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U ND ERS TAND I NG P S YC H O PAT H O LO G Y

SCHIZOPHRENIA SPECTRUM AND OTHER PSYCHOTIC DISORDERS TERESITA L. MARTINEZ MD FPNA FCNSP

DEPARTMENT OF NEUROSCIENCE AND BEHAVIORAL MEDICINE

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THE PSYCHOTIC DISORDERS

THE PSYCHOPATHOLOGY

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John Forbes Nash Jr. (June 13, 1928 – May 23, 2015)

A Beautiful Mind A Film by Ron Howard (2001) starring Russel Crowe

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PSYCHOTIC DISORDERS

a group of disorders marked by irrational ideas, distorted perceptions, and a loss of contact with reality.

Myers, D. G. (2021). Exploring Psychology. Worth Pub.

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DSM V Schizophrenia Spectrum and Other Psychotic Disorders

Wu, J. Q., Boettcher, H., V Mark Durand, Barlow, D. H., & American Psychiatric Association. (2014). A guide to the American Psychiatric Association’s diagnostic and statistical manual 2013 (DSM-5). Nelson Education.

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PSYCHOTIC DISORDERS DISORGANIZED BEHAVIOR

HALLUCINATIONS

DISORGANIZED THOUGHTS

DELUSIONS

NEGATIVE SYMPTOMS MedlinePlus. (2018). Psychotic Disorders. Medlineplus.gov. https://medlineplus.gov/psychoticdisorders.html

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THE POSITIVE SYMPTOMS

Sensory perception in the absence of external stimuli

HALLUCINATION

False beliefs Unrelenting sense of certainty maintained despite strong contradictory evidence

DELUSION

Wu, J. Q., Boettcher, H., V Mark Durand, Barlow, D. H., & American Psychiatric Association. (2014). A guide to the American Psychiatric Association’s diagnostic and statistical manual 2013 (DSM-5). Nelson Education.

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SCHIZOPHRENIA

Split mind

Early adulthood 1 in 100 (WHO 2008)

Wu, J. Q., Boettcher, H., V Mark Durand, Barlow, D. H., & American Psychiatric Association. (2014). A guide to the American Psychiatric Association’s diagnostic and statistical manual 2013 (DSM-5). Nelson Education.

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SYMPTOMS OF SCHIZOPHRENIA

DISORGANIZED THINKING

DISTURBED PERCEPTIONS

INAPPROPRIATE EMOTIONS

Wu, J. Q., Boettcher, H., V Mark Durand, Barlow, D. H., & American Psychiatric Association. (2014). A guide to the American Psychiatric Association’s diagnostic and statistical manual 2013 (DSM-5). Nelson Education.

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DELUSTIONS are false beliefs.

What Are Delusions? (n.d.). Verywell Health. https://www.verywellhealth.com/delusions-5113070

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CATATONIA

Rasmussen, S. A., Mazurek, M. F., & Rosebush, P. I. (2016). Catatonia: Our current understanding of its diagnosis, treatment and pathophysiology. World Journal of Psychiatry, 6(4), 391. https://doi.org/10.5498/wjp.v6.i4.391

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NEGATIVE SYMPTOMS DIMINISHED EMOTIONAL EXPRESSION

AVOLITION

ALOGIA

ANHEDONIA

ASOCIALITY

Wu, J. Q., Boettcher, H., V Mark Durand, Barlow, D. H., & American Psychiatric Association. (2014). A guide to the American Psychiatric Association’s diagnostic and statistical manual 2013 (DSM-5). Nelson Education.

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DSM V DIAGNOSTIC CRITERIA

2

6

Hallucinations Delusions Disorganized incoherent speech Grossly disorganized or catatonic behavior Negative symptoms

EFFECT IN FUNCTIONALITY *** 1 MONTH OF ACTIVE SYMPTOMS Wu, J. Q., Boettcher, H., V Mark Durand, Barlow, D. H., & American Psychiatric Association. (2014). A guide to the American Psychiatric Association’s diagnostic and statistical manual 2013 (DSM-5). Nelson Education.

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PHASES

PRODROMAL • Early phase • Withdrawal • Poor hygiene, sleep problems

ACTIVE • Symptoms are obvious • Criteria A

RESIDUAL • Lack of emotion • Constant low energy • Eccentric behavior

Wu, J. Q., Boettcher, H., V Mark Durand, Barlow, D. H., & American Psychiatric Association. (2014). A guide to the American Psychiatric Association’s diagnostic and statistical manual 2013 (DSM-5). Nelson Education.

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SPECTRUM OF SCHIZOPHRENIA CONDITIONS DO NOT REACH FULL CRITERIA OF THE DISORDER

▪ Delusions ▪ Catatonia

TIME LIMITED CONDITIONS

EXCLUDE OTHER CONDITIOND

▪ BRIEF PSYCHOTIC DISORDER ▪ SCHIZOPHRENIFORM DISORDER ▪ SCHIZOAFFECTIVE DISORDER

▪ MEDICATION OR SUBSTANCE ▪ MEDICAL CONDITION ▪ CATATONIA IN SEVERAL DISORDERS

Wu, J. Q., Boettcher, H., V Mark Durand, Barlow, D. H., & American Psychiatric Association. (2014). A guide to the American Psychiatric Association’s diagnostic and statistical manual 2013 (DSM-5). Nelson Education.

DURATION OF SYMPTOMS →

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SCHIZOPHRENIA

>2 Criterion A for at least a month

Total disease length >6 months including prodromal/residual phases

SCHIZOPHRENIFORM Same as Schizophrenia

Total disease length >1 to 1 days to