Schizophrenia and related disorder

• 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")
• Positive Symptoms


  • Delusions - misrepresentation of reality (disorder of thought content)
  • Hallucinations - experience of sensory events without any input from the surrounding environment
• Types of Delusions


  • Persecutory - belief that one is going to be harmed, harassed and so forth
  • Referential - certain gestures, comments, environmental cues, and so forth are directed at one-self
  • Grandiose - when an individual believes that he or she has exceptional abilities, wealth, or fame
  • Erotomanic - when an individual believes falsely that another person is in love with him or her
  • Nihilistic - conviction that a major catastrophe will occur
  • Somatic - focus on preoccupations regarding health and organ function
  • Thought Withdrawal - thoughts have been "removed" by outside force
  • Thought Insertion - thoughts have been put into one's mind
  • Delusions of Control - one's body or actions are being acted on or manipulated by some outside force
  • Capgras Syndrome - person believes someone he or she knows has been replaced by a double
  • Cotard's Syndrome - the person believes he or she is dead
  • Clerambault Syndrome - characterized by the delusional idea, usually in a young woman, that a man whom she considers to be of higher social and/or professional standing is in love with her
  • Fregoli Syndrome - a person holds a delusional belief that different people are in fact a single person who changes his or her appearance or is in disguise beliefs as attempts to deal with and relieve anxiety and stress
• Deficit View of Delusions

  Sees these beliefs as a resulting from brain dysfunction that creates these disordered cognitions or perceptions
• Types of Hallucinations


  • Auditory Hallucination - most common form experienced by people with schizophrenia
  • Autoscopic Hallucination - individual experiences, all or part of the person's own body appeared within the external space, viewed from his/her physical body
  • Hypnagogic Hallucination - happens during sleep
  • Ictal Hallucination - associated with temporal lobe foci
  • Hypnopompic Hallucinations - happens when waking up
• Negative Symptoms


  • Avolition - inability to initiate and persist activities
  • Anhedonia - lack of pleasure
  • Asociality - lack of interest in social interactions
  • Flat Affect/Affective Flattening - do not show emotions when you would normally expect them to
• Disorganized Symptoms


  • Disorganized Speech - individual may switch from one topic to another (derailment or loose associations) or answers to questions may be related or completely unrelated (tangentiality)
  • Inappropriate Affect - laughing or crying at improper times
  • Grossly Disorganized or abnormal motor behavior - childlike silliness to unpredictable agitation
• 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 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


  Used for a time to describe a mother whose cold, dominant, and rejecting nature was thought to cause schizophrenia in her children
• Double bind communication


  Used to portray communication style that produced conflicting messages, which cased 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
• Delusional Disorder


  One or more delusions for at least 1 month, persistent belief that is contrary to the reality in the absence of other characteristics of schizophrenia, tend not to have flat affect, anhedonia, or other negative symptoms, socially isolated due to being suspicious
• Shared Psychotic Disorder (Folie a Deux)


  Condition in which an individual develops delusions simply as a result of a close relationship with a delusional individual
• Types of Delusional Disorder

  • Erotomanic, Grandiose, Jealous, Persecutory, Somatic, Mixed, Unspecified
• Functioning is better in Delusional Disorder than what is observed in Schizophrenia
• Individuals with Delusional Disorder eventually develop schizophrenia
• Delusional Disorder is characterized by the absence of active phase of schizophrenia
• Brief Psychotic Disorder


  Presence of one of the following: delusions, hallucinations, disorganized speech, catatonic behavior for at least 1 day but less than 1 month, with eventual full return to premorbid level of functioning, can experience relapse
• Schizophreniform Disorder


  Two or more of the following, present during a 1-month period: delusions, hallucinations, disorganized speech, catatonic behavior, negative symptoms, at least 1 month BUT less than 6 months, development similar to schizophrenia
• Schizophrenia


  Two or more of the following, present during 1-month period: delusions, hallucinations, disorganized speech, catatonic behavior, negative symptoms, disturbance in one or more major areas, at least 6 months, abrupt or insidious, prognosis is influenced both by duration and by severity of illness and gender, possible reduced psychotic experience during late life, too much use of regression
• Schizoaffective Disorder


  Major mood episode + delusions or hallucinations for 2 or more weeks, some individuals tend to change diagnosis into mood disorder or to schizophrenia over time