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Lecture 9

Lecture 9 - Schizophrenia & Other Psychotic Disorders.docx

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PSYC 3140
Kendra Thomson

PSYC3140 Kendra Thomson November 28, 2013 Lecture 9 – Schizophrenia and Other Psychotic Disorders An Overview:  Prognosis is not great, full recovery is rare  1/100 people  Most people with schizo are unemployed and living in poverty  Some people believe Morel was the one who defined schizo but really Kraeplin  Dementia praecox (pray-cox)  Kraeplin was first one who differentiated between schizo and manic ??  People often equate schizo with multiple personality disorder  “Split mind” emphasized an associative splitting (thought processing being split or not in consistent train of thought)  In terms of stats, people with schizo are not usually violent but most sensationalized  Elyn Saks – TED Talk The “Negative” Symptom Cluster  Approx. ¼ experience these symptoms  Poor cognitive functioning  Lack of social skills  Much harder to recognize than positive o Positive = excesses of behaviour o Negative = absence of depression  Can be misdiagnosed as depression for people with negative symptoms  Leads to poor hygiene Name the Symptom: 1. Hallucinations 8. Tangentially 2. Grandeur 9. Loose associations 3. Persecution 10. Picture (#1) – catatonia (waxy 4. Auditory hallucinations flexibility) 5. Visual/ocular hallucinations 11. Demonstration (#2) – alogia 6. Olfactory hallucinations (mono syllables for responses) 7. Tactile hallucinations Subtypes of Schizophrenia  Disorganized Type o Elyn Saks  Catatonic o Echopraxia – mimicking people’s behaviours/movements  Undifferentiated – don’t fall under one category neatly DSM-V Changes  No longer have the aforementioned subtypes  Important to talk about them to see progression from where things came from to where we are now  Spectrum – hard to categorize in one subtype because so much overlap  Two of five symptoms must be present and HAS to include either delusions or hallucinations Other Disorders with Psychotic Features  Schizophreniform o Different from residual because they don’t have any leftover symptoms  Delusional Disorder o Socially isolated because of delusions o Erotomanic – think someone who doesn’t know you is in love with you o What can cause delusions?  Drugs  Brain tumors  Huntington’s, Alzheimer’s are things that have to be ruled out  Schizotypal Personality Disorder o Characteristics are related and similar but way less severe o Theory that schizo and schizotypal are genetically related so all part of same spectrum but how it presents is different Facts & Stats  About 1% of population develops schizo world-wide  Not culture specific  Decreased life expectancy by about 10-15 years  Comorbid substance abuse  Higher suicide rate  Childhood schizo is not common, don’t know a lot about it o There is child/adolescent onset  Women tend to have better outcomes than men  Onset between women and men differ o Greatest in early adulthood and declines with age for males and reverse is true for females  Strong genetic component o The more severe apparent schizophrenia is, the more likely children will be to develop it o We see all subtypes within same genetic pools  We don’t inherit a specific type, we inherit predisposition to developing it o Relatives are at higher risk of developing any of the other psychotic disorders we covered o Risk is associated to degree of relatedness of a person with schizo  Twin Studies o Environmental component o Monozygotic = identical twins o Quadruples – text – sisters were raised in same house but environment different which h led to different outcomes  Adoption studies help to identify difference between genetic and environment  Gene-environment reaction o Being placed in healthy environment, seems to protect person from developing – both factors come into play  The more genetically related you are to person with schizo, more likely you are to develop  Just because someone is related doesn’t mean they will have it or show symptoms but may pass on to their child Search for Genetic and Behavioural Markers  Search for common behavioural markers  Smooth-pursuit eye movement – just moving eyes to track object without moving head  Known deficiency in eye movement in schizo o They make jerky eye movements Causes: Biological  Several hypotheses exist – one is dopamine hypothesis o Excess amount of dopamine o Perpetuated by something happening when different types of drugs are administered o Drugs that increase dopamine – increased schizo behaviour o Drugs that decrease dopamine – decreased schizo behaviour o Some antipsychotic drugs that decrease dopamine are effective at treating schizo o Arguments against this theory
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