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7.psychosis2per - Schizophrenia Dr.FredRose AnOverview...

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10/20/10 1 Schizophrenia Dr. Fred Rose Nature of Schizophrenia and Psychosis: An Overview Schizophrenia vs. Psychosis Psychosis – Cluster of disorders; hallucina5ons and/or loss of contact with reality Schizophrenia – A type of psychosis Affects 1 in 100 persons, $65 Billion annually Historical Background Emil Kraeplin – 1896; Used the term demen5a praecox, focused on onset and outcomes Eugene Bleuler – 1911 he introduced the term “schizophrenia” or “spliJng of the mind”
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10/20/10 2 Prevalence of Schizophrenia Prevalence of 1% worldwide 2 × Alzheimer’s 5 × Mul5ple Sclerosis 6 × Insulin‐dependent Diabetes 60 × Muscular Dystrophy Schizophrenia Is Generally Chronic Moderate‐to‐severe lifelong impairment Life expectancy is slightly less than average Equal Gender DistribuLon Women ‐ beWer long‐term prognosis Onset differs between men and women Gender differences in onset of schizophrenia in a sample of 470 patients Howard et al., 1993
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10/20/10 3 Diagnosis: DSM IV Symptoms (2 or more): Delusions (content) Hallucina5ons Disorganized speech (form) Disorganized or catatonic behavior Nega5ve symptoms (flat affect etc.) Social/Occupa5onal Dysfunc5on Dura5on: 6‐months (1 month of symptoms) Not caused by substances Not Schizoaffec5ve/Mood Disorder The “PosiEve” Symptoms Ac5ve manifesta5ons of abnormal behavior or distor5ons of normal behavior Delusions ‐ 90% Soma5c: “Snake living inside my abdomen” Grandeur: “Chosen by God” Persecu5on: “ ‘They’ are monitoring me” Manifesta5ons: Thought broadcas5ng, ideas of reference, thought withdrawal
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10/20/10 4 The “PosiEve” Symptom Cluster HallucinaLons Sensory events without environmental input Auditory are the most common (can be any sensory modality) Normal volume, known, external, nega5ve Speech vs. auditory processing studies Some major language areas of the cerebral cortex
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10/20/10 5 The “NegaEve” Symptom Cluster Absence or insufficiency of normal behavior Spectrum of NegaLve Symptoms Avoli5on (or apathy) – Inability to ini5ate and persist in ac5vi5es Alogia – A rela5ve absence of speech Anhedonia – Inability to experience pleasure or engage in pleasurable ac5vi5es Flat affect – Show liWle expressed emo5on, but may s5ll feel emo5on “Disorganized” Symptoms Severe and excess disrup5ons in: Speech Cogni5ve slippage – Illogical and incoherent speech Tangen5ality – “Going off on a tangent” and not answering a ques5on directly Loose associa5ons or derailment – Taking conversa5on in unrelated direc5ons
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10/20/10 6 “Disorganized” Speech “I have also killed my ex‐wife, [name], in a 2.5 to 3.0 hours sex bout in Devon Pennsylvania in 1976,
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