SCHIZOPHRENIA - PowerPoint PPT Presentation

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SCHIZOPHRENIA

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SCHIZOPHRENIA & OTHER PSYCHOTIC DISORDERS Core Concept: Distorted perception of reality Impaired capacity to reason, speak, and behave rationally or spontaneously – PowerPoint PPT presentation

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Title: SCHIZOPHRENIA


1
SCHIZOPHRENIA OTHER PSYCHOTIC DISORDERS
  • Core Concept
  • Distorted perception of reality
  • Impaired capacity to reason, speak, and behave
    rationally or spontaneously
  • Impaired capacity to respond with appropriate
    affect motivation

2
SCHIZOPHRENIFORM DISORDER
  • 2 or more of the following sx are present for at
    least a month delusions, hallucinations,
    disorganized speech, disorganized or catatonic
    behavior, negative sx
  • R/O schizoaffective disorder, mood disorders, and
    the effects of a substance or general medical
    condition
  • An episode of the disorder (including prodromal,
    active, residual phases) lasts at least a month
    but less than 6 months
  • Provisional diagnosis prior to 6 months.

3
Shizophreniform Disorder Specifiers
  • Without Good Prognostic Features
  • With Good Prognostic Features as evidenced by 2
    or more of the following
  • acute onset of Sx
  • confusion or perplexity at height of psychotic
    episode
  • good premorbid social and occupational
    functioning
  • absence of blunted or flat affect

4
Treatment Planning for Schizophreniform Disorder
  • Psychoeducation
  • Supportive therapy
  • Maintenance antipsychotic medication
  • Better prognosis

5
Diagnostic Criteria for Schizoaffective Disorder
  • Overlap of mood sx psychotic sx
  • 2 week period of psychotic sx without mood sx
  • Mood sx are prominent enduring part of clinical
    picture
  • Specifiers
  • Bipolar Type disturbance includes manic or
    mixed episode
  • Depressive Type disturbance includes major
    depressive episode

6
Diagnostic Concerns for Schizoaffective Disorder
  • Difficult to determine whether mood sx are of
    sufficient severity and duration to warrant dx of
    Schizoaffective (vs. schizophrenia)
  • Difficult to determine whether psychotic sx occur
    only in the context of mood disorder (Mood
    Disorder with Psychotic Features)
  • Dx applies only to a given episode of the
    disorder, not to lifetime course

7
Treatment Planning for Schizoaffective Disorder
  • No clear treatment guidelines
  • Acute management antipsychotic medication for
    psychotic sx mood stabilizer for manic or mixed
    sx antidepressant for depressive sx
  • Maintenance treatment medication management and
    compliance, psychoeducation, stress reduction

8
DELUSIONAL DISORDER
  • Diagnostic Criteria
  • Presence of 1 or more nonbizarre delusions
    (involve plausible situations, e.g. being
    followed, poisoned, infected, loved at a
    distance, betrayed by a lover, or having a
    disease) of at least 1 months duration.
  • Aside from impact of delusion(s), functioning is
    not markedly impaired and behavior is not
    obviously odd or bizarre.
  • Criteria A for Schizophrenia has never been met.

9
Subtypes for Delusional Disorder
  • Based on prominent delusional theme
  • Erotomanic belief that another person, usually
    of higher status, is in love with you
  • Grandiose belief that you have inflated worth,
    power, knowledge, identity, or a special
    relationship to a prominent person
  • Jealous belief that lover is unfaithful
  • Persecutory belief that youre being treated
    malevolently, e.g. cheated, conspired against,
    poisoned, spied on
  • Somatic belief that you have a physical defect
    or general medical condition
  • Mixed gt1 of above themes no 1 theme
    predominates
  • Unspecified central theme doesnt fit other types

10
Diagnostic Concerns for Delusional Disorder
  • Could beliefs be based in reality?
  • Delusional beliefs vs. strongly held beliefs
  • Could beliefs reflect persons cultural and
    religious background?
  • Could beliefs be due to the effects of a
    substance or general medical condition?

11
Treatment Planning for Delusional Disorder
  • Use of medication antipsychotics,
    antidepressants
  • Psychotherapy confronting the delusion, reality
    testing, gentle probing

12
Brief Psychotic Disorder
  • Diagnostic Criteria
  • Presence of 1 or more of the following
  • Delusions
  • Hallucinations
  • Disorganized speech
  • Grossly disorganized or catatonic behavior
  • Duration at least a day, but less than a month
  • Diagnosis is given after person has fully
    recovered in less than a month.

13
Specifiers for Brief Psychotic Disorder
  • With Marked Stressors brief reactive psychosis
  • Without Marked Stressors
  • With Postpartum Onset within 4 weeks postpartum

14
Treatment of Brief Psychotic Disorder
  • Medication antipsychotic
  • Psychotherapy aimed at helping individual cope
    with or escape from the stressor (if one is
    present)
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