1. Schizophrenic-Like Disorders
distinguished from schizophrenia in (presenting symptoms and the duration).
DSM-V categorizes:
I- Brief psychotic disorder:
A disturbance that involves the sudden onset.
Episode at least 1 day but less than 1 month, with eventual full return to premorbid level of functioning.
Psychiatric and Mental Health Nursing

2. Schizophrenic-Like Disorders… cont.
II- Schizophreniform:
Two (or more) symptoms each present for a significant portion of time during a 1-month period (or less if successfully treated).
Episode of onset may be more thann1 month but less than 6 months.
Psychiatric and Mental Health Nursing

3. Schizophrenic-Like Disorders… cont.
III- Schizoaffective disorder:
Mood episode (depressive or manic) is concurrent with Criterion of schizophrenia.
Delusions or hallucinations for 2 or more weeks in absence of a major mood episode (depressive or manic) during duration of illness.
Major mood episode present for the majority of total duration of illness
Psychiatric and Mental Health Nursing

4. Schizophrenic-Like Disorders… cont.
Subtypes of schizoaffective disorder:
Bipolar type: if a manic episode occur, then major depressive episodes may also occur.
Depressive type: only major depressive episodes
IV- Delusional disorder (Paranoia):
Un common in clinical settings, accounts for 1- 2% of admissions to mental health facilities.
Client has appropriate affect, good reality testing , and intact personality.
Psychiatric and Mental Health Nursing

5. Schizophrenic-Like Disorders… cont.
Delusional disorder criteria DSM-V:
Presence of one or more delusions for 1 month or longer.
Hallucinations not prominent , & if present, related to the delusional theme
behavior not clearly bizarre
If manic or major depressive episodes occurred, briefly related to the duration of delusional periods.
Psychiatric and Mental Health Nursing

6. * Subtypes of delusional disorder 5:
Persecutory: most common subtype (believe others are observing and following him, putting poison for him to prevent him from achieving his goals).
Jealous: client believes his wife is unfaithful based on weak evidence.
Erotomanic: (female client believe that she is loved by a famous person or the boss in the work).
Grandiose: (client believe that he has important talents or discoveries), and may be religious as a messenger of God.
Psychiatric and Mental Health Nursing

7. Legal difficulties may arise. Clients rarely seek treatment.
5- Somatic: (client is convinced he is ugly or body organ is not working without any medical evidence)
* In all subtypes:
Mood changes, e.g. irritability, anger, depression, & violence, may occur.
Legal difficulties may arise.
Clients rarely seek treatment.
Clients have no insight.
Clients blaming others for their problems.
Clients are brought to mental health institutions by others.
Psychiatric and Mental Health Nursing

8. Schizophrenic-Like Disorders… cont.
V- Substance/Medication-Induced Psychotic Disorder:
Presence of Delusions or Hallucinations.
Symptoms developed during or soon after substance intoxication or withdrawal or after exposure to a medication.
Not related to psychotic disorder.
Persist for about one month after cessation of acute withdrawal or severe intoxication.
Psychiatric and Mental Health Nursing

9. Schizophrenic-Like Disorders… cont.
VI- Psychotic disorder due to general medical condition:
Prominent hallucinations or delusions.
Direct pathophysiological consequence of another medical condition.
- For example:
Olfactory hallucinations may occurs in the presence of temporal lobe epilepsy.
Delusions may cause from right parietal brain lesion
Psychiatric and Mental Health Nursing

10. Schizophrenic-Like Disorders… cont.
VII-Delusional symptoms in partner of individual with delusional disorder:
Delusions from dominant partner provides content for delusional belief by the individual who may not with delusional disorder
This disorder more frequently in women isolated by language, culture, or geography, &twins.
It also occurred in a group related by blood or marriage and have lived together for a long time
Psychiatric and Mental Health Nursing

11. Schizophrenic-Like Disorders… cont.
VIII- Postpartum Psychosis:
- Currently does not recognized as a distinct disorder.
- Brief psychotic disorder during pregnancy or within 4 weeks postpartum.
Incidence: 1 – 2 per 1,000 childbirths.
About 50 – 60% of affected women have just had their first child.
One of the rarest psychiatric disorders
Psychiatric and Mental Health Nursing

12. Postpartum Psychosis… cont.
-Considered a psychiatric emergency because of
* Rapid & severe onset of maternal symptoms.
* Potential for a catastrophic outcome, as infanticide or suicide
Clinical picture (PPP):
Beginning: Fatigue, insomnia, restlessness, and may have episodes of tearfulness. (crying)
Later, suspiciousness, confusion, incoherence statements.
Psychiatric and Mental Health Nursing

13. Postpartum Psychosis… cont.
Delusion may involve idea that the baby is dead or defective.
May deny the birth expressing thoughts of being unmarried, virginal, persecuted, influenced.
Hallucinations: voices telling client to kill baby or herself.
Suicidal clients may require transfer to a psychiatric hospital.
Psychiatric and Mental Health Nursing

14. Postpartum Psychosis… cont.
Management of postpartum psychosis”
- Mother usually helped by contact with her baby if she wants, under strict supervision, especially if she is preoccupied with harming the infant.
- Psychotherapy indicated after period of acute psychosis, helping her accept and be at ease with mothering role.
Psychiatric and Mental Health Nursing

15. Prognosis of schizophrenia:
About 30% of cases may recover to normal life after completing the course of schizophrenia (acute ).
About 60% deterioration of symptoms and exacerbate to active phase (chronic ) live over 5 years (remission & exacerbation).
Psychiatric and Mental Health Nursing

16. Prognosis of schizophrenia… cont.
Prognosis of schizophrenia depends on:
Premorbid history.
Severity of onset.
Support system.
Poor prognosis: associated with early premorbid history of mental disturbances, gradually progressive of symptoms, and poor social support.
(Treatment of psychotic disorders)….
Psychiatric and Mental Health Nursing