7B: Thought Disorders Flashcards
Schizophrenia
a disorder characterized by positive symptoms; hallucinations, delusions, disorganized speech and thought; negative symptoms: absence of normal cognition or affect, flat affect, poverty of speech, and lack of motivation; and cognitive symptoms: problems with working memory and attention
Hallucination (+ symptom)
a perception in the absence of a stimulus. Defined as perceptions in a conscious and awake state in the absence of external stimuli which have qualities of real perception, in that they are vivid, substantial, and located in external objective space.
Delusion (+ symptom)
an idiosyncratic, irrational belief or impression that is firmly maintained despite being contradicted by what is generally accepted as reality or rational argument, typically a symptom of mental disorder
Disorganized speech/ thought (+ symptom)
-over inclusion: jumping from idea to idea without the benefit of logical association
- paralogic thought: on the surface of thinking may appear logical, but is actually seriously flawed. EX: Jesus was a man with a beard, I am a man with a beard, therefore I am Jesus.
Flat affect (- symptom)
affect is a medical term for mood. A patient with a flat affect has very little reaction to events around them; they display little to no emotion physically, and may not feel emotions very much either.
Inappropriate affect (- symp)
the mood affect the patient displays does not match the circumstances.
EX. laughing at very serious things, crying at funny things
catatonic behavior (- symp)
unresponsiveness to environment, usually marked by immobility for extended periods and echolalia.
echolalia
parrot like speech
waxy flexibility
a psychomotor symptom of catatonic schizophrenia which leads to decreased response to stimuli and a tendency to remain in an immobile posture
paranoid type
well formed hallucinations and delusions; mostly positive symptoms and fewer negative symptoms. most common and best prognosis.
Disorganized type
Disorganized speech, silly behavior, and flat affect /
disturbed emotional expression; Delusions and hallucinations are less pronounced
than in the paranoid type and have little meaning or logic. Patients tend to be
incoherent/unintelligible and have issues with daily self-care. Also known as
hebephrenic (‘childish behavior’)
Residual type
Primarily displays negative symptoms like flat affect, reduced
speech, lack of motivation
Catatonic type
Unresponsive to surroundings with echolalia, waxy flexibility; rare
Undifferentiated type
Combination of hallucinations, specific delusions, and general disorganization - No single symptom type is most prominent. As with undifferentiated versions of other neuropsych disorders, these patients don’t fit
well into other categories
Congenital risks (cause of schizophrenia)
difficult birth (e.g., oxygen deprivation); prenatal viral infection (e.g.,
flu)
Brain structure changes
enlarged ventricles, decreased hippocampus and amygdala, loss of temporal and frontal cortex
Hypofrontality hypothesis
theory that problems in the frontal lobe are
associated with schizophrenia: For example, in identical twins, the one with
schizophrenia has decreased blood flow to the frontal lobes. Also, schizophrenics
have problems with executive function tasks like the Wisconsin card sorting task.
This evidence suggests that genetic and environmental changes to the frontal
lobes may cause schizophrenia.
Dopamine
a neurotransmitter that affects mood, energy, sexual desire and motor
coordination; May play a role in schizophrenia, especially with hallucinations.
Antipsychotic meds decrease dopamine
Glutamate
a key excitatory neurotransmitter. Some evidence suggests that
glutamate decreases may be correlated with schizophrenia. Meds that increase
glutamate, however, do not help symptoms (but do increase the risk of seizures)
Anti-psychotic medications
typical antipsychotic (older, more side effects), decreases dopamine brain-wide; primary effect is on positive symptoms. Atypical antipsychotics (fewer side effects) – affect dopamine pathways in more complex form and may also interact with serotonin pathways; primary effect is on positive symptoms, also some negative ones
tardive dyskinesia
a possibly permanent disorder of involuntary, repetitive,
purposeless movements as a side effect of long-term or high-dose use of
dopamine antagonists like antipsychotics. Compare to L-Dopa meds for
Parkinson’s disease, which cause psychosis (abnormal cognition like delusions
and hallucinations) in patients with PD by increasing dopamine too much. Here
the antipsychotics decrease dopamine so much that patients may develop
movement disorders - tardive dyskinesia specifically.
Electroconvulsive shock therapy (ECT)
used mainly in catatonic schizophrenia
occupational therapy
self care, work options
Schizophreniform disorder –
a disorder in the schizophrenic spectrum characterized by symptoms of schizophrenia for less than 6 months, less social dysfunction than schizophrenia, and a more likely recovery. May simply be early diagnosis of schizophrenia.
Schizoaffective disorder
a disorder in the schizophrenic spectrum characterized by mood changes and psychosis (think schizophrenia plus bipolar disorder)
Schizotypal personality disorder
a personality disorder in the schizophrenic spectrum characterized by symptoms of paranoia, social anxiety, inappropriate and reduced affect, lack of close relationships, magical thinking, and vague metaphorical speech. These symptoms resemble the positive symptoms of schizophrenia, which is why it is included in the spectrum.
Magical thinking
a thought pattern commonly seen in schizotypal personality disorder in which the patient experiences fear of performing certain acts or having certain thoughts because of an assumed correlation between doing so and
threatening calamities. Magical thinking may lead people to believe that their thoughts by themselves can bring about effects in the world or that thinking something corresponds with doing it.
Schizoid personality disorder
a personality disorder in the schizophrenic spectrum characterized by a lack of interest in social relationships, a tendency towards a solitary lifestyle, secretiveness, and emotional coldness. These symptoms resemble the negative symptoms of schizophrenia, which is why it is included in the spectrum. Such patients often act like hermits, happily withdrawing from society.
