《schizophrenia and other psychotic disorders》由会员分享，可在线阅读，更多相关《schizophrenia and other psychotic disorders（39页珍藏版）》请在金锄头文库上搜索。
1、Schizophrenia and Other Psychotic Disorders,Nature of Schizophrenia and Psychosis: An Overview,Schizophrenia vs. Psychosis Psychosis Broad term (e.g., hallucinations, delusions) Schizophrenia A type of psychosis Psychosis and Schizophrenia are heterogeneous Disturbed thought, emotion, behavior,Natur
2、e of Schizophrenia and Psychosis: History and Current Thinking,Historical Background Benedict Morel Introduced dementia praecox Demence (loss of mind) precoce (early, premature) Emil Kraepelin Used the term dementia praecox Focused on subtypes of schizophrenia Eugen Bleuler Introduced the term “schi
3、zophrenia” “Splitting of the mind” Impact of Early Ideas on Current Thinking Many of Kraeplin and Bleulers ideas are still with us Understanding onset and course considered important,Table 13.1,Table 13.1 Early Figures in the History of Schizophrenia,Schizophrenia: The “Positive” Symptom Cluster,The
4、 Positive Symptoms Active manifestations of abnormal behavior Distortions of normal behavior Delusions: The Basic Feature of Madness Gross misrepresentations of reality Include delusions of grandeur or persecution Hallucinations: Auditory and/or Visual Experience of sensory events without environmen
5、tal input Can involve all senses Findings from SPECT studies,Etta,Schizophrenia: The “Positive” Symptom Cluster (cont.),Figure 13.1 Major areas of functioning of the cerebral cortex. In most people, only the left hemisphere is specialized for language.,Schizophrenia: The “Negative” Symptom Cluster,T
6、he Negative Symptoms Absence or insufficiency of normal behavior Spectrum of Negative Symptoms Avolition (or apathy) Lack of initiation and persistence Alogia Relative absence of speech Anhedonia Lack of pleasure, or indifference Affective flattening Little expressed emotion,Schizophrenia: The “Diso
7、rganized” Symptom Cluster,The Disorganized Symptoms Include severe and excess disruptions Speech, behavior, and emotion Nature of Disorganized Speech Cognitive slippage Illogical and incoherent speech Tangentiality “Going off on a tangent” Loose associations Conversation in unrelated directions Natu
8、re of Disorganized Affect Inappropriate emotional behavior Nature of Disorganized Behavior Includes a variety of unusual behaviors Catatonia Spectrum Wild agitation, waxy flexibility, immobility,Subtypes of Schizophrenia,Paranoid Type Intact cognitive skills and affect Do not show disorganized behav
9、ior Hallucinations and delusions Grandeur or persecution The best prognosis of all types of schizophrenia Disorganized Type Marked disruptions in speech and behavior Flat or inappropriate affect Hallucinations and delusions Tend to be fragmented Develops early, tends to be chronic, lacks remissions,
10、Subtypes of Schizophrenia (cont.),Catatonic Type Show unusual motor responses and odd mannerisms Examples include echolalia and echopraxia Tends to be severe and quite rare Undifferentiated Type Wastebasket category Major symptoms of schizophrenia Fail to meet criteria for another type Residual Type
11、 One past episode of schizophrenia Continue to display less extreme residual symptoms,Other Disorders with Psychotic Features,Schizophreniform Disorder Schizophrenic symptoms for a few months Associated with good premorbid functioning Most resume normal lives Schizoaffective Disorder Symptoms of sch
12、izophrenia and a mood disorder Both disorders are independent of one another Prognosis is similar for people with schizophrenia Such persons do not tend to get better on their own,Other Disorders with Psychotic Features (cont.),Delusional Disorder Delusions that are contrary to reality Lack other po
13、sitive and negative symptoms Types of delusions include Erotomanic Grandiose Jealous Persecutory Somatic Extremely rare Better prognosis than schizophrenia,Additional Disorders with Psychotic Features,Brief Psychotic Disorder One or more positive symptoms of schizophrenia Usually precipitated by ext
14、reme stress or trauma Tends to remit on its owns Shared Psychotic Disorder Delusions from one person manifest in another person Little is known about this condition Schizotypal Personality Disorder May reflect a less severe form of schizophrenia,Classification Systems and Their Relation to Schizophr
15、enia,Process vs. Reactive Distinction Process Insidious onset, biologically based, negative symptoms, poor prognosis Reactive Acute onset (extreme stress), notable behavioral activity, best prognosis Good vs. Poor Premorbid Functioning in Schizophrenia Focus on functioning prior to developing schizo
16、phrenia No longer widely used Type I vs. Type II Distinction Type I Positive symptoms, good response to medication, optimistic prognosis, and absence of intellectual impairment Type II Negative symptoms, poor response to medication, pessimistic prognosis, and intellectual impairments,Schizophrenia: Some Facts and Statistics,Onset and Prevalence of Schizophrenia worldwide About 0.2% to 1.5% (or about 1% population) Often develops in early adulthood Can eme
