Psychosis for intro

Psychotic Disorders : 

Psychotic Disorders DSM-IV

Psychosis : 

Psychosis Psychosis is a condition characterized by a loss of contact with reality. Hallucinations: false perceptions Delusions: false beliefs

Examples of Hallucinations and Delusions : 

Examples of Hallucinations and Delusions Hallucinations Hearing voices Seeing visions Experiencing odd tastes, smells Experiencing odd feelings Delusions Persecution Grandeur Somatic Jealousy Erotomania Thought control Behavior control Thought withdrawal

Psychoses may be caused by : 

Psychoses may be caused by Drugs: e.g., LSD, Amphetamines, Cocaine Brain Diseases: e.g., Alzheimer’s Disease Brain Injuries: e.g., trauma, stroke Extreme stress: e.g., war, kidnapping, Bipolar and major depressive disorders Schizophrenia--most common cause

Some Recent Cases : 

Some Recent Cases Ted Kaczynski--the unabomber Mark David Chapman--killed John Lennon John Hinckley--shot President Reagan Andrea Yates--drowned her five children *Note: most schizophrenics are not violent

A few facts about schizophrenia : 

A few facts about schizophrenia Usually diagnosed in late teens/early 20’s Means “split mind”: Eugen Bleuler Affects approximately 1% of people Men have more severe cases 10-15% commit suicide More common among the poor

Diagnosing Psychiatric Disorders : 

Diagnosing Psychiatric Disorders All psychiatric disorders including schizophrenia are diagnosed on the basis of clusters of symptoms There is no brain scan, no urine test, no blood test, no cerebral spinal fluid test that can be used to diagnose schizophrenia

Positive and Negative Symptoms : 

Positive and Negative Symptoms Positive Hallucinations Delusions Disordered speech Bizarre behavior Good response to drugs, normal brain ventricles, limbic system abnormalities Negative Emotionally flat Poverty of speech Associality Apathy Avolition Frontal lobe abnormalities, enlarged ventricles, variable response to drugs

Diagnostic Criteria for Schizophrenia : 

Diagnostic Criteria for Schizophrenia Delusions Hallucinations Disorganized Speech Disorganized or catatonic behavior Negative Symptoms (deficits) Two or more of the above must be present for at least one month and some disturbance for six months Significant impairment in social/occupational functioning

Disorganized Speech : 

Disorganized Speech Disorder of thought form Loose Associations Thought derailment Neologisms (making up words)

Etiology (Causal Factors) : 

Etiology (Causal Factors) No one factor can fully explain Very good evidence for genetic transmission of a predisposition Probably polygenic Suspect chromosomes 22, 6, 8, and 1 Some evidence for other biological factors

Genetic Studies : 

Genetic Studies Family studies: risk increases as number of shared genes increases Twin studies: concordance rate higher in identical than fraternal twins Adoption studies: biological relatives show increased risk

Other suggested causal factors : 

Other suggested causal factors Prenatal viral infections, esp. 4 -7 month Rh incompatibility between mother and baby Early nutritional deficiencies Birth complications

Other Biological Aspects : 

Other Biological Aspects Enlarged ventricles 3% reduction in overall brain volume Amygdala, frontal lobes, temporal lobes, hippocampus, thalamus Most brains look normal Dopamine Glutamate

Treatment : 

Treatment Antipsychotic medications Thorazine (conventional, typical) Tardive dyskinesia serious side effect Clozaril (atypical) Case Management Family Therapy Psychotherapy usually NOT appropriate

Conclusions : 

Conclusions Schizophrenia affects about 1% of the world’s population and disables more people than any other physical or mental disorder. The cost to society is enormous. Direct medical care in the U. S. is estimated to be 20 billion dollars per year (Torrey, 1995). Loss of productivity is incalculable. There is excellent research going on in many areas-- neuroscience, genetics, molecular biology, psychology, pharmacology, and other areas. We should have the genes identified in the next five years.