Psychotic Disorders. There is a loss of contact with and difficulty in recognizing reality.

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Chapter 14. Psychological Disorders

MENTAL HEALTH DISEASE CLASSIFICATIONS

Transcription:

Psychotic Disorders A psychosis or psychotic disorder, involves a major disorganization of thought processes, confused and extreme emotional responses, and distorted perceptions of the world. There is a loss of contact with and difficulty in recognizing reality.

Characteristics of Psychotic Disorders Four major symptoms can appear in psychosis. All four may not be present in one individual, but typically at least two are. 1. The first symptom is a serious distortion of mental processes. Often it is hard to understand exactly what psychotic people are trying to say or to grasp what they are thinking. This behavior comes and goes so that they are lucid for a while, then very confused. This symptom is called thought disorder.

2. The second symptom involves seeing or hearing things that are not there. Again, this comes and goes. It is not unusual for psychotics to hear voices or see objects that are not present. This behavior is called hallucinating. 3. Next, many psychotics hold grossly inaccurate beliefs, such as thinking of themselves as avenging angels or as victims of persecution by some secret organization. Such a belief is called a delusion.

4. Finally, psychotics have a great deal of trouble with emotional responses. The emotions shown are quite inappropriate. They might show no response at all when something interesting happens, for example, or they might laugh at a tragic event. We seriously doubt that they really think it is funny. Instead, we think that they are quite confused and dominated by a malfunctioning brain.

Schizophrenic Disorders

Symptoms Schizophrenia, a psychosis, is the most serious of all mental disturbances. It affects about 1 percent of the population. Obvious symptoms of this problem are: disorganized thoughts garbled speech, hallucinations delusions.

Disorganized Thoughts & Speech In some cases, schizophrenics speak what is called word salad. Like the ingredients of a tossed salad, the words are all mixed together: The house burnt the cow horrendously always. Or the speech has what we call clang associations, the speech has a rhythm like a bell: You wear clothes and how much does this watch cost? Have you a sister? I have three and they are all fine girls, curls, furls, isn t that funny? The clang comes with girls, curls, furls.

Types of Schizophrenia Catatonic Paranoid Undifferentiated Sufferers can hold an unusual posture for hours Feelings of persecution and suspiciousness Difficult to distinguish symptoms

Catatonic Schizophrenia Catatonic schizophrenia is characterized mainly by movement, which might be strongly increased (hypekinesis) or decreased (stupor). We recognize two forms: productive form which shows catatonic excitement, extreme and often aggressive activity. Treatment by neuroleptics or by electroconvulsive therapy. stuporose form characterized by general inhibition of patient s behavior or at least by retardation and slowness, followed often by mutism, rigidity or by stupor. The consciousness is not absent. These catatonics usually do not speak, or they say very little. They appear to be in a stupor much of the time. They may rigidly hold a particular posture or simply stand or sit, unmoving, for hours.

Paranoid Schizophrenia Paranoid schizophrenia is marked by strong feelings of persecution and suspiciousness, it often includes grandiose beliefs as well. For instance, a paranoid schizophrenic might believe that he or she has some kind of special or superhuman power. The delusions are not usually well organized and lack logical connections. They are often combined with hallucinations of different senses, mostly with hearing voices. Disturbances of affect, volition and speech, and catatonic symptoms, are either absent or relatively inconspicuous.

Undifferentiated Schizophrenia Undifferentiated schizophrenia has nothing special to differentiate or distinguish it. Many professionals consider this a catchall category. In other words, this category is used when a schizophrenic does not fit into any other subtype.

Schizophrenic Episodes Schizophrenics are not necessarily out of touch with reality all the time. Their unusual behavior (called psychotic episodes) often comes in cycles, and in between they are reasonable lucid. Even those who seem unaware of their surroundings may not be as completely lost as they may appear.

Researchers doubt that schizophrenia is a single disorder but instead think that there are different causes and degrees of severity. For example, about a third of people with schizophrenia have one episode and get better, never to have it happen again. A third have very severe symptoms and do not respond to treatment very much at all. The final third are in and out of institutions most of their lives Psychologists suspect that schizophrenia results mostly from some physical or chemical problem because it appears in late adolescence or early adulthood, almost never earlier.

Hereditary and Environmental Factors in Schizophrenia 1. Heredity plays a role -Monozygotic twins (31%-78%) vs dizygotic twins 4-9% risk in first degree relatives of schizophrenics 2. Inheretability 60% People can be predisposed towards developing schizophrenia - 3. Environment may play a role in the development of schizophrenia but is not the major factor. 4. A strange and bizarre family life may trigger appearance in someone who is predisposed.

Chemical Factors in Schizophrenia 1. Dopamine is a neurotransmitter found in the brain. 2. Schizophrenics have very high levels of dopamine. 3. They report that they feel agitated, talk rapidly, and their thoughts are racing. 4. Some schizophrenics report that lower levels of dopamine make them feel better.