Bipolar, schizophrenia, and psychosis Flashcards
what is most most common comorbidity in children with bipolar disorder
ADHD
criteria for pediatric maic episode
same as for adult
emotions and mood in early onset bipolar
typically intensely emotional with fluctuating but overriding negative mood
what is typically frequent when manic episode is in an adolescent
psychotic features
predictors of rapid cycling
low socioeconomic status
presence of lifetime psychosis
dx of bipolar not otherwise specified
which antipsychotics are approved for early onset bipolar
olanzapine
quetiapine
risperidone
aripiprazole
ziprasidone
treatment modalities for early onset bipolar
pharmacotherapy
psychoeducation
psychosocial intervention w/ family and child
school interventions
recovery rate for early onset bipolar when occurring in young children
low
what are there higher risks of in early onset bipolar in young children
mixed states
rapid cycling
polarity changes
which antipsychotics work faster than depakote when treating early onset bipolar disorder
quetiapine and risperidone
which mood stabilizers have proven effective in early onset bipolar
depakote
lithium
are mood stabilizers or atypical antipsychotics more effective for early onset bipolar disorder
atypical antipsychotics
what is the first step in family focused therapy approach for early onset bipolar diorder
several sessions of psychoeducation
what is the second phase of family focused treatment for early onset bipolar disorder
several sessions focusing on current stressors and a mood management plan
what is the third phase of family focused treatment for early onset bipolar disorder
several sessions of communication enhancement training and problem solving skills training
what is often part of bipolar presentation in adolescents
psychotic features
which medications work faster than depakote for pediatric bipolar
quetiapine and risperidone
how frequent is early onset bipolar
more common in adolescents than younger children but still rare
early onset bipolar disorder is hypothesized as more severe characterized by what 5 things
-more mixed episodes
-greater psych comorbidity
-more lifetime psychotic sx
-poor response to prophylactic lithium
-greater heritability
what may be a predictor of poor response to risperidone and valproate
increased amygdala activity
common impairments in early onset bipolar disorder
-verbal memory
-processing speed
-executive function
-working memory
-attention
high number of emotional recognition errors
risk is increased for what disorders if disrupted mood dysregulation disorder is present
anxiety/depressive disorders not bipolar
what are the main differential diagnoses to distinguish between when considering early onset bipolar dx
ADHD
ODD
conduct disorder
anxiety/depressive disorders
onset for early onset schizophrenia
any age under 18
what is considered childhood onset schizophrenia
psychotic symptoms under age 13
what is early onset schizophrenia associated with compared to adult schizophrenia
-more chronic course
-more severe social/cognitive consequences
-increased negative sx
what can replace deterioration in function when considering early onset schizophrenia
failure to achieve expected social/academic functioning
what is likely to be in the premorbid hx of early onset schizophrenia
social rejection
poor peer relationships
clingy withdrawn behavior
academic trouble
what is different about hallucination type in early onset schizophrenia
auditory still most common but there is higher than expected rate of tactile, olfactory, and visual hallucination
What affect is universal in early onset schizophrenia
blunted/flat
3 most frequent comorbidities with early onset schizophrenia
ADHD
ODD
MDD
what is required in addition to hallucinations for dx of early onset schizophrenia
functional deterioration or failure to meet expected social/academic functioning
medical conditions that can cause psychosis
thyroid disease
SLE
temporal lobe disease
Poor prognostic predictors for early onset schizophrenia course
-family hx
-young age and insidious onset
-developmental delays
-lower premorbid functioning
-long initial psychotic episode
nonpharmacologic interventions for early onset schizophrenia
-family psychoeducation
-psychotherapy
-social skills interventions
-appropriate educational placement
what is the preferred antipsychotic for early onset schizophrenia and why
risperidone as it is as effective as higher potency drugs with less severe side effects
attenuated psychosis syndrome
subthreshold psychotic symptoms less severe than in psychotic disorders
what is often present in prodromal state of early onset schizophrenia
attenuated psychosis syndrome
diagnostic criteria for attenuated psychosis syndrome
-delusions, hallucination, or disorganized speech that causes functional impairment
frequency/duration of sx in attenuated psychosis syndrome
sx present at least once weekly for at least a month and have emerged or worsened over the last year
treatment of attenuated psychosis syndrome
therapy over meds as evidence is conflicting
prenatal risk factors for attenuated psychosis syndrome
fetal malnutrition
hypoxia at birth
prenatal infections
environmental risk factors for attenuated psychosis syndrome
trauma
stress
social adversity
isolation
