Schizophrenia and psychotic disoders Notes

NOTES NOTES SCHIZOPHRENIA & PSYCHOTIC DISORDERS GENERALLY, WHAT ARE THEY? PATHOLOGY & CAUSES ▪ Mental disorders characterized by fragmented patterns of thinking ▪ Feature positive, negative symptoms CAUSES ▪ Multiple factors: genetic vulnerability, physiological/biochemical dysfunction, psychosocial stressors SIGNS & SYMPTOMS Positive (psychotic) symptoms ▪ Delusions ▫ False beliefs remaining even when opposing evidence presented (e.g. delusions of control/reference) ▪ Hallucinations ▫ Perceptual experiences occurring without sensory stimuli (e.g. visual, auditory, tactile hallucinations) ▪ Disorganized speech (e.g. word salad) ▪ Disorganized behavior (e.g. wearing warm clothes on a hot day; may include catatonic behavior; e.g. resistant movement/ unresponsiveness) Negative symptoms ▪ Impairment of normal functioning in emotional expression, communication, purposeful activities ▫ Flat affect (less emotional response) ▫ Alogia (lack of content in speech) ▫ Avolition (decrease in motivation) Cognitive symptoms ▪ Difficulties with memory, learning, understanding Mood-related symptoms ▪ Sometimes DIAGNOSIS ▪ Based on symptoms’ presence over certain time period (varies by disorder) ▪ Affects day-to-day functioning (e.g. social, occupational, academic) ▪ Not caused by other condition/substance TREATMENT MEDICATIONS ▪ Antipsychotics PSYCHOTHERAPY ▪ E.g. individual/group therapy, rehabilitation OSMOSIS.ORG 733

Figure 101.1 Illustration depicting positive, negative, and cognitive syjmptoms. DELUSIONAL DISORDER osms.it/delusional-disorder PATHOLOGY & CAUSES ▪ Mental disorder characterized by persistent delusions ▪ Delusions may be bizarre (impossible)/nonbizarre (possible, but still wrong) ▪ Delusions remain even when opposing evidence presented SIGNS & SYMPTOMS Delusions ▪ Of control ▫ Others control one’s actions/thoughts ▪ Of thought broadcasting ▫ Others can hear one’s thoughts ▪ Of thought withdrawal ▫ One’s thoughts are being stolen ▪ Nihilistic ▫ World/self doesn’t exist 734 OSMOSIS.ORG Non-bizarre delusions ▪ Persecutory ▫ Others conspiring against/following oneself ▪ Jealous ▫ One’s partner unfaithful ▪ Of guilt/sin ▫ One wrongly feels guilty ▪ Of reference ▫ One believes messages directed at them/are especially significant ▪ Somatic ▫ One’s body is diseased/changed ▪ Erotomanic ▫ Another is in love with oneself ▪ Grandiose ▫ One believes they have special talents/ abilities ▪ Religious ▫ Involving spiritual aspect

Chapter 101 Schizophrenia & Psychotic Disorders DIAGNOSIS ▪ ≥ one delusion, over ≥ one month period, without meeting other criteria for schizophrenia ▫ Hallucinations may occur in some cases of delusional disorder ▪ Affects day-to-day functioning ▪ Not caused by other condition/substance TREATMENT MEDICATIONS ▪ Antipsychotics, antidepressants PSYCHOTHERAPY ▪ E.g. individual/group therapy, rehabilitation SCHIZOAFFECTIVE DISORDER osms.it/schizoaffective-disorder PATHOLOGY & CAUSES TREATMENT ▪ Mental disorder characterized by symptoms of schizophrenia + a mood disorder ▪ Treat depressive, schizophrenic symptoms separately SIGNS & SYMPTOMS ▪ Positive symptoms ▫ Delusions, hallucinations, disorganized speech, disorganized behavior ▪ Negative symptoms ▫ Flat affect, alogia, avolition ▪ Mood-related symptoms ▫ Depression, suicidal ideation ▫ Manic episodes (e.g. euphoria, grandiosity, hyperactivity) MEDICATIONS ▪ Antipsychotics, antidepressants PSYCHOTHERAPY ▪ Dialectical behavior therapy, mentalizationbased therapy, transference-focused therapy DIAGNOSIS ▪ ≥ two of following (+ at least one of first three) + a mood disorder ▫ Delusions ▫ Hallucinations ▫ Disorganized speech ▫ Disorganized or catatonic behavior ▫ Negative symptoms ▪ Delusions/hallucinations last ≥ two weeks beyond mood episode ▪ Not caused by other condition/substance OSMOSIS.ORG 735

SCHIZOPHRENIA osms.it/schizophrenia PATHOLOGY & CAUSES DIAGNOSIS ▪ Mental disorder characterized by fragmented patterns of thinking for > six months ▪ Individuals cycle through three phases, normally in order ▫ Prodromal phase: socially withdrawn; blunted affect ▫ Active phase: severe positive, negative symptoms ▫ Residual phase: cognitive symptoms; periods of remission ▪ ≥ two of following (+ at least one of first three), over one month ▫ Delusions ▫ Hallucinations ▫ Disorganized speech ▫ Disorganized or catatonic behavior ▫ Negative symptoms ▪ Other signs of disturbance (with prodromal, residual symptoms) persist ≥ six months ▪ Affects day-to-day functioning ▪ Not caused by other condition/substance CAUSES TREATMENT ▪ Success of treatment with dopamine antagonists suggests link to increased dopamine levels ▪ Genetic; more common in biological males MEDICATIONS RISK FACTORS PSYCHOTHERAPY ▪ Suicidal ideation → death SIGNS & SYMPTOMS ▪ Positive symptoms ▫ Delusions, hallucinations, disorganized speech, disorganized behavior ▪ Negative symptoms ▫ Flat affect, alogia, avolition ▪ Cognitive symptoms ▫ Difficulties with memory, learning, understanding 736 OSMOSIS.ORG ▪ Antipsychotics ▪ E.g. individual/group therapy, rehabilitation

Chapter 101 Schizophrenia & Psychotic Disorders Figure 101.1 Illustration depicting positive, negative, and cognitive syjmptoms. SCHIZOPHRENIFORM DISORDER osms.it/schizophreniform-disorder PATHOLOGY & CAUSES ▪ Mental disorder characterized by fragmented patterns of thinking over reduced period (1–6 months) ▪ Similar to active phase of schizophrenia (severe positive, negative symptoms), minus prodromal phase SIGNS & SYMPTOMS ▪ Positive symptoms ▫ Delusions, hallucinations, disorganized speech, disorganized behavior ▪ Negative symptoms ▫ Flat affect, alogia, avolition ▪ Cognitive symptoms ▫ Difficulties with memory, learning, understanding DIAGNOSIS ▪ ≥ two of following (+ at least one of first three), over one month ▫ Delusions ▫ Hallucinations ▫ Disorganized speech ▫ Disorganized or catatonic behavior ▫ Negative symptoms ▪ Other signs of disturbance (with prodromal, residual symptoms) do not persist ≥ six months (if ≥ six months, diagnosis = schizophrenia) ▪ Affects day-to-day functioning ▪ Not caused by other condition/substance TREATMENT MEDICATIONS ▪ Antipsychotics PSYCHOTHERAPY ▪ E.g. individual/group therapy, rehabilitation OSMOSIS.ORG 737

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