Download Delusional psychosis and other psychotic disorders

Schizoaffective disorder
Delusional psychosis and
other psychotic disorders
Department of Psychiatry and
Psychotherapy, Pécs
History
Kasanin – 1933
Good premorbid history
Better prognosis
Brief psychotic periods
Treatment of schizoaffective psychosis
Acute treatment – depending on the
symtomptomatology
Maintenance treatment – lithium, valproat,
carbamazepine, antipsychotics,
antidepressants
Cautious clinical approach
Schizophrenia symptoms and bipolar
symptomatology at the same time
Delusions and hallucinations at least two
weeks in the absence of mood symptoms
Specificy type:
Bipolar type
Depressive type
Epidemiology of schizoaffective
psychosis
Lifetime prevalence – 0,5 to 0,8 percent
Onset at late adolescence or early adulthood
biological background influenced by
psychological, psychodynamic factors
Marker research is nearer to results on mood
disorders although other data also available (
DST, TRH)
Schizophreniphorm psychosis
Langfeldt – 1939
Diagnostic criteria – schizophrenia symptoms
at least one month but less then six monhs (
DSM –IV)
Lifetime prevalence is 0,2 percent
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Brief psychotic disorder
Duration from one day to one month
Delusions, hallucinations,disorganized
speech, catatonia or grossly disorganized
behavior
Importance of stresses - reactive psychosis (
Jaspers, 1913)
Bouffe delirante – hysterical psychosis or
psychogenic psychosis –Scandinavian
tradition
Delusional disorder
Non-bizarre delusions
Delusion : an irreal thought which is
connected to the patient’s ego and the patient
is not able to be influenced to give it up (
Jaspers, 1913)
At least one month duration ( DSM-IV)
Case report
Attack at World Trade Center
One day after serious psychosis in a case of
young female
The patient worked at a store selling pictures
on New York City
Depersonalisation –derealisation as a denial
of reality
Good treatment response and outcome
History
Kalhbaum – paranoia 1863
Kraepelin – paraphrenia concept
Freud – Schreber case – psychological
understanding of paranoid mechanisms
PROJECTION ( latent homosexuality)
Cameron – paranoid pseudocommunity
Subtypes of delusional disorder(DSMIV)
Erotomanic type ( De Clerambault syndrome)
Grandiose type
Jealous type(Othello syndrome)
Persecutory type
Somatic type(monosymptomatic
hypochondrial psychosis)
Mixed type
Unspecified type
Monosymptomatic hypochondrial
psychosis ( Munro)
Delusions of smell
Delusions of infestation (Ekbom syndrome)
Dysmorphophobia
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