psychose the term psychotic emphasized loss of reality

psychose • the term psychotic emphasized loss of reality testing and impairment of mental functioning as manifested by delusions, hallucinations, confusion, and impaired memory. • In the most common psychiatric use of the term, psychotic became synonymous with severe impairment of social and personal functioning. • A neurosis is a chronic or recurrent nonpsychotic disorder characterized mainly by anxiety.

psychoses • • Schizophrenia Schizophreniform Disorder Delusional disorder Schizoaffective disorder Brief Psychotic Disorder MDD with psychotic feature BID with P. F. Substance induced psychotic disorder

Schizophrenia • Schizophrenia is a clinical syndrome of variable, but profoundly disruptive, psychopathology that involves cognition, emotion, perception, and other aspects of behavior. • the effect of the illness is always severe and is usually long lasting. • The disorder usually begins before age 25, persists throughout life, affects persons of all social classes • diagnosis of schizophrenia is based entirely on the psychiatric history and mental status examination

Epidemiology • the lifetime prevalence of schizophrenia is about 1 percent, • Schizophrenia is equally prevalent in men and women • Onset is earlier in men than in women. • The peak ages of onset are 10 to 25 years for men and 25 to 35 years for women. • Onset of schizophrenia before age 10 or after age 60 is extremely rare. • In general, the outcome for female schizophrenia patients is better than that for male schizophrenia patients

Etiology • There is a genetic contribution to schizophrenia. • The modes of genetic transmission in schizophrenia are unknown. • Prevalence of Schizophrenia in General population 1%, Child with one parent with schizophrenia 12%, Child of two parents with schizophrenia 40%, Monozygotic twin of a schizophrenia patient 47%. • schizophrenia results from too much dopaminergic activity in mesocortical and mesolimbic tracts.

Diagnosis • A. Characteristic symptoms: Two (or more) of the following, each present for a significant portion of time during a 1 -month period : – delusions – hallucinations – disorganized speech (e. g. , frequent incoherence) – grossly disorganized or catatonic behavior – negative symptoms • B. Social/occupational dysfunction: • C. Duration: Continuous signs of the disturbance persist for at least 6 months.

delusion • • persecutory, grandiose, religious, Somatic Control Reference thought broadcasting thought reading

hallucination • • • Auditory: command, third person Visual Tactile olfactory, and gustatory Illusions

Other symptoms • • Disorganized behaviors: bizzare / eating • • Catatonia • • Mutism • • Mannerism • • Inappropriate affect • • Negativism • • poorly groomed, fail to bathe • • Stereotypies: verbigeration • HOARDING rubbish • Flat affect • Loosening of associations Echolalia Impulsiveness, Violence, Suicide, Homicide poor insight Social withdrawal Poor function

Subtypes • • • Paranoid type Disorganized type Catatonic type Undifferentiated type Residual type

Prognosis • 20 to 30 percent of all schizophrenia patients are able to lead somewhat normal lives. • About 20 to 30 percent of patients continue to experience moderate symptoms, • 40 to 60 percent of patients remain significantly impaired for their entire lives

Treatment • • antipsychotic medications Psychotherapy Psychoeducation Hospitalization

psychoses • • Schizophrenia Schizophreniform Disorder Delusional disorder Schizoaffective disorder Brief Psychotic Disorder MDD with psychotic feature BID with P. F. Substance induced psychotic disorder