Related psychoses to schizophrenia Flashcards
Name 2 disorders related to schizophrenia
Schizoaffective disorder
Schizotypal disorder: absence of psychosis
What is schizoaffective disorder?
A disorder that has features of both schizophrenia and affective disorder.
What are the three main types of schizoaffective disorder?
Manic type: with symptoms of manic disorder
Depressive type: with symptoms of depressive disorder (at least moderate severity)
Mixed type: with symptoms of mixed bipolar affective disorder
Outline the ICD-10 criteria for schizoaffective disorder
Schizophrenia and affective symptoms present simultaneously in equal prominence.
Excludes separate episodes of schizophrenia an affective disorders, and other aetiology such as organic causes or substance use.
What are Schneirders symptoms of first rank?
Auditory hallucinations: Repeating subjects thoughts ‘echo de la pensee’, Third person, Running commentary
Thought insertion, withdrawal, or broadcasting
Passivity of affect, impulse, or volition - under external control
Somatic passivity - somatic sensations by external agency
Persistent delusions
What is the diagnostic criteria of mania?
3/9 of the following, which severely interfere with daily life:
Grandiosity Decreased sleep Pressure of speech Flight of ideas Distractibility Restlessness Recklessness Social disinhibition Increased sexual energy
What is the diagnostic criteria of moderate depression?
2 core + 3/4 other
Core:
2 week low mood
Low energy
Anhedonia
Other:
Cognitive: lack of concentration, -ve thoughts, XS guilt, suicidal ideation
Behavioural: diurnal mood variation, sleep disturbance, loss of libido, psychomotor retardation, weight loss, appetite loss
What is the ICD-10 criteria for Mixed bipolar disorder?
Current episode features a mixture of hypomanic, manic, and depressive symptoms.
Must be prominent most of the time for a 2 week period.
Previous Hx of a hypomanic, manic, depressive, or mixed affective episode.
How does mixed bipolar disorder differ from most types of bipolar disorder?
Mixed bipolar disorder experiences symptoms of mania and depression simultaneously or in quick succession rather than as 2 individual episodes.
How is schizoaffective disorder managed?
Treatment is similar to schizophrenia. (oral antipsychotic and psychological intervention)
Manic and depressive symptoms are treated like that in bipolar disorder.
What is the prognosis of schizoaffective disorder?
Overall prognosis is better (usually non-deteriorating) than schizophrenia, but worse than primary mood disorders.
Depressive symptoms are more likely to signal a chronic course compared to manic presentations.
Prognostic factors are the same as schizophrenia. Duration of untreated psychosis, education, employment, expressed emotion etc.
What is schizotypal disorder?
A disorder that shares some clinical features of schizophrenia, but without the psychotic symptoms.
Outline the ICD-10 criteria of schizotypal disorder
4+ symptoms over two years, which occur continuously or repeatedly:
Inappropriate affect Odd/eccentric behaviour or appearance Poor rapport and social withdrawal Odd beliefs Paranoid ideas Rumination without resistance Stereotypical thinking Unusual perceptual experiences
List some differential diagnoses for schizotypal disorder
Autism Asperger syndrome Expressive language disorder Chronic substance abuse Personality disorders (especially EUPD, schizoid, and paranoid)
What treatment options are available for schizotypal disorder?
Risperidone has some evidence.
CBT and IPT
