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Schneider
- First Rank Symptoms:
- 1. thought insertion/broadcast/withdrawal
- 2. made feelings/impusles/actions/somatica sensations
- 3. third person auditory hallucinations
- 4. delusional perception
- 5. thought echo
- 58% of patients show at least one FRS
- 20% never show FRS
- 10% who do not have schizophrenia show FRS
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Bleuler
- The Four A's
- 1. abnormal thought Association: breaking of mental operations (a splitting of the mind; not mpd)
- 2. autism: turning inward
- 3. ambivilance: strong but inconsistent and competing feelings
- 4. affect: flat affect- lack of emotional display or inappropriate affect: emotions don't fit subject matter
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Emil Kraeplin
auditory hallucinations, delusions, thought disorder, affective flattening, and impaired insight were common to hebephrenia, paranoia, catatonia and dementia simplex- a group of disorders he called dementia praecox
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Three subtypes of Schizophrenia
- 1. Paranoid type: preoccupation with delusions and hallucinations- no disorganized speech, catatonia, or flat affect
- 2. Disorganized Speech
- 3. Catatonic Type: at least two of the following-->
- - motoric immobility, catalepsy, stupor
- - excessive purposless motor activity
- - extreme negativism or mutism
- - peculiarities of movement, stereotypes, odd mannerisms, or grimacing
- - echolaila or echo praxia
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Related Psychotic Disorders
- 1. Brief Psychotic Disorder: less than one month
- 2. Schizophreniform Disorder: 1-5 months
- 3. Schizoaffective Disorder: Mood and Schizophrenia at alternant times- 6 months or more
- 4. Delusional Disorder: (monomania) not schizophrenic delusions- one month or more
- 5. Shared Psychotic Disorder- Folie a Deux
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Typical Antipsychotics
- Block: Delusions, Hallucinations, Disordered Thinking- Positive Symptoms
- Drugs: Phenothiazines- Chloropromazine ((Larobit))
- Butyrophenones- Halperidol
- Thioxanthenes- Chloroprothixene
- Nigrostriatal dopamine Pathway
- EPS--
- --putonias (muscle cramps)
- --tremor- coarse parkinsons type tremor
- --akinisa- decreased movement/ spoteniety
- --tardive dykinesia- involuntary movements of the lower face
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Atypical Antipsychotics
Block Dopamine in the Mesolimbic System and Blocks Serotonin (which inbibits Dopamine) in the mesocortical system, so acts as a serotonin antagonist
helps allieviate negative and EPS
metabolic changes- type II diabetes
drugs: clozapine, risperdone, olanzapine
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Major Dyssomnias
- 1. Primary Insomnia
- 2. Primary Hypersomnia
- 3. Narcolepsy
- 4. Breathing Sleep Disorders: hyoventilation, sleep apnea
- 5. Circadian Rythm Sleep Disorders
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Parasomnias
- 1. Nightmares
- 2. Sleep Terrors
- 3. Sleepwalking- somnambulism
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Sexual Dysfunctions and Paraphilia
- 1. Hypoactive Sexual Desire Disorder- little or no interest in sexual activity
- 2. Sexual Aversion Disorder: the thought of sex or a brief casual touch may evoke fear, panic, or disgust
- 3. male erectile disorder and female sexual arousal disorder
- 4. inhibited orgasm- female and male orgasmic disorder
- 5. premature ejactulation
- 6. dyspareunia
- 7. vaginismus
- 8. hyperactive sex disorder
- Paraphilias:
- 1. Frotteurism
- 2. Fetishism
- 3. Voyeurism
- 4. Exhibitionism
- 5. transvestic fetishism
- 6. sexual sadism and sexual masochisticism
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