Schizophrenia

Question 1

Schizophrenia Spectrum and Other Psychotic Disorders (SSOPD) - dx?

Answer 1

1+ of 5 domains:
delusions
hallucinations
disorganized thinking (speech)
grossly disorganized or abnormal motor behavior (including catatonia)
negative sx (absence of sx)

Question 2

SSOPD domain- delusion?

Answer 2

fixed beliefs that are not amendable to change in light of conflicting evidence
-Persecutory: i’m going to be harmed, harassed by person
-Referential: certain gestures, comments, environmental cutes
-Grandiose: I have exceptional abilities
-Erotomanic: false believe someone is in love w/me
-Nihilistic: major catastrophe is going to occur
-Somatic: preoccupied w/ health or organ fxn
Bizarre (not likely to happen)
-though withdrawal: gov stole my thoughts
-though insertion alien thoughts were put in my mind
-delusions of control: my body or actions are being determined by a force outside of me

Question 3

SSOPD domain-Hallucinations - key features?

Answer 3

perception like experiences that occur without external stimulus
vivid and clear w/ full force and impact of life - not voluntary control
MUST occur in senosrium- not drunk/high, hyphagogic, hypnopopmic

Question 4

SSOPD domain-Disorganized thinking - key features?

Answer 4

inferred from speech
derailmen of loos associations (joints about law then talks about joints about bones)
incoherence is rare
sever enough to impair communication

Question 5

SSOPD domain-Grossly disorganized or abnormal motor behavior (catatonia)?

Answer 5

wide range (childlike silliness)
difficulties in goal directed behavior

Question 5

Delusional disorder - dx?

Answer 5

1+ delusion/1+mo
+/- hallucination: if + –> HAS to be related to the delusion
timeline is important and what is prominent

Question 6

Catatonic behavior?

Answer 6

marked decrease in reactivity to the environment

• rigid, inappropriate posture
• negativism (doesn’t follow directions)
• mutism/stupor: no verbal/motor responses
• repeated movements, echolalia

Question 7

Delusional disorder type, mixed type?

Answer 7

no 1 delusional theme is predominate

Question 8

Delusional disorder types?

Answer 8

• erotomanic type
• grandiose type
• persecutory type
• somatic type
• mixed type
• unspecified type

Question 10

Delusional type, erotomanic type?

Answer 10

another person is in love w/ pt

Question 11

Delusional type, grandiose type?

Answer 11

pt is convinced of having some great talent

Question 12

Delusional type, persecutory type?

Answer 12

pt believes they are being conspired, against, cheated

Question 13

Delusional type, somatic type?

Answer 13

involving bodily fxn or sensation

Question 13

Delusional - prevalence?

Answer 13

persecutory type is most common

consider culture

Question 14

Delusional type, unspecified type?

Answer 14

delusion cannot be described - OTHER

Question 15

Brief psychotic disorder-prevalence?

Answer 15

female > male

mid 30yo

Question 16

Brief psychotic disorder -dx?

Answer 16

1+:
DELUSION*
HALLUCINATION*
DISORGANIZED SPEECH*
Grossly disorganized/catatonic behavior 
@least 1 day, no longer than1 mo

Question 17

Schizophreniform disorder-dx?

Answer 17

2+/1-6mo
*DELUSIONS
*HALLUCINATIONS
*DISORGANIZED SPEECH
grossly disorganized or catatonic behavior
negative sx

Question 18

Schizophrenia - dx?

Answer 18

2+/6mo
*DELUSION
*HALLUCINATIONS
*DISORGANIZED SPEECH
grossly disorganized or catatonic behavior
negative sx

Question 19

Associated features: schizophrenia

Answer 19

*SLEEP DISTURBANCES
inappropriate affect
dysphoric mood
reduced attn
anxiety, phobias, anger/irritability
decreased interest in food/food refusal

Question 20

Schizophrenia - caution?

Answer 20

SUCCESSFUL SUICIDE

Question 21

Schizophrenia - population?

Answer 21

early to mid 20s: male

late 20s: female

Question 22

What is the most important thing when dx?

Answer 22

frequency and duration

Question 23

Schizoaffective disorder-dx?

Answer 23

*depressed mood - req
*hallucination or delusion
2+/wk
schizo AND mood

Question 24

Schioaffective disorder - types?

Answer 24

bipolar: manic episode, +/- MDD (HALLUCINATION + DELUSION)
depressive: ONLY MDD

Question 25

Schizoaffective disorder - population?

Answer 25

female > male

early adulthood

Question 26

Substance/medication induced psychotic disorder-dx?

Answer 26

1 or both:
-delusion
-hallucination
substances involved

Question 27

Catatonia?

Answer 27

NOT independent class
-associated w/another mental disorder
d/t another disorder
unspecified catatonia

Question 28

Other specified schizophrenia spectrum and other psychotic disorder?

Answer 28

criteria is NOT met for ANY SSOPD

-used w/ specifiers

Question 29

What are the subtypes of other psychotic disorders (SSOPD)?

Answer 29

delsuional
catanoias
brief psychotic
schizophreniform
schizoaffective
substance/medication induced pyschotic
psychotic disorder d/t another medical condition
other specified
unspecified 
schizotypal personality disorder

Question 30

SSOPD domain-Negative dx?

Answer 30

alogia/aphysia d/t mental prob
avolition (no motivation in goals)
asociality (no motivation in social groups)
anhedonia
diminished emotion expression

Question 31

Psychotic disorder d/t another medical condition-dx?

Answer 31

hallucination OR delusions

DIRECT physiological consequence d/t ANOTHER medical condition

Question 32

Catatonic disorder d/t another medical condition - dx?

Answer 32

3+:
-stupor
-catalepsy
-waxy flexibility
-mutism
-negativism
-posturing
-agitation
-echolalia
-echopraxia
DIRECT physiological consequence d/t ANOTHER medical condition

Question 33

Unspecified catatonia-dx?

Answer 33

nature of underlying mental disorder is unclear
criteria for catatonia are not met
insufficient info to make dx