Psychotic Disorders Flashcards
Presents in 20’s often after life stressor, thought process disorder, thought to be due to overload of dopamine and serotonin.
Schizophrenia
Positive Symptoms of Schizophrenia
Bizarre Delusions
Hallucinations
Disorganized Speech
Disorganized or Catatonic Behaivor
Negative Symptoms of Schizophrenia
Flat Affect
Cognitive Defects
Poverty of speech anhedonia
Treatment for schizophrenia
First gen antipsychotics like haloperidol, fluphenazine, thioridazine, chlorpromazine
What leads to the negative symptoms in schizophrenia?
Decreased dopamineric activity inthe mesolimbic pathwayWh
What leads to positive symptoms in schizophrenia?
Increased dopaminergic activity in the mesolimbic pathway
What leads to extrapyramidal symptoms in the use of antipscychotics
Antipsychotics particuarly first gen make a dopamine blockage all across the board so it will block dopamine in the nigrostriatal tract that could result in parkinsonism/EPS
How do you get gynecomastia and galactorrhea?
Blockade of dopamine in the tuboinfundibular tract (disinhibtion of prolactin!)
What is the criteria for a breif psychotic disorder?
Severe stressor–> psychotic features onset of greater than a day with duration less than a month
What is the timeline for schizophreniform?
duration is 1-6 months
How might we differentiate between schizophrenia and schizoaffective?
Schizoaffective is where we see the mood symptoms predominate. No mood symptoms at all means its schizophrenia.
Which disorder: lasts greater than a day and less than a month and exhibits psychotic symptoms
Breif Psychotic Disorder, this can PROGRESS to schizophreniform
Which Disorder: lasts greater than a month and less than six months
Schizophreniform
Psychotic features lasting greater than 6 months without mood disorder
schizophrenia
Psychotic features wtih mood like major depressive episode and mania
Schizoaffective
What medications are used to treat POSITIVE symptoms?
Haloperidol, thiazide, chlorpromazine
What medications are used to treat NEGATIVE symptoms?
Risperidone, quetipine, olanzapine, ziprasidone, ariprprazole
Things are happening around us but we feel as though they are not happening to us
Dissociation
How do we treat dissociative identity disorder?
intense psychotherapy to align the personalities into one, hypnosis
How may dissociative identity arise?
Different identities/personalities arise as a means of protecting the self
Inability to recall or inconsistency in recall often associated with acute emotionall traums or stressor
Discciative amnesia
If there is travel involved in dossociative amnesia, what do we refer to it as?
Dissciative fugue
Catatonia is defined by at least three of the following…
stupor, catalepsy, waxy flexibility, mutism, negativism, stereotypy, agitation, echolalia, echopraxia
How do we treat catatonia?
Lorazepam, food/nutrition support, watch for risk of dvt and rhabdo
How do we treat refracrory catatonia?
ECT
Immobility, fever, elevated CK, autonomic instability are consistent with
Malignant catatonia, neuroleptic catatonia syndrome, serotonin catatonia, malignant hyperthermia
Malignant catatonia is caused by…
Non drug induced! Immobility/rigidity, fever, elevated CK
Neuroleptic catatonia syndrome is caused by…
antipsychotics, presents the same as malignant catatonia but is caused by the drugs
How can you differentiate serotonin syndrome from malignant catatonia and NMS?
SS presents with leadpipe rigidity (myoclonus and hyperreflexia) and hx/current ssri use
What drug leads to malignant hyperthermia?
Halothane
How do we treat malignant hyperthermia?
Dantrolene
Characerized by psychotic sx’s (delusions, hallucinations, disorganization, negative sx’s) along with significant mood episodes (MDD, manic episodes). Sx’s must exceed 6 months
Schizoaffective disorder
What is the timeline fro schizophreniform?
Demonstrating pyschoic features for greater than 1 months and less than 6 months. 2/3rds of patients ultimately develop schizophrenia
How does schizopfreniform and schizophrenia impact other cognitive functions?
attention, working memory, verbal learning, memory, and executive function all are impacted
