Showing posts with label schizophrenia. Show all posts
Showing posts with label schizophrenia. Show all posts

Thursday, June 4, 2015

DSM5 Videos from Taylor Study Method



Schizophrenia
1. Prominent psychotic symptoms, with abnormalities in one or more of five domains: delusions, hallucinations, disorganized thinking, grossly disorganized behavior, and negative symptoms
2. Positive symptoms: excess or distortion of normal functions, e.g., delusions and hallucinations
3. Negative symptoms: decrease or loss of normal functions, e.g., blunted affect, lack of fluidity of speech, avolition, alogia, anhedonia, asociality
4. Delusions: fixed beliefs unamenable to change: persecutory, referential, grandiose, erotomanic, nihilistic, somatic
5. Hallucinations: sensory modalities without external stimulus: auditory, tactile
6. Disorganized thinking: formal thought disorder inferred from speech
7. Grossly disorganized or abnormal motor behavior: range of manifestations: silliness to unpredictable agitation; catatonia
8. Mnemonic for symptoms: DELUSIONS HERALD SCHIZOPHRENIA BAD NEWS: The initials DHSBN stand for symptoms domains: Delusions, Hallucinations, Speech-disorganized, Behavior- disorganized, Negative symptoms

QUESTION:
Negative or deficit symptoms of schizophrenia include all of the following, except:

ANSWERS:
A. auditory hallucinations.
B. impoverished thought or speech.
C. low motivation.
D. social isolation.

RATIONALE:
A is correct, as hallucinations are a positive or excess symptom; Answers B, C, and D are incorrect, as they all depict negative or deficit symptoms.



Anti-social Behavior, Hypomania, Narcisistic Personality Disorder, Bipolar Disorder, Histrionic Personality Disorder

  https://vimeo.com/103349596


 Neurocognitive Disorders https://vimeo.com/103499076

Wednesday, March 19, 2014

NAMI Publications on Schizophrenia



Schizophrenia is a serious mental illness that affects more than 2 million adult American men and women. While the condition is rare in childhood, it can begin onset in the mid- to late teen years. Reading this brochure is an important first step to answering your questions and understanding recovery for people living with schizophrenia.

People living with schizophrenia have talents, goals and feelings just like anyone else. But, if left untreated, their illness can have a profoundly negative effect on their own lives, their families and their communities. Because the illness may cause unusual, inappropriate and sometimes unpredictable and disorganized behavior, people who are not effectively treated are often shunned and can become the targets of social prejudice. People living with schizophrenia may also face poverty, homelessness and high risk for suicide.

Lack of services has left many people living with schizophrenia inappropriately placed in jails and prisons. Medication, rehabilitation and other community-based supports can often help people living with schizophrenia lead meaningful, satisfying lives.

This brochure will explain the symptoms, discuss treatment options and explore the latest in schizophrenia research. You’ll also find information on where you can turn for medical care and find the support needed to manage this persistent illness.

Stay up-to-date on emerging research and treatments at www.nami.org/research.

The National Alliance on Mental Illness (NAMI) is the nation's largest
grassroots mental health organization dedicated to building better lives
for the millions of Americans affected by mental illness. NAMI has more
than 1,100 State Organizations and Affiliates across the country that
engage in advocacy, research, support and education. Members are
families, friends and people living with mental illnesses such as major
depression, schizophrenia, bipolar disorder, obsessive compulsive disorder
(OCD), panic disorder, posttraumatic stress disorder (PTSD) and borderline
personality disorder.

Written by Ken Duckworth, M.D. with additional input by Irving
Gottesman, Ph.D., and Charles Schulz, M.D. Copyright 2011 by the
National Alliance on Mental Illness. Copies of this publication can be
purchased at www.nami.org/store.

NAMI, 3803 N. Fairfax Dr., Suite 100, Arlington VA 22203
HelpLine: 1 (800) 950-NAMI (6264)
Twitter: NAMICommunicate




Source - http://www.nami.org/Template.cfm?Section=Schizophrenia9&Template=/ContentManagement/ContentDisplay.cfm&ContentID=118290



Source - http://www.nami.org/SchizophreniaSurvey/SchizeExecSummary.pdf 

The survey results also reveal major gaps between what the public believes to be true about
schizophrenia, what science tell us, and the real experiences and realities of individuals affected by
the illness.
• Early intervention and treatment are critical to preventing long-term effects of the illness,
but there is an enormous delay, averaging 8.5 years, between first experiencing symptoms to
receiving treatment for schizophrenia.

• Many people with schizophrenia report that they have difficulty accessing other healthcare
services and do not receive proper attention to other health concerns; this may be one
reason why people with schizophrenia die on average 25 years sooner than the general
population.3

• Public familiarity with schizophrenia is low, and public concern and fear is high. People
recognize that it is a medical illness and that treatment works, presenting a paradox relative
to attitudes.
• The public feels differently about people in treatment than it feels about people not in
treatment; but still, to a large degree, people don’t want to date, work for, or work with
people with schizophrenia.

• Caregivers face many challenges in caring for their loved ones, both in terms of making sure
the person they care for has access to treatment and services, as well as taking care of
themselves. They report that they often feel isolated, lonely, worried, and burned out.

• Access to appropriate medications and services remains elusive for many, if not most,
families and individuals.

• In spite of the tremendous hardship of the personal experience, the resilience of the human
spirit emerges as one of hope, faith, and triumph for many.

Finally, NAMI’s analysis offers recommendations that narrow the knowledge gap by dispelling myths and promoting understanding and the potential for recovery:
• Increase public education and awareness
• Close the gap between onset of symptoms and treatment
• Provide ready access to primary healthcare
• Increase access to treatment and services, including housing
• Ensure education and support for families and individuals living with schizophrenia
• Invest in scientific and medical research advances

We must make a commitment to individual dignity and recognize that with proper treatment,
services, and supports, horizons for people living with the illness can be restored. It is time to make
recovery real.



Source - http://www.nami.org/SchizophreniaSurvey/SchizophreniaAttitudesandAwareness.pdf

Specifically, this research seeks to:
  •  Identify gaps in knowledge and understanding among the general adult public
  •  Establish a baseline of attitudes toward the illness and those living with it
  •  Understand the experiences of caregivers and individuals living with schizophrenia
  •  Identify areas where more or better services are needed for those living with schizophrenia
The results of this study will be used by NAMI to help raise awareness about schizophrenia with the goal of reducing the stigma associated with this condition and improve the care available to those living with it.



Monday, March 17, 2014

NIH on Schizophrenia

                     Image source - http://www.nlm.nih.gov/medlineplus/ency/imagepages/17239.htm


Schizophrenia is a serious brain illness. People who have it may hear voices that aren't there. They may think other people are trying to hurt them. Sometimes they don't make sense when they talk. The disorder makes it hard for them to keep a job or take care of themselves.
Symptoms of schizophrenia usually start between ages 16 and 30. Men often develop symptoms at a younger age than women. People usually do not get schizophrenia after age 45. There are three types of symptoms:
  • Psychotic symptoms distort a person's thinking. These include hallucinations (hearing or seeing things that are not there), delusions (beliefs that are not true), trouble organizing thoughts, and strange movements.
  • "Negative" symptoms make it difficult to show emotions and to function normally. A person may seem depressed and withdrawn.
  • Cognitive symptoms affect the thought process. These include trouble using information, making decisions, and paying attention.
No one is sure what causes schizophrenia. Your genes, environment, and brain chemistry may play a role.
There is no cure. Medicine can help control many of the symptoms. You may need to try different medicines to see which works best. You should stay on your medicine for as long as your doctor recommends. Additional treatments can help you deal with your illness from day to day. These include therapy, family education, rehabilitation, and skills training.
NIH: National Institute of Mental Health

Sunday, March 16, 2014

ICD 10 on Schizophrenia, Schizotypal and Delusional Disorders

                     
                   Image source http://www.imcanz.com.au/Images/community/Schizophrenia.jpg

International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) Version for 2010

Chapter V
Mental and behavioural disorders
(F00-F99)

Schizophrenia, schizotypal and delusional disorders
(F20-F29)

This block brings together schizophrenia, as the most important member of the group, schizotypal disorder, persistent delusional disorders, and a larger group of acute and transient psychotic disorders. Schizoaffective disorders have been retained here in spite of their controversial nature.

F20Schizophrenia

The schizophrenic disorders are characterized in general by fundamental and characteristic distortions of thinking and perception, and affects that are inappropriate or blunted. Clear consciousness and intellectual capacity are usually maintained although certain cognitive deficits may evolve in the course of time. The most important psychopathological phenomena include thought echo; thought insertion or withdrawal; thought broadcasting; delusional perception and delusions of control; influence or passivity; hallucinatory voices commenting or discussing the patient in the third person; thought disorders and negative symptoms.
The course of schizophrenic disorders can be either continuous, or episodic with progressive or stable deficit, or there can be one or more episodes with complete or incomplete remission. The diagnosis of schizophrenia should not be made in the presence of extensive depressive or manic symptoms unless it is clear that schizophrenic symptoms antedate the affective disturbance. Nor should schizophrenia be diagnosed in the presence of overt brain disease or during states of drug intoxication or withdrawal. Similar disorders developing in the presence of epilepsy or other brain disease should be classified under F06.2, and those induced by psychoactive substances under F10-F19 with common fourth character .5.
Excl.:
schizophrenia:
schizophrenic reaction (F23.2)
schizotypal disorder (F21)
F20.0Paranoid schizophrenia
Paranoid schizophrenia is dominated by relatively stable, often paranoid delusions, usually accompanied by hallucinations, particularly of the auditory variety, and perceptual disturbances. Disturbances of affect, volition and speech, and catatonic symptoms, are either absent or relatively inconspicuous.
Paraphrenic schizophrenia
Excl.:
involutional paranoid state (F22.8)
paranoia (F22.0)
F20.1Hebephrenic schizophrenia
A form of schizophrenia in which affective changes are prominent, delusions and hallucinations fleeting and fragmentary, behaviour irresponsible and unpredictable, and mannerisms common. The mood is shallow and inappropriate, thought is disorganized, and speech is incoherent. There is a tendency to social isolation. Usually the prognosis is poor because of the rapid development of "negative" symptoms, particularly flattening of affect and loss of volition. Hebephrenia should normally be diagnosed only in adolescents or young adults.
Disorganized schizophrenia
Hebephrenia
F20.2Catatonic schizophrenia
Catatonic schizophrenia is dominated by prominent psychomotor disturbances that may alternate between extremes such as hyperkinesis and stupor, or automatic obedience and negativism. Constrained attitudes and postures may be maintained for long periods. Episodes of violent excitement may be a striking feature of the condition. The catatonic phenomena may be combined with a dream-like (oneiroid) state with vivid scenic hallucinations.
Catatonic stupor
Schizophrenic:
  • catalepsy
  • catatonia
  • flexibilitas cerea
F20.3Undifferentiated schizophrenia
Psychotic conditions meeting the general diagnostic criteria for schizophrenia but not conforming to any of the subtypes in F20.0-F20.2, or exhibiting the features of more than one of them without a clear predominance of a particular set of diagnostic characteristics.
Atypical schizophrenia
Excl.:
acute schizophrenia-like psychotic disorder (F23.2)
chronic undifferentiated schizophrenia (F20.5)
post-schizophrenic depression (F20.4)
F20.4Post-schizophrenic depression
A depressive episode, which may be prolonged, arising in the aftermath of a schizophrenic illness. Some schizophrenic symptoms, either "positive" or "negative", must still be present but they no longer dominate the clinical picture. These depressive states are associated with an increased risk of suicide. If the patient no longer has any schizophrenic symptoms, a depressive episode should be diagnosed (F32.-). If schizophrenic symptoms are still florid and prominent, the diagnosis should remain that of the appropriate schizophrenic subtype (F20.0-F20.3).
F20.5Residual schizophrenia
A chronic stage in the development of a schizophrenic illness in which there has been a clear progression from an early stage to a later stage characterized by long- term, though not necessarily irreversible, "negative" symptoms, e.g. psychomotor slowing; underactivity; blunting of affect; passivity and lack of initiative; poverty of quantity or content of speech; poor nonverbal communication by facial expression, eye contact, voice modulation and posture; poor self-care and social performance.
Chronic undifferentiated schizophrenia
Restzustand (schizophrenic)
Schizophrenic residual state
F20.6Simple schizophrenia
A disorder in which there is an insidious but progressive development of oddities of conduct, inability to meet the demands of society, and decline in total performance. The characteristic negative features of residual schizophrenia (e.g. blunting of affect and loss of volition) develop without being preceded by any overt psychotic symptoms.
F20.8Other schizophrenia
Cenesthopathic schizophrenia
Schizophreniform:
  • disorder NOS
  • psychosis NOS
Excl.:
brief schizophreniform disorders (F23.2)
F20.9Schizophrenia, unspecified

F21Schizotypal disorder

A disorder characterized by eccentric behaviour and anomalies of thinking and affect which resemble those seen in schizophrenia, though no definite and characteristic schizophrenic anomalies occur at any stage. The symptoms may include a cold or inappropriate affect; anhedonia; odd or eccentric behaviour; a tendency to social withdrawal; paranoid or bizarre ideas not amounting to true delusions; obsessive ruminations; thought disorder and perceptual disturbances; occasional transient quasi-psychotic episodes with intense illusions, auditory or other hallucinations, and delusion-like ideas, usually occurring without external provocation. There is no definite onset and evolution and course are usually those of a personality disorder.
Incl.:
Latent schizophrenic reaction
Schizophrenia:
  • borderline
  • latent
  • prepsychotic
  • prodromal
  • pseudoneurotic
  • pseudopsychopathic
Schizotypal personality disorder
Excl.:
Asperger syndrome (F84.5)
schizoid personality disorder (F60.1)

F22Persistent delusional disorders

Includes a variety of disorders in which long-standing delusions constitute the only, or the most conspicuous, clinical characteristic and which cannot be classified as organic, schizophrenic or affective. Delusional disorders that have lasted for less than a few months should be classified, at least temporarily, under F23.-.
F22.0Delusional disorder
A disorder characterized by the development either of a single delusion or of a set of related delusions that are usually persistent and sometimes lifelong. The content of the delusion or delusions is very variable. Clear and persistent auditory hallucinations (voices), schizophrenic symptoms such as delusions of control and marked blunting of affect, and definite evidence of brain disease are all incompatible with this diagnosis. However, the presence of occasional or transitory auditory hallucinations, particularly in elderly patients, does not rule out this diagnosis, provided that they are not typically schizophrenic and form only a small part of the overall clinical picture.
Paranoia
Paranoid:
  • psychosis
  • state
Paraphrenia (late)
Sensitiver Beziehungswahn
Excl.:
paranoid:
  • personality disorder (F60.0)
  • psychosis, psychogenic (F23.3)
  • reaction (F23.3)
  • schizophrenia (F20.0)
F22.8Other persistent delusional disorders
Disorders in which the delusion or delusions are accompanied by persistent hallucinatory voices or by schizophrenic symptoms that do not justify a diagnosis of schizophrenia (F20.-).
Delusional dysmorphophobia
Involutional paranoid state
Paranoia querulans
F22.9Persistent delusional disorder, unspecified

F23Acute and transient psychotic disorders

A heterogeneous group of disorders characterized by the acute onset of psychotic symptoms such as delusions, hallucinations, and perceptual disturbances, and by the severe disruption of ordinary behaviour. Acute onset is defined as a crescendo development of a clearly abnormal clinical picture in about two weeks or less. For these disorders there is no evidence of organic causation. Perplexity and puzzlement are often present but disorientation for time, place and person is not persistent or severe enough to justify a diagnosis of organically caused delirium (F05.-). Complete recovery usually occurs within a few months, often within a few weeks or even days. If the disorder persists, a change in classification will be necessary. The disorder may or may not be associated with acute stress, defined as usually stressful events preceding the onset by one to two weeks.
F23.0Acute polymorphic psychotic disorder without symptoms of schizophrenia
An acute psychotic disorder in which hallucinations, delusions or perceptual disturbances are obvious but markedly variable, changing from day to day or even from hour to hour. Emotional turmoil with intense transient feelings of happiness or ecstasy, or anxiety and irritability, is also frequently present. The polymorphism and instability are characteristic for the overall clinical picture and the psychotic features do not justify a diagnosis of schizophrenia (F20.-). These disorders often have an abrupt onset, developing rapidly within a few days, and they frequently show a rapid resolution of symptoms with no recurrence. If the symptoms persist the diagnosis should be changed to persistent delusional disorder (F22.-).
Bouffée délirante without symptoms of schizophrenia or unspecified
Cycloid psychosis without symptoms of schizophrenia or unspecified
F23.1Acute polymorphic psychotic disorder with symptoms of schizophrenia
An acute psychotic disorder in which the polymorphic and unstable clinical picture is present, as described in F23.0; despite this instability, however, some symptoms typical of schizophrenia are also in evidence for the majority of the time. If the schizophrenic symptoms persist the diagnosis should be changed to schizophrenia (F20.-).
Bouffée délirante with symptoms of schizophrenia
Cycloid psychosis with symptoms of schizophrenia
F23.2Acute schizophrenia-like psychotic disorder
An acute psychotic disorder in which the psychotic symptoms are comparatively stable and justify a diagnosis of schizophrenia, but have lasted for less than about one month; the polymorphic unstable features, as described in F23.0, are absent. If the schizophrenic symptoms persist the diagnosis should be changed to schizophrenia (F20.-).
Acute (undifferentiated) schizophrenia
Brief schizophreniform:
  • disorder
  • psychosis
Oneirophrenia
Schizophrenic reaction
Excl.:
organic delusional [schizophrenia-like] disorder (F06.2)
schizophreniform disorders NOS (F20.8)
F23.3Other acute predominantly delusional psychotic disorders
Acute psychotic disorders in which comparatively stable delusions or hallucinations are the main clinical features, but do not justify a diagnosis of schizophrenia (F20.-). If the delusions persist the diagnosis should be changed to persistent delusional disorder (F22.-).
Paranoid reaction
Psychogenic paranoid psychosis
F23.8Other acute and transient psychotic disorders
Any other specified acute psychotic disorders for which there is no evidence of organic causation and which do not justify classification to F23.0-F23.3.
F23.9Acute and transient psychotic disorder, unspecified
Brief reactive psychosis NOS
Reactive psychosis

F24Induced delusional disorder

A delusional disorder shared by two or more people with close emotional links. Only one of the people suffers from a genuine psychotic disorder; the delusions are induced in the other(s) and usually disappear when the people are separated.
Incl.:
Folie à deux
Induced:
  • paranoid disorder
  • psychotic disorder

F25Schizoaffective disorders

Episodic disorders in which both affective and schizophrenic symptoms are prominent but which do not justify a diagnosis of either schizophrenia or depressive or manic episodes. Other conditions in which affective symptoms are superimposed on a pre-existing schizophrenic illness, or co-exist or alternate with persistent delusional disorders of other kinds, are classified under F20-F29. Mood-incongruent psychotic symptoms in affective disorders do not justify a diagnosis of schizoaffective disorder.
F25.0Schizoaffective disorder, manic type
A disorder in which both schizophrenic and manic symptoms are prominent so that the episode of illness does not justify a diagnosis of either schizophrenia or a manic episode. This category should be used for both a single episode and a recurrent disorder in which the majority of episodes are schizoaffective, manic type.
Schizoaffective psychosis, manic type
Schizophreniform psychosis, manic type
F25.1Schizoaffective disorder, depressive type
A disorder in which both schizophrenic and depressive symptoms are prominent so that the episode of illness does not justify a diagnosis of either schizophrenia or a depressive episode. This category should be used for both a single episode and a recurrent disorder in which the majority of episodes are schizoaffective, depressive type.
Schizoaffective psychosis, depressive type
Schizophreniform psychosis, depressive type
F25.2Schizoaffective disorder, mixed type
Cyclic schizophrenia
Mixed schizophrenic and affective psychosis
F25.8Other schizoaffective disorders
F25.9Schizoaffective disorder, unspecified
Schizoaffective psychosis NOS

F28Other nonorganic psychotic disorders

Delusional or hallucinatory disorders that do not justify a diagnosis of schizophrenia (F20.-), persistent delusional disorders (F22.-), acute and transient psychotic disorders (F23.-), psychotic types of manic episode (F30.2), or severe depressive episode (F32.3).
Incl.:
Chronic hallucinatory psychosis

F29Unspecified nonorganic psychosis

Incl.:
Psychosis NOS
Excl.:
mental disorder NOS (F99)
organic or symptomatic psychosis NOS (F09)

Saturday, July 20, 2013

Inside a Psychiatric Emergency Center

A documentary inside a psychiatric emergency center showing different cases of individuals suffering from different kinds of mental illnesses.







Published on Feb 4, 2012

Get unprecedented full access to New York City's Bellevue Hospital, the country's most renowned psychiatric emergency center that treats as many as 7000 individuals annually. This documentary feature takes viewers for an exclusive tour inside the locked psychiatric wards of America's largest public hospital, where they will have the opportunity to observe the sometimes tragic, sometimes comic, and always grueling struggle faced by the doctors and patients wrestling with mental illness.
Produced in 1998/1999, first shown in 2001.

A schizophrenic woman goes berserk and is strapped to a gurney. An actor is medicated after threatening to jump out a window. A paranoid woman insists that the CIA is trying to "zap" her. A homeless man eats the pages of his Bible. These are some of the cases confronting the doctors and staff at the psychiatric unit of Bellevue hospital--the oldest and most famous hospital in America. This documentary takes a never-before-seen look inside the psychiatric emergency room and treatment areas of this New York hospital. In addition to capturing the high drama and frequent chaos that ensues when mentally ill men and women are brought in, the documentary offers some sobering insights into some of the treatments that Bellevue provides its patients.

The cases:


Brian - History of mixed personality disorder
- yelling when he was brought to hospital

- obsessive-compulsive disorder the degree sever looks like schizophrenia
 that it looks like psychotic
(10:34)

Briann's Mom - "I am painfully shocked. I like to see my kids healthy and happy and not in a hospital."
(17:52)

Connie - History of bi-polar disorder
- arrested patient was confused, disoriented  and not making any sense. Disorganized in speech and behavior, observed grandiosity and paranoia.
- declared " a danger to herself and others" and was admitted to the psychiatric ward
(12:28)

Chery - History of schizophrenia and obsessive-compulsive disorder
(29:50)

Jamie - History of bi-polar disorder
Dan - History of schizophrenia
Clare - 30 year History of chronic paranoid schizophrenia