schizophrenia and other thought disorders. origins of the diagnosis kraepelin – 19th century:...
TRANSCRIPT
![Page 1: Schizophrenia And Other Thought Disorders. Origins of the Diagnosis Kraepelin – 19th century: dementia praecox Eugene Bleuler (1908) - coined the term](https://reader035.vdocuments.net/reader035/viewer/2022062518/56649ed05503460f94bde045/html5/thumbnails/1.jpg)
Schizophrenia
And Other Thought Disorders
![Page 2: Schizophrenia And Other Thought Disorders. Origins of the Diagnosis Kraepelin – 19th century: dementia praecox Eugene Bleuler (1908) - coined the term](https://reader035.vdocuments.net/reader035/viewer/2022062518/56649ed05503460f94bde045/html5/thumbnails/2.jpg)
Origins of the DiagnosisKraepelin – 19th century: dementia
praecox
Eugene Bleuler (1908) - coined the term schizophreniaskhizein - splitphren - mind
![Page 3: Schizophrenia And Other Thought Disorders. Origins of the Diagnosis Kraepelin – 19th century: dementia praecox Eugene Bleuler (1908) - coined the term](https://reader035.vdocuments.net/reader035/viewer/2022062518/56649ed05503460f94bde045/html5/thumbnails/3.jpg)
Positive Symptoms
Delusions: false beliefs
◦delusion of grandeur: belief that one has extraordinary powers
◦delusion of persecution: belief that others are out to get you
![Page 4: Schizophrenia And Other Thought Disorders. Origins of the Diagnosis Kraepelin – 19th century: dementia praecox Eugene Bleuler (1908) - coined the term](https://reader035.vdocuments.net/reader035/viewer/2022062518/56649ed05503460f94bde045/html5/thumbnails/4.jpg)
Other Delusionsideas of reference:
thought broadcasting:
Capgras: belief that someone you know has been replaced by a “double”
Cotard: belief that you are dead
![Page 5: Schizophrenia And Other Thought Disorders. Origins of the Diagnosis Kraepelin – 19th century: dementia praecox Eugene Bleuler (1908) - coined the term](https://reader035.vdocuments.net/reader035/viewer/2022062518/56649ed05503460f94bde045/html5/thumbnails/5.jpg)
Positive SymptomsHallucinations: experience of a
sensory event without the presence of sensory stimuliauditoryvisualtactileolfactorygustatory
![Page 6: Schizophrenia And Other Thought Disorders. Origins of the Diagnosis Kraepelin – 19th century: dementia praecox Eugene Bleuler (1908) - coined the term](https://reader035.vdocuments.net/reader035/viewer/2022062518/56649ed05503460f94bde045/html5/thumbnails/6.jpg)
Auditory Hallucinations
Broca’s area: involved in speech production
Wernicke’s area: involved in speech comprehension
brain imaging studies reveal that Broca’s area of the brain was most active during auditory hallucinations.
![Page 7: Schizophrenia And Other Thought Disorders. Origins of the Diagnosis Kraepelin – 19th century: dementia praecox Eugene Bleuler (1908) - coined the term](https://reader035.vdocuments.net/reader035/viewer/2022062518/56649ed05503460f94bde045/html5/thumbnails/7.jpg)
![Page 8: Schizophrenia And Other Thought Disorders. Origins of the Diagnosis Kraepelin – 19th century: dementia praecox Eugene Bleuler (1908) - coined the term](https://reader035.vdocuments.net/reader035/viewer/2022062518/56649ed05503460f94bde045/html5/thumbnails/8.jpg)
Negative Symptomsavolition: inability to initiate and
follow through with activities
alogia: the relative absence of speech
anhedonia: lack of pleasure in life
affective flattening: limited range of emotions visible to others
![Page 9: Schizophrenia And Other Thought Disorders. Origins of the Diagnosis Kraepelin – 19th century: dementia praecox Eugene Bleuler (1908) - coined the term](https://reader035.vdocuments.net/reader035/viewer/2022062518/56649ed05503460f94bde045/html5/thumbnails/9.jpg)
Disorganized Symptoms
disorganized speech
inappropriate affect and disorganized behavior
![Page 10: Schizophrenia And Other Thought Disorders. Origins of the Diagnosis Kraepelin – 19th century: dementia praecox Eugene Bleuler (1908) - coined the term](https://reader035.vdocuments.net/reader035/viewer/2022062518/56649ed05503460f94bde045/html5/thumbnails/10.jpg)
Historic (i.e., until 2013) Schizophrenia Subtypes
paranoid: delusions of grandeur or persecution
disorganized: marked disruption in speech and behavior
catatonic: unusual motor activity (e.g., fixed positions, excessive activity, odd mannerisms)
undifferentiated: do not meet the criteria for other subtypes
![Page 11: Schizophrenia And Other Thought Disorders. Origins of the Diagnosis Kraepelin – 19th century: dementia praecox Eugene Bleuler (1908) - coined the term](https://reader035.vdocuments.net/reader035/viewer/2022062518/56649ed05503460f94bde045/html5/thumbnails/11.jpg)
DSM-V criteria for Schizophrenia2 or more of the following symptoms
for a significant portion of a month:◦ Delusions◦ Hallucinations◦ Disorganized speech◦ Grossly disorganized or catatonic behavior◦ Negative symptoms
![Page 12: Schizophrenia And Other Thought Disorders. Origins of the Diagnosis Kraepelin – 19th century: dementia praecox Eugene Bleuler (1908) - coined the term](https://reader035.vdocuments.net/reader035/viewer/2022062518/56649ed05503460f94bde045/html5/thumbnails/12.jpg)
![Page 13: Schizophrenia And Other Thought Disorders. Origins of the Diagnosis Kraepelin – 19th century: dementia praecox Eugene Bleuler (1908) - coined the term](https://reader035.vdocuments.net/reader035/viewer/2022062518/56649ed05503460f94bde045/html5/thumbnails/13.jpg)
![Page 14: Schizophrenia And Other Thought Disorders. Origins of the Diagnosis Kraepelin – 19th century: dementia praecox Eugene Bleuler (1908) - coined the term](https://reader035.vdocuments.net/reader035/viewer/2022062518/56649ed05503460f94bde045/html5/thumbnails/14.jpg)
Possible Biological Causesgenetic influence
Identical twin has it (48% chance)Fraternal twin (17%)
abnormal brain structure
viral infection
dopamine
![Page 15: Schizophrenia And Other Thought Disorders. Origins of the Diagnosis Kraepelin – 19th century: dementia praecox Eugene Bleuler (1908) - coined the term](https://reader035.vdocuments.net/reader035/viewer/2022062518/56649ed05503460f94bde045/html5/thumbnails/15.jpg)
Dopamine Hypothesis
Evidence For: Evidence Against:
many effective antipsychotics block dopamine
antipsychotics produce Parkinson’s-like side effects
L-dopa can produce schizophrenia-like symptoms
amphetamines make psychotic symptoms worse
some aren’t helped with dopamine antagonists
symptoms take a while to subside but dopamine quickly blocked
antipsychotics alleviate positive but not negative symptoms
Clozopine works – weak effect on dopamine
![Page 16: Schizophrenia And Other Thought Disorders. Origins of the Diagnosis Kraepelin – 19th century: dementia praecox Eugene Bleuler (1908) - coined the term](https://reader035.vdocuments.net/reader035/viewer/2022062518/56649ed05503460f94bde045/html5/thumbnails/16.jpg)
Psychological Influences
Causesschizphenogenic mother?double-binds?
Relapseexpressed emotion
![Page 17: Schizophrenia And Other Thought Disorders. Origins of the Diagnosis Kraepelin – 19th century: dementia praecox Eugene Bleuler (1908) - coined the term](https://reader035.vdocuments.net/reader035/viewer/2022062518/56649ed05503460f94bde045/html5/thumbnails/17.jpg)
Psychosocial Interventions: inpatient care
token economydeinstitutionalization
social skills training
family interventions
virtual reality
![Page 18: Schizophrenia And Other Thought Disorders. Origins of the Diagnosis Kraepelin – 19th century: dementia praecox Eugene Bleuler (1908) - coined the term](https://reader035.vdocuments.net/reader035/viewer/2022062518/56649ed05503460f94bde045/html5/thumbnails/18.jpg)
Intensive Case Mangement (ICM)Typically, but not always, a social
worker.
Links clients to needed services and gives instruction in basic living skills.
Has been found to reduce rates of hospitalization.
![Page 19: Schizophrenia And Other Thought Disorders. Origins of the Diagnosis Kraepelin – 19th century: dementia praecox Eugene Bleuler (1908) - coined the term](https://reader035.vdocuments.net/reader035/viewer/2022062518/56649ed05503460f94bde045/html5/thumbnails/19.jpg)
Assertive Community Treatment (ACT)
◦Mobile case management.
◦Developed by Stein and Test in 1985 in Madison, Wisconsin.
◦Other aspects of ACT is that takes a wholistic approach, attempts to capitalize on the client’s strengths, and attempts to work within the ecology of the client.
![Page 20: Schizophrenia And Other Thought Disorders. Origins of the Diagnosis Kraepelin – 19th century: dementia praecox Eugene Bleuler (1908) - coined the term](https://reader035.vdocuments.net/reader035/viewer/2022062518/56649ed05503460f94bde045/html5/thumbnails/20.jpg)
Treatment for Schizophrenia
Antipsychotic medicationsconventional:
Thorazine, Mellaril, Haldolnewer antipsychotics:
Clozaril, risperidal, Zyprexa
Extrapyramidal symptoms:tardive dyskinesia – involuntary
movements of the tongue, face, mouth, or jaw
![Page 21: Schizophrenia And Other Thought Disorders. Origins of the Diagnosis Kraepelin – 19th century: dementia praecox Eugene Bleuler (1908) - coined the term](https://reader035.vdocuments.net/reader035/viewer/2022062518/56649ed05503460f94bde045/html5/thumbnails/21.jpg)
schizophreniform disorder: symptoms of schizophrenia that last between 1 and 6 months
schizoaffective disorder: presence of a mood disorder and the presence of delusions or hallucinations for at least 2 weeks in the absence of prominent mood symptoms
![Page 22: Schizophrenia And Other Thought Disorders. Origins of the Diagnosis Kraepelin – 19th century: dementia praecox Eugene Bleuler (1908) - coined the term](https://reader035.vdocuments.net/reader035/viewer/2022062518/56649ed05503460f94bde045/html5/thumbnails/22.jpg)
brief psychotic disorder: presence of one or more positive symptoms within a month
shared psychotic disorder (Folie a deux): individual develops delusions as a result of a close relationship with a delusional individual
![Page 23: Schizophrenia And Other Thought Disorders. Origins of the Diagnosis Kraepelin – 19th century: dementia praecox Eugene Bleuler (1908) - coined the term](https://reader035.vdocuments.net/reader035/viewer/2022062518/56649ed05503460f94bde045/html5/thumbnails/23.jpg)
Delusional Disorderpersistent belief that is contrary to
reality absence of other characteristics of
schizophrenia
erotomanic: irrational belief that one is loved by another person◦ http://www.youtube.com/watch?v=fAHyA3jA
50o◦ Start at 5:50
grandiose: inflated sense of self-worth, power, knowledge, identity, or special relationship to a deity or famous person
![Page 24: Schizophrenia And Other Thought Disorders. Origins of the Diagnosis Kraepelin – 19th century: dementia praecox Eugene Bleuler (1908) - coined the term](https://reader035.vdocuments.net/reader035/viewer/2022062518/56649ed05503460f94bde045/html5/thumbnails/24.jpg)
Delusional Disorder
jealous: beliefs that sexual partner is unfaithful – no evidence for it.
persecutory: believe that you or loved one is being treated malevolently
somatic: afflicted by a physical defect or general medical condition.