CH 13 Schizophrenia and other Psychotic Disorders Flashcards
Hallucination
Sensory experience that seems real to the person having it, but occurs without any external perceptual stimulus
DSM Criteria
Schizophrenia
A. 2 or more present for significant time during 1-month period(at least 1 must be 1, 2, or 3)
* Delusions
* Hallucinations
* Disorganized speech
* Grossly disorganized or catatonic behavior
* Negative symptoms
B. Level of functioning in 1+ areas is markedly low
C. Continuous signs of disturbance persist for 6+ months
D-E. It’s not something else
F. If history of ASD/childhood communication disorder, schizophrenia is only diagnosed if prominent delusions or hallucinations are present
Delusion
Erroneous belief that is fixed and firmly held despite clear contradictory evidence
Disorganized speech
External manifestation of a disorder in thought form
Person fails to make sense
Disorganized behavior
Impairment in goal-directed activity and daily functioning
Catatonia
Virtual absence of all movement & speech
Catatonic stupor
Positive symptoms vs. Negative symptoms
P: excess or distortion in normal behavior/experience (eg. delusions and hallucinations)
N: abscence or deficit of normal behaviors
List Examples
Negative Symptoms
The absence of normal behavior:
* Alogia
* Avolition
* Anhedonia
* Flat or blunted affect
Define
Alogia
Absence of speech
Define
Avolition
The inibility to initiate or persist in goal directed behavior
DSM Criteria
Schizoaffective Disorder
A. Uninterrupted period of illness during which there is a major mood episode concurrent with Criterion A of schizophrenia
B. Delusions or hallucinations for 2+ weeks in absence of major mood episode during lifetime duration of illness
C. Symptoms that meet criteria for major mood episode are present for the majority of the total duration of the active and residual portions of the illness
D. Disturbance is not attributable to effects of a substance or other condition
DSM Criteria
Schizophreniform Disorder
A. 2+ of the following, each for a significant portion of time during 1+ month, at least 1 must be 1, 2, or 3
* Delusions
* Hallucinations
* Disorganized speech
* Grossly disorganized or catatonic behavior
* Negative symptoms
B. Episode of disorder lasts 1+ month, less than 6 months
C-D. Other disorders ruled out
DSM Criteria
Delusional Disorder
A. Presence of 1+ delusion for 1+ month
B. Schizophrenia criteria A not met
C. Apart from impact of delusion(s), functioning isn’t markedly impaired
D. Mood episodes (if occured) must be brief
E. Not attributable to other disorders
DSM Criteria
Brief Psychotic Disorder
A. Presence of 1+ of the following, 1 must be 1, 2, or 3
* Delusions
* Hallucinations
* Disorganized speech
* Grossly disorganized or catatonic behavior
B. Duration of an episode is at least 1 day, less than 1 month, eventual full return to premorbid levels of functioning
C. Disturbance not better explained by other conditions
Neurotransmitters implicated in Schizophrenia
Dopamine & Glutamate
Psychosis
Significant loss of contact with reality
Risk factors for Schizophrenia
Age of father over 50, birth trauma, more severe/earlier onset in men
List the psychotic symptoms of schizophrenia
Delusions, hallucinations, disorganized speech
Command Hallucinations
Tell you what to do
List examples of disorganized speech
Neologisms, loose associations, derailment, clanging, word salad
Neologisms
Person uses words they made up (believes they are real/correct)
Loose associations
Rapid jumps between topics
Derailment
Jumps between topics without finishing them
Clanging
Strings of rhythmic sounds or words
Word salad
Speaking only in meaningless sounds or words
Motor rigidity
Slow and rigid
Waxy flexibility
Moldable like wax
Catatonic stupor
Absence of speech and movement
Purposeless excitement
Unusual excitatory movements
Alogia
Absence of speech
Differentiate between in 4 words or less
- Schizoaffective Disorder
- Schizophreniform Disorder
- Delusional Disorder
- Brief Psychotic Disorder
- Schizoaffective Disorder: Schizophrenia + Mood Disorder
- Schizophreniform Disorder: Gateway diagnosis
- Delusional Disorder: Delusions ONLY
- Brief Psychotic Disorder: Sudden, brief psychotic episode
Describe
The influence of genetics on schizophrenia
- More common in monozygotic twins
- COMT impacts dopamine metabolism
- DISC-1
- Genome-wide association Studies
- Hundreds of genes involved
Describe
Prenatal risks for schizophrenia
- Viral infection - 2nd trimester flu in mother
- Mom’s BT is -, baby’s is +
- Birth complications - hypoxia
- Early nutritional deficiency
- Maternal stress
Describe
Structural & functional brain abnormalities associated with schizophrenia
- Loss of volume
- Hippocampus, amygdala, thalamus
- Enlarged ventricles
- White matter problems
- Dysconnectivity
Define
Neuroleptic Malignant Syndrome
- Fatal if untreated
- High fever
- Extreme muscle rigidity
- Side effect of first-gen antipsychotics
List examples
First-gen Antipsychotics
- Thorazine
- Haldol
Define & Give an example
Extrapyramidal Side Effects
- Involuntary or uncontrollable movements
- Tremors
- Muscle contractions
- More common in first-gen antipsychotics
- Tardive dyskenesia - involuntary repetitive body movements, which may include grimacing, sticking out the tongue or smacking the lips
