Schizophrenia spectrum disorders are disorders that share features with
schizophrenia.
Delusional Disorder
Characterized by delusions that have lasted 1 month or longer.
The delusions tend to have a general theme that includes grandiose,
persecutory, somatic, and referential delusions
Theses delusions usually are not severe enough to impair
occupational or daily functioning
Individuals with this personality disorder do not tend to behave
strangely or bizarrely
Brief psychotic disorder
Characterized by the sudden onset of at least one of the following:
delusions, hallucinations, disorganized speech, and disorganized or
catatonic (severely decreased motor activity) behavior
Symptoms must last longer than 1 day, but no longer than 1 month
with the expectation of a return to normal functioning
Twice as common in females
, Schizophreniform Disorder
The essential features of this disorder are exactly like those of
schizophrenia, except that symptoms last a much shorter period of
time (less than 6 months)
Schizoaffective Disorder
Characterized by an uninterrupted period of illness during which
there is a major depressive, manic, or mixed episode, concurrent with
symptoms that meet the criteria for schizophrenia
The symptoms must not be caused by any substance use or abuse or
general medical condition
Long-term disorder
Substance induced psychotic disorder and psychotic disorder due to another
medical condition
Substances such as drugs, alcohol, medications, or toxin exposure can
induce delusions and/or hallucinations
Hallucinations or delusions can also be caused by a general medical
condition such delirium, neurological problems, alterations, hepatic or
renal diseases, and many more
Substance use and medical conditions should always be ruled out
before a primary diagnosis of schizophrenia or other psychotic
disorder is made
2. Discuss at least three of the neurobiological findings of schizophrenia in
terms of treatment and effect on quality of life.
Genetic
Schizophrenia-spectrum disorders are inherited
Concordance rates are about 50% for identical twins and about 25%
for fraternal twins. Evidence suggests that multiple genes on different
chromosomes interact with one another on complex ways to create
vulnerability for schizophrenia
Dopamine Theory
The first antipsychotic drugs, known as first-generation
antipsychotics, block the activity of dopamine-2 receptors in the brain
and reduce symptoms such as hallucinations and delusions
Symptom reduction suggested that dopamine plays a significant role
in psychosis
Other neurochemical hypotheses
Second-generation antipsychotics block serotonin and dopamine,
which suggests that serotonin may play a role in schizophrenia as well
, Glutamate, dopamine, and serotonin act synergistically in
neurotransmission and thus glutamate may also play a role in causing
psychosis
3. Differentiate among the positive and negative symptoms of
schizophrenia in terms and effect on quality of life.
Positive symptoms: the presence of something that should not be present
(symptoms that add to the person’s personality)
Hallucinations
Delusions
Paranoia
Disorganized or bizarre thoughts, behaviors, or speech
Alterations in reality testing
Alterations in speech patterns
o Associative looseness
a. Results from haphazard and illogical thinking where
concentration is poor and individuals loosely associate
their thoughts
b. Example: “I need to get a Band-Aid. My friend was
talking about AIDS. Friends talk about French fries but
how can you like the French?”
c. Word salad- most extreme form of associative looseness;
a jumble of words that is meaningless to the listener;
“throat hoarse strength of policy highlighters on a boat
reigning supreme”
o Clang Association
a. Choosing words based on their sound rather than their
meaning and often involves words that rhyme or have
similar beginning sound
b. Ex: “On the track… have a big mac” or “Click, clack,
clutch, close”
o Neologisms
a. Words that have meaning for the patient but a different
or nonexistent meaning to others
o Echolalia
b. Pathological repetition of others words
o Circumstantiality
a. Including unnecessary and often tedious details in
conversation, but eventually reaching the point
o Tangentiality:
a. Wandering off topic or gong off on tangents and never
reaching the point
o Cognitive retardation
, a. Generalized slowing of thinking, which is represented
by delays in responding to questions or difficulty
finishing thoughts
o Pressured speech
a. Urgent or intense and resists allowing comments from
others
o Flight of ideas
a. Moving rapidly form one thought to the next, often
making it difficult for others to follow the conversation
o Symbolic speech
a. Using symbols instead of direct communication
b. For example: a patient reports “demons are sticking
needles in me” when what he means is that he is
experiencing a sharp pain (symbolized by “needles”)
Disorders or distortions of thought
o Thought blocking
a. A reduction or stoppage of thought. Interruption of
thought by hallucinations can cause this
o Thought insertion
a. The uncomfortable belief that someone else has
inserted thoughts into their brains
o Thought deletion
a. A belief that thoughts have been taken or are missing
o Magical thinking
a. Believing that thoughts or actions affect other’s
consequences
o Paranoia
a. An irrational fear, ranging from mild (wary, guarded) to
profound (believing irrationally that another person
intends to kill you)
Alterations in perception
o Hallucinations
a. Auditory, visual, olfactory, gustatory, tactile, command
(directs the person to take an action)
o Depersonalization
a. A feeling of being unreal or having lost identity. Body
parts do not belong or the body has drastically changed
(person may see the fingers as being smaller or not
theirs)
o Derealization
a. A feeling that the environment has changed (everything
seems smaller or bigger or familiar surroundings
somehow seem strange and unfamiliar)
o Illusions
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