Psychiatric Disorders Flashcards
What are the two psychiatric disorders?
- Bipolar
- Schizophrenia
What were the four A’s of psychosis?
- Autism
- Apathy
- Associations (loose)
- Affect (flat)
What are the first rank symptoms of psychosis?
- Delusions
- Hallucinations
- Hearing voices
- Thought withdrawl
- Imposed feelings/impulses
What are the diagnostic criteria for schizophrenia? (5) How many are needed?
- Delusions
- Hallucination
- Disorganized thinking/speech
- Disorganized or abnormal motor behavior
- Negative symptoms
-1 or more
What are delusions?
Fixed beliefs that are not amenable to change in light of conflicting evidence
What are persecutory delusions?
Harmed or harassed by individual or group
What are referential delusions?
Gestures, comments, environmental cues are directed at oneself
What are grandiose delusions?
Individuals believe that they have exceptional abilities of wealth or fame
What are erotomanic delusions?
Individuals believes falsely that another person is in love with them
What are nihilistic deulsions?
Involve a conviction that a major catastrophe will occur
What are somatic delusions?
Preoccupation regarding health and organ function
In what mental health disorder is somatic delusions common in?
MDD
What is the age distribution of MDD
Bimodal–20s and 60s
What are hallucinations?
Perception-like experiences that occur without an external stimuli
What are auditory hallucinations?
Voices distinct from an individual’s thoughts
What is disorganized speech? What must be present in order to diagnose this correctly?
Inferred from the individual’s speech and it must impair communication
What is derailments or loose association speech?
Switching from topic to topic
What is tangentiality or loose association speech?
Answers to questions obliquely related or unrelated
What is incoherence or loose association speech?
“word salad”–Severely disorganized resembling receptive aphasia
What are the grossly disorganized or abnormal motor behaviors? When in particular are the noticeable?
Behavior that manifests in a variety of ways from childlike silliness to unpredictable agitations.
Problems may be noted in any form of goal directed behavior including performing ADLs
Why do schizophrenics smell bad?
They have a disturbed sense of smell
What is negativism catatonia?
Resistance to instruction
What is mutism and stupor catatonia?
Ridigs, inappropriate or bizarre posture to a complete lack of verbal or motor responses
What is catatonic excitment?
Purposeless and excessive motor activity without an obvious cause
True or false: catatonia can occur in bipolar, depressive, or other medical conditions
True
Are echolalia and coprolalia forms of catatonia?
Yes
What are the negative symptoms of psychosis?
Diminished emotional expression–reductions in the expression of emotions in face, eye contact and intonation of speech
What is avolition?
Decrease in motivated self initiated purposeful activities
What is alogia?
Diminished speech output–sometimes to the point of mutism
What is anhedonia?
Decreased ability to experience pleasure from positive stimuli or degradation in the recollection of pleasure previously experienced
What is asociality?
Lack of interest in social interactions
What is schizotypal disorder?
A pervasive pattern of social and interpersonal deficits marked by discomfort or inability to have close relationships, as well as cognitive and perceptual distortions and eccentricities of behavior
What are the 8 diagnostic criteria for schizotypal disorder?
- Idea of reference
- Odd beliefs or magical thinking
- Unusual perceptual experience, including body illusions
- Odd thinking or speech
- Suspicious or paranoid ideation
- Inappropriate or constricted affect
- Behavior or appearance that is odd
- Lacks close friends
- Extensive social anxiety
Can schizotypal disorders occur in the presence of other mental health disorders like bipolar, or other psychotic disorders?
No
What are the associated features of schizotypal disorder?
- Present with depression
- Stress leads to very brief transient psychosis
What percent of pts with schizotypal disorder have at least one episode of MDD?
50%
What percent of pts with schizotypal disorder are diagnosed with MDD when admitted?
30-50%
True or false: most schizotypal disorders are stable, with only a small proportion go on to become schizophrenic or psychotic
True
When do schizotypal disorders first begin to manifest?
Childhood and adolescence
True or false: most schizotypal disorders are more common in males
True
What is the criteria for delusional disorders? (2)
- Presence of one or more delusions of 1 month or longer
- Hallucinations are not prominent and related to the delusion
True or false: in order to correctly diagnose delusional disorders, functioning cannot be markedly impaired
True
True or false: in order to correctly diagnose delusional disorders, the disturbance is attributable to physiological effect of a substance of another medial condition
False
In order to correctly diagnose delusional disorders, what must be true of any manic or depressive episodes the pt had?
Must have been brief in relationship to the duration of the delusional period
What is the most frequent sub type of delusional disorders?
persecutory
True or false: the jealous type of delusional disorders is more common in females than males
False–other way around
What are the diagnostic criteria for brief psychotic disorders? (4)
- Delusions
- Hallucinations
- Disorganized speech
- Grossly disorganized or catatonic behavior
What is the min and max duration of s/sx to be diagnosed with a brief psychotic disorder?
At least 1 day, but not more than 1 month, with eventual return to premorbid functioning
True or false: to diagnose brief psychotic disorder, the disturbance must not be better explained by a MDD or bipolar disorder
True
What is the relative level of impairment with brief psychotic disorders?
Severe
True or false: the risk of suicidality in brief psychotic disorders are not increased relative to the general population
False–increased in the acute episode
What is the prevalence of brief psychotic disorders, as a percentage of all first onset psychoses?
9% of first onset psychoses
What is the timeframe of brief psychotic disorders in developing countries? Developed?
1-6 months as opposed to 1 month in developed countries
True or false: brief psychotic disorders are more common in females
True–2x
What is the development and course of brief psychotic disorders?
Appear in adolescence and early adulthood with onset possible across the entire lifetime
What is the average age of onset for brief psychotic disorders?
mid 30s
In order to diagnose brief psychotic disorders, the individual must return to full premorbid functioning within what timeframe?
one month, but it may occur in a few days
What is the rate or relapse with brief psychotic disorders?
High rates of relapse, but excellent outcomes in terms of function and s/sx
What are the diagnostic criteria for schizophreniform disorder?
- Delusions
- Hallucination
- Disorganized speech
- Disorganized behavior
- Negative symptoms
How many of the diagnostic criteria must be present to diagnose schizophreniform disorder? What is the timeframe?
2 or more present for a significant time during a 1 month period, but less than 6 months
Can you diagnose schizophreniform disorder if it is 2/2 drug use?
No
What is the incidence of schizophreniform disorder?
5x less than that of schizophrenia
What is the development and course of schizophreniform disorders?
1/3 recover in 6 months and the other 2/3 go on to have schizophrenia
What are the diagnostic criteria for schizophrenia? (5)
- Delusion
- Hallucinations
- Disorganized speech
- Disorganized behavior
- Negative symptoms
How long must s/sx of schizophrenia last for to be diagnosed with schizophrenia?
2 symptoms for at least 1 month
What must happen to the functioning of schizophrenic pts to diagnose them?
1 area must be below pre onset level
What is the diagnostic criteria for schizophrenia in terms of duration of symptoms?
Continuous signs of disturbance persist for at least 6 months, with 1 month of active symptoms
What must be done prior to diagnosing schizophrenia?
Cannot be attributed to bipolar or other disorder
Do schizophrenics usually have insight into their disease? What is the clinical significance of this?
No–but this is not a coping strategy
Anosognosia predicts non-adherence to treatment and poorer outcomes
True or false: negative s/sx of schizophrenia are most common in females
false–males
True or false: mood symptoms and brief presentation show equal risk among both sexes
True
What is the usual age of onset of schizophrenia?
late teens - 30s
What percent of schizophrenia complain of depressive symptoms?
50%
What percent of schizophrenics have a good outcome?
20%
What is the major issue with chronic marijuana use?
Impairs frontal lobes
True or false: psychotic symptoms of schizophrenia tend to increase over the life of the individual
False- tend to diminish
Do children have more auditory or visual hallucinations with schizophrenia?
Visual
True or false: schizophrenia is more common in urban areas
True
What, generally, is schizophreniform disorder?
a mental disorder diagnosed when symptoms of schizophrenia are present for a significant portion of the time within a one-month period, but signs of disruption are not present for the full six months required for the diagnosis of schizophrenia
What is the lifetime prevalence of schizophrenia?
0.3-0.7%
