Schizophrenia and Psychotic Disorder PDF

Schizophrenia É DPT415 all  Psychosis of loss contact Psychosis is a state defined by a loss of contact with reality...

Schizophrenia É DPT415 all  Psychosis of loss contact Psychosis is a state defined by a loss of contact with reality Find The ability to perceive and respond to the environment is significantly disturbed; functioning is impaired Symptoms may include hallucinations (false sensory perceptions) and/or delusions (false beliefs) Psychosis WE's  Substance-induced residency its  Caused by brain injury trest  Most psychoses appear in the form of schizophrenia  Schizophrenia Definition The DSM-5 describes Schizophrenia in terms of a severe, chronic, and potentially disabling thought disorder. (American Psychiatric Association, 2013) Schizophrenia: “A psychotic disorder in which personal, social and occupational functioning deteriorates as a result of strange perceptions, disturbed thought processes, unusual emotions, and motor abilities” It tends to appear during young adulthood and is typically marked by periods of remission and relapse throughout the lifespan.  DSM V Criteria for Schizophrenia A. Two (or more) of the following, each present for a significant portion of time during a 1-month period (or less if successfully treated). At least one of these must be (1), (2), or (3): Fatima A. Delusions. EB. Hallucinations. C. Disorganized speech (e.g., frequent incoherence) D. Catatonic behavior. E. Negative symptoms (i.e., diminished emotional expression). B. For a significant portion of the time since the onset of the disturbance, the level of functioning in one or more major areas, such as work, interpersonal relationships, or self-care, is markedly below the level achieved prior to the onset (or when the onset is in childhood or adolescence, there is failure to achieve the expected level of interpersonal, academic, or occupational functioning). chetproductivity  DSM V Criteria for Schizophrenia C. Continuous signs of the disturbance persist for at least 6 months. This 6-month period must include at least 1 month of symptoms (or less, if successfully treated) that meet Criterion A (i.e., active phase symptoms). D. Schizoaffective disorder and depressive or bipolar disorder with psychotic features have been ruled out because either 1) no major depressive or manic episodes have occurred concurrently with the active-phase symptoms, or 2) if mood episodes have occurred during active-phase symptoms, they have been present for a minority of the total duration of the active and residual periods of the illness. E. The disturbance is not attributable to the physiological effects of a substance (eg, a drug of abuse, a medication) or another medical condition. F. If there is a history of autism spectrum disorder or a communication disorder of childhood onset, the additional diagnosis of schizophrenia is made only if prominent delusions or hallucinations, in addition to the other required symptoms of schizophrenia, are also present for at least 1 month (or less if successfully treated). Emitter  Symptoms of Schizophrenia Symptoms of schizophrenia are categorized as Positive Negative Cognitive Further classified as motor, behavioral, or mood disturbances  Symptoms of Schizophrenia 1. Positive symptoms: Positive symptoms are disorders of commission, meaning they are something that patients do or think. Examples include hallucinations, delusions, and bizarre or disorganized behavior.  Symptoms of Schizophrenia Hallucinations thing The Sensory perceptions that occur in the absence of external stimuli Most common are auditory Hallucinations can involve any of the other senses: tactile, somatic, visual, gustatory, or olfactory Delusions SEE here Ideas that one believes but have no basis in fact Delusions are. “faulty interpretations of reality”  Symptoms of Schizophrenia delusi Delusion of reference: EatenEditions -They attach special and personal meaning to the actions of others or various objects, events -Example…(car license plates have a meaning relevant to them) Delusion of persecution: -Most common -People believe they are spied on, threatened, attacked, or deliberately victimized. Delusion of grandeur: user -Believe themselves to be great inventors, religious saviors, or other specially empowered persons. -Example…(Jezus, Queen Beatrix) Delusion of control: -Believe their feelings, thoughts, and actions are being controlled by other people Erotomanic delusion: -Belief without any basis whatsoever that they are loved by someone who may actually be a complete stranger.  Bizarre or disorganized behavior Bizarre additions to a person’s behavior Disordered thinking and speech Loose associations (derailment): “The problem is insects. My brother used to collect insects. He’s now a man 5 foot 10 inches. You know, 10 is my favorite number; I also like to dance, draw, and watch TV.” Neologisms (made-up words): “This desk is a cramstile” “He’s an easterhorned head” Perseveration: Patients repeat their words and statements again and again Clang (rhymes): How are you? “Well, hell, it’s well to tell” How’s the weather? “So hot, you know it runs on a cot” But: Loose association also in mania (bipolar disorder) and in normal people who are fatigued.  Symptoms of Schizophrenia 2. Negative symptoms Negative symptoms are disorders of omission, meaning they are things patients do not do. Examples include lack of speech, flat affect, anhedonia, asociality, avolition, and apathy. masteface not engagints  Symptoms of Schizophrenia The poverty of speech (alogia): -Long lapses before responding to questions, or failure to answer -Reduction of quantity of speech or speech content Blunted and flat affect: -show less emotion than most people -Avoidance of eye contact -Immobile, expressionless face -Monotonous voice, low and difficult to hear Anhedonia: -general lack of pleasure or enjoyment Loss of volition (motivation or directedness): -Feeling drained of energy and interest in normal goals -Inability to start or follow through on a course of action Social withdrawal (asociality) -Withdraw from the social environment and attend only to their own ideas and fantasies -breakdown of social skills, incl. the ability to recognize people’s needs and emotions accurately  Symptoms of Schizophrenia 3. Cognitive symptoms Deficits are moderate to severe across several domains, including attention, working memory, verbal learning and memory, and executive functions. 4. Symptoms are further divided by type, including motor, behavioral, and mood disturbances. research II  Onset The DSM-5 reports that Schizophrenia symptoms typically become apparent at ages 18- 35, and Onset prior to adolescence is rare. The peak age at onset for the first psychotic episode is in the 20-25 for males and 26 and up for females. Onset may be abrupt, appearing virtually overnight, or insidious, unfolding over several weeks or months.  Prevalence The prevalence of schizophrenia is about one percent of the general population.  Risk Factors Birth month has been correlated with schizophrenia, specifically late winter through early spring, which is also the flu season. Maternal influenza during the third trimester has been implicated as causal in schizophrenia (Brown & Patterson, 2011). There is a higher incidence of schizophrenia in urban areas and some fee minority ethnic groups. Other genetic factors correlated with risk for schizophrenia include: pregnancy/labor complications with hypoxia, an older father, stress, infection, malnutrition, and maternal diabetes. The DSM -5 notes these factors are inconclusive as far as causality (American Psychiatric Association, 2013). Causes of Schizophrenia  Subtypes of Schizophrenia 1. Paranoid type 2. Disorganized type 3. Catatonic type 4. Undifferentiated type 5. Residual type  Subtypes of Schizophrenia 1. Paranoid type 2. Disorganized type 3. Catatonic type 4. Undifferentiated type 5. Residual type  Subtypes of Schizophrenia 1. Paranoid type 2. Disorganized type 3. Catatonic type 4. Undifferentiated type 5. Residual type  Subtypes of Schizophrenia 1. Paranoid type 2. Disorganized type 3. Catatonic type 4. Undifferentiated type 5. Residual type  Subtypes of Schizophrenia 1. Paranoid type 2. Disorganized type 3. Catatonic type At least 2 4. Undifferentiated type Odd beliefs 5. Residual type Trouble paying attention Withdrawing from society Talking less  Clinical Features tut times Mental status examination: Appearance & behavior ( variable presentations) Mood, feelings & affect ( reduced emotional responsiveness, inappropriate emotion) Perceptual disturbances ( hallucinations, illusions ) Thought: Thought content ( delusions) Form of thought ( looseness of association) Thought process ( thought blocking, poverty of thought content, poor abstraction, perseveration) Impulsiveness, violence, suicide & homicide sett Cognitive functioning Poor insight and judgment Er acted hotter Et  1 Treatment Biological therapies Psychosocial therapies Social skills training Family-oriented therapies Group therapy Individual psychotherapy Assertive community treatment CPT  Treatment Physical inactivity and poor cardiorespiratory fitness Brain volume reductions A Beautiful Mind Evaluation  https://www.youtube.com/watch?v=ehhy-_Cg4QU  Activity John is a 27-year-old man who has been living with his parents. He has a history of schizophrenia, diagnosed at age 22. He has been inconsistent with his medication due to a lack of insight into his illness. Over the past few weeks, his family noticed a sharp decline in his behavior, including prolonged periods of immobility and strange postures. He was brought to the emergency room after refusing to eat or move for several days. catatonic Any Questions??? Thank you!