Schizophrenia Flashcards
What is criteria of delusional disorders?
Diagnostic Criteria 297.1(F22)
The presence of one (or more) delusions with a duration of 1 month or longer.
Criterion A for schizophrenia has never been met.
Note: Hallucinations, if present, are not prominent and are related to the delusional theme (e.g., the sensation of being infested with insects associated with delusions of infestation).
Apart from the impact of the delusion(s) or its ramifications, functioning is not markedly impaired, and behavior is not obviously bizarre or odd.
If manic or major depressive episodes have occurred, these have been brief relative to the duration of the delusional periods.
The disturbance is not attributable to the physiological effects of a substance or another medical condition and is not better explained by another mental disorder, such as body dysmorphic disorder or obsessive-compulsive disorder.
Specify whether:
Erotomanic type: This subtype applies when the central theme of the delusion is that another person is in love with the individual.
Grandiose type: This subtype applies when the central theme of the delusion is the conviction of having some great (but unrecognized) talent or insight or having made some important discovery.
Jealous type: This subtype applies when the central theme of the individual’s delusion is that his or her spouse or lover is unfaithful.
Persecutory type: This subtype applies when the central theme of the delusion involves the individual’s belief that he or she is being conspired against, cheated, spied on, followed, poisoned or drugged, maliciously maligned, harassed, or obstructed in the pursuit of long-term goals.
Somatic type: This subtype applies when the central theme of the delusion involves bodily functions or sensations.
Mixed type: This subtype applies when no one delusional theme predominates.
Unspecified type: This subtype applies when the dominant delusional belief cannot be clearly determined or is not described in the specific types (e.g., referential delusions without a prominent persecutory or grandiose component).
What is criteria for brief psychotic disorders?
Diagnostic Criteria 298.8(F23)
Presence of one (or more) of the following symptoms. At least one of these must be (1), (2), or (3):
Delusions.
Hallucinations.
Disorganized speech (e.g., frequent derailment or incoherence).
Grossly disorganized or catatonic behavior.
Note: Do not include a symptom if it is a culturally sanctioned response.
Duration of an episode of the disturbance is at least 1 day but less than 1 month, with eventual full return to premorbid level of functioning.
The disturbance is not better explained by major depressive or bipolar disorder with psychotic features or another psychotic disorder such as schizophrenia or catatonia, and is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition.
Specify if:
With marked stressor(s) (brief reactive psychosis): If symptoms occur in response to events that, singly or together, would be markedly stressful to almost anyone in similar circumstances in the individual’s culture.
Without marked stressor(s): If symptoms do not occur in response to events that, singly or together, would be markedly stressful to almost anyone in similar circumstances in the individual’s culture.
With peripartum onset: If onset is during pregnancy or within 4 weeks postpartum.
What is the criteria of Schizophreniform disorder?
Diagnostic Criteria 295.40(F20.81)
A) Two (or more) of the following, each present for a significant portion of time during a 1-month period (or less if successfully treated). At least one of these must be (1), (2), or (3):
Delusions.
Hallucinations.
Disorganized speech (e.g., frequent derailment or incoherence).
Grossly disorganized or catatonic behavior.
Negative symptoms (i.e., diminished emotional expression or avolition).
B) An episode of the disorder lasts at least 1 month but less than 6 months. When the diagnosis must be made without waiting for recovery, it should be qualified as “provisional.”
C) Schizoaffective disorder and depressive or bipolar disorder with psychotic features have been ruled out because either 1) no major depressive or manic episodes have occurred concurrently with the active-phase symptoms, or 2) if mood episodes have occurred during active-phase symptoms, they have been present for a minority of the total duration of the active and residual periods of the illness.
D) The disturbance is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition.
What is criteria for Schizophrenia?
A) Two (or more) of the following, each present for a significant portion of time during a 1-month period (or less if successfully treated). At least one of these must be (1), (2), or (3):
Delusions.
Hallucinations.
Disorganized speech (e.g., frequent derailment or incoherence).
Grossly disorganized or catatonic behavior.
Negative symptoms (i.e., diminished emotional expression or avolition).
B) For a significant portion of the time since the onset of the disturbance, level of functioning in one or more major areas, such as work, interpersonal relations, or self-care, is markedly below the level achieved prior to the onset (or when the onset is in childhood or adolescence, there is failure to achieve expected level of interpersonal, academic, or occupational functioning).
C) Continuous signs of the disturbance persist for at least 6 months. This 6-month period must include at least 1 month of symptoms (or less if successfully treated) that meet Criterion A (i.e., active-phase symptoms) and may include periods of prodromal or residual symptoms. During these prodromal or residual periods, the signs of the disturbance may be manifested by only negative symptoms or by two or more symptoms listed in Criterion A present in an attenuated form (e.g., odd beliefs, unusual perceptual experiences).
D) Schizoaffective disorder and depressive or bipolar disorder with psychotic features have been ruled out because either 1) no major depressive or manic episodes have occurred concurrently with the active-phase symptoms, or 2) if mood episodes have occurred during active-phase symptoms, they have been present for a minority of the total duration of the active and residual periods of the illness.
E) The disturbance is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition.
F) If there is a history of autism spectrum disorder or a communication disorder of childhood onset, the additional diagnosis of schizophrenia is made only if prominent delusions or hallucinations, in addition to the other required symptoms of schizophrenia, are also present for at least 1 month (or less if successfully treated).
What is the criteria of Schoaffective disorders?
A) An uninterrupted period of illness during which there is a major mood episode (major depressive or manic) concurrent with Criterion A of schizophrenia.
Note: The major depressive episode must include Criterion A1: Depressed mood.
b) Delusions or hallucinations for 2 or more weeks in the absence of a major mood episode (depressive or manic) during the lifetime duration of the illness.
c) Symptoms that meet criteria for a major mood episode are present for the majority of the total duration of the active and residual portions of the illness.
D) The disturbance is not attributable to the effects of a substance (e.g., a drug of abuse, a medication) or another medical condition.
What is criteria of substance/medication-induced psychotic disorder?
A) Presence of one or both of the following symptoms:
Delusions.
Hallucinations.
B) There is evidence from the history, physical examination, or laboratory findings of both (1) and (2):
The symptoms in Criterion A developed during or soon after substance intoxication or withdrawal or after exposure to a medication.
The involved substance/medication is capable of producing the symptoms in Criterion A.
C) The disturbance is not better explained by a psychotic disorder that is not substance/medication-induced. Such evidence of an independent psychotic disorder could include the following:
The symptoms preceded the onset of the substance/medication use; the symptoms persist for a substantial period of time (e.g., about 1 month) after the cessation of acute withdrawal or severe intoxication; or there is other evidence of an independent non-substance/medication-induced psychotic disorder (e.g., a history of recurrent non-substance/medication-related episodes).
C) The disturbance does not occur exclusively during the course of a delirium.
The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
D) The disturbance does not occur exclusively during the course of a delirium.
E) The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
What is the criteria for psychotic disorder due to another medical condition?
A) Prominent hallucinations or delusions.
B) There is evidence from the history, physical examination, or laboratory findings that the disturbance is the direct pathophysiological consequence of another medical condition.
C) The disturbance is not better explained by another mental disorder.
D) The disturbance does not occur exclusively during the course of a delirium.
E) The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
What is catatonia associate with another mental disorder (catatonia specifier)?
The clinical picture is dominated by three (or more) of the following symptoms:
Stupor (i.e., no psychomotor activity; not actively relating to environment).
Catalepsy (i.e., passive induction of a posture held against gravity).
Waxy flexibility (i.e., slight, even resistance to positioning by examiner).
Mutism (i.e., no, or very little, verbal response [exclude if known aphasia]).
Negativism (i.e., opposition or no response to instructions or external stimuli).
Posturing (i.e., spontaneous and active maintenance of a posture against gravity).
Mannerism (i.e., odd, circumstantial caricature of normal actions).
Stereotypy (i.e., repetitive, abnormally frequent, non-goal-directed movements).
Agitation, not influenced by external stimuli.
Grimacing.
Echolalia (i.e., mimicking another’s speech).
Echopraxia (i.e., mimicking another’s movements).
What is catatonic disorder to another medical condition?
The clinical picture is dominated by three (or more) of the following symptoms:
Stupor (i.e., no psychomotor activity; not actively relating to environment).
Catalepsy (i.e., passive induction of a posture held against gravity).
Waxy flexibility (i.e., slight, even resistance to positioning by examiner).
Mutism (i.e., no, or very little, verbal response [Note: not applicable if there is an established aphasia]).
Negativism (i.e., opposition or no response to instructions or external stimuli).
Posturing (i.e., spontaneous and active maintenance of a posture against gravity).
Mannerism (i.e., odd, circumstantial caricature of normal actions).
Stereotypy (i.e., repetitive, abnormally frequent, non-goal-directed movements).
Agitation, not influenced by external stimuli.
Grimacing.
Echolalia (i.e., mimicking another’s speech).
Echopraxia (i.e., mimicking another’s movements).
There is evidence from the history, physical examination, or laboratory findings that the disturbance is the direct pathophysiological consequence of another medical condition.
The disturbance is not better explained by another mental disorder (e.g., a manic episode).
The disturbance does not occur exclusively during the course of a delirium.
The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
What is the criteria for Other specified schizophrenia spectrum and other psychotic disorder?
1) Persistent auditory hallucinations occurring in the absence of any other features.
2 )Delusions with significant overlapping mood episodes: This includes persistent delusions with periods of overlapping mood episodes that are present for a substantial portion of the delusional disturbance (such that the criterion stipulating only brief mood disturbance in delusional disorder is not met).
3) Attenuated psychosis syndrome: This syndrome is characterized by psychotic-like symptoms that are below a threshold for full psychosis (e.g., the symptoms are less severe and more transient, and insight is relatively maintained).
4) Delusional symptoms in partner of individual with delusional disorder: In the context of a relationship, the delusional material from the dominant partner provides content for delusional belief by the individual who may not otherwise entirely meet criteria for delusional disorder.
