psychotic disorders Flashcards
delusions of control
includes thought broadcasting (belief that one’s thoughts can be heard by others) and thought insertion (belief that other people’s thoughts are being placed in one’s head)
delusions of grandeur
belief that one has special powers beyond those of a normal person
somatic delusions
false belief that one is infected with a disease or has a certain illness
olfactory hallucination comes usu in what scenario
aura assoc with epilepsy
what meds can cause psychosis
corticosteroids antiparkinsonian agents anticonvulsants antihistamines anticholinergics some antihypertensives including beta blockers digitalis methaylphenidate fluoroquinolones illicit drugs
positive symptoms of schizophrenia
hallucinations
delusions
bizarre behavior
disorganized speech
tend to respond more robustly to current antipsychotic meds
neg symptoms of schizophrenia
blunted affect anhedonia apathy alogia (poverty of speech) lack of interest in socialization
these symptoms often tx resistant
cognitive symptoms of schizophrenia
impairments in attention, executive fxn, working memory
possibly leading to poor work and school performance
diagnosis of schizophrenia
pg 25
catatonic schizophrenic pts-what signs?
stereotyped mvmt
bizarre posturing
musc rigidity
higher functioning form of schizophrenia
paranoid type
paranoid type of schizophrenia must meet what criteria
preoccupation w one or more delusions or freq auditory hallucinations
no predominance of disorganized speech, disorganized or catatonic behavior, or inappropriate affect
disorganized type of schizophrenia must meet what criteria
diroganized speech
disorgznied behvior
flat or inappropriate affect
catatonic type of schizophrenia must meet at least two of what critera
motor immobility
excessive purposeless motor activity
etreme negativism or mutism
peculair voluntary movements or posturing
ECHOLALIA or ECHOPRAXIA (repetition of mvmts of others)
undifferentiated type of schizophrenia
characteristic of more than 1 subtype or none of the subtypes
residual type of schizophrenia
prominent negative symptoms (such as flattened affect or oscial withdrawal) with only minimal evidence of positive symptoms
the 5 A’s of schizophrenia
anhedonia affect (flat) alogia avolition attention (poor)
typical PE findings for schizophrenia pts
disheveled appearance falttened affect disorganized thought process intact memory and orientation audiotyr hallucinations paranoid delusions ideas of reference concrete understanding of similarities/proverbs lack insight into their disease
if first degree relative has schizophrenia, what is risk of having schizophrenia
12 percent
what drugs can increase dopamine activity
cocaine, amphetamines
in schizophrenia, where in the brain is there excessive dopaminergic activity?
mesolimbic pathway
neurotransmitter abnormalities other than dopamine in schizophrenia
elevated serotonin
elevated NE
decreased GABA
decreased glutamate receptors
what factors are assoc w better prognosis in schizophrenia
later onset good social support positive symptoms mood symptoms acute onset female sex few relapses good premorbid functioning
what factors are assoc w worse prognosis in schizophrenia
early onset poor social support neg symptoms family hx gradual onset male sex many relapses poor premorbid functioning (social isolation) comorbid substance abuse
