Overview – Schizophrenia Disorders II
Much has changed over the last couple of centuries in relation to Schizophrenia Disorders. Just in the last few decades alone, evidence has been accumulating that schizophrenia disorders are biologically based diseases of the brain. Brain imaging has revealed the tissue destruction that occurs in brains that are suffering from schizophrenia. Its etiology or causes along with the pathophysiology or functional changes that occur with this psychotic disorder remain somewhat elusive and are not fully understood.
The specific cause of the disorders in the schizophrenia spectrum are unknown. What is known is that a predisposition to develop schizophrenia is inheritable. When genetic factors are acted upon by a variety of environmental factors, a diagnosis of schizophrenia may result. Environmental factors may include those that occur during gestation, while others may involve Adverse Childhood Experiences or ACE’s.
The clinical manifestations of Schizophrenia Spectrum Disorders are very diverse. The symptoms may vary considerably depending on the individual. Schizophrenia itself remains reliably diagnosable. Several subtypes have been identified that incorporate information that is being learned about the nature of these psychotic mental disorders.
In Schizophrenia Part 1, four types were addressed. They included:
- Schizophrenia Disorder
- Schizoaffective Bipolar Disorder
- Schizoaffective Depressive Type Disorder
- Schizophrenia Substance Induced Disorder
Schizophrenia Disorders, Part 2, presents Information about four additional subtype disorders, one type each day for four days. These are:
Schizotypal Disorder formerly was referred to as ‘Schizophrenia simple type’. Now it is considered a Schizophrenia Spectrum Disorder, a mental illness that is characterized by a pattern of odd, eccentric feelings, behaviors, perceptions, and relating to others that markedly interferes with the person’s ability to function. It is, however, less severe than Schizophrenia. It is rare that people with Schizotypal Disorder develop a mature psychotic disorder. Should someone with Schizotypal Disorder develop an overlapping Schizophrenia, Schizophreniform Disorder, Brief Psychotic Disorder, or Delusional Disorder diagnosis, it is considered co-morbid and not two-in-one. It must be understood that once the psychotic episode remits, the person returns to the baseline Schizotypal Personality.
An estimated 30-50 percent of individuals with schizoid personality disorder have a coexisting diagnosis of major depressive disorder. It’s also possible for schizoid, paranoid, avoidant, and borderline personality disorders to co-occur. It is comorbid with a number of psychological disorders, including anxiety disorders, narcissistic, and borderline personality disorder. It is a somewhat mysterious condition ad the exact cause is unknown.
Delusional Disorder is one of the less common psychotic disorders. It is a mental illness characterized by delusions, but it does not exhibit other classical symptoms of schizophrenia such as thought disorder, hallucinations, mood disturbance, or flat affect. Although the logic of the delusion may be abnormal, general logical reasoning is unaffected, and there is no general disturbance of behavior. A primary disorder, it is chronic and may be lifelong. The cause of delusional disorder has not been identified
Delusions are associated with a variety of mental and neurological disorders but are of diagnostic importance in psychotic disorders. A delusion is a belief that is held with strong conviction despite evidence disproving it that is stronger than any evidence supporting it. It is distinct from an erroneous belief that is caused by the individual having incomplete information, poor memory recall, or incorrect perceptions. .The patient has a heightened sense of self-reference, and trivial or nonspecific events assume great importance through a connection to the delusional belief. Abnormal behavior, if it occurs, is specifically related to the delusional belief.
Brief Psychotic Disorder
Brief Psychotic Disorder is a mental illness described as a transient thought disorder, which typically occurs in adolescence or young adulthood. It is of short duration, although it can result in increased risk of suicidality, or inability to perform selfcare. It is characterized by the sudden onset of at least one psychotic symptom.
A diagnosis of brief psychotic disorder requires that symptoms last at least 1 day but no longer than 1 month. During this time, individuals perceive or interpret things differently from those around them. It is often accompanied by emotional turmoil. Remission of all symptoms is complete with patients returning to their previous level of functioning. This condition may or may not be recurrent, and it should not be caused by another condition.
A Schizophreniform Disorder is a mental illness in which symptoms of Schizophrenia are present, including delusions, hallucinations, disorganized speech, disorganized or catatonic behavior, and negative symptoms. However, they are not present for the length of time required for a diagnosis of schizophrenia. The duration requirement for schizophreniform disorder is intermediate between that for brief psychotic disorder, which lasts more than 1 day and resolves by 1 month, and schizophrenia, which lasts for at least 6 months.
Brain imaging neurological studies (e.g., MRI, PET, SPECT) have linked anatomic and functional cortical deficits with both schizophreniform and schizophrenic disorders.
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