* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Download Schizophrenia and Other Psychoses
Social anxiety disorder wikipedia , lookup
Panic disorder wikipedia , lookup
Bipolar disorder wikipedia , lookup
Sluggish cognitive tempo wikipedia , lookup
Antisocial personality disorder wikipedia , lookup
Symptoms of victimization wikipedia , lookup
Rumination syndrome wikipedia , lookup
Child psychopathology wikipedia , lookup
Bipolar II disorder wikipedia , lookup
Conduct disorder wikipedia , lookup
Factitious disorder imposed on another wikipedia , lookup
Generalized anxiety disorder wikipedia , lookup
Mental disorder wikipedia , lookup
Depersonalization disorder wikipedia , lookup
Depression in childhood and adolescence wikipedia , lookup
Treatment of bipolar disorder wikipedia , lookup
Diagnostic and Statistical Manual of Mental Disorders wikipedia , lookup
Asperger syndrome wikipedia , lookup
Spectrum disorder wikipedia , lookup
Post-concussion syndrome wikipedia , lookup
Causes of mental disorders wikipedia , lookup
Schizoaffective disorder wikipedia , lookup
Dissociative identity disorder wikipedia , lookup
History of mental disorders wikipedia , lookup
Diagnosis of Asperger syndrome wikipedia , lookup
Conversion disorder wikipedia , lookup
Schizophrenia wikipedia , lookup
Schizophrenia and Other Psychoses Assessment & Diagnosis SW 593 Introduction • Arguably the most serious and debilitating of the mental disorders. • Involve distortions in the perceptions of reality; • Impairments in the capacity to reason, speak and behave rationally; • Impairments in affect and motivation. • Directly or indirectly disrupt all aspects of a client’s life. Schizophrenia • Symptoms include severe disruptions in thinking • Gross disorganization in thoughts • May involve delusions (system of false beliefs that are not open to reason or appeal) • There will be perceptual disturbances including hearing voices. (auditory hallucinations) Schizophrenia • Remaining symptoms (negative): – Absence of affect – Absence of motivation – Absence of interaction • There will be significant psychosocial impairment and/or distress • Symptoms must have begun at least 6 months earlier. Schizophrenia • Subtypes are based by the predominant symptoms: – Paranoid type: delusions/hallucinations are elaborate and encompassing – Catatonic type: most rare of all subtypes – Disorganized type: disorganized speech and negative symptoms, some catatonia present – Residual type: negative symptoms alone – Undifferentiated type: no particular features are prominent. Schizophreniform Disorder • Same features as schizophrenia but the time frame since the initial display of symptoms is between 1 and 6 months. • This diagnosis exists to ensure that the label of schizophrenia is not used too quickly. • Clients with this disorder may not evidence marked psychosocial problems. Brief Psychotic Disorder • Sudden onset of positive symptoms that last more than one day but remit within 30 days. • Criteria includes a return to the premorbid level of functioning. • Should be provisional • A specifier is used to indicate whether there is a discernable stressor that has triggered the episode. Schizoaffective Disorder • Includes the same symptoms as schizophrenia but also has symptoms that constitute one of the episodes of a mood disorder. • Periods when only the schizophrenic symptoms are evident. • Usually diagnosed after examination of the severe symptoms. Delusional Disorder • Differs in both symptoms and impairment from schizophrenia • Disorganization and negative symptoms are not present • Social and vocational functioning effected but not as severe. • Content of delusional material is not considered bizarre. Delusional Disorder • The distinction between bizarre and nonbizarre delusions is focused on whether the delusional situation could occur in real life. Shared Psychotic Disorder • Occurs when a person who is closely associated with someone else with some psychotic disorder “buys into” the delusional system. • Fairly rare but it is more likely to occur when the individual with the original delusions exercises power over the other person. Assessment • Assessment with these clients is accomplished through structured interviews commonly known as mental status examinations. • Designed to accrue information about the quality of the client’s mental processes. Mental Status Examination • Cognitive functioning: – – – – – – – – – Normal intelligence? Oriented to person, place, and time? Evidence of problem-solving thinking? Preoccupied? Delusional thinking? Bizarre? Thinking coherent and goal directed? Exhibits good judgment? Memory problems? (immediate, recent, remote) Hallucinations? Peculiar speech? Mental Status Examination • Emotional functioning – What emotions are described? – Congruent to thoughts? – Feeling over the past year? – Emotional state creating difficulties? – Emotionally stable? – Blunted or flattened affect? – Expansive? Mental Status Examination • Physical functioning: – Level of energy? Past year? – Unusual motor behaviors? – Medical problems? – Recent physical exam? Results? – Any prescribed meds? What? – Any psychological treatment? – Presents with any disabilities? Mental Status Examination • Substance use: – Alcohol? How much? – Other substances? – Social, legal, occupational troubles? – CAGE – Treatment? Emergency Considerations • • • • • Dangerous behavior may occur Mostly toward themselves 60 – 80% will experience suicidal ideations 10 – 15% will actually commit suicide 50% will make a suicide attempt with younger clients making more attempts • The more positive the symptoms the greater likelihood. Cultural Considerations • A disproportionately high number of cases of schizophrenia are found among disadvantaged ethnic cultures. • Greater in groups with high ethnic discrimination; low educational attainment; and low occupational status. Social Selection Theory • Cultures that are oppressed and unable to attain high socioeconomic status have a greater number of individuals with disabilities and poor health. • The result of their oppressed status over the centuries and subsequent genetic predisposition rather than their ethnic background per se. Cultural Factors • Play a role in the course of the illness. • Prognosis was more favorable in developing countries (Nigeria, India, Columbia) than in nine industrialized countries (the United Kingdom, the United States, the former Soviet Union). • Evidence has indicated that high expressed emotion (EE) within a U.S. family can have a negative impact on the person coping with schizophrenia. Cultural Factors • Psychoeducational support for high EE families has been effective in reducing the relapse and rehospitalization of schizophrenic family members. • Social skills training is most effective with Caucasian individuals and families. • Less effective with Latinos.