Schizophrenia Spectrum and Other Psychotic Disorders
Mental Health Treatment, Boise, ID
Schizophrenia is characterized by the following symptoms:
- Disorganized speech
- Grossly disorganized or catatonic behavior
- Negative symptoms: emotionless, reduced ability to plan and follow through with activities, neglect of personal hygiene, social withdrawal, decrease in talkativeness, loss of motivation.
Other symptoms of psychosis/schizophrenia may include the following:
- Marked social isolation or withdrawal
- Marked impairment in role functioning as wage earner or homemaker
- Markedly peculiar behavior (hoarding, talking to self in public, collecting garbage, etc.)
- Marked impairment in personal hygiene and grooming
- Blunted or inappropriate affect
- Vague overelaborate circumstantial speech, poverty of speech, etc.
- Odd beliefs or magical thinking influencing behavior and inconsistent with social norms
- Unusual perceptual experiences (illusions, sensing the presence of a force or person that is not actually present, etc.)
- Marked lack of initiative, interest, or energy
Schizophrenia is a severe form of mental illness that affects all aspects of a person’s daily life, including work, leisure, enjoyment of life, and interpersonal relationships. Schizophrenia is a brain disorder that disables the brain’s ability to sort, process, and respond normally to stimuli. It may disrupt all aspects of brain function, including perceptions, thoughts, mood, and behavior. Schizophrenia is a biological disease of the brain unrelated to interpersonal events of childhood or adulthood. The onset of symptoms may be abrupt or gradual. Most individuals display a slow and gradual development of a variety of signs and symptoms such as social withdrawal, loss of interest in work or home life, poor hygiene and grooming, unusual behavior, or outbursts of anger. Eventually, the appearance of more active symptoms persist and increase negative behaviors that attract serious attention and may lead to a diagnosis of schizophrenia.
Perceptual disturbances may include all of the senses, including vision, hearing, taste, touch, smell, location in space, balance, and time. The ill person may experience distortion such as the following:
- Colors appearing brighter or subdued
- Voices sounding sharper or subdued as if “coming from the bottom of a barrel”
- Food not tasting right, bitter or “off taste”
- Temperatures feeling too hot or too cold
- Things feel like crawling on the skin, tingling or itching
The person may also experience full-blown hallucinations such as hearing voices and seeing things that are not there. Hallucinations are most commonly auditory (hearing voices).
Thought disturbances and people with schizophrenia may include the following:
- Inability to think logically or concentrate
- Ideas of reference (a stimulus may be seen by the ill person as being specifically targeted just to him or her as in thinking that the television is speaking specifically to him or her)
- Concrete thinking
- Loose associations
- Attaching special meaning to ordinary objects or events
- Thought broadcasting (one may think others can hear his or her thoughts)
- Thought insertion or withdrawal (one may feel people are putting thoughts into their head or removing them)
- Lack of insight
Mood disturbances in a schizophrenic individual may include some or all of the following:
- Loss of pleasure in life’s activities
- Extreme fatigue and decreased energy
- Loss of appetite or increased appetite
- Feelings of worthlessness and guilt
- Feelings of inadequacy
- Negativity about one’s worth
- Flat, silly, or inappropriate mood, appearance, and behavior
- Feels of elation, euphoria, or being “high”
- Feelings of exaggerated self-esteem
- Excessive energy
- Flight of ideas
Changes in behavior are most often a response to things occurring within the brain, e.g., an inability for the brain to sort, process, or respond normally to stimuli. The behavior of a person with schizophrenia is logical and rational to him or her. He does things for reasons which given his or her disordered senses and thinking make sense to him or her. To the outsider, the behavior may appear irrational. Because of thought-processing difficulties, the person with schizophrenia may find it difficult to make decisions, choose one item or activity over another, or sort and organize things. This along with inability to concentrate impedes work performance, daily functioning, and in extreme cases can cause disorientation and delusional thinking.
Not all psychotic illness is due to schizophrenia. There are other forms of psychosis that may not meet criteria for the diagnosis of schizophrenia, but the person still exhibits both positive and negative symptoms.
Brief Psychotic Disorder
This is a psychotic disorder that has a sudden onset and includes at least one of the following symptoms: delusions, hallucinations, disorganized speech, or grossly disorganized behavior. The episode lasts at least one day, but is less than one month. After the psychotic episode, the patient returns to his or her normal level of functioning.
This is a psychotic disorder with the same symptoms as schizophrenia, only the symptoms last more than one month but less than six months, and impairment and social and executive functioning may not occur.
Certain mood disorders may lead to “psychotic breaks” during periods of high stress: major depressive disorder, generalized anxiety disorder, schizoaffective disorder, bipolar disorder. Also, certain medical conditions can cause psychosis. Finally, controlled substance abuse (many illicit recreational drugs) can cause psychosis (eg., amphetamines/stimulants, LSD, psychedelic mushrooms, cocaine, etc.)
Medical science has “come a long way” in treating psychosis. There are many new and safer medications that are very effective in treating schizophrenia and other psychotic disorders. Also, a supportive therapist and community-based program are essential in helping these patients to improve and lead a higher quality of life.
Delusional disorder is a form of psychosis, although there are usually no hallucinations present and, apart from the delusion itself, overall functioning is not markedly impaired and behaviors are not obviously bizarre or odd. In delusional disorders, there is the presence of one or more delusions with a duration of one month or longer. Delusions can fall into several different subtypes such as the following:
- Erotomanic type-this subtype applies when the central theme of the delusion is that another person is in love with the individual.
- Grandiose type-the delusion is the conviction of having some great talent or insight or having made some important discovery.
- Jealous type-the delusion is that his or her spouse or lover is unfaithful.
- Persecutory type-the delusion involves the individual’s belief that he or she is being conspired against, cheated, spied on, followed, poisoned, drugged, maliciously maligned, harassed, or obstructed in pursuit of some long-term goals.
- Somatic type-the central theme of this delusion involves bodily functions and sensations.
Delusions can occur within the context of other psychotic disorders such as schizophrenia or schizophreniform disorder. The difference in a delusional disorder is that the delusion itself is the only main form of psychosis present in the patient.