Key Terms Chapter 13 Schizophrenic disorders Prodromal phase Precedes the active phase of schizophrenia and is marker by an obvious deterioration in role functioning Prodromal signs and symptoms are less dramatic than those seen during the active phase of the disorder Residual phase Follows the active phase of a disorder such as schizophrenia At this point psychotic symptoms have improved but the person continuous to be impaired in various ways Negative symptoms may be more pronounced during this phase Positive symptoms Include hallucinations delusions disorganized speech inappropriate affect and disorganized behavior Negative symptoms Include flat or blunted affect avolition alogia and anhedonia Hallucinations A perceptual experience in the absence of external stimulation such as hearing voices that aren t really there Delusions An obviously false and idiosyncratic belief that is rigidly held in spite of its preposterous nature Blunted affect A flattening or restriction of the person s nonverbal display of emotional responses Blunted patients fail to exhibit signs of emotion or feeling Anhedonia The inability to experience pleasure In contrast to blunted which refers to the lack of outward expression anhedonia is a lack of positive subjective feelings Avolition lack of volition or will A negative symptom of schizophrenia involving a loss of willpower indecisiveness and ambivalence The person becomes apathetic and ceases to engage in purposeful actions Alogia A form of speech disturbance found in schizophrenia Can include reductions in the amount of speech poverty of speech or speech that does not convey meaningful information poverty of content speech Disorganized speech also known as formal thought disorder Severe disruptions of verbal communication involving the form of the person s speech Inappropriate affect A form of emotional disturbance seen in schizophrenia Central features are incongruity and lack of adaptability in emotional expression Catatonic type A subtype of schizophrenia that is characterized by symptoms of motor immobility including rigidity and posturing or excessive and purposeless motor activity Disorganized type A subtype of schizophrenia formerly known as hebephrenia that is characterized by disorganized speech disorganized behavior and flat or inappropriate affect If delusions or hallucinations are present their content is not well organized Paranoid type A subtype of schizophrenia that is characterized by systematic delusions with persecutory or grandiose content Preoccupation with frequent auditory hallucinations can also be associated with the paranoid type Undifferentiated type A subtype of schizophrenia that includes patients who display prominent psychotic symptoms and either meet the criteria for several subtypes or otherwise do not meet the criteria for the catatonic paranoid or disorganized types Residual type A subtype of schizophrenia that includes patients who no longer meet the criteria for active phase symptoms but nevertheless demonstrate continued signs of negative symptoms or attenuated forms of delusions hallucinations or disorganized speech Schizoaffective disorder A disorder defined by a period of disturbance during which the symptoms of schizophrenia partially overlap with a major depressive or manic episode Delusional disorder Describes persons who do not meet the full symptomatic criteria for schizophrenia but who are preoccupied for at least 1 month with delusions that are not bizarre Brief psychotic disorder A diagnostic category in DSM IV that includes people who exhibit psychotic symptoms for at least 1 day but no more than 1 month After the symptoms are resolved the person returns to the same level of functioning that have been achieved prior to the psychotic episode Vulnerability marker A specific measure such as biochemical assay or a psychological test that might be useful in identifying people who are vulnerable to a disorder such as schizophrenia Antipsychotic drugs Various forms of medications that have a beneficial effect on positive symptoms of psychosis and psychotic disorganization The effect of first generation antipsychotic drugs depends largely on the blockade of receptors in dopamine pathways in the brain Second generation antipsychotics have a much broader effect on different neurotransmitters All antipsychotics have negative side effects including motor side effects such as tardive dyskinesia Objective Sheet Chapter 13 Schizophrenic disorders What are the general characteristics of schizophrenia Splitting of the mind Splitting or loosening of associative threads Schizophrenia is officially defined by various combinations of psychotic symptoms in the absence of other forms of disturbances such as mood disorders substance dependence delirium or dementia No single symptom or specific set of symptoms is characteristic of all schizophrenic patients What is its impact on patients their families and society For patients It can disrupt many aspects of the person s life well beyond psychotic disorders Dramatic and lasting impact on quality of life o Subjective satisfaction o Ability to hold a job o Education o Developing relationships Must come to terms with the severe disorder and the fact that the persons life might be affected by schizophrenia forever For families For society o Second leading cause of disease burden o Most will not fully recover o Homelessness Long term care is not available Cost of treatment Substantial indirect cost with loss of productivity and unemployment What are the 3 phases of schizophrenia Prodromal phase o Marked by obvious deterioration in role functioning as a student employee or homemaker o Friends and family notice a change in personality o Signs and symptoms include Peculiar behavior ex Talking to oneself in public Unusual perceptual experiences Outburst of anger Increased tension and restlessness Social withdrawal Indecisiveness Lack of willpower Active phase o Signs and symptoms include Hallucinations Delusions Disorganized speech Residual phase o Very similar to prodromal symptoms o Most dramatic symptoms of psychosis have improved o Negative symptoms such as impoverished expression of emotions may remain pronounced What are the 3 dimensions into which the symptoms of schizophrenia have been divided Positive psychotic symptoms o Delusions Persecutory Thought insertion Mind reading Grandiose Being controled o Hallucinations Auditory Visual Somatic Olfactory Negative symptoms more
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