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Lecture 8

PSY240H1 Lecture Notes - Lecture 8: Psychoeducation, Migraine, Brief Psychotic Disorder

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Stephanie Cassin

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Psychotic Disorders
o Alterations in perceptions, thoughts or consciousness
DSM-IV categories
o Schizophrenia
o Schiozphreniform disorder
History of Schizophrenia
Kraeplin - "dementia praecox"
Bleuler - "schizophrenia"
o Fragmented mind/split head
o His son did the first outcome study
"group of schizophrenias"
Schizophrenia Diagnosis
Two or more of the following, each present for a significant portion of time during a 1-month
o Delusions
o Hallucinations
o Disorganized speech
o Grossly disorganized or catatonic behaviour
o Negative symptoms
Note: only 1 symptom is required in certain circumstances (bizarre delusions, multiple voices
conversing, running commentary)
Must cause significant dysfunction
Must last more than 6 months (acute symptoms + residual symptoms)
More prevalent in people of lower socioeconomic status
Prevalent in about 1% of the population
Occurs about equally between both genders
About 10 years younger in males (15-25 years)
o Course tends to be more chronic
Between about 25 and 34 years in females
Theory exists that estrogen may provide some sort of protective factor against schizophrenia
High suicide rate
Very costly disorder
About 8% of all hospital beds in Canada are dedicated to schizophrenia patients
o These patients tend to have a long stay
Positive Symptoms (Type I symptoms)
Excess or distortion of normal functions and are usually present in the early stages of
Tend to occur in the early stages of the disorder

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Two dimensions:
o Psychotic - delusions, hallucinations
o Disorganized - thought/speech, behaviour
Distortion in thought content
Bizarre vs. non-bizarre
o Persecutory
Belief of being followed, tormented, tricked or ridiculed
o Referential
Gestures, news reports, etc. are directed to them specifically
o Grandiose
Belief that you have special powers, relationships with people who are really high up
o Somatic
o Being controlled
Thought broadcasting, removal and implementation of thoughts
Tend to be very firmly held beliefs and usually involve some sort of misperception
Distortions in perception
May occur in any sensory modality
o Auditory
(most common, voices that are distinct from one's own thoughts or voice)
o Visual
o Tactile
o Somatic
o Gustatory (smell or taste things that don't exist, fairly rare)
Have to take into consideration whether or not these hallucinations are not part of a religious
context and do cause distress or interference in some way
Disorganized Speech
Distortions if thought process
o Derailment
Where a person is speaking but just seems for "fall off the tracks" and the
conversation doesn't make sense
o Tangentiality
Sounds coherent, but the way they answer questions is completely unrelated
o Word salad
Non-sensical speech
o Neologisms
Making up new terms , may sound like it fits in the sentence or in context of
conversation, but is not a real word
o Clang associations
Rhyming answers
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