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Lecture 9

PSYCH 2AP3 Lecture Notes - Lecture 9: Schizoaffective Disorder, Schizotypal Personality Disorder, Schizophreniform Disorder


Department
Psychology
Course Code
PSYCH 2AP3
Professor
Richard B Day
Lecture
9

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Schizophrenia
Schizophrenia spectrum disorder and other psychotic disorders
o Schizotypal personality disorder
o Schizophreniform disorder
o Schizophrenia
o Schizoaffective disorder (mood and schizophrenia)
o Substance/medical induced
o Psych disorder due to another medical condition
o Other specified/unspecified schizophrenia
Delusional disorder
Brief, psychotic disorder
Catatonia
DSM-5 criteria for Schizophrenia
o Look at it as a spectrum
o At least 2 of the following during a 1-month period 1 must be one of
the first three:
Delusion believes that aren’t reflective of reality
Hallucinations things seen/felt/heard that aren’t caused by
external stimulus (most common are auditory)
Disorganized speech frequent derailment or incoherence
(thought processes aren’t connected)
Disorganized or catatonic behavior
Negative symptoms are diminished behaviors (allogia,
avolition
Positive symptoms are add on to cognitive symptoms
o Signs of disturbance must persist for 6 months, including 1 month of
symptoms from the list
o Schizoaffective disorder and depressive or bipolar disorder with
psychotic features have been ruled out
o Disturbances are not due to substance or to another medical condition
Ex. elders who are put under anesthesia show these symptoms
after
Some other symptoms of schizophrenia (not part of diagnostic label but often
are seen with schizophrenia)
o Disorder in Form or Content of Thought
Form of though:
Loosing of associations (rambling, strange associations
of sentences)
Poverty of speech content (short sentences,
clipped/slowed speech)
Vagueness/abstraction of speech
Neologisms (making up new words), clanging (playing
with sounds), perseveration (repeating words, like in
autism)

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Content of Thought: Implausible Delusions:
Of persecution (ex. think they’re Jesus) or reference
(people/things are messaging to you, when they’re not,
but signs everywhere are speaking directly to them)
Thought manipulations
o Thought insertion (think you thoughts are being
inserted into your head)
o Thought withdrawal (individual used to have
thought but they were taken away)
o Thought broadcast (think people around you can
hear what you are thinking)
External control (doing things because outside forces
are making them do it)
o Disorders of Perception: Hallucinations
Auditory:
Voices outside the head
Criticizing or commenting on behavior
Repeating individual’s thought
Commanding individual to act
Tactile:
Feelings of things that aren’t really there
Ex. tingling, burning, sensations (insects crawling on
you- formication)
Somatic:
Feeling like there are living things living within your
body
Ex. snakes crawling in abdomen (rare)
Ex. Penetration by knife and hands (rare)
o Flat or inappropriate affect
Monotone, flat emotional responses
Inappropriate affect- show the wrong emotions
o Disturbance to sense of self
Unclear sense of identity due to feeling that they are controlled
by an external thing
o Avolition (like depression)
Loss of interest, will and ambivalence
o Impaired interpersonal functioning
Social withdrawal and emotion attachment
Don’t know if this is because other symptoms or a symptoms
within itself
o Psychomotor behavior (catatonia)
Stupor: cerea flexibilitas (can ‘mold’ individuals body and
they’ll slowly return to original position)
Excitement: they become violent and aggressive
Symptom Frequency
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o Lack of insight= 94% (unlike OCD, they don’t see their symptoms are a
problem but rather the outside world is the problem- they are okay
why personal distress isn’t a criteria but they don’t show distress due
to symptoms but rather their distress are because what their
symptoms are showing them about the world)
o Blunted affect= 82%
o Asociality= 79% (cant function properly, hold down a job, don’t have a
social support system anymore
o Delusions= 73%
o Austism= 72% (self-absorption/self-stimulation NOT that they meet
criteria for ASD)
o Apathy= 60%
o Thought derailment= 58%
o Suspiciousness= 51%
Positive vs. negative symptoms
o Positive symptoms are disturbances or excess of some normal
function (can be fixed by med/higher chance of recovery)
Hallucinations
Delusions
o Negative symptoms are diminution or loss of some normal function
Alogia (poverty of speech)
Flat affect
Anhedonia, asociality
Avolition
o Make this separation because treatments work different (meds are a
lot more effective on positive symptoms)
Course of schizophrenia
o One episode and full remission= 25% of cases
o Episodic and partial remission = 25% of cases
o Episodic and full remission= 20% of cases
o Episodic and becoming chronic= 15% of cases
o Chronic deterioration= 15% of cases
Epidemiology:
Point prevalence in Canada and US is 0.5-0.7%
Lifetime prevalence in Canada US is 1-2%
Onset in adolescence or early adulthood (we usually diagnosed between 18-
30/35)
We see more males than females and is at a roughly 2:1 ratio
No racial or ethnic sort of bias and is fairly similar around the world
Etiology: Brain Structure
Most common and frequently reported difference is enlargement of cerebral
ventricles
o Just areas filled with CSF
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