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Schizophrenia Flashcards

1
Q

Diagnostic Criteria for Schizophrenia

A

2 or more of the following symptoms, each present for a significant portion of time during a 1 month period. At least one of 1, 2, or 3 must be present:

  1. Delusions
  2. Hallucinations
  3. Disorganized speech
  4. Grossly disorganized or catatonic behaviour
  5. Negative symptoms
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2
Q

4 Types of Symptoms of Schizophrenia

A
  1. Positive
  2. Negative
  3. Neurocogntive
  4. Disorganized
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3
Q

Positive Symptoms of Schizophrenia

A

Excess or distortion of normal functions

Delusions
- Grandiose: the belief that one has exceptional powers, wealth, skill, influence or destiny
- Nihilistic: the belief that one is dead or a calamity is impending
- Persecutory: the belief that one is being watch, ridiculed, harmed, or plotted against
- Somatic: beliefs about abnormalities in bodily functions or structures

hallucinations

thought disturbances

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4
Q

Negative Symptoms of Schizophrenia

A

Flat Affect

Alogia: reduced fluency and productivity of thought and speech

Avolition: withdrawal and inability to initiate and persist in goal-directed activity

Anhedonia: inability to experience pleasure

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5
Q

Alogia

A

reduced fluency and productivity of thought and speech

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6
Q

Avolition

A

withdrawal and inability to initiate and persist in goal-directed activity

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7
Q

Anhedonia

A

inability to experience pleasure

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8
Q

Epidemiology of Schizophrenia

A

Early adulthood

Male (estrogen protectice)

First degree relative 10x higher

Depression, diabetes, Cannabis

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9
Q

Biologic Etiology of Schizophrenia

A

Neuroanatomic:
- decreased/abnormal blood flow to areas of brain
- decrease in grey matter
- thinner cortex

Neurotransmitters
- dopamine hypothesis

Also familial and neurodevelopmental theories

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10
Q

Biologic Theory or + and - symptoms

A

+ = hyperactivity of mesolimbic tract

  • = hypoactivity of meso-cortical tract
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11
Q

Antipsychotic medications have the general effect of:

A

blocking dopamine transmission in the brain by blocking receptors

Decrease in dopamine leads to unpleasant symptoms

Atypical/newer have less effects and affect other neurotransmitter systems (serotonin)

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12
Q

How long until you see changes in psychotic symptoms with medication

A

1-2 weeks

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13
Q

When is clozapine initiated?

A

Clozapine may be initiated when no other antipsychotic is effective; only used when others are not effective because it requires WBC monitoring

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14
Q

What are EPS symptoms caused by and how is that corrected?

A

blockage of dopamine receptors which throws off acetylcholine and dopamine in the brain, increasing acetylcholine. Symptoms are managed by re-establishing the balance between acetylcholine and dopamine by reducing the dosage of antipsychotic (increasing dopamine) or adding an anticholinergic drug (decreasing acetylcholine activity)

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15
Q

Akathisia

A

physical restlessness

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16
Q

Dystonic Reactions

A

intermittent/fixed abnormal postures of the eyes, face, tongue, neck, trunk, extremities

17
Q

Tardive dyskinesia

A

Later onset EPS

abnormal dyskinetic movements of the face, mouth, jaw, choreoathetoid movements of the legs, arms, and trunk

Dyskinesia: involuntary movement
Dystonia: involuntary contraction/stiffening

18
Q

Tardive dystonia

A

Later onset EPS

persistent sustained abnormal postures in the face, eyes, tongue, neck, trunk, and limbs

19
Q

Tardive akathisia

A

Later onset EPS

persisting unabating sense of subjective and objective restlessness

20
Q

Neuroleptic Malignant Syndrome

A

Severe muscle rigidity develops with elevated temperature and a rapidly accelerating cascade of symptoms (occurring during the next 48-72 hours) which can include 2 or more of the following: hypertension, tachycardia, tachypnea, prominent diaphoresis, incontinence, mutism, leukocytosis, changes in LOC, and lab evidence of muscle injury (elevated CK/myoglobin).

21
Q

Anticholinergic Crisis

A
  1. neuropsychiatric signs
    confusion, recent memory loss, agitation, dysarthria, incoherent speech, pressure speech, delusions, ataxia, and periods of hyperactivity alternating with somnolence, paranoia, anxiety, or coma
  2. hallucinations
    accompanied by picking, plucking, or grasping motions, delusions or disorientation
  3. physical signs
    unreactive dilated pupils, blurred vision, hot m dry, flushed skin, facial flushing, dry mucous membranes, difficulty swallowing, fever, tachycardia, hypertension, decreased bowel sounds, urinary retention, nausea, vomiting, seizures, or coma
22
Q

Anosognosia

A

denial of mental illness, lack of insight

23
Q

Mood and Affect of Schizophrenic

A

Affective lability: abrupt, dramatic, unprovoked changes in the type of emotions expressed

Ambivalence: the presence and expression of 2 opposing feelings, leading to inaction

Apathy: reactions to stimuli are decreased; diminished interest and desire

24
Q

Speech of Schizophrenic

A

Dysarthria: difficulty articulating words

Dysphagia: difficulty swallowing

25
Q

Thought processes of schizophrenic

A

Bizarre delusions: sufficient enough to diagnose schizophrenia

Hallucinations: most common example of disturbed sensory perception observed in patients with schizophrenia

26
Q

Communication of Schizophrenic

A

Word salad
Flight of ideas
Loose associations
Tangentiality
Echolalia

27
Q

Behavioural Issues of Schizophrenic

A

stereotypy: idiosyncratic repetitive, purposeless movements

echopraxia: involuntary imitation of others movements

waxy flexibility: posture held in odd or unusual fixed position for extended periods

28
Q

stereotypy

A

idiosyncratic repetitive, purposeless movements

29
Q

Echopraxia

A

involuntary imitation of others movements

30
Q

Waxy flexibility

A

posture held in odd or unusual fixed position for extended periods

31
Q

Schizoaffective Disorder

A

Varying degrees of symptoms of both schizophrenia and mood disorders beginning in youth

Characterized by intervals of intense symptoms alternating with quiescent periods

Episodic nature is characteristic, chronic roller coaster ride

To receive diagnosis, a patient must have an uninterrupted period of illness when there is a major depressive, manic, or mixed episode along with some schizophrenic symptoms

32
Q

Delusional Disorder

A

psychotic disorder characterized by nonbizarre, logical, stable, and well-systemized delusions that occur in the absence of other psychiatric symptoms

§ Erotomanic
§ Grandiose
§ Jealous
§ Persecutory
§ Unspecified type
§ Shared delusional

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