Psychotic disorders Flashcards
What are the neural bases for psychotic disorders?
reduced regional brain volume, enlarged cerebral ventricles, reduced limbic regions, dopamine function
What are some of the identified risk factors for schizophrenia?
low SE status, low IQ, perinatal factors, cannabis use
Distinguish positive versus negative symptoms of schizophrenia
positive - hallucinations,
negative - lack of motivation, poor self care, alogia, asociality
What are the medications used to treat schizophrenia?
antipsychotics, psychosocial support
What is schizoaffective disorder and how is it different from schizophrenia?
have symptoms of schizophrenia plus major mood disturbance. psychotic features persist 2 weeks after mood symptoms resolve
What is the treatment for schizoaffective disorder?
antipsychotics plus mood stabilizers
What is schizophreniform disorder?
schizophrenia that lasts 6 months and does not involve social withdrawal
What is delusional disorder?
non-bizarre delusions without psychotic symptoms, typically long term and non-remitting
What populations seem to be at risk for delusional disorder?
women, migratory patterns, paranoid
What are the treatments for delusional disorder?
psychotherapy
What is the definition of a brief psychotic episode?
psychotic symptoms lasting 1 day to 1 month
When can brief psychotic episodes occur?
post partum, post stressor
What medical conditions should be considered for psychosis?
CNS disease, Addison’s/Cushings, B12/folate,
What are the DSM IV criteria for schizophrenia?
2 or more for at least 1 month: - delusions - hallucinations - disorganized speech - catatonia - negative symtpoms Only 1 required if delusions are a running voice Duration of symptoms more than 6 months not allowed
What are the different types of schizophrenia?
Paranoid, disorganized (disorganized speech, poor functioning, early onset) catatonic (rare, echolalia and echopraxia present) residual (prominent negative symptoms)
Describe epidemiology for schizophrenia
More common among those born in winter, men at 20, women at 30
Post psychotic depression
Substance abuse common
Very strong genetic predisposition
What is folie a deux?
Shared psychotic disorder when patient develops same delusional symptoms
What medications are especially helpful in the treatment of negative symptoms of schizophrenia?
clozapine, olanzepine
What medications can increase schizophrenia medication compliance?
injectable haloperidol
What medication can be useful in treating tardive dyskinesia?
clozapine
What is the rate of suicide in schizophrenics?
10%
What drugs can induce a psychotic event?
amphetamines
How does schizophrenia differ in males vs. females?
incidence is the same - occurs at earlier age in men; worse prognosis in men
A patient with schizophrenia presents with hyponatremia - what is the cause?
psycogenic polydipsia
A man becomes agitated after a period of brooding. this is called…
amok
A man becomes convinced that his penis is receding into his body. This is called..
koro
A Brazilian lady presents with depressive and anxiety symptoms. This is..
nervios
An Indian man presents with weakness, anxiety and is preoccupied by semen discharge. This is..
Dhat
A Native American man presents with a preoccupation with death. This would be called..
ghost sickness
What symptom is most specifc for schizophrenia?
bizarre delusions
What is the lifetime risk of suicide in schizophrenics?
10%
What are the soft neurological signs associated with schizophrenia?
Sensory gating issues, decreased ability to habituate to repeated stimuli
What is palinopsia?
Sense of object remaining even after stimulus removed
What is one of the advantages of aripiprazole compared to other atypcal antipsychotics?
less likely to cause weight gain
What is the neurological correlate of schizophrenia?
lateral ventricular enlargement
