Classification of Schizophrenia and Other Psychotic Disorders (Diagnostic and Statistical Manual of Mental Disorders-.4th edition, DSM-1V):
Schizophrenia
Subtypes - Paranoid, Disorganized, Catatonic, Undifferentiated, and
Sehizophreniform Disorder
Meets criteria for Schizophrenia but of less than 6 months duration
Sehizoaffective Disorder
Brief Psychotic Disorder schizophrenia, scitzophrenia, scizophrenia, scizofrenia, scitzofrenia, schitzophrenia
Meets criteria for Schizophrenia but duration of more than I day but less than
Shared Psychotic Disorder (Folie a Deux)
Delusion develops in an individual in a close relationship with another person who already has an established delusion,
New delusion is usually of similar content to that of the person who has the established delusion
F.Psychotic Disorder due to a General Medical Condition
G.Substance Induced Psychotic Disorder
1t.Psychotic Disorder, Not Otherwise Specified
Schizophrenia
Diagnosis of exclusion without pathognomonic signs, symptoms, or lab findings
Essential features
Two or more of these symptoms for 1 month:
Delusions - fixed, false beliefs
Hallucinations - false sensory perceptions without external stimuli
Disorganized speech
Grossly disorganized behavior or catatonic behavior e. Negative symptoms
Social or occupational dysfunction
Duration of at least 6 months
Positive and negative symptoms
Positive symptoms = represent exaggerated or distorted normal mental functions.
Perceptual disturbances - hallucinations, delusions
Formal thought disorder - eg. incoherence, derailment, tangentiality, illogicality, influential thinking, overinclusive, loss of abstraction, poverty of speech and content, perseveration, clanging, neologisms, echolalia
Bizarre or disorganized behavior
Bizarre speech
Catatonic stupor, excitement, waxy flexibility, stereotypy (non goal-directed movement), mannerisms
Negative symptoms = represent deficiency or loss of normal mental functions.
Alogia - marked poverty of speech or content of speech
Affective flattening, anhedonia (inability to experience pleasure), anergia c. Avolition, apathy, asociality d. Attentional impairment.
Current Subclassifications - developed to enhance predictive validity, guide treatment, and predict outcome. Not as clinically useful as intended.
1. Paranoid
a. Older age onset and better premorbid functioning than
2. Disorganized (hebephrenic)
a. Early onset and poor
3. Catatonic
a. Characterized by motoric immobility or excessive motor activity, extreme negativism, mutism, odd/bizarre voluntary movement, echolalia, echopraxia
b. Caution with this subtype as these symptoms occur in a variety medical conditions such as
4. Undifferentiated - doesn't meet criteria for any other subclass
5.Residual - no current, prominent psychotic symptoms but once met criteria for schizophrenia with continued evidence of illness
L. Pharmacotherapy
1.Antipsychotics - only since 1952 with the development ofcMorpromazine, all more effective than
a. Before advent of antipsychotics >550,000 mental patients in state hospitals, 20 years
b. "Major tranquilizers" is misnomer as aim of these reeds is to
c. Differences lie mainly in chemical structure, rate of absorption, distribution, potency, and side effects.
d. Mechanism of
III. Schizoaffective Disorder
A.Essential features (DSM-IV) - full criteria are met for active phases of Schizophrenia and Major Depressive Episode, a Manic Episode or a Mixed episode
1.Mood for a substantial portion of the total duration of the disturbance and concurrent active phase symptoms of
IV. Delusional Disorder
A. Essential features (DSM-IV)
1.One or more nonbizarre delusions for at least 1 month
2.Never met criteria for Schizophrenia and if hallucinations are present they aren't prominent
3.Psychosocial functioning is affected but not markedly impaired and behavior is not obviously odd or
4. Subtypes - persecutory is most common subtype
a. Erotomanic - theme is that another person, usually of a higher status, is in love with the