1. Schizophrenia and Other Psychotic Disorders Part I
Chapter 14
Schizophrenia and Other Psychotic Disorders
Part I

2. Introduction
The word schizophrenia is derived from the Greek words skhizo (split) and phren (mind)

3. Introduction (cont.)
Schizophrenia is probably caused by a combination of factors, including
Genetic predisposition
Biochemical dysfunction
Physiological factors
Psychosocial stress

4. Nature of the Disorder Schizophrenia disturbs Thought processes
Perception
Affect

5. Nature of the Disorder (cont.)
With schizophrenia, there is a severe deterioration of social and occupational functioning
In the United States, the lifetime prevalence of schizophrenia is about 1%

6. Phase I. The Premorbid Phase
Characterized by
Social maladjustment
Social withdrawal
Irritability
Antagonistic thoughts and behavior

7. Phase II. The Prodromal Phase
Characterized by
Functional impairment
Deterioration in role functioning
Social withdrawal
Physical symptoms: sleep disturbance, anxiety irritability, depression, fatigue, and poor concentration

8. Phase III. Schizophrenia
In the active phase of the disorder, psychotic symptoms are prominent
Delusions
Hallucinations
Impairment in work, social relations, and self-care

9. Phase IV. Residual Phase
Symptoms similar to those of the prodromal phase
Flat affect and impairment in role functioning are prominent

10. Etiological Implications (cont.)
Physiological influences
Factors that have been implicated
Viral infection
Brain abnormalities
Histological changes in the brain

11. Etiological Implications (cont.)
Physiological influences (cont.)
Various physical conditions
Epilepsy
Huntington’s disease
Birth trauma
Head injury
Alcohol abuse
Cerebral tumor
Cerebrovascular accidents
Systemic lupus erythematosus
Myxedema
Parkinson’s disease
Wilson’s disease

12. Etiological Implications (cont.)
Psychological influences
Purely psychological factors no longer hold any credibility
Researchers in the last decade have focused their studies more in terms of schizophrenia as a brain disorder

13. Etiological Implications (cont.)
Environmental influences
Sociocultural factors: poverty has been linked with development of schizophrenia
Downward drift hypothesis: poor social conditions are seen as a consequence of, rather than a cause of, schizophrenia

14. Etiological Implications (cont.)
Environmental influences (cont.)
Stressful life events may be associated with exacerbation of schizophrenic symptoms and increased rates of relapse

15. Etiological Implications (cont.)
Theoretical integration
Schizophrenia is most likely a biologically based disease, the onset of which is influenced by factors in the internal or external environment

16. Types of Schizophrenia and Other Psychotic Disorders (cont.)
Paranoid schizophrenia
Characterized by delusions of persecution or grandeur
Auditory hallucinations
Client may be argumentative, hostile, and aggressive

17. Types of Schizophrenia and Other Psychotic Disorders
Disorganized schizophrenia
Chronic variety with flat or inappropriate affect
Silliness and incongruous giggling common
Behavior bizarre; social interaction impaired

18. Types of Schizophrenia and Other Psychotic Disorders (cont.)
Catatonic schizophrenia
Catatonic stupor: characterized by extreme psychomotor retardation; patient usually mute; posturing common

19. Types of Schizophrenia and Other Psychotic Disorders (cont.)
Catatonic schizophrenia (cont.)
Catatonic excitement: extreme psychomotor agitation; purposeless movements that must be curtailed to prevent injury to client or others

20. Types of Schizophrenia and Other Psychotic Disorders (cont.)
Undifferentiated schizophrenia
Bizarre behavior that does not meet the criteria outlined for the other types of schizophrenia; delusions and hallucinations prominent

21. Types of Schizophrenia and Other Psychotic Disorders (cont.)
Residual schizophrenia
Used to diagnose a person who has a history of at least one episode of schizophrenia with prominent psychotic symptoms

22. Types of Schizophrenia and Other Psychotic Disorders (cont.)
Schizoaffective disorder
Schizophrenic symptoms accompanied by a strong element of symptomatology associated with mood disorders, either manic or depressive

23. Types of Schizophrenia and Other Psychotic Disorders (cont.)
Brief psychotic disorder
Sudden onset of psychotic symptoms following a severe psychosocial stressor
Symptoms persist less than month; client returns to the full premorbid level of functioning

24. Types of Schizophrenia and Other Psychotic Disorders (cont.)
Schizophreniform disorder
Same symptoms as schizophrenia, with exception that the duration of the disorder has been at least 1 month but fewer than 6 months

25. Types of Schizophrenia and Other Psychotic Disorders (cont.)
Delusional disorder
The existence of prominent, non-bizarre delusions
Erotomanic type: the individual believes that someone, usually of a higher status, is in love with him or her

26. Types of Schizophrenia and Other Psychotic Disorders (cont.)
Delusional disorder (cont.)
Grandiose type: person has irrational ideas regarding own worth, talent, knowledge, or power
Jealous type: person has the irrational idea that the sexual partner is unfaithful

27. Types of Schizophrenia and Other Psychotic Disorders (cont.)
Delusional disorder (cont.)
Persecutory type: person believes he or she is being treated malevolently in some way
Somatic type: person has an irrational belief that he or she has some physical defect, disorder, or disease

28. Types of Schizophrenia and Other Psychotic Disorders (cont.)
Shared psychotic disorder
Delusional system develops in a second person as a result of a close relationship with a person who already has a psychotic disorder with prominent delusions (also called folie á deux)

29. Types of Schizophrenia and Other Psychotic Disorders (cont.)
Psychotic disorder due to general medical condition
Symptoms of this disorder include prominent hallucinations and delusions that can be directly attributed to a general medical condition

30. Types of Schizophrenia and Other Psychotic Disorders (cont.)
Substance-induced psychotic disorder
The presence of prominent hallucinations and delusions that are judged to be directly attributable to the physiological effects of a substance