psychose

1. psychose the term psychotic emphasized loss of reality testing and impairment of mental functioning as manifested by delusions, hallucinations, confusion, and impaired memory. In the most common psychiatric use of the term, psychotic became synonymous with severe impairment of social and personal functioning. A neurosis is a chronic or recurrent nonpsychotic disorder characterized mainly by anxiety.

2. psychoses • Schizophrenia • Schizophreniform Disorder • Delusional disorder • Schizoaffective disorder • Brief Psychotic Disorder • MDD with psychotic feature • BID with P. F. • Substance induced psychotic disorder

3. Schizophrenia • Schizophrenia is a clinical syndrome of variable, but profoundly disruptive, psychopathology that involves cognition, emotion, perception, and other aspects of behavior. • the effect of the illness is always severe and is usually long lasting. • The disorder usually begins before age 25, persists throughout life, affects persons of all social classes • diagnosis of schizophrenia is based entirely on the psychiatric history and mental status examination

4. Epidemiology • the lifetime prevalence of schizophrenia is about 1 percent, • Schizophrenia is equally prevalent in men and women • Onset is earlier in men than in women. • The peak ages of onset are 10 to 25 years for men and 25 to 35 years for women. • Onset of schizophrenia before age 10 or after age 60 is extremely rare. • In general, the outcome for female schizophrenia patients is better than that for male schizophrenia patients

5. Etiology • There is a genetic contribution to schizophrenia. • The modes of genetic transmission in schizophrenia are unknown. • Prevalence of Schizophrenia in General population 1%, Child with one parent with schizophrenia 12%, Child of two parents with schizophrenia 40%, Monozygotic twin of a schizophrenia patient 47%. • schizophrenia results from too much dopaminergic activity in mesocortical and mesolimbic tracts.

6. Diagnosis • A. Characteristic symptoms: Two (or more) of the following, each present for a significant portion of time during a 1-month period : • delusions • hallucinations • disorganized speech (e.g., frequent incoherence) • grossly disorganized or catatonic behavior • negative symptoms • B. Social/occupational dysfunction: • C. Duration: Continuous signs of the disturbance persist for at least 6 months.

8. delusion • persecutory, • grandiose, • religious, • Somatic • Control • Reference • thought broadcasting • thought reading

10. hallucination • Auditory: command, third person • Visual • Tactile • olfactory, and gustatory • Illusions

11. Other symptoms • Disorganized behaviors: bizzare / eating • Catatonia • Mutism • Mannerism • Inappropriate affect • Negativism • poorly groomed, fail to bathe • Stereotypies: verbigeration • HOARDING rubbish • Flat affect • Loosening of associations • Echolalia • Impulsiveness, • Violence, • Suicide, • Homicide • poor insight • Social withdrawal • Poor function

12. Subtypes • Paranoid type • Disorganized type • Catatonic type • Undifferentiated type • Residual type

13. Prognosis • 20 to 30 percent of all schizophrenia patients are able to lead somewhat normal lives. • About 20 to 30 percent of patients continue to experience moderate symptoms, • 40 to 60 percent of patients remain significantly impaired for their entire lives

14. Treatment • antipsychotic medications • Psychotherapy • Psychoeducation • Hospitalization

15. psychoses • Schizophrenia • Schizophreniform Disorder • Delusional disorder • Schizoaffective disorder • Brief Psychotic Disorder • MDD with psychotic feature • BID with P. F. • Substance induced psychotic disorder