Psychotic Disorders Flashcards
Schizophrenia
Prevalence: 0.7-1%
PFC = hypodopaminergic
Limbic system = hyperdopaminergic
A) 2 or more of the following symptoms for at least one month, one of them must be 1, 2 or 3:
1) Delusions
2) Hallucinations
3) Disorganized Speech
4) Grossly disorganized or catatonic behavior
5) Negative symptoms
B) Must be signs of disturbance for 6 months, can include prodromal or residual symptoms
C) No, or very minor, congruence with mood episodes (depression or mania)
D) Rule out organicity/iatrogenicity
E) If comorbid with autism spectrum or communication disorders, must have hallucinations and delusions for at least a month
F) for a significant portion of time since onset of the disturbance, level of functioning is markedly below level achieved before onset of disturbance
Schizoaffective Disorder
- Major mood episode (depressive or manic) concurrent with criteria A) for schizophrenia
- Delusions or Hallucinations for two or more weeks without major mood episode during the duration of the disease
- Major mood episode is present for the majority of active and residual symptoms
- Rule out iatrogenicity/organicity
- Bipolar type
- Depressive type
Delusional Disorder
-Prevalence: 0.4-0.6%
-Presence of one or more delusions for 1 month or longer
-Criterion A for schizophrenia has never been met
-Hallucinations, if present, are not prominent and are related to the delusion
-Functioning is not markedly impaired
-behavior is not obviously bizarre or odd
-if manic or major depressive episodes have occurred, they are brief relative to the delusional periods
-Rule out iatrogenicity/organicity
-Subtypes:
A) Erotomanic type: central theme of delusion is that another person is in love with the individual
B) Grandiose: God
C) Jealous: being cheated on
D) Persecutory: conspired against, spied on, followed, etc.
E) Somatic type: bodily functions or sensations
F) Mixed type
G) Unspecified type
Specify if with bizarre content
Brief Psychotic Disorder
A) Presence of one or more of the following. At least one must be 1, 2, or 3:
1) Delusions
2) Hallucinations
3) Disorganized speech
4) Grossly disorganized or catatonic behavior
B)Duration of disturbance 1 day to 1 month, eventual return to premorbid level of functioning
C) Disturbance not better explained by major depressive or bipolar disorder with psychotic features, or schizophrenia, or catatonia
D) rule out iatrogenicity/organicity
E) Specify if:
-with marked stressors
-without marked stressors
-with postpartum onset
Schizophreniform Disorder
A) same criteria as A for schizophrenia
B) an episode lasts at least 1 month but less than 6
C) no major mood episodes during active phase, if present, only present for minority of the duration of disturbance
D) rule out organicity/iatrogenicity
Substance/Medication-induced Psychotic Disorder
- Presence of delusions and/or hallucinations
- Evidence that the symptoms developed during or soon after substance intoxication, withdrawal or exposure
- Medication must be capable of producing psychosis
- Not better explained by another psychotic disorder
- Disturbance does not occur exclusively during the course of a delirium
- Must cause clinically significant distress or impairment in social, occupational or other areas of functioning
- Specify onset during withdrawal vs. onset during intoxication
Psychotic disorder due to another medical condition
- Prominent hallucinations or delusions
- Evidence of pathophysiological consequence of another medical condition (history, physical, lab test)
- Not better explained by another mental disorder
- Does not occur exclusively during the course of a delirium
- Clinically significant distress or impairment in social, occupational or other areas of functioning
Catatonia
3 or more of the following symptoms:
Stupor, catalepsy, waxy flexibility, mutism, negativism, posturing, mannerism, stereotypy, agitation, grimacing, echolalia, echopraxia
