Overview exam 4

[Audio] Overview- Schizophrenia 1 This lecture begins the final section of the course, focusing on schizophrenia, other psychotic disorders, and developmental disorders. The instructor, whose research area is schizophrenia, outlines the upcoming lectures and dives into schizophrenia's symptoms, prevalence, common misconceptions, and course. The goal is to comprehensively understand schizophrenia before moving on to diagnostic criteria, videos, ideology, and treatment in subsequent lectures. Detailed Summary The lecture first clarifies the course structure, with three lectures on schizophrenia, one on other psychotic disorders, and two on developmental disorders. Schizophrenia, a severe and heterogeneous mental illness affecting about 1% of the population, is characterized by a loss of contact with reality. It often impacts those of lower socioeconomic status and is slightly more common in men, with different onset ages between genders. Common misconceptions about schizophrenia are addressed, such as its confusion with dissociative identity disorder, the belief that people with schizophrenia are violent, and the idea that all cases are chronic. In fact, about a quarter of patients achieve complete remission after an initial psychotic episode, a quarter recover with treatment, a quarter have episodic illness, and a quarter develop a chronic condition. The lecture then delves into schizophrenia's symptoms, divided into positive, negative, and psychoot (catatonic) symptoms. Positive symptoms include delusions (like persecution, reference, grandeur, and control), disorganization (loose associations, neologism, perseveration, clanging), hallucinations (auditory, visual, tactile, somatic, olfactory), and inappropriate affect. Negative symptoms involve the absence of normal functions, such as poverty of speech (alogia), blunted affect, loss of volition (avolition/apathy), loss of pleasure (anhedonia), and social withdrawal (asociality). Psychoot symptoms are abnormal movements due to a disturbed mental state, including catatonic stupor, rigidity, posturing, and excitement..

[Audio] The course of the disorder typically affects people from their late teens to mid - 30s, with males having an earlier onset. It consists of a prodromal phase with early signs like brief intermittent psychotic symptoms or attenuated positive symptoms, an active phase with a full - blown psychotic episode, and a residual phase where the person attempts to regain normal function. Recovery varies, with factors like rapid onset, higher functioning at onset, older age, and a stress - triggered psychosis associated with better outcomes. Main Points - Schizophrenia Basics: Defined by loss of contact with reality, it has a 1% prevalence, is more common in lower socioeconomic groups and males, and shows gender differences in onset age. - Misconceptions: Not the same as dissociative identity disorder; most individuals are not violent; not all cases are chronic (rule of quarters). - Symptoms - Positive: Include delusions, disorganization, hallucinations, and inappropriate affect. - Negative: Characterized by absence of normal functions like speech, emotion, motivation, pleasure, and social interaction. - Psychoot (Catatonic): Abnormal movements such as stupor, rigidity, posturing, and excitement. - Course of Disorder: Includes prodromal, active, and residual phases. Recovery varies based on factors like onset speed, initial functioning, age, and stressors. Overview- Schizophrenia 2 This lecture delves into schizophrenia, commencing with real - life examples of individuals with the disorder. It then details the diagnostic criteria, associated features, and the type one - type two schizophrenia classification. The lecture also explores the diathesis - stress model, the dopamine hypothesis, and various biological factors like brain structure, winter birth, and brain function..

[Audio] Detailed Summary The lecture begins with Tony's case, a schizophrenic showing positive symptoms, disorganization, and lack of insight as he hasn't taken meds for 14 months. His delusions include believing mental health workers are Masons. Ashley's story follows, highlighting how psychosis led to a crime, diagnosis, and her journey to recovery. The diagnostic criteria demand two or more specific symptoms in a one - month period, with at least one from delusions, hallucinations, or disorganized speech, along with significant dysfunction and a six - month disturbance. Features like dysphoric mood, sleep and eating disturbances, cognitive impairments, and lack of insight are common. The diathesis - stress model posits a genetic vulnerability triggered by environmental stress. Family, twin, and adoption studies support a genetic link. The dopamine hypothesis, though widely accepted, has flaws as dopamine - related meds only treat positive symptoms, and there are inconsistencies in the relationship between dopamine and schizophrenia. Brain structure differences such as increased ventricular size and reduced frontal and temporal lobe mass are observed, along with functional differences like hypofrontality. Key Points Examples: Tony exhibits positive symptoms, disorganization, and lack of insight; Ashley's psychosis led to a crime and eventual diagnosis. Diagnostic Criteria: Require specific symptoms in a one - month period, significant dysfunction, and a six - month disturbance. Features: Include dysphoric mood, sleep/eating disturbances, cognitive impairments, and lack of insight. Type One vs. Type Two: Type one has more positive symptoms, better pre - morbid adjustment, and responds well to traditional antipsychotics; type two has more negative symptoms, poor pre - morbid adjustment, and less responsiveness. Diathesis - Stress Model: Genetic vulnerability triggered by environmental stress, supported by family, twin, and adoption studies. Dopamine Hypothesis: Suggests schizophrenia is related to excess dopamine activity, but has limitations..

[Audio] Biological Factors: Abnormal brain structure (e.g., increased ventricles, reduced lobe mass), winter birth hypothesis, and abnormal brain function (e.g., hypofrontality) are associated with schizophrenia. Overview- Schizophrenia 3 This lecture, the third in a series on schizophrenia, delves into the disorder's sociocultural, neurodevelopmental, and treatment aspects. It first explores how social labeling, family dysfunction, and environmental factors impact schizophrenia. The neurodevelopmental model, highlighting early motor and cognitive impairments, is presented. Social and environmental factors affecting the illness course are discussed. Treatment options, including antipsychotics and behavioral interventions like CBT, are examined, emphasizing the need for a comprehensive approach. Detailed Summary The lecture begins by recapping previous discussions on schizophrenia's clinical symptoms (positive, negative, disorganization) and biological causes (neurotransmitters, brain abnormalities). It then focuses on sociocultural factors. Social labeling, as shown in Rosenhan's 1973 study, can lead to self - fulfilling prophecies and reduced functioning. Family dysfunction, specifically expressed emotion (high levels of hostility, criticism, and emotional over - involvement), is linked to higher relapse rates. The neurodevelopmental model, developed by Weineberger, suggests that early motor, cognitive, and obstetric complications interact with the environment over time to cause schizophrenia. Social factors like pre - morbid functioning, social problem - solving, social skills, social cognition, and social networks, as well as environmental factors such as expressed emotion, life events, social class, and season of birth, all influence the illness course. Treatment for psychosis mainly involves antipsychotics. Typical antipsychotics, developed in the 1950s, block dopamine receptors but cause severe extrapyramidal symptoms like tardive dyskinesia. Atypical antipsychotics, emerging in the 1980s, work on both dopamine and serotonin receptors, having fewer movement - related side effects but causing issues like rapid weight gain. Behavioral interventions, especially CBT, are adjunctive treatments. CBT includes psychoeducation,.

[Audio] symptom monitoring, behavioral experiments, and role - plays. Other psychosocial approaches like insight therapy, family therapy, and social therapy also play important roles in treatment. Key Points Sociocultural Factors: Social labeling can trap individuals in a mentally ill role. Family dysfunction, especially high expressed emotion, impacts relapse rates. Neurodevelopmental Model: Early motor, cognitive impairments, and obstetric complications are risk factors for schizophrenia, interacting with the environment. Social and Environmental Factors: Pre - morbid functioning, social skills, life events, and social class affect the course of schizophrenia. Treatment: Antipsychotics are the primary treatment. Typical antipsychotics have severe side effects, while atypicals have different side - effect profiles. CBT and other psychosocial approaches are important adjunctive treatments. Overview- Other psychotic disorders This lecture focuses on various psychotic disorders. It begins with a review of schizophrenia's diagnostic criteria, then delves into other related disorders. These include schizophreniform disorder, schizoaffective disorder, brief psychotic disorder, delusional disorder, and more. The speaker emphasizes the importance of differentiating between these disorders as it impacts treatment approaches. Detailed Summary The lecture first reviews schizophrenia's diagnostic criteria, which include having at least two out of five symptoms (delusions, hallucinations, disorganized speech, disorganized/catatonic behavior, negative symptoms) for a month, with at least one being from the first three. There must also be dysfunction in work, relationships, or self - care, and continuous disturbance for at least six months. Schizophreniform disorder has similar symptoms but a duration of more than one month but less than six months. It can be diagnosed as provisional if the six - month mark for schizophrenia isn't reached. Specifiers for good or bad prognosis exist. Schizoaffective disorder combines psychosis (meeting schizophrenia's criterion.