Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Psychopathology > Schizophrenia > Flashcards

Schizophrenia Flashcards

1
Q

what is psychosis

A

syndromes that impair both thought content and thought process, including perceptions not based in reality and disorganized/ illogical thoughts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

positive symptoms of SZ

A

hallucinations, delusions - these can be a/w suicidality or homicidality
disorganized speech/thought, disorg or catatonic behavior
*respond well to tx usually

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

negative symptoms of SZ

A

alogia (poverty of speech), diminished emotional expression (esp in face, eye contact, intonation aka prosody), avolition (inability to initiate purposeful activity), anhedonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

“A” criteria for SZ

A

2 of the following for min 1 month: grossly disorganized behavior, negative symptoms (dec emotions or avolition), delusions, hallucinations, disorganized speech*
*at least 1 required

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

B and C criteria for SZ

A

B: social or occupational dysfunction
C: duration - disturbance persists for 6 months, including 1 month of A criteria, that may include prodromal or residual sx
*no better explanation: schizoaffective or mood disorder, substance or general medical condition (may have SZ and autism if delusions or hallucinations)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is a delusion

A

false, fixed belief involving misinterpretation or perception or experience
m/c: persecutory delusions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

persecutory delusion

A

belief of being tormented, followed, tricked, spied on, or ridiculed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

referential delusion

A

belief that certain gestures, comments, book passages, newspapers, song lyrics, or other things are specifically directed at patient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

“bizarre” delusions

A

clearly implausible and not understandable beliefs that do not derive from normal life experiences
or loss of control over mind or body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is a hallucination

A

perception of sensory experiences w/o external stimulus; any sensory modality but auditory is m/c (voices that aren’t the person’s own thoughts)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

3 ways thinking may be disorganized

A

answers to questions are unrelated or barely related
“derailment” or loose associations between topics
incomprehensible “word salad”; ~receptive aphasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

incoherence vs derailment/ loose associations

A

incoherence: disturbance in speech within clauses
derailment: disturbance between clauses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

grossly disorganized behavior: examples

A

markedly disheveled, unusual dress, inappropriate sexual behavior, unpredictable or untriggered agitation, bizarre affect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

catatonic psychomotor behaviors

A

stupor, catalepsy, waxy flexibility, mutism, negativism, posturing, mannerism, stereotypy agitation not influenced by external stimuli, grimacing, echolalia, echopraxia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

D2 and 5HT2-R antagonists’ effect on positive and negative sx

A

negative: much less responsive, especially to pure D2-blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

prevalence of SZ

A

0.3-0.7% adults

more often diagnosed in African Americans and Asian Americas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

onset of SZ

A

occurs between late teens-mid-30s, prior to adolescence is rare

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

SZ-like sx common to other childhood disorders

A

disorganized speech - autism, pervasive development disorders
disorganized behavior - ADHD
*do not contribute to SZ without considering other common childhood d/o

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

age of onset of SZ for M and F

A

F - late 20s, M - early-mid 20s

female more likely to have late onset (over 40)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

sx of SZ in M and F

A

+ more common in F, - more common in M

female more likely to have pre-morbid functioning, affective sx, better short and med term prognosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

family hx in M and F with SZ

A

F: more SZ
M: more schizotypal, schizoid personality traits

22
Q

neuroanatomical differences in SZ

A

enlarged lateral ventricles a/w negative sx
dec brain tissue, widened sulci
dec temporal lobe volume a/w + sx; less often frontal lobe
hypofrontality
abnormal smooth pursuit and saccadic eye movements

23
Q

complement and SZ

A

immune-system gene C4 a/w increased risk for SZ d/t too much pruning –> impaired mental function

24
Q

neuropsychological deficits in SZ

A

short-term memory, psychomotor processing speed, attention

*severity is a strong predictor of social and vocational outcome

25
Q

stages of SZ

A

premorbid - around 10 yo, minimal sx
prodromal - 11-18 yo, slow development of negative sx, “going through a phase”, cognitive sx present
onset - 18-30 yo, active sx, + sx present, cognitive sx present
chronic/ relapse - >30 yo, remission uncommon; cognitive sx; negative sx persist b/t episodes of + sx, which diminish w time

26
Q

outcomes of chronic residual/ relapsing phase of SZ

A

single episode - less than 10%
stable/intermittent - 35-55%
progressive worsening a/w severe disability - 35-55%

27
Q

factors a/w better prognosis

A

acute onset w precipitating event at a later age; female; associated mood disturbance; good inter-episode fxn; compliance with meds; no CNS abnormality; no fam hx of SZ

28
Q

poor insight in SZ

A

manifestation of illness, may lead to poor med compliance -> more relapsing, more hospital admissions, poorer psychosocial functioning and course of illness

29
Q

SZ and suicide

A

5% commit suicide, but 20% make 1+ attempt; elevated during post-psychotic periods
risk factors: male, under 45, substance use d/o, depressive/ hopeless sx, unemployment, recent hospital discharge

30
Q

SZ and substance use d/o

A

57% SZ pts had lifetime diagnosis, EtOH m/c then cannabis
nicotine dependence in 80-90% bc relieves negative sx and cognitive impairment, but smokers may have more + sx and hospitalizations

31
Q

SZ and polydipsia

A

prevalent in SZ pts (25%), d/t defect in osmoregulation of thirst and renal sensitivity to AVP
Na

32
Q

genetics and SZ

A

80% pts have no fam hx

a/w greater paternal age

33
Q

developmental and environmental theories of causation

A

dev: altered interstitial neuron connections, a/w hypoxia during gestation and birth
env: late winter/ early spring birth and 2nd trimester flu exposure -> brain damage

34
Q

SZ and mesolimbic pathway

A

increased activity -> delusions, hallucinations, + sx

35
Q

SZ and mesocortical pathway

A

decreased activity -> apathy, withdrawal, lack of motivation, - and cognitive sx

36
Q

SZ and nigrostriatal pathway

A

inhibition -> extrapyramidal side effects of antipsychotic drugs

37
Q

SZ and tuberoinfundibular pathway

A

DA inhibition -> sexual side effects of antipsychotic drugs

38
Q

MOA of 5HT-2A blockers for SZ

A

5HT-2A inhibits DA release

5HT-2A blockers disinhibit -> more DA release in midbrain with minimal EPS

39
Q

NMDA-R and SZ

A

NMDA hypofunction = dec Glu transmission -> dec GABA tone -> inc DA in mesolimbic pathway = pos sx
dec Glu -> dec DA in mesocortical pathway = neg sx; hypofrontality

40
Q

schizoaffective disorder criteria

A
  • uninterrupted period of illness with major mood episode (MDE or bipolar) with A criteria of SZ
  • delusion/ hallucination for 2+ wk w/o major mood episode
  • major mood episode sx present for majority of total duration of active and residual illness
  • not attributable to substance or other condition
41
Q

tx for schizoaffective d/o

A

paliperidone
depressed: antipsychotic + antidepressant
bipolar type: antipsychotic +/- mood stabilizer

42
Q

prognosis schizoaffective d/o

A

better than SZ, worse than mood d/o’s, bipolar > depressed, - sx less severe and pervasive than SZ

43
Q

delusional disorder criteria

A

1+ delusions for min 1 month (not if SZ A criteria met)
impairments of psychosocial functioning more circumscribed than other psychotic disorders, and behavior not as bizarre or odd

44
Q

types of delusions in delusional disorder

A

erotomanic, grandiose, jealous (M>F), persecutor (m/c), somatic

45
Q

tx, course, and prognosis of delusional d/o

A

tx: anti-psychotic
course: sudden onset usually
prognosis: recovery (20-50%), decrease or chronic sx (50-80%)

46
Q

brief psychotic d/o criteria

A

1+ of the following for 1d-1m:
delusions, hallucinations, disorganized speech*, disorganized or catatonic behavior
*one of these must be present
eventual return to premorbid level of functioning

47
Q

prevalence, onset, and risk factors of brief psychotic d/o

A

prev: 9% of cases of first-onset psychosis
onset: mean age mid-30s, but any age possible
RF: pre-existing personality d/o (m/c schizotypal and borderline)

48
Q

tx, course, and prognosis of brief psychotic disorder

A

tx: short-term anti-psychotics
course: emotional turmoil or overwhelming confusion
prognosis: 100% return to normal functioning w/i 1 mo; high relapse rates; 50% will dev SZ or mood d/o

49
Q

schizophreniform d/o

A

SZ sx between 1-6 mo

*no necessary decline in functioning

50
Q

shared psychotic d/o criteria

A

presence of a delusion in pt influenced by someone else (primary case)
primary case has longer-standing delusion with similar content

51
Q

DA receptor occupancy and effectiveness of anti-psychotics

A

65-80% D2 occupancy in striatum = good response

>80% occupancy -> EPS

52
Q

conventional vs atypical antipsychotics

A

conv: high affinity for D2-R
atyp: D2-blocker (ML pathway) and 5HT-2A blocker(MC, NS, TI) = fewer EPS
both are effective for diminishing + sx

Psychopathology (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions