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ch 13

Psychosis

based on Hallucinations and Delusions

Clinical Description of Schizo

Delusions
Hallucinations
Disorganized speech
grossly disorganized
negative symptoms

positive symptoms

added to normal behavior
-exaggeration or excesses

Delusions
Hallucination

Delusions

- Gross misrepresentation of reality
- Disorder of thought content
- Grandeur
- Persecution
- Capgras and Cotard's symptoms
- Comes from your mind

Hallucinations

perceive things that are not there
-> comes from your senses
most common - auditory

Negative Sympotoms

absence or insufficiency of normal behavior
Symptom Cluster
- Avolition
- Alogia
- Anhedonia
- Affective flattening

Disorganized speech

Avolition

inability to initiate and participate in activities

Alogia

relative absence of speech

Anhedonia

presumed lack of pleasure

affective flattening

they do not show emotion at all , they speak in a flat and toneless manner

Disorganized Symptoms

Disorganizing thinking
- Catatonia
Inappropriate affect

Catatonia

disorder of movement involving immobility or excited agitation

Inappropriate affect

laughing and crying at inapproripate times

Schizophrenia duration to diagnose

a person must display 2 or more positive, negative and or disorganized symptoms for a major portion of at least one month

catatonic immobility

disturbance of motor behavior in which the person remains motionless sometimes in an awkward posture for extended periods

Schizophrenia Subtypes Paranoid

Delusions and hallucination
- cognitive skills are intact
- little to no disorganized behavior

Best prognosis

Schizophrenia Subtypes Disorganized

Marked disruptions
- speech
- behavior

Flat or inappropriate affect
Hallucinations and delusions
Chronic
Develops early
Few remissions

Schizophrenia Subtypes Catatonic

Unusual motor responses
Odd mannerisms
- echolalia
- echopraxia

echolalia

repeat or mimic the words of others

echopraxia

repeat or mimic the movements of others

Schizophrenia Subtypes Undifferentiated Type

do not fit into other subtypes
major symptoms
fail to meet criteria

Schizophrenia Subtypes Residual

One or more past episodes
No more major symptoms
Persistent, less extreme symptoms

Schizophreniform Disorder

symptoms similar to schizo
1 month minimum but less then 6 month duration
Most resume normal lives

Schizoaffective Disorder

schizo plus a mood disorder
- disorders are independent
- delusions for 2 weeks in absence of mood
Prognosis - similar to schizo
persistent
no improvement without treatment

Delusional disorder

contrary to reality
lack other positive and negative symptoms

Types
erotomanic- one that is believed to be loved by someone of higher status
grandiose- type of delusion involves famous ppl
jealous - unfaithful
persecutory- malevolently
somatic - medical condition or physical defect

brief psychotic disorder

one or more positive symptoms
last 1 month or less
usually precipitated
- extreme stress
- trauma
Typically return to premorbid baseline

Shared pyschotic disorder

delusions from relationship with delusional person
- 50 % female
- Cognitive impairment in secondary member

Schizotypical personality

related to psychotic disorder
less severe
genetic relationship to schizo

viral infections

influenza

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