HLTHAGE 1CC3 Lecture Notes - Lecture 2: Grandiosity, Features Of The Marvel Universe, Catatonia
10 Jan 2017
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Department
Course
Professor
What is Psychosis?
Mental state characterized by a significant disturbance in thought
!
“Losing touch with reality”
!
Symptom of a disorder, not a disorder.
!
What is Schizophrenia?
Disease of the brain, Somatic problem
!
Disturbance of thinking; language, perception and sense of self
!
Loss of contact with reality
!
No distinct knowledge of what actually causes schizophrenia
!
Symptoms of Schizophrenia
Positive Symptoms (acute) (in addition to)
Hallucinations- false sensory experiences
Most commonly auditory, can be any type of sense though
§
Often frightening, can occasionally be comforting
§
5% of population hear voices- more common than red heads
§
Argued that it is a normal part of the human experience, and that they can be positive
§
○
Delusions- beliefs held even when there is proof that their belief is likely impossible/improbable, but they still believe it
Can be fragmented, may not be coherent to others
§
Problems with term “Fixed False Belief”
Sometimes they are true, even if it is paranoid- wife cheating on you
"
False beliefs are not necessarily delusional- earth is flat
"
Sometimes fixed beliefs are not able to be proved- religion
"
Types of delusions:
Control
Thought intersection, reading, broadcasting
◊
Controlled by and external force
◊
®
Grandiosity
®
Paranoia
®
Jealousy
®
Reference- reading into something that is unnecessary
®
Nihilism- negative, dark delusions
®
Somatic- missing a heart
®
Erotomania- secretly in love
®
Guilt
®
"
§
○
!
Sept. 14
Negative Symptoms (chronic) (something missing) #$$%&'&'(&)*+,&*-./0
Chronic affective and emotional disturbance
Blunted Affect (outward expression of mood)
§
Anhedonia (inability to experience pleasure)
Could also include lack of physical experience (taste, touch, etc)
"
§
Association- social isolation or withdrawal
§
Avolition- decrease in motivation
§
Alogia -general lack of speech or lack of content
§
○
Cognitive/Disorganized symptoms
Memory, Attention, etc.
§
Bizarre Behaviour
Rigid movements, awkward and unusual to others
"
§
Disorganized speech (word salad)
Tangents
"
Use words that they understand, but others don’t
"
Repetitive use of words
"
§
○
!
Classification of Schizophrenia
*Same diagnoses- different experience
*Based on clinicians opinions, no concrete testing
Hippocrates describes a girl who heard voices, these voices told her to jump into a well and drown herself- leads us to think she had
schizophrenia, however we don't have all the symptoms, that’s only one
Edward Hare says Schizophrenia is a new disease, based on the way society changes. People with schizophrenia have low fertility rates
and if it has always been around the population would have seen an effect
Emil Kraeplin: All these diseases, maybe they’re just symptoms of a larger disorder
Dementia Praecox- emphasis on psychotic and positive symptoms
Starts in adolescence
Adopted by Europeans
Eugen Bleuler: Schizophrenia (greek: pulling apart the persons mind)
Greater emphasis on negative symptoms and mood
Doesn’t necessarily start in adolescence
Adopted by Americans
Schizophrenia is not just a single disease- like cancer
Manifests differently.
Hence why people with different symptoms are more likely to be diagnosed differently but with the same disorder
Key Changes in DSM 4 to 5
No longer sub categories of Schizophrenia (paranoia, catatonic, etc.)
!
Person must now have at least one positive symptom to be diagnosed with schizophrenia
!
Schizo Affective Disorder
Described a bridge between mood disorders and Schizophrenia
!
semi-psychotic behaviours and mood behaviours (mania or depression)
!
Prone to be isolated, and lonely
!
Symptomology is substantial misdiagnoses of mood disorder symptoms and schizophrenia
!
Misdiagnoses- assumes there is a ‘correct’ diagnoses
!
Is there a spectrum?
!
Epidemiology:
Matter of debate for schizophrenia
WHO: says it’s 1% of the population **Highly debatable
Men and Women are equally likely to be diagnosed
Typical age of onset is 15-35
People in poorer countries who are diagnosed with schizophrenia tend to do better than those in richer countries… why? What is
considered “better”?
Stigma? Medication? Family Support? More employment?
Etiology of Schizophrenia
The big question: What is the cause of Schizophrenia????
Whose fault is it? Who can fix it?
GENETICS
Appears to be a genetic component
in a study of twins approx. 50% are both diagnosed
Adopted twins 7-15% chance to develop schizophrenia
Spouse w/ schizophrenia 2% for you
Identical twins: up to 50%
Child of 2 parents with schizophrenia: 27-46%
child of 1 parent w schizophrenia: 7-15%
Not one “schizophrenia” gene. There have been a series of similar genes.
A lot of overlap between mood disorder chemicals and schizophrenia
Other Somatic
Birth Complications
Viral infections in pregnancy
Neuropathology
is it Neurodevelopmental or Neurodegenerative?
Has the brain changed since birth? Does this change if you have Medications? or changed brain pattern?
Dopamine Hypothesis
Levels affected whether or not someone had a delusion/psychotic episode
Dopamine in drugs help reduce episodes so…
Social Factors
More likely in low income neighbourhoods than high income neighbourhood
Social Causation Hypothesis
High stress, poor diet, more exposure to toxins, less education, etc. therefore higher rates of schizo
Social Drift Hypothesis
Person has schizophrenia, troubles holding job, getting educated, drifts down social ladder, must live in low income neighbourhood.
The Protest Psychosis
Until 1960s, noticed majority are non-violent, petty criminals, white women
1970s, black, belligerent male
Look into social context for explanation of this shift- civil rights movements
Institutionalized racism?
Drapetomania: A black person who was a slave ran away from their master
Drug / Pharmaceutical Marketing
Monday, September 12, 2016
Schizophrenia,-Psychotic-and-Delusional-Disorders
What is Psychosis?
Mental state characterized by a significant disturbance in thought
!
“Losing touch with reality”
!
Symptom of a disorder, not a disorder.
!
What is Schizophrenia?
Disease of the brain, Somatic problem
!
Disturbance of thinking; language, perception and sense of self
!
Loss of contact with reality
!
No distinct knowledge of what actually causes schizophrenia
!
Symptoms of Schizophrenia
Positive Symptoms (acute) (in addition to)
Hallucinations- false sensory experiences
Most commonly auditory, can be any type of sense though
§
Often frightening, can occasionally be comforting
§
5% of population hear voices- more common than red heads
§
Argued that it is a normal part of the human experience, and that they can be positive
§
○
Delusions- beliefs held even when there is proof that their belief is likely impossible/improbable, but they still believe it
Can be fragmented, may not be coherent to others
§
Problems with term “Fixed False Belief”
Sometimes they are true, even if it is paranoid- wife cheating on you
"
False beliefs are not necessarily delusional- earth is flat
"
Sometimes fixed beliefs are not able to be proved- religion
"
Types of delusions:
Control
Thought intersection, reading, broadcasting
◊
Controlled by and external force
◊
®
Grandiosity
®
Paranoia
®
Jealousy
®
Reference- reading into something that is unnecessary
®
Nihilism- negative, dark delusions
®
Somatic- missing a heart
®
Erotomania- secretly in love
®
Guilt
®
"
§
○
!
Sept. 14
Negative Symptoms (chronic) (something missing) #$$%&'&'(&)*+,&*-./0
Chronic affective and emotional disturbance
Blunted Affect (outward expression of mood)
§
Anhedonia (inability to experience pleasure)
Could also include lack of physical experience (taste, touch, etc)
"
§
Association- social isolation or withdrawal
§
Avolition- decrease in motivation
§
Alogia -general lack of speech or lack of content
§
○
Cognitive/Disorganized symptoms
Memory, Attention, etc.
§
Bizarre Behaviour
Rigid movements, awkward and unusual to others
"
§
Disorganized speech (word salad)
Tangents
"
Use words that they understand, but others don’t
"
Repetitive use of words
"
§
○
!
Classification of Schizophrenia
*Same diagnoses- different experience
*Based on clinicians opinions, no concrete testing
Hippocrates describes a girl who heard voices, these voices told her to jump into a well and drown herself- leads us to think she had
schizophrenia, however we don't have all the symptoms, that’s only one
Edward Hare says Schizophrenia is a new disease, based on the way society changes. People with schizophrenia have low fertility rates
and if it has always been around the population would have seen an effect
Emil Kraeplin: All these diseases, maybe they’re just symptoms of a larger disorder
Dementia Praecox- emphasis on psychotic and positive symptoms
Starts in adolescence
Adopted by Europeans
Eugen Bleuler: Schizophrenia (greek: pulling apart the persons mind)
Greater emphasis on negative symptoms and mood
Doesn’t necessarily start in adolescence
Adopted by Americans
Schizophrenia is not just a single disease- like cancer
Manifests differently.
Hence why people with different symptoms are more likely to be diagnosed differently but with the same disorder
Key Changes in DSM 4 to 5
No longer sub categories of Schizophrenia (paranoia, catatonic, etc.)
!
Person must now have at least one positive symptom to be diagnosed with schizophrenia
!
Schizo Affective Disorder
Described a bridge between mood disorders and Schizophrenia
!
semi-psychotic behaviours and mood behaviours (mania or depression)
!
Prone to be isolated, and lonely
!
Symptomology is substantial misdiagnoses of mood disorder symptoms and schizophrenia
!
Misdiagnoses- assumes there is a ‘correct’ diagnoses
!
Is there a spectrum?
!
Epidemiology:
Matter of debate for schizophrenia
WHO: says it’s 1% of the population **Highly debatable
Men and Women are equally likely to be diagnosed
Typical age of onset is 15-35
People in poorer countries who are diagnosed with schizophrenia tend to do better than those in richer countries… why? What is
considered “better”?
Stigma? Medication? Family Support? More employment?
Etiology of Schizophrenia
The big question: What is the cause of Schizophrenia????
Whose fault is it? Who can fix it?
GENETICS
Appears to be a genetic component
in a study of twins approx. 50% are both diagnosed
Adopted twins 7-15% chance to develop schizophrenia
Spouse w/ schizophrenia 2% for you
Identical twins: up to 50%
Child of 2 parents with schizophrenia: 27-46%
child of 1 parent w schizophrenia: 7-15%
Not one “schizophrenia” gene. There have been a series of similar genes.
A lot of overlap between mood disorder chemicals and schizophrenia
Other Somatic
Birth Complications
Viral infections in pregnancy
Neuropathology
is it Neurodevelopmental or Neurodegenerative?
Has the brain changed since birth? Does this change if you have Medications? or changed brain pattern?
Dopamine Hypothesis
Levels affected whether or not someone had a delusion/psychotic episode
Dopamine in drugs help reduce episodes so…
Social Factors
More likely in low income neighbourhoods than high income neighbourhood
Social Causation Hypothesis
High stress, poor diet, more exposure to toxins, less education, etc. therefore higher rates of schizo
Social Drift Hypothesis
Person has schizophrenia, troubles holding job, getting educated, drifts down social ladder, must live in low income neighbourhood.
The Protest Psychosis
Until 1960s, noticed majority are non-violent, petty criminals, white women
1970s, black, belligerent male
Look into social context for explanation of this shift- civil rights movements
Institutionalized racism?
Drapetomania: A black person who was a slave ran away from their master
Drug / Pharmaceutical Marketing
Monday, September 12, 2016
Schizophrenia,-Psychotic-and-Delusional-Disorders
What is Psychosis?
Mental state characterized by a significant disturbance in thought
!
“Losing touch with reality”
!
Symptom of a disorder, not a disorder.
!
What is Schizophrenia?
Disease of the brain, Somatic problem
!
Disturbance of thinking; language, perception and sense of self
!
Loss of contact with reality
!
No distinct knowledge of what actually causes schizophrenia
!
Symptoms of Schizophrenia
Positive Symptoms (acute) (in addition to)
Hallucinations- false sensory experiences
Most commonly auditory, can be any type of sense though
§
Often frightening, can occasionally be comforting
§
5% of population hear voices- more common than red heads
§
Argued that it is a normal part of the human experience, and that they can be positive
§
○
Delusions- beliefs held even when there is proof that their belief is likely impossible/improbable, but they still believe it
Can be fragmented, may not be coherent to others
§
Problems with term “Fixed False Belief”
Sometimes they are true, even if it is paranoid- wife cheating on you
"
False beliefs are not necessarily delusional- earth is flat
"
Sometimes fixed beliefs are not able to be proved- religion
"
Types of delusions:
Control
Thought intersection, reading, broadcasting
◊
Controlled by and external force
◊
®
Grandiosity
®
Paranoia
®
Jealousy
®
Reference- reading into something that is unnecessary
®
Nihilism- negative, dark delusions
®
Somatic- missing a heart
®
Erotomania- secretly in love
®
Guilt
®
"
§
○
!
Sept. 14
Negative Symptoms (chronic) (something missing) #$$%&'&'(&)*+,&*-./0
Chronic affective and emotional disturbance
Blunted Affect (outward expression of mood)
§
Anhedonia (inability to experience pleasure)
Could also include lack of physical experience (taste, touch, etc)
"
§
Association- social isolation or withdrawal
§
Avolition- decrease in motivation
§
Alogia -general lack of speech or lack of content
§
○
Cognitive/Disorganized symptoms
Memory, Attention, etc.
§
Bizarre Behaviour
Rigid movements, awkward and unusual to others
"
§
Disorganized speech (word salad)
Tangents
"
Use words that they understand, but others don’t
"
Repetitive use of words
"
§
○
!
Classification of Schizophrenia
*Same diagnoses- different experience
*Based on clinicians opinions, no concrete testing
Hippocrates describes a girl who heard voices, these voices told her to jump into a well and drown herself- leads us to think she had
schizophrenia, however we don't have all the symptoms, that’s only one
Edward Hare says Schizophrenia is a new disease, based on the way society changes. People with schizophrenia have low fertility rates
and if it has always been around the population would have seen an effect
Emil Kraeplin: All these diseases, maybe they’re just symptoms of a larger disorder
Dementia Praecox- emphasis on psychotic and positive symptoms
Starts in adolescence
Adopted by Europeans
Eugen Bleuler: Schizophrenia (greek: pulling apart the persons mind)
Greater emphasis on negative symptoms and mood
Doesn’t necessarily start in adolescence
Adopted by Americans
Schizophrenia is not just a single disease- like cancer
Manifests differently.
Hence why people with different symptoms are more likely to be diagnosed differently but with the same disorder
Key Changes in DSM 4 to 5
No longer sub categories of Schizophrenia (paranoia, catatonic, etc.)
!
Person must now have at least one positive symptom to be diagnosed with schizophrenia
!
Schizo Affective Disorder
Described a bridge between mood disorders and Schizophrenia
!
semi-psychotic behaviours and mood behaviours (mania or depression)
!
Prone to be isolated, and lonely
!
Symptomology is substantial misdiagnoses of mood disorder symptoms and schizophrenia
!
Misdiagnoses- assumes there is a ‘correct’ diagnoses
!
Is there a spectrum?
!
Epidemiology:
Matter of debate for schizophrenia
WHO: says it’s 1% of the population **Highly debatable
Men and Women are equally likely to be diagnosed
Typical age of onset is 15-35
People in poorer countries who are diagnosed with schizophrenia tend to do better than those in richer countries… why? What is
considered “better”?
Stigma? Medication? Family Support? More employment?
Etiology of Schizophrenia
The big question: What is the cause of Schizophrenia????
Whose fault is it? Who can fix it?
GENETICS
Appears to be a genetic component
in a study of twins approx. 50% are both diagnosed
Adopted twins 7-15% chance to develop schizophrenia
Spouse w/ schizophrenia 2% for you
Identical twins: up to 50%
Child of 2 parents with schizophrenia: 27-46%
child of 1 parent w schizophrenia: 7-15%
Not one “schizophrenia” gene. There have been a series of similar genes.
A lot of overlap between mood disorder chemicals and schizophrenia
Other Somatic
Birth Complications
Viral infections in pregnancy
Neuropathology
is it Neurodevelopmental or Neurodegenerative?
Has the brain changed since birth? Does this change if you have Medications? or changed brain pattern?
Dopamine Hypothesis
Levels affected whether or not someone had a delusion/psychotic episode
Dopamine in drugs help reduce episodes so…
Social Factors
More likely in low income neighbourhoods than high income neighbourhood
Social Causation Hypothesis
High stress, poor diet, more exposure to toxins, less education, etc. therefore higher rates of schizo
Social Drift Hypothesis
Person has schizophrenia, troubles holding job, getting educated, drifts down social ladder, must live in low income neighbourhood.
The Protest Psychosis
Until 1960s, noticed majority are non-violent, petty criminals, white women
1970s, black, belligerent male
Look into social context for explanation of this shift- civil rights movements
Institutionalized racism?
Drapetomania: A black person who was a slave ran away from their master
Drug / Pharmaceutical Marketing
Monday, September 12, 2016
Schizophrenia,-Psychotic-and-Delusional-Disorders
Document Summary
Mental state characterized by a significant disturbance in thought. Disturbance of thinking; language, perception and sense of self. No distinct knowledge of what actually causes schizophrenia. Most commonly auditory, can be any type of sense though. 5% of population hear voices- more common than red heads. Argued that it is a normal part of the human experience, and that they can be positive. Delusions- beliefs held even when there is proof that their belief is likely impossible/improbable. Can be fragmented, may not be coherent to others. Sometimes they are true, even if it is paranoid- wife cheating on you. False beliefs are not necessarily delusional- earth is flat. Sometimes fixed beliefs are not able to be proved- religion bable, but they still believe it. Sometimes fixed beliefs are not able to be proved- religion. Negative symptoms (chronic) (something missing) (**remember the a"s) Could also include lack of physical experience (taste, touch, etc)
