schizo 2

dr. daniel weinberger and other leading National institute of mental health schizo researchers. learned the gray matter loss may be reversible. MIMH is currently researching a drug that seems to have potential for reversing the cognitive decline that is caused by schizo and there are many drug companies also now researching in this area

• least to severe
• brief psychotic disorder
• - psychotic symptoms 1-30 days duration, return to prior level of functioning
• substance/med induced psychotic disorder
• psychotic disorder due to another medical condition
• schizo disorder
• - symptoms of schizo 1 month but < 6 months duration
• schizoaffective disorder- symptoms of depression and mania
• delusion disorder
• schizo

• severe mental condition in which there is disorganization of personality, deterioration in social functioning and loss of  contact with or distortion of reality
• maybe evidence of hallucination and delusional thinking

• catatonic features may be associated with other psychotic disorders such as brief psychotic disorder schizophreniform disorder, schizophrenia, schizoaffective disorder and substance-induced psychotic disorder
• stupor and muscle rigidity or excessive purposeless motor activity
• waxy flexibility negativism echolia (repeat words), echopraxia (way of talking weird), mutism, negativims

• content of thought= what are they talking about
• form of thought
• perception- seeing hearing
• affect
• sense of self- don't know who they are
• volition
• interpersonal functioning
• psychomotor behaviors

all classifed as positive or negative symptoms

• positive symptoms are manifestation of things that are not normally present (relatively good response to meds)
• Like:
• negative symptoms the absence of things that are normally present- difficult to treat most destructive
• like:
• cognitive symptoms problem that impact living and independence
• like
• -

• delusion: false fixed belief
• persecution/paranoia harmed by other CIA poisoing
• grandeur (all powerful, god like, kingly)
• reference- everything is r/t them tv shows etc
• control (forces outside of body controlling behavior)
• somatic body growing third arm changing in weird way)
• nihilistic (body self or other world in non existing the world is gone, i have no heart)

• religiousity (varies greatly in religious beliefs, level of commitment, voices of hod incessantly searching bible)
• thought broadcasting (thought heard by others)
• thought insertion (others inserted into mind)
• thought withdrawal (thought removed by outside agency)
• magical thinking (thought have control over certain people or situation)

• hallucination - false sensory sensation not associated with real external stimuli. caution with command hallunication
• auditory, gustatory (taste, eating), visual, olfactory, tactile,
• illusions- misinterpretation of real external stimuli- snakes coming out of light
• be careful with these pts

responds to meds

• loose association- topics are unrelated and incoherence
• shift with no relationship and happens so fast cant' understqand
• concrete thinking- literal interpretation of the environment- what brought you to the hospital- a car
• circumstantiality- unable to get to the point of the communication bc of unnecessary layers of details
• tangentiality- never get to the point; unrelated topics are introduced, the original point is lost
• neologisms- invents new word that have symbolic meaning to the person, not to anyone else, calls table an ergot

• clang association- choice of words govern by sound, often rhyming. it is very cold, i am cold and bold, the has been sold
• word salad- words put together randomly without connection, most forward action grows life double plays circle uniform
• mutism- inability or refusal to speak
• perservation- persistenly repeats the same word or idea in response to different question

• echopraxia- purposely imititates movements made by others
• echolia- repeating heard words
• indentification and imitation- behavior often takes on form of what they see in another person
• depersonalization- feelings of unreality (one's extremities have changed in size, or sense of seeing self form a distance)
• due to weak ego boundaries schizophrenic lacks feeling of being unique, has identity confusion

• affective flattening- associated with feeling state or emotions, unchanging, facial expression, poor eye contact, reduce body language, inapproriate affect (incongruent), diminished emotional expression (or devoid, flat, or bland)
• alogia (poverty of speech) brief empty responses decreased fluency and content of speech
• avolition/apathy- inablity to initiate goal directed activity little interest in work or social activities, impaired grooming hygiene

• anhedonia- can lead to suicide
• ambivalence- the co existence of opposite emotions to the same object. person or situation, interfering with the ability to make even a very simple decision, also demonstrated in relationships having simultaneously the need for and fear of intimacy
• deteriorated appearance
• all very difficult to tx

• impaired social interation- clings or intrudes on personal space
• social isolation- focus exclusive on self
• anergia- lack of energy to carry our simple task
• waxy flexibility- posturing oddly even though discomfort
• posturing (voluntary assumptions of bizzare position)
• pacing and rocking (swaying back and forth)
• regression (to early stage of life seen as dysfunctional attempt to reduce anxiety)

• inapproriate (incongruent)
• over-reactive (out of proportion)
• blunted (weak)
• flat (void in tone)
• labile (changing)
• chx in mood?

• presence of hallucinations and/or delusions that occur for at least 2 werrks in absence of a major mood episode
• prominent mood disorder symptoms evident for majority of the time
• - depressed with psychomotor retardation, and SI
• - euphoria, grandiosity and hyperactivity
• prognosis better than schizo disorder
• meds- antipsych and mood stabilizers
• mood disorder is there

• trouble discerning dreams from reality
• seeing and hearing voices that are not real
• confused thinking
• vivid and bizarre thoughts and ideas
• extreme moodiness
• peculiar behavior
• concept that people are out to get them
• behaving younger than chronological age
• severe anxiety and fearfulness
• confusing tv and movies with reality

• severe problem in making and keeping friends
• develops gradually in children w/o the sudden pyschotic break that sometimes occurs in adolescents and adults
• talking about strange fears and ideas
• cling to parents or say things that don't make sense. thouse who used to enjoy relationships w/others may become more shy or withdrawn and seem to be in their own world