Chapter 14-15 - Psychotic Disorders Flashcards

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1
Q

What are positive symptoms of schizophrenia?

A

Presence or addition of behavior

  • Hallucinations
  • Delusions
  • Strange speech
  • Unusual motor behaviors
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2
Q

What are negative symptoms of schizophrenia?

A

Absence of behavior

  • Flat affect
  • Lack of motivation
  • Social withdrawal
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3
Q

What is acute schizophrenia or type I?

A
  • More sudden onset of symptoms (within a week or month)

* More positive symptoms than negative

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4
Q

What is chronic schizophrenia or type II?

A
  • More prolonged onset and show a prolonged history of withdrawal from functioning
  • More negative symptoms than positive
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5
Q

What are hallucinations? What are the most common types?

A

False perceptions - most common are auditory

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6
Q

What are delusions? What are the most common types?

A

Deeply entrenched false beliefs - most common are persecution, thought broadcasting, thought insertion, delusions of reference

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7
Q

What is the loosening of associations?

A

Topics shifting quickly without meaning - product of disordered thinking

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8
Q

What is odd speech?

A

Word salad, clanging - incomprehensible mix of words

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9
Q

What is inappropriate emotion?

A

Emotions inappropriate to the environment or to what is currently happening

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10
Q

What is the loss of ego boundaries?

A

Sense of merging with one’s environment/with others

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11
Q

What are strange motor behaviors?

A

Hyperactivity or a lack of motor behavior - purposeless behavior

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12
Q

What are the main characteristic symptoms of schizophrenia?

A
  • Hallucinations
  • Delusions
  • Odd speech
  • Loss of ego boundaries
  • Strange motor behaviors
  • Loosening of associations
  • Inappropriate emotion
  • Lack of motivation
  • Inappropriate social behavior
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13
Q

What are the clusters of schizophrenic symptoms?

A
  • Catatonia
  • Disorganized
  • Paranoid
  • Undifferentiated
  • Residual
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14
Q

What is the catatonia cluster of schizo symptoms?

A
  • Bizarre or unusual body movements - lack of movement/rigidity
  • Waxy flexibility (position someone and they will hold that position for hours)
  • Lots of negative symptoms
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15
Q

What is the disorganized cluster of schizo symptoms?

A
  • Most bizarre and obvious symptoms

* Incoherent communications, inappropriate affect, no coherent themes to delusions/hallucinations

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16
Q

What are other psychotherapies for schizo?

A
  • CBT: may be useful with some in population
  • ACT: Acceptance Commitment Therapy - studies show it can be effective. Doesn’t decrease hallucinations/delusions, but decreases hospitalizations
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17
Q

What is the undifferentiated cluster of schizo symptoms?

A

Symptoms mixed and don’t fit into other categories

18
Q

What is the residual cluster of schizo symptoms?

A

Strictly for diagnosis: no new prominent symptoms, still some lingering

19
Q

What are the phases of schizo?

A
  • Prodromal phase - period of progressive deterioration of behavior
  • Active phase - period of prominent intense symptoms (duration of at least 1 month)
  • Residual phase - continuing symptoms of disturbance, not as intense
20
Q

What are some examples of prodromal phase behaviors?

A
  • Social withdrawal
  • Decrease in work performance
  • Decrease in personal grooming
  • Increase in odd behaviors
21
Q

Treatment of schizophrenia

A

Neuroleptics

22
Q

What is the possible sociocultural explanation for the difference in prognosis in developing vs developed countries?

A

Developing countries are more collectivistic –> tend to treat and work with schizo patients better than developed countries

23
Q

What are cultural issues in schizo?

A
  • Schizo in Western cultures report more depressive symptoms, thought broadcasting, thought-insertion, more affective/cognitive.
  • Schizo in non-Western report more visual + auditory (directed) hallucinations
  • Schizo diagnosed often among AA, Asians, Hispanics
24
Q

What are the psychodynamic treatments for schizo?

A

Psychodynamic treatment is not effective, can maybe even feed into delusions

25
Q

What are other psychotherapies for schizo?

A
  • CBT: may be useful with some in population
  • ACT: Acceptance Commitment Therapy - studies show it can be effective. Doesn’t decrease hallucinations/delusions, but decreases hospitalizations
26
Q

What are behavioral therapies for schizo?

A
  • Social training - train in social skills

* Behavior modifications - using operant techniques, “token economy”

27
Q

What is the possible cause of positive symptoms?

A

Dopamine hypothesis - excess DA at the synapse

28
Q

Types of delusional disorders

A
  • Erotomania - one of higher status is in love with you
  • Grandiose delusional disorder - one has inflated worth/power
  • Jealous delusional disorder - one’s partner is unfaithful
  • Persecutory delusional disorder - one is being persecuted
  • Somatic delusional disorder - delusion about body (body odor, rotting away)
29
Q

What is the difference between schizophrenia prognosis in developed vs developing countries?

A

Schizo patients from developed countries have poorer prognosis

30
Q

What is the possible biological explanation for the difference in prognosis in developing vs developed countries?

A

Type II is a more virulent form of schizo and is often seen in developed countries - related to maternal/perinatal problems. Type I is benign and more often seen in developing countries. With our medical tech, we have more type II schizo –> poorer prognosis. Therefore developing countries have more type I bc they can’t support type II with tech

31
Q

Causes of psychotic disorders

A
  • Biological findings
  • Unusual family relations or communication (negativity, emotionally expressive, intrusive, fragmented communication)
  • Stressful events may precipitate in first psychotic episode (diathesis-stress model)
32
Q

What are cultural issues in schizo?

A
  • Schizo in Western cultures report more depressive symptoms, thought broadcasting, thought-insertion, more affective/cognitive.
  • Schizo in non-Western report more visual + auditory (directed) hallucinations
  • Schizo diagnosed often among AA, Asians, Hispan
33
Q

What is schizoaffective disorder?

A
  • Overlap between schizo and mood disorder
  • Must experience psychotic symptoms even in absence of mood disorder
  • Better prognosis than schizo, function at higher level
34
Q

What is brief psychotic disorder?

A
  • Symptoms: delusions, hallucinations, disorganized speech, prominent affective symptoms
  • Symptoms last > 1 day,
35
Q

What is schizophreniform disorder?

A
  • Bridge between brief psychotic and schizo
  • Same symptoms as schizo but last 1-6 months
  • Is provisional diagnosis - matter of duration
36
Q

What are delusional disorders?

A

Single striking delusion - could be conceivably true

37
Q

Types of delusional disorders

A
  • Erotomania - one of higher status is in love with you
  • Grandiose delusional disorder - one has inflated worth/power
  • Jealous delusional disorder - one’s partner is unfaithful
  • Persecutory delusional disorder - one is being persecuted
  • Somatic delusional disorder - delusion about body (body odor, rotting away)
38
Q

What is shared psychotic disorder?

A
  • One or more people develop psychotic symptoms from close association with psychotic person
  • Buying into someone’s delusions
39
Q

Biological causes of psychotic disorders

A
  • Too much dopamine in synapse, more related to pos symptoms, effected more strongly by meds on DA neurons
  • Enlarged ventricles - evidence toward cortical atrophy (neg symptoms)
40
Q

Causes of psychotic disorders

A
  • Biological findings
  • Unusual family relations or communication (negativity, emotionally expressive, intrusive, fragmented communication)
  • Stressful events may precipitate in first psychotic episode (diathesis-stress model)
41
Q

What are schizo spectrum disorders?

A

More likely to occur in families of individuals with schizo

  • Schizotypal PD - magical thinking
  • Schizoid PD - removed/distant/uncaring
  • Paranoid PD
  • Schizophreniform