Psychotic Disorders Flashcards
a false, fixed belief
delusion
Positive symptoms in schizophrenia are due to ?
increased dopamine levels
Negative symptoms in schizophrenia are due to?
increased levels of serotonin
What are some positive symptoms of schizophrenia?
- delusions (persecution or grandiosity or both)
- hallucinations
- disorganized speech
- disorganized behavior
what are some negative symptoms of schizophrenia?
- flat affect
- cognitive delay of speech or movement
- poverty of speech
- anhedonia
A psychotic break in a schizophrenic patient can occur after?
A major stressor
-ex: seen in young adults living on their own for the first time may induce a psychotic break
What are the criteria to diagnose schizophrenia?
- Symptoms must be going on for at least 6 months
- must have either delusions, hallucinations, or disorganized speech as one of the symptoms
- Must have two or more of the positive and/or negative symptoms
Always rule out ___ in possible schizophrenia patients.
Drug use via urine tox
Tx for schizophrenia
antipsychotics–> depending on positive and or negative symptoms which one to use
If a patient is experiencing delusions or hallucinations, what is the time line to diagnose brief psychotic disorder?
- the symptoms must be going on for at least one day but less than one month
If a patient is experiencing delusions or hallucinations, what is the time line to diagnose schizophreniform disorder?
- Symptoms must be going on for at least 3 months but less than 6 months.
What is the difference between schizoaffective disorder and schizophrenia?
Patients with schizoaffective disorder will have a mood component. They will be experiencing the same symptoms as a schizophrenic patient, like the positive and negative symptoms, but they will also have episodes of mood changes, like depression or mania.
When treating schizoaffective disorder, what should be your first concern in treating?
their mood symptoms
When treating mood disorder with psychotic features, what should be your first concern in treating?
their mood symptoms
A compliant schizophrenic patient or a patient that needs an antipsychotic, what are your first line options?
- The atypical antipsychotics, such as olanzapine, quetiapine, risperidone
A combative schizophrenic patient first line antipsychotic is?
haloperidol
In the ED if the patient is combative and is a schizophrenic, first line?
haloperidol or olanzapine (can see both be given)
A noncompliant schizophrenic patient would best be treated with what kind of antipsychotic?
- A depot injection, Haldol IM
- Invega Sustaina IM
*they last longer and do not need to be taken every day–> helps increase compliance
A case of refractive schizophrenia should be treated with?
clozapine
What should be closely monitored when a patient is on clozapine?
blood counts, look for neutropenia/leukopenia
A patient on an antipsychotic may present with increased heart rate, blood pressure, and temp with rigidity, like a lead pipe. What is the diagnosis and how should you treat them?
- neuroleptic malignant syndrome
- First, remove the offending agent.
- Second, prescribe dantrolene
Patient with NMS will have an elevated ___ on labs.
- creatine kinase
define delusional disorder
- patient has a fixed, false belief that is non-bizarre but they have no impairment in every day functioning
Positive symptoms of schizophrenia are driven by?
- dopamine due to the D2 receptors in the mesolimbic system
