“a”= no, lexi= “words”, thymia= “feeling”; inability to express feelings in words;

Somatization Disorders

Somatization= Spontaneous physical SS in many organ systems

Conversion disorder is a neurosis marked by the appearance of physical symptoms such as partial loss of muscle function without physical cause but in the presence of psychological conflict. Symptoms include numbness, blindness, paralysis, or fits without a neurological cause. It is thought that these problems arise in response to difficulties in the patient's life.

In short, conversion disorders are neurological while somatoforms involve many organ systems.

Conditions that involve disruptions or breakdowns of memory, awareness, identity and/or perception.

People with dissociative disorders are able to escape from reality involuntarily.

Typically the development of these orders are the reaction to some sort of trauma, used as a coping mechanism to avoid thinking about difficult memories (wiki).

Sudden amnesia, often related to traumatic experience (subconscious memory suppression to protect yourself),

aka Psychogenic Amnesia

From Wiki: A rare psychiatric disorder characterized by reversible amnesia for personal identity, including the memories, personality, and other identifying characteristics of individuality.

Usually short-lived (hours to days), but can last months or longer.

Usually involves unplanned travel or wandering, and is sometimes accompanied by the establishment of a new identity.

TRUE;

These patients have a serious mental illness.

FALSE

Malingerers are aware of what they are doing and are motivated by secondary gain. This is not considered a medical diagnosis.

Loosening of associations,

Incoherence (word salad),

Neologisms (creating new words),

Mutism,

Echolalia (repetition of the words of others),

Clanging (rhyming/alliteration),

and Verbigeration (Meaningless repetition of words/phrases, not req external stim to elicit)

Catalepsy= waxy flexibility- like an action figure (holds position when placed there by someone else);

Typically discussed as a symptom of catatonic schizophrenia.

Bizarre illusions are impossible (garden gnomes never speak, a person couldn't have had dinner with a dead individual);

The presence of Bizarre delusions is sufficient to make a diagnosis of schizophrenia alone (normally req 2+ Sx)

(Wiki) The dopamine hypothesis of psychosis/schizophrenia is a model attributing symptoms of schizophrenia (like psychoses) to a disturbed and hyperactive dopaminergic signal transduction.

Draws evidence from the observation that a large number of antipsychotics have DA-antagonistic effects. The theory, however, does not posit dopamine overabundance as a complete explanation for schizophrenia.

Amphetamine and coke and similar drugs ↑ DA in the brain and can cause sx resembling those present in psychosis. This is often referred to as "Amphetamine/Cocaine psychosis" but may produce experiences virtually indistinguishable from the + Sx assoc w/ schizophrenia.

Pt tx w/ DA-enhancing levodopa for PD can experience psychotic SE mimicking the sx of schizo.

Up to 75% of patients with schizophrenia have ↑ S/Sx of their psychosis upon challenge with moderate doses of methyphenidate or amphetamine or other DA-like compounds, all given at doses at which control nl volunteers do not have any disturbing efx.

fMRI studies have also shown that, after taking amphetamine, patients diagnosed with schizo show ↑ levels of DA release than non-psychotic pt.

Phenothiazines, incl antipsychotics such as chlorpromazine, has been found to antagonize DA binding (esp @ D2) and ↓ + psychotic symptoms (also true with haldol).

Other experiments suggested that the binding affinity of antipsychotic drugs for D₂ receptors is inversely proportional to their therapeutic dose. This correlation, suggests that receptor binding is causally related to therapeutic potency.

It has been suggested also that specific variants of genes, that code for mechanisms involved in DA function, which may be more prevalent in people experiencing psychosis or diagnosed with schizophrenia. Dopamine related genes linked to psychosis in this way incl COMT, DRD4 and AKT1^.

Schizophrenics appear to have a high rate of self-medication w/ nicotine; the effect likely occurs through DA modulation by nicotinic Ach receptors.

2+: Delusions, hallucinations, disorganized thinking, disorganized or catatonic speech, or negative symptoms (deficits of normal emotional responses/thought processes. Respond less well to meds.Incl flat/blunted affect and emotion, alogia, anhedonia, asociality and avolition);

Note that if delusions are bizarre, or hallucinations consist of hearing one voice participating in a running commentary of the patient's actions or of hearing two or more voices conversing with each other, only that symptom is required above.

The speech disorganization criterion is only met if it is severe enough to substantially impair communication (Wiki).

Duration of Sx >6 months;

Psychosis only when the mood episodes flare; usually associated with grandiose disorders; psychosis resolves with euthymia.

Note that this is unlike schizoaffective disorder where psychotic features remain during periods of euthymia.