Psychopath VIII: psychotic disorders Flashcards
What are the 3 kinds of psychotic symptoms?
hallucinations, delusions, thought process derailments (thought blocking, loose associations)
What are the diagnositic criteria for schizophrenia?
2 or more of the following (only 1 if bizarre delusions or having conversations with voices):
delusions, hallucinations, disorganized thoughts, grossly disorganized or catatonic behvior
may also have negative symptoms like affect flattening, alogia, avolition
causes major functional imapirment ais present for 6 months or more including prodrome and residual symptoms.
What is catatonia?
motor immobility or excessive purposeless motor activity; extreme negtaivsm or mutism, or peculiar movements (bizarre postures), echolalia, echopraxia
When do we see catatonia?
schizophreia, affective psychoses, or sometimes secondary to basal ganglia disease
Typical course of schizophrenia
chronic, remitting relapsing with deterioration. may have a residual phase with fewer positive symptoms but profound dysfunction from negative symptoms like abulia and social withdrawal
What are major comorbidities with schizophrenia?
suicide, superimposed depression, mentally ill chemical abuser population.
What is the concordance for MZ twins with schizophrenia? With first degree relatives?
50% for MZ twins; 10% for first degree relatives
What are neuroimaging changes seen in schizophrenia?
increased ventricle:brain ratio and decreased function of the dorsolateral prefrontal cortex. vermis, sleep, visual integration all different too. NO GLIOSIS suggests its not a recent lesion.
What are schizophreniform disorder and brief psychotic distorder?
schizophreniform disorder: symptoms last 1-6 mo
brief psychotic disorder: symptoms last less than 1 month
if symptoms recur, chance diagnosis to schizophrenia
What is schizoaffective disorder?
mixe between schizophrenia and mood disorders. with periods of just psychosis and periods of just mania or depression (sometimes with psychotic features)
What is delusional disorder?
people have delusions (erotomanic = ppl believe someone is madly in love with them; jealous, grandiose, etc); hallucinations usually not present but if they are they are there to support the delusion, no negative symptoms and no thought process disturbance. they are still relatively functional and only get psychiatric attention when they start to act on their delusions.
Treatments for delusional disorder?
antipsychotics, supportive therapy so that they don’t act on their delusions, restraining orders
