Psychotic disorders Flashcards
Gender for Schizophrenia
M=W
Role of socioeconomic status in Schizophrenia
-higher prevalence in lower classes
what age is onset of schizophrenia
late adolescence and early adulthood
Cannabis and Schizophrenia
increases risk 6x
what are the prognostic variables for Schizophrenia
- Positive symptoms: better
- Negative symptoms: poor
- Better prognosis: pts with mood disorders= schizoaffective, major Depression with psychotic features or bipolar
- Poor prognosis: Negative symptoms, poor cognitive performance on testing, poor supports, younger onset
- Poor premorbid functioning, insidious onset
what are the positive symptoms of schizophrenia
- symptoms added to presentation
- typically present in Active phase
- Delusions
- Hallucinations
- Catatonia
- Agitation
What are the negative symptoms of Schizophrenia?
- Symptoms that appear missing from the presentation
- Typically present in Residual phase
- Affective flattening
- Apathy
- Social Withdrawal
- Anhedonia (no fun)
- Poverty of thought
- Content of speech
for Schizophrenia, symptoms must be present for how long?
6 months
Schizophrenia higher rates in pts born in what months?
winter and early spring . . possible prenatal exposure to influenza virus
current hypothesis for schizophrenia
- increased dopamine in neuronal tracts: blocks pathways responsible for symptoms, Target of many anti-psychotic drugs
- Increased serotonin and norepinephrine
- Decreased GABA and Glutamate receptors
Brain imaging and schizophrenia
enlarged ventricles
are Schizophrenics more likely to commit homicide?
no
what would you give a violent schizophrenic in the ED?
Lorazepam and haloperidol IM
leading cause of death in Schizophrenics?
Suicide
what may reduce risk of suicide in schizophrenics?
Clozapine
The clinical picture of the catatonic type of schizophrenia is dominated by at least 2 of the following symptoms:
- Motoric immobility as evidenced by catalepsy or stupor
- Excessive motor activity (apparently purposeless and not influenced by external stimuli)
- Extreme negativism or mutism
- Peculiarities of voluntary movement such as posturing, stereotyped movements, prominent mannerisms, or prominent grimacing
- Echolalia or echopraxia: repeating someones sounds or movements
what can be used for schizophrenia for the Catatonic disorder
Benzoa
Treatment of Schizophrenia
- Hospitalization
- Group Therapy
- Individual Psychotherapy
- Community Treatment
- Self-Help Programs
- Pharmacology
- ECT
Know the Pharmacology
Slides 26-28
Describe Schizoaffective Disorder
- Uninterrupted period of illness with either a major depressive episode or manic episode concurrent with symptoms that meet criterion A for Schizophrenia
- Same period of illness, have been delusions or hallucinations for at least 2 weeks in absence of prominent mood symptoms
Describe a Brief Psychotic Disorder
- Presence of at least one of following: delusions, hallucinations, disorganized speech, Grossly disorganized or catatonic behavior
- Duration of an episode of the disturbance is AT LEAST 1 DAY and NO MORE THAN 1 MONTH with eventual return to premorbid level of functioning
Describe Schizophreniform
- symptoms like schizophreniform
- an episode of the disorder lasts at least 1 months but less than 6 months
Describe Delusional Disorder
- Delusions (situations that could occur in real life)
- Has never met criterion A for schizophrenia (for more than a few hours)
- Apart from the impact of the delusion, functioning is not impaired and behavior is not odd or bizarre
