PHASE 5

• Schizophrenia Spectrum


  Disorders characterized by distortions of reality, including delusions, hallucinations, disorganized speech and behavior, and impaired cognitive ability

  
• John Haslam - superintendent of a British Hospital who outlined a description of the symptoms of Schizophrenia in his book Observations on Madness and Melancholy

  
• Philippe Pinel - French physician who described cases of schizophrenia

  
• Benedict Morel - used the term demence precoce meaning early or premature loss of mind to describe schizophrenia

  
• Emil Kraepelin - unified the distinct categories of schizophrenia under the name Dementia Praecox

  
• Dementia Praecox


  1. Combined several symptoms of insanity that had usually been viewed as reflecting separate and distinct disorders:

  2. Catatonia - alternating immobility and excited agitation

  3. Hebephrenia - silly and immature emotionality

  4. Paranoia - delusions of grandeur or persecution

  
• Eugen Bleuler - introduced the term schizophrenia ("splitting of mind")

  
• Associative Splitting


  A core feature of schizophrenia where there is a disruption in the normal flow of thought and speech
• Positive Symptoms of Schizophrenia


  • Delusions
  • Hallucinations
• Delusions


  Misrepresentation of reality (disorder of thought content)
• Types of Delusions


  • Persecutory
  • Referential
  • Grandiose
  • Erotomanic
  • Nihilistic
  • Somatic
  • Thought Withdrawal
  • Thought Insertion
  • Delusions of Control
  • Capgras Syndrome
  • Cotard's Syndrome
  • Clerambault Syndrome
  • Fregoli Syndrome

  
• Motivational View of Delusions


  Delusions are attempts to deal with and relieve anxiety and stress
• Deficit View of Delusions

  Delusions result from brain dysfunction that creates disordered cognitions or perceptions

  
• Hallucinations


  Experience of sensory events without any input from the surrounding environment
• Types of Hallucinations


  • Auditory
  • Autoscopic
  • Hypnagogic
  • Ictal
  • Hypnopompic
• Negative Symptoms of Schizophrenia

  • Avolition
  • Anhedonia
  • Asociality
  • Flat Affect/Affective Flattening
• Disorganized Symptoms of Schizophrenia


  • Disorganized Speech
  • Inappropriate Affect
  • Grossly Disorganized or abnormal motor behavior
• Neologisms


  Construction of new words in order to communicate with schizophrenics thoughts
• More severe symptoms of schizophrenia first occur in late adolescence or early adulthood

  
• Prodromal Stage


  1. 2 year period before the serious symptoms of schizophrenia occur but when less severe yet unusual behaviors start to show themselves

  
• Schizophrenia is partially the result of excessive stimulation of striatal dopamine d2 receptors
• Several brain sites are implicated in the cognitive dysfunction observed among people with schizophrenia, especially prefrontal cortex, various related cortical regions and subcortical circuits, including thalamus and the striatum
• Schizophrenogenic Mother


  A mother whose cold, dominant, and rejecting nature was thought to cause schizophrenia in her children
• Double bind communication


  Communication style that produced conflicting messages, which caused schizophrenia to develop
• Families with high expressed emotion view the symptoms of schizophrenia as controllable and that the hostility arises when family members think that patients just do not want help themselves
• Treatments for Schizophrenia


  • Individual Therapy
  • Group Therapy
  • Family Therapy
  • Social Skills Trainings
  • Neuroleptic Medications
• Delusional Disorder


  Persistent belief that is contrary to reality in the absence of other characteristics of schizophrenia

  
• Delusional Disorder can be distinguished from Schizophrenia and Schizophreniform by the absence of other symptoms of active phase of schizophrenia

  
• Delusions in Schizophrenia


  Show greater disorganization, whereas in Delusional Disorder, they show greater conviction, greater extension, and greater pressure

  
• If delusions occur exclusively during mood episodes, the diagnosis is MDD or BD, with psychotic features

  
• Brief Psychotic Disorder


  Presence of one or more positive symptoms lasting a month or less
• Specifiers for Brief Psychotic Disorder

  • With Good Prognostic Features
  • Without Good Prognostic Features
  • With Catatonia
  • Current Severity

  
• Schizophreniform Disorder


  Some people who experience the symptoms of schizophrenia for a few months only

  
• Specifiers for Schizophrenia and Schizoaffective Disorder

  • First episode, currently in acute episode
  • First episode, currently in partial remission
  • First episode, currently in full remission
  • Continuous
  • With catatonia
  • Current severity

  
• Schizophrenia and Schizoaffective Disorder typically emerge between the late teens and the mid-30s

  
• Onset of Schizophrenia prior to adolescence is rare

  
• Course and outcome in schizophrenia are heterogeneous, and prognosis is uncertain at the onset of psychosis

  
• There is a tendency for reduced psychotic experience during late life in schizophrenia
• Cognitive impairment and negative symptom pathology are core features of schizophrenia

  
• The essential features of schizophrenia are the same in childhood, but it is more difficult to make diagnosis