Chapter 15: Schizophrenia Spectrum and Other Psychotic Disorders Flashcards
Intro: Schizophrenia is probably caused by a combination of factors, including:
Genetic predisposition
Biochemical dysfunction
Physiological factors
Psychosocial factors
We still don’t know the exact cause. More predisposed for it if you have a parent with it. Definitely dysfunctional neurotransmitters. Early onset of drug use can cause more mental illness.
Treatment for schizophrenia needs to be…
Comprehensive and presented in a multidisciplinary effort
There is a sense of loss for people who have schizophrenia. We need to treat with de-stigmatization.
1/3 of people with schizophrenia die from suicide
High ongoing SI is common
Of all mental illnesses, schizophrenia probably causes more…
Lengthy hospitalizations
Chaos in family life
Exorbitant costs to people and governments
Fear
Majority of people do w/ it will be dead by age 25
Nature of schizophrenia. It can cause disturbances in:
Thought processes
Perception (often paranoid delusions)
Affect (often blunted)
There is a severe deterioration of social and occupational functioning
In the U.S. the lifetime prevalence of schizophrenia is about 1%
Psychosis: a break from reality
Sometimes a loss of abstract thinking
Four phases of schizophrenia: phase 1
Premorbid phase
Could be seen as a normal part of puberty or middle school
Social maladjustment, antagonistic thoughts and behavior, shy and withdrawn
Poor peer relationships
Doing poorly in school
Antisocial behavior
Four phases of schizophrenia: Phase Two
Prodromal phase
A distinct change
Lasts from a few weeks to a few years
Deterioration in role functioning and social withdrawal
Substantial functional impairment
Sleep disturbance, anxiety, irritability
Depressed mood, poor concentration, fatigue
Perceptual abnormalities, ideas of reference, and suspiciousness herald onset of psychosis
Four phases of schizophrenia: Phase Three
Schizophrenia
Acute psychosis. Many have hallucinations
If one gets tx. On first break, then prognosis is better overall.
In the active phase of the disorder, psychotic symptoms are prominent
Delusions
Hallucinations
Impairment in work, social relations, and self-care
Four Phases of Schizophrenia: Phase Four
Residual phase
Symptoms similar to those off the prodomal phase
Flat affect and impairment in role functioning are prominent
One becomes more impaired with the more episodes of psychosis they have
Meds and other tx’s may help
Talk dismissal to voices can help
Pts often go off meds
Prognosis of Schizophrenia
A return to full premorbid functioning is not common
Better is later onset
More positive prognosis if there is no family history
And if they are female
Biological Predisposing factors for schizophrenia
Biological influences: genetics play an important role in development of schizophrenia.
Biochemical influences: one theory suggests that schizophrenia may be caused by an excess of dopamine activity in the brain. Abnormalities in other neurotransmitters have also been suggested.
Other biological predisposing factors for schizophrenia
Factors that have been implicated:
Viral infection
Anatomical abnormalities
Electrophysiology
Epilepsy
Huntingtons disease
Birth trauma, head injury in adulthood, alcohol abuse, cerebral tumor, cerebrovascular accident, Lupus
Psychosis. Predisposing factors of schizophrenia
These theories no longer hold credibility. Researchers now focus their studies of schizophrenia as a brain disorder.
Psychosocial theories probably developed early on out of a lack of info related to a biological connection.
Environment predisposing factors for schizophrenia
Sociocultural factors: poverty has been linked with the development of schizophrenia
Downward drift hypothesis: Poor social conditions seen as consequence of, rather than a cause of, schizophrenia.
More environment Predisposing factors for schizophrenia
Stressful life events may be associated with exacerbation of schizophrenic symptoms and increased rates of relapse
Studies of genetic vulnerability for schizophrenia have linked certain genes to increased risk for psychosis and particularly for adolescents who use cannabinoids.
Theoretical integration for schizophrenia
It is likely a biologically based disease, the onset of which is influenced by factors in the internal or external environment
Complication of Clozapine
Can cause agranulocytosis which one can die from. Rare.
It is an effective drug otherwise that can save peoples lives.
Schizophrenia and Marijuana use
Marijuana can cause schizophrenia in 1/10 people who are predisposed to it. Can be after on use, or chronic use.
Types of Schizophrenia: Delusional disorder
Must be at least one month of 1 of the following (remember this criteria)
The existence of prominent, non bizarre delusions
Erotomanic type (someone like a celebrity is in love with them)
Grandiose
Jealous
Persecutory
Somatic type or mixed type
Types of psychotic disorders: Brief psychotic disorder
Sudden onset of symptoms
May or may not be preceded by a severe psychosocial stressor
Lasts less than 1 month
Return to full premorbid level of functioning
Substance induced psychotic disorder
The presence of prominent hallucinations and delusions that are judged to be directly attributable to substance intoxication or withdrawal.
Can also occur with prescription meds.
Psychotic disorder associated with another medical condition
Prominent hallucinations and delusions are directly attributable to a general medical condition.
Catatonic disorder
Catatonic features may be associated with other psychotic disorders, such as brief psychotic disorder, schizophreniform disorder, schizophrenia, schism affective disorder, and substance-induced psychotic disorder.
Symptoms of catatonic disorder include: Stupor and muscle rigidity or excessive, purposeless motor activity
Also waxy flexibility, negativism, echolalia, echopraxia
Catatonic disorder associated with another medical condition
When we know the general medical condition is causing the catatonic symptoms
Schizophreniform disorder
Same symptoms as schizophrenia with the exception that the duration of the disorder has been at least 1 month but less than 6 months
1-6 months
