NOTES

NOTES
SCHIZOPHRENIA & PSYCHOTIC
DISORDERS

GENERALLY, WHAT ARE THEY?

PATHOLOGY & CAUSES
▪ Mental disorders characterized by
fragmented patterns of thinking
▪ Feature positive, negative symptoms
CAUSES
▪ Multiple factors: genetic vulnerability,
physiological/biochemical dysfunction,
psychosocial stressors
Negative symptoms
▪ Impairment of normal functioning in
emotional expression, communication,
purposeful activities
▫ Flat affect (less emotional response)
▫ Alogia (lack of content in speech)
▫ Avolition (decrease in motivation)
Cognitive symptoms
▪ Difficulties with memory, learning,
understanding

Mood-related symptoms
SIGNS & SYMPTOMS ▪ Sometimes

Positive (psychotic) symptoms

▪ Delusions
DIAGNOSIS
▫ False beliefs remaining even when
▪ Based on symptoms’ presence over certain
opposing evidence presented (e.g.
time period (varies by disorder)
delusions of control/reference)
▪ Affects day-to-day functioning (e.g. social,
▪ Hallucinations
occupational, academic)
▫ Perceptual experiences occurring
▪ Not caused by other condition/substance
without sensory stimuli (e.g. visual,
auditory, tactile hallucinations)
▪ Disorganized speech (e.g. word salad) TREATMENT
▪ Disorganized behavior (e.g. wearing warm
clothes on a hot day; may include catatonic MEDICATIONS
behavior; e.g. resistant movement/
▪ Antipsychotics
unresponsiveness)

PSYCHOTHERAPY
▪ E.g. individual/group therapy, rehabilitation

OSMOSIS.ORG 733
 Figure 101.1 Illustration depicting positive, negative, and cognitive syjmptoms.

DELUSIONAL DISORDER
osms.it/delusional-disorder
Non-bizarre delusions
PATHOLOGY & CAUSES ▪ Persecutory
▫ Others conspiring against/following
▪ Mental disorder characterized by persistent
oneself
delusions
▪ Jealous
▪ Delusions may be bizarre (impossible)/non-
bizarre (possible, but still wrong) ▫ One’s partner unfaithful
▪ Delusions remain even when opposing ▪ Of guilt/sin
evidence presented ▫ One wrongly feels guilty
▪ Of reference
▫ One believes messages directed at
SIGNS & SYMPTOMS them/are especially significant
▪ Somatic
Delusions
▫ One’s body is diseased/changed
▪ Of control
▪ Erotomanic
▫ Others control one’s actions/thoughts
▫ Another is in love with oneself
▪ Of thought broadcasting
▪ Grandiose
▫ Others can hear one’s thoughts
▫ One believes they have special talents/
▪ Of thought withdrawal abilities
▫ One’s thoughts are being stolen ▪ Religious
▪ Nihilistic ▫ Involving spiritual aspect
▫ World/self doesn’t exist

734 OSMOSIS.ORG
 Chapter 101 Schizophrenia & Psychotic Disorders

DIAGNOSIS TREATMENT
▪ ≥ one delusion, over ≥ one month MEDICATIONS
period, without meeting other criteria for ▪ Antipsychotics, antidepressants
schizophrenia
▫ Hallucinations may occur in some cases
PSYCHOTHERAPY
of delusional disorder
▪ E.g. individual/group therapy, rehabilitation
▪ Affects day-to-day functioning
▪ Not caused by other condition/substance

SCHIZOAFFECTIVE DISORDER
osms.it/schizoaffective-disorder

PATHOLOGY & CAUSES TREATMENT

▪ Mental disorder characterized by symptoms ▪ Treat depressive, schizophrenic symptoms
of schizophrenia + a mood disorder separately

MEDICATIONS
SIGNS & SYMPTOMS
▪ Antipsychotics, antidepressants
▪ Positive symptoms
▫ Delusions, hallucinations, disorganized PSYCHOTHERAPY
speech, disorganized behavior ▪ Dialectical behavior therapy, mentalization-
▪ Negative symptoms based therapy, transference-focused
▫ Flat affect, alogia, avolition therapy
▪ Mood-related symptoms
▫ Depression, suicidal ideation
▫ Manic episodes (e.g. euphoria,
grandiosity, hyperactivity)

DIAGNOSIS
▪ ≥ two of following (+ at least one of first
three) + a mood disorder
▫ Delusions
▫ Hallucinations
▫ Disorganized speech
▫ Disorganized or catatonic behavior
▫ Negative symptoms
▪ Delusions/hallucinations last ≥ two weeks
beyond mood episode
▪ Not caused by other condition/substance

OSMOSIS.ORG 735
 SCHIZOPHRENIA
osms.it/schizophrenia

PATHOLOGY & CAUSES DIAGNOSIS

▪ Mental disorder characterized by
fragmented patterns of thinking for > six
months
▪ Individuals cycle through three phases,
normally in order
▫ Prodromal phase: socially withdrawn;
blunted affect
▫ Active phase: severe positive, negative
symptoms
▫ Residual phase: cognitive symptoms;
periods of remission
▪ ≥ two of following (+ at least one of first
three), over one month
▫ Delusions
▫ Hallucinations
▫ Disorganized speech
▫ Disorganized or catatonic behavior
▫ Negative symptoms
▪ Other signs of disturbance (with prodromal,
residual symptoms) persist ≥ six months
▪ Affects day-to-day functioning
▪ Not caused by other condition/substance

CAUSES
▪ Success of treatment with dopamine TREATMENT
antagonists suggests link to increased
dopamine levels MEDICATIONS
▪ Genetic; more common in biological males ▪ Antipsychotics

RISK FACTORS PSYCHOTHERAPY

▪ Suicidal ideation → death ▪ E.g. individual/group therapy, rehabilitation

SIGNS & SYMPTOMS

▪ Positive symptoms
▫ Delusions, hallucinations, disorganized
speech, disorganized behavior
▪ Negative symptoms
▫ Flat affect, alogia, avolition
▪ Cognitive symptoms
▫ Difficulties with memory, learning,
understanding

736 OSMOSIS.ORG
 Chapter 101 Schizophrenia & Psychotic Disorders

Figure 101.1 Illustration depicting positive, negative, and cognitive syjmptoms.

SCHIZOPHRENIFORM DISORDER
osms.it/schizophreniform-disorder

PATHOLOGY & CAUSES DIAGNOSIS

▪ Mental disorder characterized by ▪ ≥ two of following (+ at least one of first
fragmented patterns of thinking over three), over one month
reduced period (1–6 months) ▫ Delusions
▪ Similar to active phase of schizophrenia ▫ Hallucinations
(severe positive, negative symptoms), ▫ Disorganized speech
minus prodromal phase
▫ Disorganized or catatonic behavior
▫ Negative symptoms
SIGNS & SYMPTOMS ▪ Other signs of disturbance (with prodromal,
residual symptoms) do not persist ≥ six
▪ Positive symptoms months (if ≥ six months, diagnosis =
schizophrenia)
▫ Delusions, hallucinations, disorganized
speech, disorganized behavior ▪ Affects day-to-day functioning
▪ Negative symptoms ▪ Not caused by other condition/substance
▫ Flat affect, alogia, avolition
▪ Cognitive symptoms TREATMENT
▫ Difficulties with memory, learning,
understanding MEDICATIONS
▪ Antipsychotics

PSYCHOTHERAPY
▪ E.g. individual/group therapy, rehabilitation

OSMOSIS.ORG 737
738 OSMOSIS.ORG