Final Flashcards
Schizophrenia
- a neurodevelopmental disorder of the brain- expressed in abnormal mental functions and disturbed behaviour
- characterized by severe psychotic symptoms, bizarre delusions, hallucinations, thought disturbances, grossly disorganized behaviour or catatonic behaviour, extremely inappropriate or flat affect, and significant deterioration or impairment in functioning
Child onset schizophrenia (COS)
- rarer and possibly more severe (but not distinct) form of schizophrenia
- occurs during childhood
- gradual, rather than sudden onset
- likely to persist into adolescence and adulthood
- has profound negative impact on developing social and academic competence
Positive symptoms
- things that are there/ added
- delusions (beliefs)
- hallucinations (most common auditory- occurs in 80%)
Negative symptoms
- loss of function
- slowed thinking, speech, movement; emotional apathy; lack of drive; indifference to social contact; self- neglect
- can be very persistent and difficult to treat
- difficult to recognize
DSM-5 diagnostic criteria schizophrenia
A) severe disturbance in sensory functioning and/ or behaviour (2+) (at least one delusions, hallucinations, or disorganized speech)
B) social/ occupational dysfunction
C) duration 6+months with at least one month of symptoms that meet criteria D) Schizoaffective and mood disorder exclusion
E) substance/ medical condition exclusion
F) relationship to autism spectrum disorder or communication disorder- schizophrenia only diagnosed if delusions and hallucinations present for one month
Other times psychotic symptoms can occur
- depression
- bipolar disorder
- substance abuse
Precursors childhood onset schizophrenia
- gradual onset
- almost 95% have history of behavioural, social, and psychiatric disturbances before onset of psychosis
- developmental precursors
Comorbidities childhood onset schizophrenia
- 70% meet criteria for another diagnosis
- most commonly mild disorder or ODD/ CD
- number links between COS and ASD
- one study found that COS preceded ASD in 30-50% cases (both deficits in TOM, accelerated brian development near onset of disorder, similar abnormalities in rural connectivity)
Prevalence COS
- extremely rare (1/10,000)
- dramatic increase adolescence, model onset around 22 years of age
- COS earlier onset in boys by 2-4 years (gender differences disappear in adolescence)
- most psychotic diagnosis onset I. Late adolescents/ early adulthood (peak 15-25 males, 20-29 females)
- prodromal period thought to precede psychotic diagnosis by 1-6 years
Potential problems in assessment COS?
- screening measures developed for adolescents and young adults
- children responses to these measures need to be Interpeted with caution
- children’s questionarire endorsement of hallucinations
- delusions and persecutory ideas also found common in childhood
Neurodevelopmental model causes of COS
- genetic vulnerability and early neurodevelopmental insults result in impaired connections between many brian regions
- defective neural circuitry increases a child’s vulnerability to stress
Biological factors for causes of COS
- strong genetic contribution (several potential susceptibility genes)
- best represented by continuum of risk with many GxE interactions
- CNS dysfunction and improvements with medication suggest it is a disorder of the brain (enlarged ventricles, grey matter shrinkage, and other structural differences)
- widespread developmental disruption of neural connectivity
Environmental factors causes of COS
- familial disorder and no genetic factors may place a role trough interaction with a genetic susceptibility
- do not alone cause schizophrenia
- high communication deviance
- stress, distress and personal trashed experienced by families and children with schizophrenia
Treatment of COS
- chronic disorder with poor long- term prognosis
- antipsychotic medications (block dopamine transmission but serious side effects) combined with psychotherapy and social and educational support programs
Mood disorders
- run spectrum grime severe depression to extreme mania and involve extreme, persistent, or poorly regulated mood states
DSM-5 divides mood disorder into Eros general categories:
- depressive disorders and
- bipolar disorders
Depressive disorders
- excessive unhappiness (dysphoria) and loss of interest in activities (anhedonia), irritability
Bipolar disorder
- mood swings from deep sadness to high elation (euphoria) and expansive mood (mania)
Major Depressive Disorder DSM-5 criteria
A. 5 or more present during same 2 week period: depressed mood, diminished interest/ pleasure, weight & appetitie, insomnia/ hypersomnia, psychomotor agitation/ retardation, fatigue/ loss of energy, feelings or worthlessness/ excessive guilt, diminished ability to think/ concentrate or indecisiveness, recurrent thoughts of death/ suicidal ideation
B. Distress/ impairment
C. Not due to substance or another medical condition
D. Not better explained by another psychiatric disorder
E. Has never been a manic or hypermanic episode
Depression and development
- experience/ expression of depression changes with age
Children under 7 (as young as 3-5) depression
- less easily identified
- anaclitic depression (spitz)- infants raised in clean but emotionally cold institutional environment displayed reactions resembling depression, sometimes resulting in death (similar symptoms can occur in infants raised in severely disturbed families)
Preschoolers depression
- somber/ tearful
- lack enthusiasm
- excessive clinging/ whiny behaviour around others
- separation/ abandonment fears
- irritability, physical complaints
School-aged children depression
- increased irritability, disruptive behaviours, tantrums, combativeness
- physical complaints (et loss, headaches, sleep)
- suicide threats begin
Preteens depression
- self- blame and low self- esteem
- persistent sadness
- social inhibition
- sleep/ eating disturbances