Psychotic Disorders

Psychotic Disorders - Schizophrenia Psychosis Defined by a...

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    Schizophrenia
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Psychosis Defined by a loss of contact with reality 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 may be substance-induced or  caused by brain injury, but most psychoses  appear in the form of schizophrenia
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Schizophrenia Appears to be present throughout history Haslam: 1st detailed clinical description  (1810) Kraepelin: Dementia Praecox (1896) Bleuler: Schizophrenia (1911) Presence around the world in fairly similar  proportions of population
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Epidemiology of Schizophrenia Prevalence: 1 in 100 people About 2.5 million Americans  Gender differences  None in prevalence rates  Symptoms begin earlier and are more severe in males Increased rates in some groups Lower SES People with older fathers (increases risk 2-3x) Reared in urban communities (raises risk 2.75x)
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DSM-IV Schizophrenia Two or more of the following: Delusions Hallucinations Disorganized speech Disorganized behavior Negative symptoms (flat affect, alogia,  avolition) Impaired functioning >  6 month duration
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Symptoms of Schizophrenia Positive symptoms Bizarre additions to behavior e.g., delusions, hallucinations, disordered thinking  (loose associations, neologisms,  perseverations, and clang) Negative symptoms Pathological deficits in behavior e.g., poverty of speech, affect, volition Psychomotor symptoms
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Positive Symptoms of Schizophrenia: Delusions False belief, based on incorrect inferences  about external reality, not consistent with  patient’s intelligence and background Implausible Patients are typically preoccupied by them Patients are resistant to contradictory  arguments or facts proving their delusions  wrong
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Common Delusions Paranoid delusions   Belief of being watched or tormented by  others  Grandiose delusions Belief that one is a special person or entity or  has special powers   Delusions of reference Belief that random events or comments are  directed at oneself
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Other Common Delusions Delusions of control belief that one’s thoughts are being  controlled by outside forces  thought insertion  thought extraction Somatic delusions false belief involving functioning of the body
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Inappropriate affect disharmony between the emotional feeling  tone and the idea, thought, or speech  accompanying it  Heightened perceptions feeling that one’s senses are being flooded  by sights and sounds Hallucinations
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Psychotic Disorders - Schizophrenia Psychosis Defined by a...

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