Psychotic Disorders

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Psychotic Disorders
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History

• Emil Kraepelin
• Catatonia
• Hebephrenia
• Silly, immature emotionality
• Paranoia

• dementia praecox

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History

• Dementia Praecox
• Early age of onset
• Poor prognosis
• Hallucinations
• Delusions
• Stereotyped behavior

• Bipolar Disorder
• Early or late
• Prognosis guarded
• Hallucinations and delusions possible

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History

• Eugen Bleuler
• Introduced the term schizophrenia
• Derived from Greek words for
• Split (skhizein)
• Mind (phren)
• Believed underlying disorder was an associative
  splitting
• Breaking of the basic functions of personality
• Presents as difficulty keeping a train of thought

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Schizophrenia

• Clinical Description
• Three categories of symptoms
• Positive
• Negative
• Disorganized

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Schizophrenia

• Positive symptoms
• Active manifestations of aberrant behavior
• Delusions
• Belief that is a misrepresentation of reality
• Delusions of grandeur
• Delusions of persecution
• Roberts (1991)
• Hallucinations
• Experiencing sensory events without environmental
  input
• Auditory
• Visual
• Somatosensory
• Olfactory
• Imaging studies

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Clinical Description

• Negative symptoms
• Deficits in normal behavior
• Anhedonia
• Affective flattening
• Avolition
• Inability to initiate and persist in activities
• Alogia

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Clinical Description

• Disorganized Symptoms
• Rambling speech
• Erratic behavior
• Inappropriate affect
• catatonia
• Diagnosis of schizophrenia requires
• 2 or more positive, negative, and/or disorganized
  behavior must be present for at least 1 month

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Schizophrenia Subtypes

• Paranoid Type
• Disorganized Type
• Catatonic Type
• Undifferentiated Type
• Residual Type

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Other Psychotic Disorders

• Schizophreniform Disorder
• Onset of psychotic symptoms within 4 weeks
• 0.2 prevalence
• Schizoaffective Disorder
• Poor prognosis
• Presence of a mood disorder
• Psychotic symptoms persist for 2 weeks in absence
  of mood symptoms

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Other Psychotic Disorders

• Delusional Disorder
• Persistent belief that is contrary to reality
• Subtypes
• Erotomanic
• Grandiose
• Jealous
• persecutory
• somatic

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Other Psychotic Disorders

• Brief Psychotic Disorder
• Presence of 1 or more positive symptoms or
  disorganized speech or behavior w/in 1 month
• Shared Psychotic Disorder (Folie a deux)
• One develops delusions as a result of a close
  relationship with a delusional disorder