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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