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Lecture 8

Lecture 8 - Schizophrenia and Psychotic Disorders. In two columns per page, printing two pages (in total four columns) per page side works well =)

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Department
Psychology
Course Code
PSY240H1
Professor
S.Cassin

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PSY240 Lecture 8 Psychotic Disorders
Symptoms:
Alterations in perceptions, thoughts, or
consciousness
Rarely diagnosed in children
DSM-IV categories:
Schizophrenia
Schizophreniform disorder
Schizoaffective disorder
Delusional disorder
Brief psychotic disorder
Shared psychotic disorder
Psychotic disorder due to general medical
condition
Substance-induced psychotic disorder
History of Schizophrenia
Ppl described as crazy
Kraeplin dementia praecox , chronic
intellectual deterioration, didnt get into
subtypes and variations
Bleuler schizophrenia = fragmented
mind, split head, used to think multiple
identity disorder was schizophrenia, didnt
think course was always deteriorating
oHis son did longitudinal study in USA:
only 10% chronic symptoms, 25%
improved, 50% fluctuated btwn
unstable and normal
One of the most studied mental illnesses
oWhy so much heterogeneity
Group of schizophrenias
Schizophrenia Diagnosis
At least 2 of the following, each present for
a significant portion of time during 1
month:
oDelusions firmly held distortions in
thought content
Misinterpretations of experiences
Strong beliefs
Important to ask background
questions for evidence
Bizarre (cannot possibly happen,
ex. Organ replacement w/o scars,
thoughts telecasted) vs. non-
bizarre (in theory could happen
but no evidence)
Persecutory: typically to self,
spied on or ridiculed, most
often non-bizarre
Referential: believes random
things directed at him/her
specifically
Grandiose: special/magical
powers, special relationships to
higher-ups
Somatic: organs removed but
no scars, insects crawling
inside body
Being controlled: thoughts
withdrawn from external
forces, thoughts broadcasted,
thoughts planted into head
oHallucinations distortions in perception
May occur in any sensory modality:
Auditory by far most
common, usually experienced
as voices distinct from ones
own thoughts/voice
oOrders, including to kill
self + others
Visual often accompanied by
auditory
Tactile something crawling
on skin or inside skin
Somatic electricity in veins
Make sure not considered part of
religious/cultural ceremonies
Make sure cause
distress/impairment in some way
Louis Wain cats paintings
progressively more abstract as
disease progresses
oDisorganized speech distortions in
thought process
Some think is most significant
feature of schizophrenia
Incoherence of train of thought:
Derailment some thread of
thought but must pay close
attention
Tangentiality might sound
completely coherent but
www.notesolution.com
answers to questions are
unrelated
Word salad completely
nonsensical jumble of words,
no explanation for why words
together
Neologisms make up new
terms
Clang associations
speak/answer in rhymes to
connect thoughts together
Perseveration repeat words
or sentences over and over
oDisorganized behaviour:
Grossly disorganized
distortions, self-monitoring of bhvr
(ex. Not dressed appropriately for
weather/occasion, inappropriate
sexual bhvr), unpredictable
agitations
Doesnt fit context of what is
going on
or Catatonic bhvr really
marked decrease in responsivity to
environment (ex. Pose and not
move for extended period of time,
face not showing emotions), waxy
flexibility (remain in pose until
moved, than remains in that pose),
dont see spontaneous movement
oNegative (Type II) symptoms loss of
normal functions, usually appear
during the later stages
Flattened affect no range in
emotions, restriction, monotone,
low eye contact, not engaged or
interacting w/ environment
eventually in 60% of
schizophrenics
Alogia restriction in either
efficiently or productivity of
thoughts spoken, might have to do
w/ thought blocking (self-sensoring
of hallucinations)
Avolition absence of goal-
directed bhvr, unmotivated, apathy,
loss of energy; very difficult to
treat
Anhedonia inability to
experience pleasure from normal
sources
Note: only 1 symptom is required in
certain circumstances (bizarre
delusions; multiple voices conversing,
running commentary since characteristic of
schizophrenia)
Must cause significant dysfunction
Must last more than 6 months (acute
symptoms + regular symptoms) seeing
prodromal and residual symptoms
Prevalence : 1% of population, more common
in lower socio-economical status, equally in
males (15-24 years) in females (25-34
years), male symptoms ten to be more
severe
oHypothesis estrogen might be
protective factor
10% of schizophrenics eventually commit
suicide
Family members often more affected by
negative symptoms the person they knew
seems no longer there
Costly, 8% of Canadian hospital beds
devoted to schizophrenia typically long
hospital stays
Positive (Type I) Symptoms
(Excess or distortion of normal functions)
Usually present in early stages of
schizophrenia
Usually more prominent
2 dimensions:
oPsychotic delusions/fixed beliefs,
hallucinations
oDisorganized thought/speech, bhvr
Schizophrenia Subtypes
Prognoses vary
Subtypes diagnosed by current
symptoms at time of assessment
Paranoid prominent persecutory or
grandiose delusions and/or auditory
hallucinations, normal preserved cognitive
function, can communicate properly
oHighest risk of violence when anger
involved but only small proportion of
individuals
www.notesolution.com

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Description
PSY240 Lecture 8 Psychotic Disorders bizarre (in theory could happen but no evidence) Persecutory: typically to self, Symptoms: Alterations in perceptions, thoughts, or spied on or ridiculed, most consciousness often non-bizarre Rarely diagnosed in children Referential: believes random things directed at himher DSM-IV categories: specifically Grandiose: specialmagical Schizophrenia powers, special relationships to Schizophreniform disorder Schizoaffective disorder higher-ups Delusional disorder Somatic: organs removed but no scars, insects crawling Brief psychotic disorder Shared psychotic disorder inside body Psychotic disorder due to general medical Being controlled: thoughts withdrawn from external condition Substance-induced psychotic disorder forces, thoughts broadcasted, thoughts planted into head oHallucinations distortions in perception History of Schizophrenia May occur in any sensory modality: Ppl described as crazy Kraeplin dementia praecox , chronic Auditory by far most intellectual deterioration, didnt get into common, usually experienced as voices distinct from ones subtypes and variations Bleuler schizophrenia = fragmented own thoughtsvoice mind, split head, used to think multiple o Orders, including to kill self + others identity disorder was schizophrenia, didnt Visual often accompanied by think course was always deteriorating oHis son did longitudinal study in USA: auditory only 10% chronic symptoms, 25% Tactile something crawling on skin or inside skin improved, 50% fluctuated btwn unstable and normal Somatic electricity in veins One of the most studied mental illnesses Make sure not considered part of oWhy so much heterogeneity religiouscultural ceremonies Group of schizophrenias Make sure cause distressimpairment in some way Schizophrenia Diagnosis Louis Wain cats paintings At least 2 of the following, each present for progressively more abstract as a significant portion of time during 1 disease progresses oDisorganized speech distortions in month: oDelusions firmly held distortions in thought process thought content Some think is most significant Misinterpretations of experiences feature of schizophrenia Incoherence of train of thought: Strong beliefs Important to ask background Derailment some thread of questions for evidence thought but must pay close attention Bizarre (cannot possibly happen, ex. Organ replacement wo scars, Tangentiality might sound thoughts telecasted) vs. non- completely coherent but www.notesolution.com
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