Schizophrenia Flashcards
General on schizophrenai
- The prototypical psychotic illness
- Consists of several related symptom clusters
- Accounts for roughly 2.5% of total health-care expenses in the United States
Etiology of Schizophrenia
- Huge worldwide public health problem with devastating effects on patients and families
- Lifetime prevalence 0.6%-1.9% in various cultures—average about 1% worldwide
- Lifetime prevalence in men and women equal, but average age of onset lower in men
- Onset often in late teens—generally insidious
EMIL KRAEPELIN: differentiated manic- depressive illness from progressive illness he called “________”—a premature deteriorating disorder
dementia praecox
EUGEN BLEULER: characterized “the group of schizophrenias” as having in common a split among
affect, thought, emotion, and behavior
Bleuler’s 4 A’s
- Associations : taco bell, bell from beauty and the beast, beast mode
- Affect: disconnect from how they feel internally and outward dispay
- Autism: hard time telling whats inside vs outside; breakdown of ego boundaries
- Ambivalence: breakdowno f neural circuitry, hard time making decisions
KURT SCHNEIDER: characterized thought broadcasting, thought withdrawal, voices arguing or commenting, and somatic passivity as first-rank, but non- specific, symptoms
“FIRST-RANK SYMPTOMS”
Characteristic symptoms: Two (or more) of the following, each present for a significant portion of time during a 1-month period (or less if successfully treated):
• (1) delusions
• (2) hallucinations
• (3) disorganized speech (e.g., frequent derailment or incoherence)
• (4) grossly disorganized or catatonic behavior
• (5) negative symptoms, i.e., affective flattening, alogia, or
avolition
Key note for symptomatology of schizophrenai
Only one Criterion A symptom is required if delusions are bizarre or hallucinations consist of a voice keeping up a running commentary on the person’s behavior or thoughts, or two or more voices conversing with each other.
When dx schizophrenia, we say there is ‘social/occupational dysfunction’ What does that mean?
Social/occupational dysfunction: For a significant portion of the time since the onset of the disturbance, one or more major areas of functioning such as work, interpersonal relations, or self-care are markedly below the level achieved prior to the onset (or when the onset is in childhood or adolescence, failure to achieve expected level of interpersonal, academic, or occupational achievement).
What is the duration necessary to dx someone with schizophreai
ontinuous signs of the disturbance persist for at least 6 months. This 6-month period must include at least 1 month of symptoms that meet Criterion A and may include periods of prodromal or residual symptoms.
• D. Schizoaffective and Mood Disorder exclusion: Schizoaffective Disorder and Mood Disorder With Psychotic Features have been ruled out as being dx with schizophrenia because either
(1) no Major Depressive, Manic, or Mixed Episodes have occurred concurrently with the active-phase symptoms; or
(2) if mood episodes have occurred during active-phase symptoms, their total duration has been brief relative to the duration of the active and residual periods.
If a pt has a Pervasive Disorder or Autism, how can we dx them with Schizophrenia?
the additional diagnosis of Schizophrenia is made only if prominent delusions or hallucinations are also present for at least a month (or less if successfully treated).
What’s the difference between Positive and NEgative symptoms
Positive symptoms: delusions, hallucinations, behavioral disturbance
• Negative symptoms: social isolation, withdrawal, poor grooming, anergy, loss of interest, blunted affect
What cognitive symptoms are present in schizophrenia
impaired abstract thinking, impaired problem-solving, disturbed memory
What are the historical classificaitons of schizophrenia (eliminated in DSM 5)
- Catatonic
- Disorganized
- Paranoid
- Residual
- Undifferentiated
