type of delusion involves the belief that one's thoughts are being broadcast externally?
Which type of delusion involves the belief that one's thoughts are being broadcast externally?
Signup and view all the answers
In which type of delusion does the individual think that events or objects have personal significance?
In which type of delusion does the individual think that events or objects have personal significance?
Signup and view all the answers
In which disorder are delusions related to unjustified guilt and perceived bodily changes primarily found?
In which disorder are delusions related to unjustified guilt and perceived bodily changes primarily found?
Signup and view all the answers
What is the defining characteristic of a grandiose delusion?
What is the defining characteristic of a grandiose delusion?
Signup and view all the answers
Which delusion is focused on believing one is being conspired against?
Which delusion is focused on believing one is being conspired against?
Signup and view all the answers
What key feature is associated with psychotic disorders?
What key feature is associated with psychotic disorders?
Signup and view all the answers
What type of delusion is characterized by the belief that thoughts are not one's own but inserted by an external source?
What type of delusion is characterized by the belief that thoughts are not one's own but inserted by an external source?
Signup and view all the answers
What differentiates a bizarre delusion from other types of delusions?
What differentiates a bizarre delusion from other types of delusions?
Signup and view all the answers
Which type of delusion would likely involve thinking a famous person is in love with the individual?
Which type of delusion would likely involve thinking a famous person is in love with the individual?
Signup and view all the answers
Which of the following is not a stereotypical delusion found in schizophrenia?
Which of the following is not a stereotypical delusion found in schizophrenia?
Signup and view all the answers
How do ideas of reference differ from delusions of reference?
How do ideas of reference differ from delusions of reference?
Signup and view all the answers
In delusional disorder, which belief is typical?
In delusional disorder, which belief is typical?
Signup and view all the answers
How are hallucinations defined?
How are hallucinations defined?
Signup and view all the answers
What differentiates hallucinations from illusions?
What differentiates hallucinations from illusions?
Signup and view all the answers
Which type of hallucination involves the perception of taste?
Which type of hallucination involves the perception of taste?
Signup and view all the answers
Are auditory hallucinations limited to sounds perceived as external?
Are auditory hallucinations limited to sounds perceived as external?
Signup and view all the answers
Which of the following statements is true concerning insights into hallucinations?
Which of the following statements is true concerning insights into hallucinations?
Signup and view all the answers
Transient hallucinatory experiences can occur in which of the following groups?
Transient hallucinatory experiences can occur in which of the following groups?
Signup and view all the answers
Which of the following is classified as a somatic hallucination?
Which of the following is classified as a somatic hallucination?
Signup and view all the answers
Perceptions of odors like burning rubber are classified as which type of hallucination?
Perceptions of odors like burning rubber are classified as which type of hallucination?
Signup and view all the answers
In which scenario is the term 'hallucination' not generally applied?
In which scenario is the term 'hallucination' not generally applied?
Signup and view all the answers
What is the concordance rate for identical twins (MZ) suffering from schizophrenia according to the studies reviewed?
What is the concordance rate for identical twins (MZ) suffering from schizophrenia according to the studies reviewed?
Signup and view all the answers
What percentage of individuals diagnosed with schizophrenia have neither parent diagnosed with the disorder?
What percentage of individuals diagnosed with schizophrenia have neither parent diagnosed with the disorder?
Signup and view all the answers
Which disorder shows the highest twin concordance rate based on the provided studies?
Which disorder shows the highest twin concordance rate based on the provided studies?
Signup and view all the answers
What was the concordance rate for dizygotic twins (DZ) with schizophrenia according to Gottesman's review?
What was the concordance rate for dizygotic twins (DZ) with schizophrenia according to Gottesman's review?
Signup and view all the answers
What type of twins show a higher concordance rate for schizophrenia?
What type of twins show a higher concordance rate for schizophrenia?
Signup and view all the answers
In the context of schizophrenia, what does a higher concordance rate suggest about the influence of genetics?
In the context of schizophrenia, what does a higher concordance rate suggest about the influence of genetics?
Signup and view all the answers
What does the study of the Genain quadruplets illustrate in the context of schizophrenia?
What does the study of the Genain quadruplets illustrate in the context of schizophrenia?
Signup and view all the answers
Which of the following is the main focus of study when discussing the aetiology of schizophrenia?
Which of the following is the main focus of study when discussing the aetiology of schizophrenia?
Signup and view all the answers
In epidemiological studies, what is the general finding regarding family history in those diagnosed with schizophrenia?
In epidemiological studies, what is the general finding regarding family history in those diagnosed with schizophrenia?
Signup and view all the answers
What kind of studies are primarily relied upon to assess the genetic factors in schizophrenia?
What kind of studies are primarily relied upon to assess the genetic factors in schizophrenia?
Signup and view all the answers
Which statement correctly summarizes the findings regarding schizophrenia's genetic factors?
Which statement correctly summarizes the findings regarding schizophrenia's genetic factors?
Signup and view all the answers
How does higher disturbance in the proband relate to twin studies on schizophrenia?
How does higher disturbance in the proband relate to twin studies on schizophrenia?
Signup and view all the answers
Which of the following disorders had the lowest concordance rate among dizygotic twins according to the data?
Which of the following disorders had the lowest concordance rate among dizygotic twins according to the data?
Signup and view all the answers
From the provided studies, which disorder has a direct comparison illustrating divergence in twin types?
From the provided studies, which disorder has a direct comparison illustrating divergence in twin types?
Signup and view all the answers
Study Notes
Copyright Notice
- This material is reproduced and communicated by or on behalf of the University of South Australia, according to section 113P of the Copyright Act 1968.
- The material may be subject to copyright under the act.
- Further reproduction is also subject to copyright protection under the act.
Chapter 7: Psychotic Disorders
- This chapter discusses psychotic disorders.
Learning Objectives
- Outline the defining symptoms of psychosis.
- Describe the symptoms of DSM-5 psychotic disorders and problems associated with psychosis.
- Explain the evolution of schizophrenia diagnostic criteria and controversies surrounding the diagnosis.
- Outline the prevalence, age of onset, and stages of psychosis.
- Describe the various factors involved in the aetiology of psychosis.
- Describe main treatment priorities and evidence-based treatment options in relation to psychosis phases.
Historical Conceptualisations of Psychotic Disorders
- Kraeplin identified 'dementia praecox', meaning 'senility of the young'.
- Bleuler coined the term 'schizophrenia' meaning 'split mind'.
- Schneider argued for 'first rank symptoms' that were specific to schizophrenia.
Schizophrenia(s)
- Eugen Bleuler noted that schizophrenia involved various diseases.
DSM-5 Types of Psychotic Disorders
- Schizophrenia: At least one month of two or more of the following: delusions, hallucinations, disorganized speech, grossly disorganized/catatonic behaviour, and/or negative symptoms. The disturbance must last at least six months.
- Schizotypal disorder: Pervasive social and interpersonal deficits and cognitive/perceptual distortions and eccentricities of behaviour beginning before early adulthood.
- Schizophreniform disorder: Equivalent to schizophrenia but with a shorter disturbance (one to six months).
- Schizoaffective disorder: Co-occurrence of schizophrenia and a major mood episode, with at least a two-week period of delusions or hallucinations without mood disturbance. Mood symptoms are present for most of the illness duration.
- Delusional disorder: At least one month of delusions.
- Brief psychotic disorder: A psychotic disturbance lasting between one day and a month and returning to premorbid functioning.
- Psychotic disorder due to another medical condition: Prominent hallucinations or delusions resulting from another medical condition.
- Substance/medication-induced psychotic disorder: Hallucinations or delusions arising from substance intoxication or withdrawal.
- Other specified schizophrenia spectrum and other psychotic disorder: Symptoms of psychosis causing distress or impairment but not fully meeting criteria for another psychotic disorder.
- Unspecified schizophrenia spectrum and other psychotic disorder: Symptoms of psychosis causing distress or impairment but not meeting criteria of any psychotic disorder (no specific reasons are provided).
Key Features of the Psychotic Disorders
- Delusions
- Hallucinations
- Disorganized Thinking
- Disorganized or Abnormal Motor Behaviour
- Negative Symptoms
Principal Psychotic Experiences: Delusions
- Firmly held beliefs opposed to reality but maintained despite contrary evidence.
Principal Psychotic Experiences: Hallucinations
- Perceptual experiences involving perceiving something that is not there (positive) or not perceiving something that is there (negative).
Kinds of Delusions
- Bizarre: Implausible according to the person's culture.
- Delusional jealousy: Delusion that relational partner is unfaithful.
- Erotomanic: Delusion that another person is in love.
- Grandiose: Delusion of inflated worth, power, knowledge, identity, or special relationship to a deity.
Kinds of Delusions
- of being controlled: Experiences of actions, thoughts, or impulses being controlled by an external force.
- of Reference: Delusion that events or objects have special significance to the individual.
- Persecutory: Delusion that one (or someone close) is being attacked, harassed, cheated, persecuted, or conspired against.
- Somatic: Delusions related to body appearance or functioning.
- Thought broadcasting: Delusion that one's thoughts are being heard by others.
- Thought insertion: Delusion that thoughts are not one's own, but rather are inserted into one's mind.
Delusional Content in Various Disorders
- Schizophrenia (examples of various contents)
- Depressive disorders (examples of various contents)
- Bipolar disorders (mania)(examples of various contents)
- Delusional disorder (examples of various contents)
Kinds of Hallucinations
- Auditory: Perception of sounds (most commonly voices).
- Gustatory: Perception of taste (usually unpleasant).
- Olfactory: Perception of odours.
- Somatic: Perception of physical sensations in the body.
- Tactile: Perception of touch or something crawling on skin.
- Visual: Perception of images, flashes of light, or people.
Disorganised Thinking in Psychotic Disorders
- Disorganisation
- Loosening of associations
- Confusion
- Disturbances in logical sequencing
DSM-5 Schizophrenia Spectrum and Other Psychotic Disorders (List)
- Schizophrenia
- Schizophreniform disorder
- Brief psychotic disorder
- Schizoaffective disorder
- Delusional disorder
- Schizotypal (personality) disorder
- Substance-induced psychotic disorder
- Psychotic disorder due to a medical condition
DSM-5-TR Diagnostic Criteria for Schizophrenia
- Two or more of the following, present for a significant portion of one-month period.
- Delusions
- Hallucinations
- Disorganized speech
- Grossly disorganized or catatonic behavior
- Negative symptoms
- Marked below premorbid functioning in at least one aspect of life.
- Must have continuous signs lasting at least 6 months
DSM-5-TR: Schizophreniform Disorder
- Similar to schizophrenia, but with a shorter episode (at least 1 month but not exceeding 6 months).
DSM-5-TR: Brief Psychotic Disorder
- Psychotic symptoms that last at least one day but less than one month.
- Return to premorbid level of functioning.
DSM-5-TR Diagnostic Criteria for Schizoaffective Disorder
- Major mood episode (depression or mania) concurrently with schizophrenia symptoms.
- Symptoms of delusions or hallucinations should be present for a period without mood episode
DSM-5-TR Diagnostic Criteria for Delusional Disorder
- One or more delusions lasting at least one month.
- Criterion A for schizophrenia has never been met.
- Functioning is not markedly impaired, and the behavior is not bizarre or odd.
Subtypes of Delusional Disorder
- Erotomanic
- Grandiose
- Jealous
- Persecutory
- Somatic
Epidemiology of Schizophrenia
- Lifetime prevalence is approximately 1-2%
- Men are slightly more affected than women.
- Increased prevalence rate in developed nations and urban settings.
- Onset typically during late adolescence and early adulthood.
Epidemiology of Schizophrenia: Course
- Premorbid phase: Period before symptoms.
- Prodromal phase: Period before onset of full symptoms.
- Acute phase: Active positive and negative symptoms.
- Early recovery phase: Reduction in depressive or anxious symptoms.
- Later recovery: Challenges with reintegration into social, recreational, and vocational pursuits.
Epidemiology of Schizophrenia: Associated Features
- Depression is often prevalent in patients with psychosis.
- High rates of suicide attempts are common in psychotic disorders.
- Anxiety and trauma-related problems are common
- Substance abuse is a common aspect of psychosis
Aetiology of Schizophrenia: Genetic Research
- Genetic factors don't fully explain the disorder.
- Diathesis-stress model: Genetic predisposition + stress triggers onset.
- Possible genetic heterogeneity among individuals.
Aetiology of Schizophrenia: Neurotransmitters
- Dopamine theory (excess dopamine levels; drugs that reduce dopamine activity may reduce symptoms but takes a while.)
- Revised dopamine theory (excess number of dopamine receptors or overly sensitive receptors; dopamine abnormalities related to positive symptoms)
Aetiology of Schizophrenia: Brain Structure and Function
- Enlarged ventricles.
- Reduced activity in prefrontal cortex.
- Developmental factors (prefrontal cortex matures in adolescence).
- Stress activates HPA system (increasing cortisol and dopamine activity).
Treatment of Schizophrenia: Medications
- First-generation antipsychotics (Phenothiazines, butyrophenones).
- Second-generation antipsychotics (Clozapine, olanzapine,risperidone.)
- Newer medications may improve cognitive function.
Treatment of Schizophrenia: Psychological Approaches
- Patient Outcomes Research Team (PORT) recommendations.
- Social skills training, and cognitive behavioral therapy.
- Family therapy to reduce expressed emotion.
- Treatments with a focus on reducing relapse.
Treatment of Schizophrenia: Prodromal Phase
- Emphasis on early detection and intensive intervention to prevent progression.
- Evidence for use of antipsychotics combined with CBT.
Treatment of Schizophrenia: Acute Phase
- Needs 24-hour access to treatment (hospitalisation).
- Pharmacological approaches (antipsychotics).
- Psychosocial approaches (addressing co-morbidities).
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
