777 schizophrenia Flashcards
PSYCHOSIS:
symptom state that refers to the presence of reality misinterpretations, disorganized thinking, and lack of awareness regarding true and false reality.
Schizophrenia is Defined by abnormalities in 1 of the following 5 domains
Delusions Hallucinations Disorganized thinking Grossly disorganized or abnormal motor behavior, including catatonia Negative symptoms
Delusions
Fixed false beliefs:
Delusions: Persecutory:
belief that one is going to be hurt, harassed by an individual organization
Delusions: Referential:
belief that certain gestures, comments, environmental cues are directed at oneself
Delusions: Grandiose:
belief that one has exceptional abilities, wealth or fame
Delusions: Erotomanic:
belief that another person is in love with him or her
Delusions: Nihilistic:
belief that a major catastrophe will occur
Delusions: Somatic:
beliefs and preoccupations regarding health and organ function
Delusions defined as bizarre when:
they are clearly implausible and not understandable to same culture peers
Thought withdrawal:
thoughts have been removed by an outside force
Thought insertion:
thoughts have been put into one’s mind
Delusions of control:
one’s body or actions are being manipulated by an outside force
Hallucinations
Perception like experiences that occur without an external stimulus
Vivid, clear with the full-force and impact of normal perceptions
Not under voluntary control
Occur in any sensory modality: auditory, visual, olfactory, tactile, gustatory
Auditory most common:
Disorganized Thinking (Speech)
Formal thought disorder
Inferred from person’s speech
Loose associations/derailment
Tangential speech
Word salad
Must be severe enough to substantially impair effective communication
Grossly Disorganized or Abnormal Behavior
Catatonic: marked decrease in reactivity to the environment
Range from resistance to instructions to complete lack of verbal or motor responses (mutism, stupor)
Catatonic excitement: excessive motor activity without a purpose/cause
Usually associated with schizophrenia
Can be present in Bipolar Disorder, MDD and some medical conditions
Negative Symptoms
Associated with schizophrenia Diminished emotional expression Avolition: lack of motivation Alogia: inability to speak Anhedonia: lack of pleasure Asociality Account for a substantial portion of the morbidity associated with schizophrenia
Schizophrenia
Clinical syndrome of variable but profoundly disruptive, psychopathology that involves cognition, emotion, perception, and other aspects of behavior
Estimated to account for approximately 2.5 percent of all health care costs
Not a homogeneous disorder with a single cause
WHO one of the 10 leading causes of disability
Schizophrenia Diagnostic Criteria
Criteria A. Two or more of the following, present for a significant amount of time during a one month period, at least one of the symptoms must be 1, 2 or 3
1. Delusions 2. Hallucinations 3. Disorganized speech 4. Grossly disorganized or catatonic behavior 5. Negative symptoms
Schizophrenia Diagnostic Criteria (continued)
Criteria B. Level of functioning in one or more major area such as work, interpersonal relations, or self care is markedly below the level achieved prior to onset
Criteria C. Continuous signs persist for at least 6 months, must include one month of Criteria A
Criteria D. Schizoaffective disorder and bipolar disorder have been ruled out
Criteria E. Disturbance not attributable to physiological effects of a substance or another medical condition
In autism spectrum or communication disorders, the additional diagnosis of schizophrenia is made if delusions and hallucinations are present
Schizophrenia Epidemiology
Lifetime prevalence in the US is 1%
Higher incidence in urban areas of industrialized nations
Found in all societies and geographic areas
Only about ½ of all patients with schizophrenia obtain treatment
Equally prevalent in men and women
Onset earlier in men
Peak age of onset 10-25 years in men, 25-35 years for women
1st degree biological relatives of persons with schizophrenia have a 10 times greater risk for developing the disease
Persons with schizophrenia have a higher mortality rate
80% of patients have significant concurrent medical illnesses
More likely to have been born in winter and early spring
Prenatal exposure to influenza
Substance abuse common co-morbidity and associated with poorer function
90% of persons with schizophrenia may be dependent on nicotine
Patients with schizophrenia account for 15-45% of the homeless population in US
Occupy 50% of all psychiatric inpatient beds
Biochemical Factors
Dopamine hypothesis: schizophrenia results from too much dopaminergic activity
Serotonin excess
GABA loss in hippocampus
