Matrixfinal - Summary/Matrix about Abnormal Psychology PDF

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Carin, Mary Angela R. BS PSYCH-IV TTH 4:30-6:00 PEMATRIX OF ABNORMALITYGENERAL DISORDERDIAGNOSTIC CRITERIACAUSATIVE FACTORSDURATIONCOMORBIDITYPOSSIBLETREATMENTSCHIZOPHRENIA AND OTHER PSYCHOTIC DISORDERSI. SchizophreniaPrevalence Lifetime prevalence appears to be approximately 0% to 0%, although the...

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Carin, Mary Angela R.

BS PSYCH-IV

TTH 4:30-6:00 PE24

MATRIX OF ABNORMALITY

GENERAL DISORDER

DIAGNOSTIC CRITERIA

CAUSATIVE FACTORS

DURATION

COMORBIDITY

POSSIBLE TREATMENT

SCHIZOPHRENIA AND OTHER PSYCHOTIC DISORDERS I.

Schizophrenia

Environmental



substance-related disorders

A. Two (or more) of the following,  The incidence of each present for a significant schizophrenia and related  anxiety disorders Prevalence portion of time during a 1-month disorders is higher for  Rates of period (or less if successfully children growing up in an 6 months or more  Lifetime prevalence appears to be obsessive-compuls treated.) At least one of these urban environment and approximately 0.3% to 0.7%, ive disorder and must be (1), (2), or (3): for some minority ethnic although there is reported variation panic disorder are groups. by race/ethnicity, across countries, 1. Delusions elevated in and geographic origin individuals with Genetic and Physiological 2. Hallucinations schizophrenia  Higher incidence rates on negative

Individual, Group, and Family Therapy - Can help patient and family understand the disease and symptom triggers - Teaches families communication skills - Provides resources



symptoms and longer duration of 3. disorder (associated with poorer outcome) for male

Disorganized speech frequent derailment incoherence)

(e.g., or

Inclusion of more mood symptoms 4. and brief presentation (associated with better outcome) show 5. equivalent risks for both male and female

Grossly disorganized or catatonic behavior Negative symptoms (i.e., diminished emotional expression or avolition).



There is a strong contribution for genetic factors in determining risk for schizophrenia, although most individuals who have been diagnosed with schizophrenia have no family history of psychosis.

and birth B. Level of functioning in one or  Pregnancy complications with more major areas like work, Development hypoxia and greater interpersonal relations, or  Psychotic features typically emerge paternal age are self-care is markedly below the associated with a higher between the late teens and the level achieved prior to the onset. risk of schizophrenia for mid-30’s C. Continuous signs of the the developing fetus.  Onset prior to adolescence is rare disturbance persist for at least 6 months and must include at least 1  In addition, other prenatal  Peak age of onset for the first and perinatal adversities, month of symptoms (or less if psychotic episode is in the early to including stress, infection, successfully treated) that meet mid-20’s for males, late-20’s for malnutrition, maternal Criterion A and may include females diabetes, and other periods of prodromal and residual medical conditions, have symptoms. During these periods, been linked with the signs of disturbance may be Course schizophrenia. manifested only negative symptoms or by two or more  Psychotic symptoms tend to symptoms listed in Criterion A diminish over the life course in

compared with the for dealing with general population. emotional and pratical challenges Social Skills Training - Can occur in hospital or community settings - Teaches the person with schizophrenia social, self-care, and vocational skills Medical Treatment 

Historical Precursors



Antipsychotic (Neuroleptic) Medications

Phenothiazines, Butyrophenone, Second-generations agents, others 

Transcranila Magnetic

association with normal age-related declines in dopamine activity.

present in an attenuated form (e.g., odd beliefs, unusual perceptual experiences). D. Schizoaffective disorder and depressive or bipolar disorder with psychotic features have been ruled out because either 1 ) no major depressive or manic episodes have occurred concurrently with the active-phase symptoms, or 2) if mood episodes have occurred during active-phase symptoms, they have been present for a minority of the total duration of the active and residual periods of the illness. E. The disturbance is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition. F.

If there is a history of autism spectrum disorder or a communication disorder of childhood onset, the additional diagnosis of schizophrenia is

Simulation Psychosocial Treatment 

Psychosocial Approaches

- Behavioral (i.e., token economies) on inpatient units - Community programs

care

- Social and living skills training - Behavioral therapy

family

Vocational rehabilitation

made only if prominent delusions or hallucinations, in addition to the other required symptoms of schizophrenia, are also present for at least 1 month (or less if successfully treated). Specify if: The following course specifiers are only to be used after a 1-year duration of the disorder and if they are not in contradiction to the diagnostic course criteria. First episode, currently in acute episode: First manifestation of the disorder meeting the defining diagnostic symptom and time criteria. An acute episode is a time period in which the symptom criteria are fulfilled. First episode, currently in partial remission: Partial remission is a period of time during which an improvement after a previous episode is maintained and in which the defining criteria of the disorder are only partially fulfilled.

First episode, currently in full remission: Full remission is a period of time after a previous episode during which no disorder-specific symptoms are present. Multiple episodes, currently in acute episode: Multiple episodes may be determined after a minimum of two episodes (i.e., after a first episode, a remission and a minimum of one relapse). Multiple episodes, partial remission

currently

in

Multiple episodes, currently in full remission Continuous: Symptoms fulfilling the diagnostic symptom criteria of the disorder are remaining for the majority of the illness course, with subthreshold symptom periods being very brief relative to the overall course. Unspecified Specify if: With catatonia (refer to the criteria for catatonia associated with

another mental disorder, pp. 119-120, for definition). Coding note: Use additional code 293.89 (F06.1) catatonia associated with schizophrenia to indicate the presence of the comorbid catatonia. Specify current severity: Severity is rated by a quantitative assessment of the primary symptoms of psychosis, including delusions, hallucinations, disorganized speech, abnormal psychomotor behavior, and negative symptoms. Each of these symptoms may be rated for its current severity (most severe in the last 7 days) on a 5-point scale ranging from 0 (not present) to 4 (present and severe). (See Clinician-Rated Dimensions of Psychosis Symptom Severity in the chapter “Assessment Measures.”) Note: Diagnosis of schizophrenia can be made without using this severity specifier II. Schizophreniform Disorder

Medical Treatment

A. Two (or more) of the following, Genetic and physiological each present for a significant Prevalence portion of time during a 1-month  Relatives of individuals with schizophreniform period (or less if successfully  Incidence of schizophreniform disorder have an treated). At least one of these must disorder across sociocultural increased risk for be (1), (2), or (3): settings is likely similar to that schizophrenia. observed in schizophrenia. 1. Delusions. 

In developed countries, the 2. incidence is low, possibly fivefold less than that of schizophrenia.In 3. developing countries, the incidence may be higher.



The development of schizophreniform disorder is similar to that of schizophrenia.

Course 

Disorganized speech frequent derailment incoherence).

(e.g., or

Grossly disorganized or catatonic behavior.

5.

Negative symptoms (i.e., diminished emotional expression or avolition).

B. An episode of the disorder lasts at least 1 month but less than 6 months. When the diagnosis must be made without waiting for recovery, it should be qualified as “provisional.” '

About one-third of individuals with an initial diagnosis of schizophreniform disorder (provisional) recover within the 6-month period and C. Schizoaffective

N/A

- anti-psychotics These include: Risperidone (Risperdal®) Clozapine (Clozaril®) Quetiapine (Seroquel®)

Hallucinations.

4. Development

at least 1 month but less than 6 months.

disorder

and

Ziprasidone (Geodon®) Olanzapine (Zyprexa®) Iloperidone (Fanapt®) Paliperidone (Invega®) Asenapine (Saphris®) Lurasidone (Latuda® Psychotherapy - Family therapy

schizophreniform disorder is their final diagnosis. 

The majority of the remaining two-thirds of individuals will eventually receive a diagnosis of schizophrenia or schizoaffective disorder.

depressive or bipolar disorder with psychotic features have been ruled out because either 1 ) no major depressive or manic episodes have occurred concurrently with the active-phase symptoms, or 2) if mood episodes have occurred during active-phase symptoms, they have been present for a minority of the total duration of the active and residual periods of the illness. D. The disturbance is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition. Specify if: With good prognostic features: This specifier requires the presence of at least two of the following features: onset of prominent psychotic symptoms within 4 weeks of the first noticeable change in usual behavior or functioning; confusion or perplexity: good premorbid social and

After the person’s symptoms are better, he or she should continue treatment for 12 months. This includes gradually reducing the dosage of medication and carefully monitoring the person for signs of relapse (return of symptoms). Also, it is important to educate the person and the person’s family to help them cope with the illness and to detect early signs of relapse.

occupational functioning; and absence of blunted or flat affect. Without good prognostic features: This specifier is applied if two or more of the above features have not been present. Specify if: With catatonia (refer to the criteria for catatonia associated with another mental disorder, pp. 119-120, for definition). Coding note: Use additional code 293.89 (F06.1) catatonia associated with schizophreniform disorder to indicate the presence of the comorbid catatonia. Specify current severity: Severity is rated by a quantitative assessment of the primary symptoms of psychosis, including delusions, hallucinations, disorganized speech, abnormal psychomotor behavior, and negative symptoms. Each of these symptoms may be rated for its current severity

(most severe in the last 7 days) on a 5-point scale ranging from 0 (not present) to 4 (present and severe). (See Clinician-Rated Dimensions of Psychosis Symptom Severity in the chapter “Assessment Measures.”) Note: Diagnosis of schizophreniform disorder can be made without using this severity specifier

III. Schizoaffective Disorder A. An uninterrupted period of illness Genetic and physiological. 2 or more weeks during which there is a major  Among individuals with Prevalence mood episode (major depressive schizophrenia, there may or manic) concurrent with  appears to be about one-third as be an increased risk for Criterion A of schizophrenia. common as schizophrenia. schizoaffective disorder Note: The major depressive in first-degree relatives. episode must include Criterion  Lifetime prevalence of schizoaffective disorder is estimated A1 : Depressed mood.  The risk for to be 0.3%. The incidence of schizoaffective disorder schizoaffective disorder is higher in B. Delusions or hallucinations for 2 may be increased among or more weeks in the absence of a females than in males, mainly due to individuals who have a major mood episode (depressive an increased incidence of the first-degree relative with or manic) during the lifetime depressive type among females. schizophrenia, bipolar duration of the illness. disorder, or



substance disorders

use Medical Treatment



anxiety disorders

Anti-psychotics (paliperidone (invega)) Mood-stabilizing medications -Antidepressants Psychotherapy - Individual therapy -

Family

or

group

C. Symptoms that meet criteria for a major mood episode are present Development for the majority of the total duration of the active and residual  The typical age at onset of portions of the illness. schizoaffective disorder is early adulthood, although onset can occur D. The disturbance is not attributable anywhere from adolescence to late to the effects of a substance (e.g., in life. a drug of abuse, a medication) or another medical condition.  A significant number of individuals diagnosed with another psychotic illness initially will receive the diagnosis schizoaffective disorder later when the pattern of mood episodes has become more apparent. 

295.70 (F25.0) Bipolar type: This subtype applies if a manic episode is part of the presentation. Major depressive episodes may also occur. 295.70 (F25.1) Depressive type: This subtype applies if only major depressive episodes are part of the presentation.

With the current diagnostic Criterion C, it is expected that the diagnosis for some individuals will convert from schizoaffective disorder to another disorder as mood Specify if: symptoms become less prominent.

With catatonia (refer to the criteria for catatonia associated with another Schizoaffective disorder may run a mental disorder, pp. 119-120, for unique course in each affected definition). person, so it's not as well-understood or well-defined as Coding note: Use additional code

Course 

Specify whether:

schizoaffective disorder.

therapy Life skills training - Social skills training Vocational rehabilitation and supported employment Hospitalization Electroconvulsive Therapy

other mental health conditions.

293.89 (F06.1) catatonia associated with schizoaffective disorder to indicate the presence of the comorbid catatonia. Specify if: The following course specifiers are only to be used after a 1 -year duration of the disorder and if they are not in contradiction to the diagnostic course criteria. First episode, currently in acute episode: First manifestation of the disorder meeting the defining diagnostic symptom and time criteria. An acute episode is a time period in which the symptom criteria are fulfilled. First episode, currently in partial remission: Partial remission is a time period during which an improvement after a previous episode is maintained and in which the defining criteria of the disorder are only partially fulfilled. First

episode,

currently

in

full

remission: Full remission is a period of time after a previous episode during which no disorder-specific symptoms are present. Multiple episodes, currently in acute episode: Multiple episodes may be determined after a minimum of two episodes (i.e., after a first episode, a remission and a minimum of one relapse). Multiple episodes, partial remission

currently

in

Multiple episodes, currently in full remission Continuous: Symptoms fulfilling the diagnostic symptom criteria of the disorder are remaining for the majority of the illness course, with subthreshold symptom periods being very brief relative to the overall course.

Specify current severity: Severity is rated by a quantitative assessment of the primary symptoms of psychosis,

including delusions, hallucinations, disorganized speech, abnormal psychomotor behavior, and negative symptoms. Each of these symptoms may be rated for its current severity (most severe in the last 7 days) on a 5-point scale ranging from 0 (not present) to 4 (present and severe). (See Clinician-Rated Dimensions of Psychosis Symptom Severity in the chapter “Assessment Measures.”) Note: Diagnosis of schizoaffective disorder can be made without using this severity specifier

IV. Delusional Disorder

Prevalence 

Lifetime prevalence estimated at around 0.2%, and the most frequent subtype is persecutory.

A. The presence of one (or more) Genetic 1month or more delusions with a duration of 1  It is believed that, as with month or longer. other mental disorders, a B. Criterion A for schizophrenia has tendency to develop never been met. Note: delusional disorder might be passed on from parents Hallucinations, if present, are not to their children. prominent and are related to the delusional theme (e.g., the sensation of being infested with Biological insects associated with delusions  Abnormalities in the

N/A

Medical Treatment - Antipsychotic drugs - Antidepressants Mood-stabilizing medications Psychotherapy Cognitive Behavioral

Development 

Although it can occur in younger age groups, the condition may be more prevalent in older individuals.

Course 

of infestation).

functioning of brain regions that control perception and thinking may be linked to the formation of delusional symptoms.

C. Apart from the impact of the delusion(s) or its ramifications, functioning is not markedly impaired, and behavior is not obviously bizarre or odd.

Has a significant familial D. If manic or major depressive relationship with both schizophrenia episodes have occurred, these and schizotypal personality disorder have been brief relative to the duration of the delusional periods. E. The disturbance is not attributable to the physiological effects of a substance or another medical condition and is not better explained by another mental disorder, such as body dysmorphic disorder or obsessive-compulsive disorder. Specify whether: Erotomanie type: This subtype applies when the central theme of the delusion is that another person is in love with the individual. Grandiose type: This subtype applies

Environmental/psychologica l 

Evidence suggests that delusional disorder can be triggered by stress



Alcohol abuse also contribute condition.



People who tend to be isolated, such as immigrants or those with poor sight and hearing, appear to be more vulnerable to developing delusional disorder.

and drug might to the

Disorder

when the central theme of the delusion is the conviction of having some great (but unrecognized) talent or insight or having made some important discovery. Jeaious type: This subtype applies when the central theme of the individual’s delusion is that his or her spouse or lover is unfaithful. Persecutory type: This subtype applies when the central theme of the delusion involves the individual’s belief that he or she is being conspired against, cheated, spied on, followed, poisoned or drugged, maliciously maligned, harassed, or obstructed in the pursuit of long-term goals. Somatic type: This subtype applies when the central theme of the delusion involves bodily functions or sensations. Mixed type: This subtype applies when no one delusional theme predominates.

Unspecified type: This subtype applies when the dominant delusional belief cannot be clearly determined or is not described in the specific...