Psychotic Disorders

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Psychotic Disorders
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What are they?

• Patterns of belief, language use and perception
  that become disordered.
• People experiencing psychosis may report
  hallucinations or delusional beliefs, and may
  exhibit personality changes and disorganized
  thinking.
• This may be accompanied by unusual or bizarre
  behaviour, as well as difficulty with social
  interaction and impairment in carrying out the
  activities of daily living.

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Causes

• brain tumors
• drug abuse amphetamines, cocaine, alcohol among
  others
• brain damage
• severe clinical depression
• severe psychosocial stress
• sleep deprivation
• some epileptic disorders, especially if the
  temporal lobe is affected
• exposure to some traumatic event (violent death,
  terrorist activity, etc.)
• abrupt or over-rapid withdrawal from certain
  recreational or prescribed drugs

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The Nature of Schizophrenia

• Schizophrenia
• form of psychosis involving disorders of
• perception
• language
• thought
• emotion
• behaviour

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Schizophrenia Symptoms

• Perceptual Symptoms
• Sensory filtering perception impaired
• Hallucinations - perceptions without sensations
• Language and Thought Disturbance
• Word salad jumbled speech
• Delusions - mistaken beliefs maintained despite
  contrary evidence
• Paranoid
• Persecution

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• Schizophrenia Symptoms
• Emotional Disturbance
• Behavioral Disturbance
• Unusual actions that have meaning to the person
• Catalepsy immobile stance (like a statue)
• Waxy Flexibility
• Refusal to communicate with others

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Classification of Schizophrenia

• Positive symptoms involve distorted or excessive
  mental activity
• Delusions, hallucinations,altered emotions,
  erratic behaviors
• Positive symptoms occur during acute episodes
• Negative symptoms involve behavioral and mental
  deficits
• Flattened emotions, social withdrawal
• Negative symptoms are chronic
• Disorganization of behaviour

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Biological Views of Schizophrenia

• Genetics 43 to 83 correlation (identical twin
  studies)
• Neurotransmitters Dopamine activity excessive
  in the schizophrenic brain
• Brain damage enlarged ventricles are evident in
  schizophrenia

A common finding in the brains of people with
schizophrenia is larger than normal lateral
ventricles.
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Heritability of Schizophrenia
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Psychosocial Theories of Schizophrenia

• Stress
• Genetic predisposition overwhelming stress
• Family communication

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Delusional Disorder

• Delusional disorder is a mental illness that
  involves holding one or more delusions in the
  absence of any other signs or symptoms of mental
  illness.
• A person with delusional disorder has never met
  any other criteria for schizophrenia and does not
  have any major hallucinations, although
  hallucinations may be present if they are related
  to the theme of the delusion

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Hallucinations and Delusions

• A hallucination is a perception in the absence of
  a stimulus.
• Hallucinations can occur with any sense form
  visual, auditory, olfactory, gustatory, tactile,
  equilibrium, and sense of hot and cold.

• A delusion is a fixed false belief and is used to
  describe a belief that is either false, fanciful
  or derived from deception.
• They are found in psychotic disorders and
  particularly in schizophrenia and mania in
  episodes of bipolar disorder.

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• The patient expresses an idea or belief with
  unusual persistence or force. That idea exerts an
  undue influence on his or her life, and the way
  of life is often altered.
• Despite his/her conviction, there is often a
  quality of secretiveness or suspicion when the
  patient is questioned about it.
• The individual tends to be humorless and
  oversensitive, especially about the belief.
• There is a quality of centrality no matter how
  unlikely it is that these strange things are
  happening to him, the patient accepts them
  unquestioningly.

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• An attempt to contradict the belief is likely to
  arouse an inappropriately strong emotional
  reaction, often with irritability and hostility.
• The belief is, at the least, unlikely.
• The patient is emotionally over-invested in the
  idea and it overwhelms other elements of his
  psyche.
• The delusion, if acted out, often leads to
  behaviors which are abnormal and/or out of
  character, although perhaps understandable in the
  light of the delusional beliefs.
• Individuals who know the patient will observe
  that his belief and behavior are uncharacteristic
  and alien.
• Often claims to "speak with god"

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Features

• It is characterized by the presence of delusions
  to which the patient clings.
• The illness is chronic and frequently lifelong.
• The delusions are logically constructed and
  internally consistent.
• The delusions do not interfere with general
  logical reasoning (although within the delusional
  system the logic is perverted) and there is
  usually no general disturbance of behavior. If
  disturbed behavior does occur, it is directly
  related to the delusional beliefs.