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PSYB32 - 8.docx

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Konstantine Zakzanis

PSYB32 – 8  Schizophrenia: psychotic disorder characterized by major disturbances in thought, emotion and behaviour  Disordered thinking in which ideas are not logically related, faulty perception and attention, flat or inappropriate affect and bizarre disturbances in motor activity  One of the most disabling disorders, more so than AD, because there is an earlier age of onset allows of a lot of chronic disability  A little more common in males, prevalence 1% of population, males onset is early 20s and female onset is late 20s  A great deal of co morbidity with depression and delusional ideations that can lead to suicide n 10% of the pts  Delusions in which people they believe they have special powers in which they put themselves in dangerous situations  Personality disorders are also co morbid with schizophrenic pts (avoidant personality in social circles)  Co morbid with alcohol and cannabis substance abuse, the reason for this is because they can self medication to relieve anxiety they could be feeling  Depression and anxiety are also co morbid with schizophrenia which can prevent them from having a career or family  Disorder is not person specific, everyone around the pt is affected as it is a lifelong disease  There can be acute episodes that are considered psychotic and display positive symptoms  When the acute episodes go away person is in the remission phase and they suffer from the negative symptoms which is just as if not more debilitating  There are no breaks between the symptoms that allow for a period or normality Clinical Symptoms of Schizophrenia  Positive symptoms also called Type 1 include: excesses or distortions, disorganized speech (thought disorder), incoherence, loose associations or derailment, delusions, hallucinations  Positive symptoms are excesses or distortions of a behaviour that is apparent in most persons  There are different types of positive symptoms, disorganized speech and thought disorder in which communication is slow and broken  Incoherent speech is characterized as neologism in which there are made up words without semantic meanings – word salad  In schizophrenia there is no marker or similar symptoms that are pts present  There is a great deal of heterogeneity in the symptoms, cognitive and biological inquiry  Delusions are beliefs that are contrary to reality and they are improbable and implausible  Persecutory delusions are the most common – feelings of someone chasing you or someone is out to hurt you  There is a common delusional belief that your thoughts are being broadcasted or of thought insertions in your mind via other people or things  Hallucinations are sensory experiences in the absence of any environmental stimuli and can be within any of the different senses  Auditory hallucinations are the most common  Three important hallucinations that are specific to the diagnosis of schizophrenia - Hearing your own thoughts spoken via another person’s voice - Arguing voices in their heads - Person’s voice commenting on your behaviour, can be annoying frightening or humorous  Negative or Type 2 symptoms are experienced during the remission period of schizophrenia 1 PSYB32 – 8  Negative symptoms include: behavioural deficits, avolition, alogia, anhedonia, flat affect, asociaility  Once the anti-psychotic medications have worked these negative symptoms show up and they are the absence to certain behaviour that are present in most people  Negative symptoms can also be present during the acute episodes and they predict the amount of disability the pt will suffer  Avolition is the lack of energy or absence of interest in the ability to persist a certain task and can affect any aspect of daily living  Alogia is a poverty of speech in which there is lack of quantity of speech or there is a lack of content of speech in which the person is vague and repetitive  Anhedonia is where a person is cannot experience pleasure  Flat affect is a lack of expression in their voice and it is specific to the person’s outward experience in which there is motor inability to express themselves but their inward experience is expressive  Other symptoms – catatonic immobility (inability of physical movement), waxy flexibility (put a person in a certain positions and they can stay like that), catatonia is rare because medications help elevate catatonic symptoms, inappropriate affect is irregular Reponses to certain situations Diagnosis  DSM requires at least six months of disturbances for the diagnosis  Hard to diagnose because the symptoms are not specific with respect to causation because many other thing cause these symptoms ie drugs, epilepsy  Brief psychotic disorder is when a person will display symptoms of schizophrenia from a day to a month and is caused by some sort of stressor  For there to be a schizophrenic diagnosis there must be an active phase in which there is a presence of at least two positive symptoms an
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