CH 16 Flashcards
Schizophrenia
Positive Symptoms
Delusions
Hallucinations
Disorganized thinking, speech, and behavior (psychosis)
- associative looseness
- bizarre behavior
- echolalia
- echopraxia
- flight of ideas
Ambivalence
Ideas of Reference
Perseveration
Negative Symptoms
Flat affect
Anhedonia
Lack of volition (Avolition)
Social withdrawal or discomfort (Asociality)
Alogia
Apathy
Blunted affect
Catatonia (involves echolalia, echopraxia)
Inattention
Schizoaffective Disorder (SCA/SAD), diagnosis:
Psychosis +
Mood disorder (depression or bipolar disorder)
Uninterrupted illness:
Positive or negative symptoms (positive symptoms for at least 2 weeks) +
Mood disorders (major depressive, manic, or mixed)
Schizoaffective Disorder (SCA/SAD), treatment:
1st choice: atypical AP
+ mood stabilizers or antidepressants
True or False: The earlier onset, the worse the outcome/ progression of Schizophrenia?
True
greater cognitive impairment
poorer premorbid adjustment
more prominent negative signs
Higher relapse rates due to:
non-adherence to medication
negative attitude toward treatment
caregiver criticism
persistent substance use
Improved outcomes for Schizophrenia (3):
lower relapse rate
improved QOL, insight, social functioning
Schizophreniform disorder
Acute, reactive psychosis for less than 6 months
If more than 6 months, upgraded to dx of Schizophrenia
Delusions
fixed, false beliefs
Hallucinations
false sensory perceptions (auditory, visual, tactile, olfactory, gustatory)
Schizophrenia, etiology:
biological predisposition/ vulnerability (genetics, neuroanatomy, neurochemical, immunovirologic)
environmental stressor
Schizophrenia, neurochemical irregularities:
Excess dopamine
Low serotonin (modulates excess dopamine) or excess serotonin
Neuroleptics
Antipsychotics
Conventional/ Typical Antipsychotics, class and MOA:
Dopamine antagonists
Decrease positive symptoms (temporal lobe)
Atypical Antipsychotics, class and MOA
Diminish positive symptoms
Lessen negative symptoms
LAIs (Long-Acting Injections) APs (6)
not for acute episodes, may need oral stabilizing before transition to depot
Fluphenazine (Prolixin): 7 - 28 days
Haloperidol (Haldol): 4 weeks
Risperidone (Risperdal)
Paliperidone (Invega)
Olanzapine (Zyprexa)
Aripiprazole (Abilify)
Serious neurologic SEs of APs (4)
EPS (acute dystonic reactions, akathisia, pseudoparkinsonism)
Tardive dyskinesia (TD)
Seizures
Neuroleptic malignant syndrome (NMS)
Non-neurologic SEs of APs
weight gain
sedation
photosensitivity
anticholinergic sx (dry mouth, blurred vision, constipation, urinary retention, orthostatic hypotension)
Acute dystonic reactions (EPS) -
