Download Schizophrenia and Other Psychotic Disorders Chapter 10 Chapter

Schizophrenia and Other Psychotic Disorders
Chapter 10
Chapter Outline

Psychotic Disorders
 Characterized by unusual thinking, distorted perceptions, and odd behaviors
 Psychosis – a severe mental condition characterized by a loss of contact with reality
 Delusion – a false belief
 Hallucination – a false sensory perception

What Is Schizophrenia?
 A severe psychological disorder characterized by disorganization in thought, perception, and
behavior
-First defined over 100 years ago by German psychiatrist Emil Kraepelin
-Dementia praecox
-Dementia (pervasive disturbances of perceptual and cognitive faculties)
-Praecox (early life onset)
-Schizophrenia vs. DID

Schizophrenia in Depth: Positive Symptoms
 Group of symptoms including unusual thoughts, feelings, and behaviors
 Persecutory delusions
 Delusions of influence
 Loose associations
 Thought blocking
 Clang associations
 Catatonia and waxy flexibility

Schizophrenia in Depth: Negative Symptoms
 Behaviors, emotions, or thought processes that are absent in people with schizophrenia
 Blunted affect
 Anhedonia
 Avolition
 Alogia
 Psychomotor retardation
 Cognitive impairments

Functional Impairment of Schizophrenia
 Symptom severity equals the level of impairment
 Significant human toll on the individual and the family (quality of life)
 One of the top ten most debilitating conditions in the world (DALY)
 Cultural factors
 Violence
 …violent acts committed by people with schizophrenia is higher than the rates of
violence from the general population. Some researchers have reported that 8% of
patients committed a violent act upon being discharged from a hospital stay, and
15% committed a violent act after their first year of being hospitalized.

Epidemiology of Schizophrenia
 Prevalence rates averages 1% to 0.3 to 1.6% of U.S. general population
 16 to 40 of every 100,000 people develop schizophrenia
 Gradual onset (some deterioration of functioning)
 Prodromal phase (social withdrawal or deterioration in hygiene)
 Acute phase (starts to exhibit positive symptoms)
 Residual phase (psychotic symptoms are no longer present but negative symptoms remain)

Sex, Race, Ethnicity, and Development
 Women (develop schizophrenia at a later age and tend to have milder forms)
 Developmental factors
 Hormonal and sociocultural implications
 Symptoms common across racial and ethnic groups
 African Americans (more likely to be diagnosed than white and Latino patients)
 EOS (schizophrenia that develops before the age of 18)

Ethics and Responsibility
 Racial bias is a real factor in the diagnosis of Schizophrenia
 Determine diagnosis based solely on a person’s symptoms without knowing race
 Inaccurate diagnosis may result
 Inattention to cultural different behavior
 Lack of cultural competence among clinicians
 Language barriers
 Few bilingual therapists
 Diagnostic errors

Other Psychotic Disorders
 Brief psychotic disorder (sudden onset of psychotic symptoms does not last for more than a
month)
 Schizophreniform disorder (identical to schizophrenia but the illness is less than 6 months)
 Schizoaffective disorder (patient suffers from schizophrenia and depression, main, or mixed)
 Delusional disorder (presence of nonbizarre delusion)
 Shared psychotic disorder (two people sharing a delusional belief)

Etiology _Biological
-Dopamine hypothesis (the presence of too much dopamine in the neural synapse)
-Neurotransmitters
-Genetics
-Neuroanatomy (structural and functional abnormalities in the brain)
-Viral theories and prenatal stressors
-Synaptic pruning (process in which weaker synaptic contacts in the brain are eliminated and
stronger connections strengthened)

Genetics and Environment: Schizophrenia
1. A research study found that 36.8% of the biological children of schizophrenic mothers who were
raised in “disordered” family environment developed a “schizophrenic spectrum disorder.”
Fact: Both genetic and environmental factors increase the risk of psychotic disorders, but even
without the genetic risk and “healthy family environment,” 4.8% of individuals still develop the
disorder.
Evidence: The research shows both factors play a role.

Etiology _Family Influences
-The cause of the disorder is not the same as what people believe is responsible for their suffering
-Expressed emotion (describes the level of emotional involvement and attitudes that exist within a
family of a patient with schizophrenia)
-A variety of cultural explanations for the disorder (biological, social, supernatural, and family
environment)
-Gene-environment correlation (the same person who provides one’s genetic make-up also provides
the environment in which one lives)

Treatment of Schizophrenia_Pharmacological
-Antipsychotics (a class of medications that block dopamine receptors)
-Typical antipsychotics (medications that reduce the positive symptoms)
-Atypical antipsychotics (medications that treat positive symptoms, less likely to produce side effects,
and affect negative symptoms and cognitive impairments)
-Side effects
-Tardive dyskinesia (abnormal and involuntary motor movements of the face, mouth, limbs, and
trunk)

Treatment of Schizophrenia_Psychosocial
-Psychoeducation (both patient and family members are educated about disorder)
-CBT (used to reduce or eliminate psychotic symptoms)
-Social skills training (teaches the basics of social interaction and both verbal and nonverbal skills)
-Supported employment (a psychosocial intervention that provides job skills)
Research Hot Topic: Transcranial Magnetic Stimulation (TMS)
 Goal (provide stimulation to a targeted area of the cerebral cortex to change brain activity)
 Use of small coil placed over the scalp to induce electrical current
 Based on neuroimaging studies
 Decreases (temporarily) the frequency of hallucinations
 Reduction in positive symptoms (reduced frequency of voices and reduced distraction)
 Does not reduce delusions
 Time-limited results and need for further studies