Schizophrenia Flashcards
Primary psychosis
Derived from schizophrenia spectrum disorder
Secondary psychosis
Derived from substance intoxicaaation and dementia
So we know that primary and secondary psychosis can
Coexist and may potentiate eachother
Ex.. dementia and schizophrenia
Or schizophrenia and substance abuse
How long can Schizopreniform disorder last ?
Symptoms must last at least 1 mo but not more than 6 mo
Description of schizophreniform disorder
Essential features are identical to those of schizophrenia but of shorter duration
How long does Brief psychotic disorder last
Usually no longer than a month
Person can return back to premorbid functioning and usually precipitated by extreme stress
Description of brief psychotic disorder
Sudden onset of psychiatric symtpoms
Schizoaffective disorder is
Better prognosis than schizophrenia but significantly worse than a mood disorder
Description of schizoaffective disorder
Symptom of a mood disorder , major depressive , manic or mixed episode , concurrent with symptoms that meet the criteria for schizophrenia
Common psychotic disorder
Description of schizoaffective disoder
Symptom of a mood disorder: major depressive, manic, or mixed episode, concurrent with symptoms that meet the criteria for schizophrenia. Common psychotic disorder
Schizotypal personality disorder may what
May progress to developing schizophrenia
Description of schizotypal personality disorder
Personality disorder considered part of the schizophrenia spectrum disorders (DSM-5) shares common genetics and neuropsychiatric characteristics
Intense discomfort with close relationships
Delusional disorder is
Ranges from remission without relapse to chronic waxing and waning symptoms must last at least 1 month
Delusional disorder description
Involves bizarre delusions as being followed, infected, loved at a distance, or deceived by a spouse
Substance/ medication induced psychotic I disorder
Psychosis usually resolves
Primary intervention for schyzophrenia
Targets people at high risk
Secondary intervention of schizophrenia
Intervening early and reducing duration of untreated diagnosis
Prodomal phase of schizophrenia
Early recognition of exacerbation and treatment is vital in this time
Some people may ignore
acute phase of schizophrenia
Severe and well developed symptoms (positive, negative , cognitive, neuro cognitive and mood symptoms)
Stabilization phase
They are not having delusions or psychosis due to meds that are working
Maintenance phase for schizophrenia
We want to keep them there as long as possible
What can cause an exacerbation of schizophrenia?
Not taking meds, and high stress
Secondary causes to psychosis
Brain tumors
Cyst
Dementia
Neurological diseases
Enviromental toxins
Misuse of and addiction of prescription meds
Positive symptoms
Hallucination
Delusions
Bizarre behavior
Catatonia
Formal thought disorder
Negative symptoms
Apathy
Lack of motivation
Anhedonia
Blunted or flat affect
Poverty and speech
Social withdraw
Anhedonia
Asociality
Cognitive symptoms of schizophrenia
Impairment in memory
Disruption in social learning
Inability to reason, solve problems , focus attention
Mood symptoms of schizophrenia
Depression
Anxiety
Demoralization
Suicidality
Excitability
Agitation
Mind reading
Believe they can read others minds and know what they are thinking
Somatic
False belief body is changing in an unusual way ( they may be growing an additional limb)
ideas of reference
When they misinterpret the normal day to day events
( two people talking together - they may be plotting against an individual)
Grandiose
They believe they are Jesus , famous or even the stank booty devil
Jealousy
Think their boyfriend or wife is cheating but proof is not tied to reality
Control
They believe their mind and body is being controlled by outside entity or agency
Thought broadcasting
They believe their own thoughts can be heard by others and that they can control the thoughts of others
Thought insertion
People are putting thoughts in their mind
Thoughts withdrawal
They believe their thoughts are being erased
Concrete thinking *
Thinking one way of these such as a pt coming to ED and you ask them what brought you here
Delusions such as :Mind Reading, Somatic,Ideas of reference, Persecution, Grandiose , Religious , Jealousy, Control, Thought broadcasting, Thought insertion, Thought withdrawal, Concrete Thinking
Are examples of alterations of thinking in :?
Positive symptoms
Alterations in speech
Associative looseness
Tangential
Clanging
Neologisms
Echolalia
Word salad
Circumstantiality
Pressured speech
Thought blocking
Associative looseness
Flight of ideas
All over the place
Fragmented sentences
Can’t tie to one idea
( starting a sentence with one thought but ending with another)
Tangential
Train of though wonders off and never returns
Clanging
Meaningless rhyming or sound alike words
Tik tak clickity cat big mac
Neologisms
Made up words
Special meaning or a person
Echolalia
Repeating words
( may repeat what you say to them)
Word salad
No rhythm, rhyme, reason, can’t form complete thought
Circumstantiality
Excessive derealization
Cannot seperate relevant from irrelevant
Pressured speech
Talking fast they dont let you put a word in
Though blocking
Patient stops talking in the middle of a sentence and remains silence
((Can’t complete a thought)
Hallucinations
Auditory (voices)
Somatic or tactile
Olfactory
Visual
Gustatory ( taste)
Illusions
Misinterpretations of real experiences
What is the primary thing to do when someone has auditory hallucinations
Ask what are they telling you so assess
Personal boundary difficulties
Depersonalization
Derealization
Will be all up in yo koolaid
Depersonalization
Loss of identity
Body parts may not feel like their own
Derealization
Envioronment is different
Things larger or smaller than they really are
Catalonia
Slow movement or overactive movement keep their bodies in a weird posture
Catatonia specifier
Stereotypes behaviors
Automatic obedience
Bizzare posturing
Waxy flexibility
Negativism
Stupor
Waxy flexibility
Holding a posture for a long time
Stupor
Not responsive when talk to they dont understand what you are talking about
Negativism
Does the opposite of what is told
Automatic obedience
Robotic movements to performance commands
Avolition
No motivation , may not take a bath
Alogia
Same as poverty of speech
Anhedonia
Loss of pleasure , what they once found pleasurable not anymore
Asociality
Social withdraw , not interested in mingling with people
Neurocognitive /cognitive symptoms
Poor executive functioning
Inability to sustain attention
Problems with working memory
Inability to reason
Inability to problem solve
Can’t learn new things
Mood symptoms (negative)
Anxiety , depression , suicidality , dysphoria , postpsychotic depressive disorder , demoralization , excitability , agitation , increase substance use
How can you share mist trust w/o supporting delusion in paranoia
“We understand that you are scared”
When we see someone who is disorganizes we know that they have a poor premorbid functioning. What does that mean?
Before they were diagnosed the symptoms were pretty bad
(Poor prognosis , social withdrawn severe cognitive impairment , require structured and well supervised setting)
Schizophrenia and symptoms of mood disorder of either bipolar or major depression
We treat psychosis as well as the mood disorder
(AIMS) abnormal involuntary movement scale
To see if they have any symptoms or abnormal involuntary movements from medication so this one can be done by others
What can we implement if pt is not complaint with meds
May need to be apart of home health or long acting meds like invega so they dont have to remember to take meds daily
Patients who are highly suspicious and hostile
Allow pt as much control as possible within limits , explain treatments , meds , lab test before initiating them
Patients who are aggressive and agitated
Increase supervision
Decrease stimulus , deescelate verbally , offer medication
Patients with hallucination/delusion
Ask directly “are you hearing voices and what are they saying” reduce stimulus. Focus on feelings and reality and not delusions
How do we treat acute dystonia
Give Benadryl IM can’t give PO because they can choke
EPS
Akasthisia
Pseudoparkinsonism
Acute dystonia
Torticolus
Torticolus
Neck important to treat can coke
