Chapter 14- schizophrenia and other psychotic disorders

Chapter 14- schizophrenia and other psychotic disorders -...

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Chapter 14- Schizophrenia and Other Psychotic Disorders SCHIZOPHRENIA The epidemiology of schizophrenia - Fathers were older (aged 45-50) at the time of their birth higher risk - Begin earlier in men than in women - Female sex hormones play some protective role. When estrogen levels are low (pms) or are falling, psychotic symptoms in women with schizophrenia often get worse. late onset of schizophrenia in women estrogen declining when aging. Origins of the schizophrenia construct - Emil Kraepelin Dementia praecox someone who becomes suspicious of those around him, sees poison in his food, is pursued by the police, feels his body is being influenced, or thinks that he is going to be shot or that the neighbors are jeering at him. Characterized by hallucinations, apathy and indifference, withdrawn behavior, and incapacity for regular work. - Eugen Bleuler To split, mind Characterized by disorganization of thought proceses, a lack of coherence between thought and emotion, and an inward orientation away from reality. THE CLINICAL PICTURE IN SCHIZOPHRENIA Delusions - Erroneous belief held despite clear contradictory evidence - Involves disturbance in the CONTENT OF THOUGHT. - Ones feelings, thoughts or actions are being controlled by external agents/ thought broadcasting/ thought insertion/ thought withdrawal (robbed one of one’s thought). - Or delusions of reference neutral environmental event is believed to have special and personal meaning intended only for the patient - Delusions of bodily changes, or removal of organs
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Hallucinations - Sensory experience that occurs in the absence of any external perceptual stimulus. - Misperception of a stimulus that actually exists - Auditory hallucinations are a form of misperceived subvocal speech Disorganized speech - Disorder in THOUGHT FORM - Words and word combinations sound communicative, but the meaning has little or no understanding of the point the speaker is trying to make. - New made-up words Disorganized and Catatonic behavior - Deterioration from previously mastered standard of performance in everyday affairs daily functioning, such as work, social relations and self-care. - Grossly disorganized behaviors silliness or unusual dress due to impairment in prefrontal region - Catatonia: virtual absence of all movement and speech catatonic stupor Unusual posture hold it for an extended period of time without any seeming discomfort Negative symptoms - Positive symptoms: Excess or distortion in a normal repertoire of behavior Hallucination/ delusions - Negative symptoms: Reflect an absence or deficit of behaviors that are normally present Flat or blunted emotional expressiveness Alogia (very little speech) Avolition (no ability to initiate or persist in goal directed activities.) SUBTYPES OF SCHIZOPHRENIA Paranoid Type- paranoid schizophrenia - Increasing suspiciousness and of severe difficultires in interpersonal relationships
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- Illogical ideas and eliefs that are highly elaborated and organized into a coherent, though delusional, framework.
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