Clinical Approach to Schizophrenia and Other Psychotic Disorders Flashcards
When is the onset of schizophrenia?
- Peak time of onset at late adolescence and early adulthood
What are some precipitating events of schizophrenia?
- Psychosocial stressor
- Traumatic events
- Drug and alcohol abuse (cannabis use increases risk 6x)
What are some prognostic variables in schizophrenia?
- Positive symptoms: better prognosis
- Negative symptoms: poor prognosis
What is seen in the better prognosis of schizophrenia?
- Patients with mood disorders = schizoaffective disorder, major depression with psychotic features or bipolar disorder
What is seen in the poorer prognosis of schizophrenia?
- Negative symptoms
- Poor cognitive performance on testing
- Poor supports
- Younger onset
What are some prodromal signs and symptoms of schizophrenia?
- May exist before symptoms of disease
- Possible schizoid or schizotypal personalities
- Few close friends as adolescents
- Minimal social activities
What are the positive symptoms of schizophrenia?
- Symptoms added to the presentation and typically present in the active phase
- Delusions
- Hallucinations
- Catatonia
- Agitation
How is the form of thought affected in schizophrenia?
- Loosening of associations: connections among patient’s ideas are absent or obscure
- Poverty of content and speech
- Thought blocking: internal interruption in patient’s speech/thoughts
How is the content of thought affected in schizophrenia?
- Delusions of persecution/reference/influence
- Thought broadcasting
- Grandiose delusions
- Somatic delusions
How are perceptual disorders affects in schizophrenia?
- Hallucinations
- Illusions: distortions of real images
What are the negative symptoms of schizophrenia?
- Symptoms that appear missing from the presentation and typically present in the residual phase
- Affective flattening
- Apathy
- Social withdrawal
- Anhedonia
- Poverty of thought
- Content of speech
How long must the symptoms be present for the diagnosis of schizophrenia?
- 6 months
How is the diagnosis of schizophrenia made?
- Psychiatrist usually comes to diagnosis based on clinical symptoms
What needs to be ruled out in the medical screening for schizophrenia?
- Seizure disorders
- Metabolic disorders
- Thyroid disorders
- Brain tumor
- Neurosyphilis
- Street drug use
What is associated with higher rates of schizophrenia?
- In patients born in the winter and early spring months (may have possible association of prenatal exposure to influenza virus)