Approach to Psychotic DOs

Question 1

What are the symptoms of schizophrenia?

Answer 1

Positive sym.: Delusions, hallucinations, catatonia, agitation.
Negative sym.: Flat affect, apathy, social withdrawal, anhedonia, poverty of thought, content of speech

Question 2

Epidemiology of schizophrenia?

Answer 2

Prominent in men and women equally but presents earlier in life in men.

Higher prevalence in lower socioeconomic classes

Question 3

Etiology of schizophrenia?

Answer 3

Drug abuse, traumatic events and psychosocial stressors

Question 4

Pharmacologic tx of schizophrenia?

Answer 4

1st Gen. - blocks dopamine receptors:
Haloperidol, Fluphenazine, Lorazepam.

2nd Gen. - blocks dopamine R and affects serotonin activity:
Clozepine, Risperidone, Olanzapine, Quetiapine, Ziprasidone (QTc prolondation), Iloperidone, Aripiprazole

Question 5

Schizophrenia subtypes (5)

Answer 5

1. Paranoid
2. Disorganized
3. Catatonic
4. Undifferentiated
5. Residual

Question 6

Catatonic schizophrenia criteria

Answer 6

Has at least 2 of the following

• motoric immobility (catalepsy or stupor)
• Excessive, purposeless, motor activity
• Extreme negativity or mutism
• Peculiarities of voluntary movement
• Echolalia or echopraxia

Question 7

What is schizoaffective DO?

Answer 7

Uninterrupted period of illness with a major depressive or manic episode concurrent with symptoms of schizophrenia.

Question 8

Brief Psychotic DO

Answer 8

Duration of an episode of delusions, hallucinations, disorganized speech, disorganized or catatonic behavior for 1 day and no more than 1 mo., returning to premorbid level of functioning after episode

Question 9

Schizophreniform

Answer 9

An episode of the disorder that lasts at least 1 mo but less than 6 mo.’s

Question 10

Schizophreniform

Answer 10

An episode of the disorder that lasts at least 1 mo but less than 6 mo.’s

Question 11

Delusional DO

Answer 11

Delusions of at least 1 mo duration but has never met the criterion A for schizophrenia Functioning is not impaired.

Question 12

The “schizo spectrum”

Schizoid, schizotypal, schizophrenia, schizoaffective

Answer 12

Schizoid - v. introverted & VOLUNTARILY withdraws from social interactions
Schizotypal - Schizoid + magical thinking and odd behavior
Schizophrenia - Schizotypal + psychosis
Schizoaffective - Schizophrenia + mood DO