Psychotic Disorders

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Psychotic Disorders

• Schizophrenia
• Delusional Disorder

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Schizophrenia

• Positive Symptoms
• Symptoms found in schizophrenics
• Negative Symptoms
• Normal behaviors that are absent in schizophrenics

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Positive Symptoms

• Hallucinations(mostly auditory)
• Delusions(delusions of grandeur and persecution
  are most common)
• Speech disturbances(including word salad)
• Disorganized behavior(including silliness, weird
  motor behaviors)
• Inappropriate affect(emotional responses that are
  inappropriate for the circumstances, such as
  crying at comedy shows)

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Negative Symptoms

• Social withdrawal, limited speech and action,
  poor hygiene, apathy
• Flat affect (no emotional response at all)

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Schizophrenia Types

• Disorganized
• Inappropriate affect actions
• Incoherent verbal behavior silliness
• Delusions hallucinations

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Schizophrenia Types

• Catatonic
• Periods of frenzied activity alternating with
  periods of immobility
• May stay in odd positions for hours

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Schizophrenia Types

• Paranoid
• Delusions of grandeur
• Delusions of persecution
• Usually harmless, but may become violent if
  threatened

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Schizophrenia Types

• Undifferentiated
• Used to describe schizophrenics with mixed or
  unusual symptoms

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Causes

• Brain Abnormalities
• Excessive Dopamine Activity
• Stress

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Brain Abnormalities

• Some schizophrenics have
• Low frontal lobe activity
• Undersize hippocampus,amygdala, or thalamus
• Larger than normal ventricles

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Excess Dopamine

• 2/3 of schizophrenics improve when given dopamine
  reducers
• PET scans show excess dopamine activity in
  sufferers
• Drugs that increase dopamine cause schizophrenic
  symptoms
• People taking excessive L-dopahave schizophrenic
  symptoms

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Genetic Aspects

• Schizophrenia runs in families
• Concordance is higher among closer relatives

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Treatments

• Anti-psychotic drugs such as Phenothiazines,Butyro
  phenonesused to reduce dopamine levels
• Stress reduction also appears helpful
• Psychotherapy

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Anxiety Disorders

• Panic disorders
• Phobias
• Post Traumatic Stress Disorder (PTSD)
• Obsessive Compulsive Disorder (OCD)

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Panic Disorder

• Intense, short-lived, recurring attacks of
  overwhelming anxiety or terror
• May involve the limbic system

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Phobias

• Phobia an unreasonable, excessive, or irrational
  fear
• To be a phobia, there must be great distress or
  major interference with life

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Phobias -Specific

• Specific fear of a specific object, place, or
  event
• situational phobias (elevator, airplane)
• natural environment (water, height)
• blood-injection-injury
• animal phobias (dogs, snakes)

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Phobias -Social

• Social Phobias
• fear of embarrassing or humiliating oneself in
  front of others (public speaking, eating in
  public places, writing in front of others)
• Lead to avoidance of social situations

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Phobias -Agoraphobia

• "Fear of the marketplace"
• Marked by intense fear when isolated in open
  spaces or in crowds
• May develop after panic attacks.
• The person may become Housebound.

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Systematic Desensitization

• Teach subject to relax
• Create a hierarchy of feared situations, from
  least to most
• Work through situations, while maintaining
  relaxation

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Modeling

• Provide a role model who does not show the fear
• To be effective, the role model must be seen as
  like the person with the fear

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Phobias Group Therapy

• People with the same phobia often treated
  together
• Thus, patients with milder fears serve as role
  models for those with more severe fears

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Obsessive Compulsive Disorder

• Obsessions persistent, uncontrollable thoughts
• Compulsions ritualistic acts one feels compelled
  to perform

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Biology O-C Disorders

• OCD patients show excessive functioning in the
  frontal lobes the limbic system
• OCD patients show serotonin imbalances that
  respond to depression medications

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Somatoform Disorders

• Hypochondriasis
• Body Dysmorphic Disorder
• Conversion Disorder
• Pain Disorder
• Somatization Disorder

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Somatoform Disorders

• Real physical symptoms with no biological cause
• Hypochondriasis
• Excessive attention to state of health, along
  with preoccupation with the minor aches and pains
  of living. may "doctor shop".
• Conversion
• Physical symptoms, such as paralyses and
  blindness, with no physical explanation
• Treatment Psychotherapy and sometimes medication

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Personality Disorders

• Antisocial Personality Disorder

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Personality Disorders

• Antisocial Personality Disorder
• Marked by a lack of empathy, chronic
  underarousal, willingness to lie, cheat, steal,
  and break the law

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Antisocial Personality Disorder

• Pattern begins in childhood or early adolescence.
  
• Possible Causes
• emotional deprivation in childhood,
• Observational learning,
• problem in moral development,
• genetic and biological factors

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Sexual Disorders

• Includes sexual dysfunctions and paraphilias
• Only dysfunctions paraphilias causing distress
  to self or others are disorders

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Paraphilias

• Voyeurism Sexual attraction to watching
  unconsenting people nude or engaged in sexual
  activity
• Fetishism Sexual attraction to inanimate objects
• Pedophilia Sexual attraction to prepubescent
  children

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Paraphilias

• Exhibitionism Sexual attraction to exposing
  one's genitals to unsuspecting strangers
• Masochism Sexual attraction to being bound,
  beaten, or made to suffer
• Sadism Sexual attraction to hurting others

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Paraphilias

• Many arise through classical conditioning
• Most are strengthened when the person fantasizes
  the attraction while masturbating

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Personality Disorder Treatment

• Treatment varies for the person and disorder, but
  generally
• Psychotherapy
• Medications
• Antidepressant medications. Antidepressants may
  be useful if you have a depressed mood, anger,
  impulsivity, irritability or hopelessness, which
  may be associated with personality disorders.
• Mood-stabilizing medications. As their name
  suggests, mood stabilizers can help even out mood
  swings or reduce irritability, impulsivity and
  aggression.
• Anti-anxiety medications. These may help if you
  have anxiety, agitation or insomnia. But in some
  cases, they can increase impulsive behavior.
• Antipsychotic medications. Also called
  neuroleptics, these may be helpful if your
  symptoms include losing touch with reality
  (psychosis) or in some cases if you have anxiety
  or anger problems.
• Hospitalization or Residential Care

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Other DSM-IV disorders..

• SLEEP DISORDERS
• Disorders which are characterised by a
• significant sleep disturbance. Examples
• include
• Primary Insomnia difficulty getting to sleep or
  staying asleep
• Narcolepsy irresistible attacks of refreshing
  sleep
• Sleep Terror Disorder repeated occurrence of
  sleep terrors (awakenings from sleep usually
  beginning with a panicky scream or cry)

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Other DSM-IV disorders..

• INFANCY, CHILDHOOD OR
• ADOLESCENT DISORDERS
• Disorders which are usually first diagnosed in
• infancy, childhood or adolescence . Examples
• include
• Reading Disorder reading achievement that is
  below that expected given the individuals
  chronological age
• Stuttering a disturbance in the normal fluency
  and time pattering of speech
• Encopresis the repeated passage of faeces into
  inappropriate places (e.g. clothing or floor).

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Other DSM-IV disorders..

• DISSOCIATIVE DISORDERS
• Disorders in which there is a disruption in the
• usually integrated functions of consciousness,
• memory, identity or perception of the
  environment.
• Examples include
• Dissociative Identity Disorder the presence of
  two or more distinct identities/personalities
  within the same individual
• Dissociative Amnesia an inability to recall
  important personal information, usually of a
  traumatic/stressful nature

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Other DSM-IV disorders..

• IMPULSE-CONTROL DISORDERS
• Disorders in which there is a failure to resist
  an
• impulse, drive or temptation to perform an act
  that is
• harmful to the person or to others. Examples
  include
• Kleptomania the recurrent failure to resist
  impulses to steal objects not needed for personal
  use or monetary value
• Pyromania a pattern of fire setting for
  pleasure, gratification or relief of tension
• Pathological gambling recurrent and persistent
  maladaptive gambling behaviour

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Other DSM-IV disorders..

• DELIRIUM, DEMENTIA AND AMNESTIC
• OTHER COGNITIVE DISORDERS
• Disorders in which there is a significant deficit
  in
• cognition or memory. Examples include
• Delirium a disturbance of consciousness
• Dementia multiple cognitive deficits that
  include impairment in memory (e.g. Alzheimers)