psychose
•the term psychotic emphasized loss of reality testing
and impairment of mental functioning as manifested
by delusions, hallucinations, confusion, and impaired
memory.
•In the most common psychiatric use of the term,
psychotic became synonymous with severe
impairment of social and personal functioning.
•A neurosis is a chronic or recurrent nonpsychotic
disorder characterized mainly by anxiety.
psychoses
•
•
•
•
•
•
•
•
Schizophrenia
Schizophreniform Disorder
Delusional disorder
Schizoaffective disorder
Brief Psychotic Disorder
MDD with psychotic feature
BID with P. F.
Substance induced psychotic disorder
Schizophrenia
• Schizophrenia is a clinical syndrome of variable,
but profoundly disruptive, psychopathology that
involves cognition, emotion, perception, and
other aspects of behavior.
• the effect of the illness is always severe and is
usually long lasting.
• The disorder usually begins before age 25,
persists throughout life, affects persons of all
social classes
• diagnosis of schizophrenia is based entirely on
the psychiatric history and mental status
examination
Epidemiology
• the lifetime prevalence of schizophrenia is about 1
percent,
• Schizophrenia is equally prevalent in men and women
• Onset is earlier in men than in women.
• The peak ages of onset are 10 to 25 years for men and
25 to 35 years for women.
• Onset of schizophrenia before age 10 or after age 60
is extremely rare.
• In general, the outcome for female schizophrenia
patients is better than that for male schizophrenia
patients
Etiology
• There is a genetic contribution to schizophrenia.
• The modes of genetic transmission in schizophrenia
are unknown.
• Prevalence of Schizophrenia in General population 1%,
Child with one parent with schizophrenia 12%, Child of two parents
with schizophrenia 40%, Monozygotic twin of a schizophrenia patient
47%.
• schizophrenia results from too much dopaminergic
activity in mesocortical and mesolimbic tracts.
Diagnosis
• A. Characteristic symptoms: Two (or more) of the
following, each present for a significant portion of
time during a 1-month period :
– delusions
– hallucinations
– disorganized speech (e.g., frequent incoherence)
– grossly disorganized or catatonic behavior
– negative symptoms
• B. Social/occupational dysfunction:
• C. Duration: Continuous signs of the disturbance
persist for at least 6 months.
delusion
•
•
•
•
•
•
•
•
persecutory,
grandiose,
religious,
Somatic
Control
Reference
thought broadcasting
thought reading
hallucination
•
•
•
•
•
Auditory: command, third person
Visual
Tactile
olfactory, and gustatory
Illusions
Other symptoms
• Disorganized behaviors:
bizzare / eating
• Catatonia
• Mutism
• Mannerism
• Inappropriate affect
• Negativism
• poorly groomed, fail to bathe
• Stereotypies: verbigeration
• HOARDING rubbish
• Flat affect
• Loosening of associations
•
•
•
•
•
•
•
•
Echolalia
Impulsiveness,
Violence,
Suicide,
Homicide
poor insight
Social withdrawal
Poor function
Subtypes
•
•
•
•
•
Paranoid type
Disorganized type
Catatonic type
Undifferentiated type
Residual type
Prognosis
• 20 to 30 percent of all schizophrenia patients
are able to lead somewhat normal lives.
• About 20 to 30 percent of patients continue to
experience moderate symptoms,
• 40 to 60 percent of patients remain
significantly impaired for their entire lives
Treatment
•
•
•
•
antipsychotic medications
Psychotherapy
Psychoeducation
Hospitalization
psychoses
•
•
•
•
•
•
•
•
Schizophrenia
Schizophreniform Disorder
Delusional disorder
Schizoaffective disorder
Brief Psychotic Disorder
MDD with psychotic feature
BID with P. F.
Substance induced psychotic disorder