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Chapter XI.docx

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Martha Mc Kay

Chapter XI: Schizophrenia Psychosis: the inability to distinguish between real and unreal. Schizophrenia At least one month of acute symptoms of delusions, hallucinations, disorganized thought and speech, disorganized behaviour, and negative symptoms and at least six months of some symptoms of disorder Schizophreniform disorder Same symptoms as schizophrenia, lasting more than one month but less than six months Schizoaffective disorder Symptoms of schizophrenia coinciding with symptoms of depression or mania, but at least a two-week period when only symptoms of schizophrenia present Delusional disorder Evidence only of non-bizarre delusions (ex. one is being followed/deceived_ of at least one months duration; function at relatively high level Brief psychotic disorder Presence of delusions, hallucinations, disorganized speech or behaviour for at least one day but less than one month Shared psychotic disorder The individual in a close relationship with someone who is delusional with similar delusions (also known as folie a deux) Substance-induced Hallucinations or delusions caused by the direct psychotic disorder physiological effects of a substance (such as cocaine) Coping with Schizophrenia: 1. Sense of humour: cannot laugh at the person, but can laugh with the person 2. Acceptance of the illness: accept the reality that the disorder will not go away, likely to place limitations on the family member, and will need active management by the family. NOT giving up. 3. Family balance: achieve a balance of concern for the afflicted member and appreciation for the needs of other family members 4. Expectations that are realistic: not to abandon all expectations, but have more realistic expectations in respect to schizophrenia Symptoms: I. Positive Symptoms: presence of usual perceptions, thoughts or behaviour - Also occur in other disorders like depression and bipolar disorder, schizophrenics are also depressed or show tremendous mood swings Schizophrenia or Schizoaffective disorder Mood disorder with Psychoti- Psychotic symptoms occur psychotic features Depressedubstantially in the absence of depression or mania - Psychotic symptoms occur Mood swings only during periods of clear OR depression or mania - Depression or mania does not meet the criteria for a diagnosis of a mood disorder Delusions Beliefs that are highly unlikely and often simply impossible Delusions Self-Deceptions - Impossible - Not completely - Preoccupied with the implausible beliefs (look for evidence to support - Think about them their beliefs, convince occasionally, not people, and take actions preoccupied based on them) - typically acknowledge that their beliefs may be - Highyl resistant to wrong arugments - Can be simple and transient, often complex and elaborate - Different types of delusions can coexist - Types of delusions occur in all cultures, but the specific content differ across cultures Persecutory False belief that oneself of ones loved delusions one are being persecuted, watched, or conspired against by others (people they know or higher authorities) Delusion of Belief that random events are directed reference at oneself Grandiose False belief that one has great power, delusions knowledge, or talent or that one is a famous and powerful person Delusions of being Beliefs that ones thoughts, feelings, or controlled behaviours are being imposed or controlled by an external force Thought Belief that ones thoughts are being broadcasting broadcast from ones mind for others to hear Thought insertion Belief that another person or object is inserting thoughts into ones head Thought Belief that thoughts are being removed withdrawal from ones head by another person or object Delusion of guilt or False belief that one has committed a sin terrible act or is responsible for a terrible event Somatic delusions False belief that ones appearance of part of ones body is diseased of altered Hallucinations Unreal perceptual or sensory experiences that are bizarre and troubling; not precipitated only by sleep deprivation, stress, or drugs - Types across all cultures, but specific content differs Auditory Hearing voices, music; most common hallucination Visual See Satan/devils; often accompanied by hallucination auditory hallucination Tactile Perception that something is happening hallucination to the outside of ones body (ex. bugs are crawling up ones back) Somatic Perception that something is happening hallucination inside ones body (ex. worms are eating ones intestines) Disorganized Grossly disorganized patterns of speech thought and - Often referred to as a formal thought disorder speech - Loosening of associations/derailment: Most common; tendency to slip from one topic to a seemingly unrelated topic withy little coherent transition - Word Salad: when the persons speech is so disorganized as to be incoherent to the listener Neologisms Make up words that mean something only to him or her Clangs Make associations between words based Word Salad on sounds rather than content
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