Schizophrenia and Other Psychotic Disorders - Essay Example

20 May 2008 Schizophrenia and Other Psychotic Disorder: A Lifetime Development Psychotic disorders are a group of serious illnesses that affect the mind. “These illnesses alter a persons ability to think clearly, make good judgments, respond emotionally, communicate effectively, understand reality and behave appropriately” (WebMD, May 20, 2008). Two of the main symptoms are: delusions or false beliefs, such as thinking that someone is haunting you or receiving secret messages from an image believed as God; and hallucinations or false perceptions, such as hearing, seeing, or feeling something that is not actually there. In severe cases, people with psychotic disorders are not attuned with reality and oftentimes level of functioning to meet the ordinary demands of daily life is strongly affected. However, these disorders are usually treatable most effectively in mental institutions that employ the right rehabilitative measures for specific cases of mental disorders. The types on psychotic disorders are summarized in WebMD Medical Reference (May 20, 2008) as: “Schizophrenia: People with this illness have changes in behavior and other symptoms - such as delusions and hallucinations - that last longer than six months, usually with a decline in work, school and social functioning. Schizoaffective disorder: People with this illness have symptoms of both schizophrenia and a mood disorder, such as depression or bipolar disorder. Schizophreniform disorder: People with this illness have symptoms of schizophrenia, but the symptoms last more than one month but less than six months. Brief psychotic disorder: People with this illness have sudden, short periods of psychotic behavior, often in response to a very stressful event, such as a death in the family. Recovery is often quick - usually less than a month. Delusional disorder: People with this illness have delusions involving real-life situations that could be true, such as being followed, being conspired against or having a disease. These delusions persist for at least one month. Shared psychotic disorder: This illness occurs when a person develops delusions in the context of a relationship with another person who already has his or her own delusion(s). Substance-induced psychotic disorder: This condition is caused by the use of or withdrawal from some substances, such as alcohol and crack cocaine, that may cause hallucinations, delusions or confused speech. Psychotic disorder due to a medical condition: Hallucinations, delusions or other symptoms may be the result of another illness that affects brain function, such as a head injury or brain tumor. Paraphrenia: This is a type of schizophrenia that starts late in life and occurs in the elderly population”. Schizophrenia and brief psychotic disorder are similar in characteristic or behavioral symptoms. The most predominant manifestation of schizophrenia is the auditory hallucinations. Some manifestations include paranoia, bizarre delusions, disorganized speech and thinking, and catatonia such as immobility or rigid positioning of a person for a considerable length of time often days, weeks or even longer. Only in the case of schizophrenia the person manifests negative symptoms (i.e., affective flattening, alogia, or avolition). With schizophreniform, schizoaffective disorder and brief psychotic disorder, symptoms of Criteria A in the DSM IV-TR diagnostic criteria of schizophrenia are met or manifested by the person. Social/occupational dysfunctions are noted only in schizophrenia. Where onset of schizophrenia was during childhood or adolescent, the child starts to exhibits auditory and visual hallucinations, impaired development of communication skills, and social, interpersonal and academic performance is below the expected range. On adults, work, social or interpersonal relations, and self care are also less achieved to be normally performed by the person. Cognitive changes are predominant in schizophrenia. These include disturbance of attention and concentration, preoccupation, daydreaming, thought blocking, and reduced abstraction. While behavioral changes include deterioration in role functioning, social withdrawal, impulsivity, odd behavior, aggressive and disruptive behavior (Yung, 2005, p.10). APA (2008) showed the following information as to the duration of schizophrenia and schizophreniform: continuous signs of the disturbance in schizophrenia persist for at least 6 months and must include at least 1 month of symptoms (or less if successfully treated) that meet Criterion A (I.e., active-phase symptoms) and may include periods of prodromal or residual periods, the signs of the disturbance may be manifested by only negative symptoms or two or more symptoms listed in Criterion A present in attenuated form; for schizophreniform, at least 1 month, but less than 6 month; and for brief psychotic disorder, at least 1 day but less than 1 month, with eventual full return to premorbid level of functioning. Psychotic disorders such as schizophrenia “can affect people throughout the lifespan although new instances of the illness are most likely to occur in early adulthood. It is relatively rare for children and older adults to develop schizophrenia, but it do happen” (SWCDS, 2008). Though genetic is a factor, SWCDS added that “more commonly the incidence (rate of diagnosis) of new cases of psychotic disorder (such as schizophrenia) increases in the teen years, reaching a peak of vulnerability between the ages of 16 and 25 years. Men and women show different patterns of susceptibility for developing schizophrenia. Males reach a single peak of vulnerability for developing schizophrenia between the ages of 18 and 25 years. In contrast, female vulnerability peaks twice; first between 25 and 30 years, and then again around 40 years of age”. Table 1 presents DSM-IV-TR diagnostic criteria for schizophrenia; and Table 2 presents the DSM-IV-TR diagnostic criteria for other psychotic disorder. Table 1. DSM-IV-TR Diagnostic Criteria for Schizophrenia A. Characteristic symptoms: Delusions Hallucinations Disorganized speech Grossly disorganized or catatonic symptoms Negative symptoms B. Social and occupational dysfunction (work, relationships, self-care) C. Duration: 6 months with at least 1 month of symptoms Prodromal or residual symptoms- only negative symptoms or symptoms from A are attenuated Course specifiers: Single episode in partial remission Single episode in full remission Other or unspecified pattern Episodic with interepisode residual symptoms Episodic with no interepisode residual symptoms Types: Paranoid 295.30 Preoccupation with delusions or auditory hallucinations Disorganized 295.10 Disorganized speech Disorganized behavior Flat or inappropriate affect Catatonic 295.20 Motoric immobility evidenced by catelpsy Excessive motor activity Extreme negativism Peculiarities of voluntary movement Echolalia or echopraxia Undifferentiated 295.90 Meets criteria A; not another types Residual 295.60 Absence of symptoms from A, except Negative symptoms Table 2. DSM-IV-TR Diagnostic Criteria for Other Psychotic Disorders Schizophreniform 295.40 Symptoms A from schizophrenia Duration is at least 1 month, but less than 6 months Specifiers: With good prognostic features Onset of prominent psychotic symptoms within 4 weeks of first noticeable change Confusion or perplexity at height of episode Good premorbid social/ occupational functioning Absence of blunted or flat affect Without good prognostic features Schizoaffective Disorder 295.70 Symptoms met for Criteria A for Schizophrenia Meet symptoms for Major Depressive, Manic, or Mixed Episode For 2 weeks with no mood symptoms the presence of delusions or hallucinations Symptoms for mood are present during active and residual periods Types: Bipolar Depressive Delusional Disorder  297.1 Nonbizarre delusions for 1 month No Criteria A Schizophrenia symptoms Functioning is not impaired, no odd behavior Types: Erotomanic- Another person (of higher status) loves the individual Grandiose- Delusions of inflated worth, power, knowledge, identity, or relationship with famous person or deity Jealous- Sexual partner is unfaithful Delusional Persecutory- Person or close person is being malevolently treated Somatic- Person has some physical defect or medical condition Mixed Unspecified Brief Psychotic Disorder- 298.8 Criteria A Delusions Hallucinations Disorganized speech Grossly disorganized or catatonic behavior Criteria B- At least 1 day, but less than 1 month Specifiers: With marked stressors (brief reactive psychosis) Without marked stressors With postpartum onset Shared Psychotic Disorder 297.3 (Folie à Deux) Delusion develops in context of close relationship with individual with a delusion Delusions are similar in content Other Psychotic Disorders Psychotic disorder due to a general medical condition Substance-induced psychotic disorder Psychotic disorder NOS References American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th Edition. (2008). Washington, DC, American Psychiatric Association, 2000. Gerstein, P.S. Schizophrenia. (Jan 23, 2007) eMedicine from Web M.D. SWCDS (Southwest Counseling and Development Services). Schizophrenia and Psychosis. (2008) Copyright © CenterSite, LLC, 1995-2008 Yung, A.R. Working with People at High Risk of Developing Psychosis: A Treatment Handbook. (October 26, 2005). Edited by J. Addington, S.M. Francey and A.P. Morrison. C 2006 John Wiley & Sons, Ltd. WebMD. Mental Health: Psychotic Disorder (May 20, 2008). ©2005-2008 WebMD, LLC. Read More