Transcript Genetics of Schizophrenia

Are You Crazy?
is micronationalism
explained by mental disorder?
Eric Lis
MD,CM
Why me?
MD.,CM 2010
Residency
Research
McGill University Psychiatry Perceptions
of Emerging Technologies Labs
Disclosures
Relevant biases
Conflicts of interest
Financial incentives
Case
Mr. L.
30 yo M
Ashkenazi Jewish origin
Single, longest relationship 5 years
Works full time
Good social supports (family, friends, etc)
O/E, Mr. L insists he rules a small country as its
“emperor” and to have hundreds of “citizens.”
Otherwise, no grandiosity, paranoia, homicidality,
suicidality. Thoughts logical, goal-directed.
What is mental disorder?
“illness” vs “disorder”
“sick” vs “crazy”
subjective vs objective
function vs dysfunction
“normal” as per the DSM, ICD, CCMD…
micronationalists
Grandiosity
Odd or uncommon beliefs
Argumentativeness
Depression?
Substance dependence?
Alzheimer’s Disease?
Anxiety?
Schizophrenia
Schizophrenia vs psychosis
schizoaffective disorder
delusional disorder
brief psychotic episode
What it is
What it isn’t
Bipolar Disorder
Mania and depression
Psychosis and “mood congruency”
“Happy manics” and “angry manics”
elevated, expansive, and irritable
Time course:
>1 week
Hypomania: when cheerfulness is bad for you
Autism
(A) A total of six (or more) items from (1), (2), and (3), with at least two from (1), and one each from (2) and (3)
(1) qualitative impairment in social interaction, as manifested by at least two of the following:
1. impairments in use of nonverbal behaviors (eye-to-eye gaze, facial expression) in social interaction
2. failure to develop peer relationships appropriate to developmental level
3. lack of spontaneous seeking to share enjoyment, interests, or achievements with other people
4. lack of social or emotional reciprocity (not participating in simple social play or games)
(2) qualitative impairments in communication as manifested by at least one of the following:
1. delay in, or total lack of, the development of spoken language (without attempt to compensate)
2. in individuals with adequate speech, impairment in the ability to initiate or sustain a conversation
3. stereotyped and repetitive use of language or idiosyncratic language
4. lack of varied, make-believe play or social imitative play appropriate to developmental level
(3) restricted repetitive and stereotyped patterns of behavior and interests as manifested by at least two of:
1. preoccupation with restricted patterns of interest that is abnormal either in intensity or focus
2. apparently inflexible adherence to specific, nonfunctional routines or rituals
3. stereotyped and repetitive motor mannerisms (e.g. hand or finger flapping or twisting)
4. persistent preoccupation with parts of objects
(B) Delays or abnormal functioning in at least one of the following areas, with onset prior to age 3 years:
(1) social interaction
(2) language as used in social communication
(3) symbolic or imaginative play
(C) The disturbance is not better accounted for by (other diagnoses)
Asperger’s Disorder
Diagnosable via Microwiki?
Personality disorders
“a pervasive pattern of maladaptive behaviours”
When does
“who are you”
become pathological?
Schizotypal personality
“Cognitive or perceptual distortions”
“Eccentricities” outside the “norms of subculture”
Social deficits, lack of confidants/close friends
social anxiety vs paranoia
Borderline Personality
Impulsivity
Sense of emptiness or “identity disturbance”
Emotions are unstable and “too big”
Terror of being abandoned
Chronic suicidal ideation, non-suicidal self-harm
Antisocial Personality
Disregard for the rights of others
Impulsivity/irresponsibility
Aggressiveness, criminality
Lack of empathy and remorse
Histrionic personality
Excessive, rapid shifting, “shallow” emotions
Attention-seeking
Self-dramatizing and theatrical
Overly familiar and intimate
Not “culturally appropriate”
Narcissistic personality
Grandiose sense of self-importance
Preoccupied by fantasies of own success
Belief in own uniqueness, “specialness”
Exploitative, lacking in empathy
Sense of entitlement
So…
So…
does that mean everybody’s crazy?
or just you?
But are you sick?
“The symptoms cause a clinically
significant distress or impairment
in social, occupational, or other
important areas of functioning.”
The bottom line
Is micronationalism
explained by mental disorder?
Do you:
have friends and family?
a job and/or scholastic success?
hobbies you share with others?
money/organization to make it to Polination?
The bottom line
Congratulations!
You might be weird,
but you aren’t crazy
Questions
and discussion